Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital, Beijing, 100101, China.
Beijing Anding Hospital, Capital Medical University, Beijing, China.
Eur Arch Psychiatry Clin Neurosci. 2022 Aug;272(5):887-896. doi: 10.1007/s00406-021-01375-4. Epub 2022 Jan 5.
The stress sensitization model indicates that early adversity (e.g., childhood stress) sensitizes individuals to subsequent proximal stress (e.g., stressful life events in adult life), thereby increasing their vulnerability to psychiatric disorders. However, the effect of stress sensitization on suicidality in patients with major depressive disorder (MDD) has not been previously investigated. Data for the present study were derived from the Objective Diagnostic Markers and Personalized Intervention in MDD Patients (ODMPIM) study. The psychiatric diagnosis and suicidal ideation were evaluated by the Mini-International Neuropsychiatric Interview (M.I.N.I.). We used a multiple logistic analysis to examine the association among childhood adversity (CA), adulthood adversity (AA) and suicidal ideation. Among 1084 MDD patients, 48.6% had suicidal ideation and 65.6% experienced life adversity during their childhood or adulthood. Patients who reported suicidal ideation were more likely to report CA (46.7% vs. 38.7%, P = 0.008) or AA (49.5% vs. 40.9%, P = 0.004) than patients without suicidal ideation. Patients who experienced two waves of adversity (both CA and AA) were associated with higher rates of suicidal ideation (odds ratio = 1.68, 95% CI = 1.19-2.37, P = 0.003); however, neither CA nor AA alone was associated with suicidal ideation. This study first verifies the hypothesis of stress sensitization on suicidal ideation in patients with MDD. Focusing on stress sensitization may enhance the early identification of MDD patients at suicidal risk and the ability to provide timely and appropriate intervention. Clinicaltrials.gov identifier: NCT02023567.
应激敏感化模型表明，早期逆境（例如儿童时期的压力）会使个体对随后的近端压力（例如成年期的生活压力事件）敏感化，从而增加其患精神障碍的脆弱性。然而，应激敏感化对重度抑郁症（MDD）患者自杀意念的影响尚未得到研究。本研究的数据来自客观诊断标志物和 MDD 患者个体化干预（ODMPIM）研究。精神病诊断和自杀意念通过 Mini-国际神经精神访谈（MINI）进行评估。我们使用多元逻辑分析来检查儿童期逆境（CA）、成年期逆境（AA）和自杀意念之间的关联。在 1084 名 MDD 患者中，48.6%有自杀意念，65.6%在儿童期或成年期经历过生活逆境。有自杀意念的患者更有可能报告 CA（46.7%比 38.7%，P=0.008）或 AA（49.5%比 40.9%，P=0.004），而没有自杀意念的患者。经历过两波逆境（CA 和 AA）的患者自杀意念发生率更高（比值比=1.68，95%置信区间=1.19-2.37，P=0.003）；然而，CA 或 AA 单独与自杀意念无关。本研究首次验证了应激敏感化对 MDD 患者自杀意念的假设。关注应激敏感化可能有助于早期识别有自杀风险的 MDD 患者，并及时提供适当的干预。临床试验标识符：NCT02023567。
