Huong Pham Thi Thu, Wu Chia-Yi, Lee Ming-Been, Chen I-Ming
School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.
Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam.
Front Psychiatry. 2022 Mar 2;13:806291. doi: 10.3389/fpsyt.2022.806291. eCollection 2022.
Treatment-resistant depression (TRD) is one of the primary causes of disability and a major risk for suicide among patients living in the community. However, the suicide risks and care needs for safety among patients with TRD during the community reintegration process appear to be underestimated. This study aimed to investigate the association between community integration and suicide risks among patients with treatment-resistant depression (TRD) with sub-analysis by gender.
Patients diagnosed with major depressive disorder were recruited upon psychiatrists' referral in two general hospitals in northern Taiwan during 2018-2019. The participants who experienced more than two failed treatments of antidepressants with partial remission were defined as TRD. A structured questionnaire was used to collect socio-demographic, suicidality, and psychosocial information.
In a total of 125 participants, gender difference was identified in certain community integration aspects such as home integration, productivity, and electronic social networking. The male participants appeared to have better involvement in social contact with internet but slightly less video link than women, while women had higher level of home integration in the past month. The participants who performed worse in the social integration and better home-based activity or productivity levels had higher suicide risks including suicide ideation and overall suicide risks.
Community integration levels of home, social, and productivity were associated with suicidality in terms of overall suicide risk and recent suicide ideation. Facilitation of community integration at home and life arrangements might reduce suicide risks in TRD patients.
难治性抑郁症（TRD）是导致残疾的主要原因之一，也是社区患者自杀的主要风险因素。然而，在社区重新融入过程中，难治性抑郁症患者的自杀风险和安全护理需求似乎被低估了。本研究旨在调查难治性抑郁症（TRD）患者社区融入与自杀风险之间的关联，并按性别进行亚组分析。
2018 - 2019年期间，在台湾北部的两家综合医院，通过精神科医生的转诊招募被诊断为重度抑郁症的患者。经历过两种以上抗抑郁药治疗失败且部分缓解的参与者被定义为难治性抑郁症患者。使用结构化问卷收集社会人口统计学、自杀倾向和心理社会信息。
在总共125名参与者中，在家庭融入、生产力和电子社交网络等社区融入的某些方面发现了性别差异。男性参与者在通过互联网进行社交接触方面似乎参与度更高，但视频联系比女性略少，而女性在过去一个月的家庭融入水平更高。在社会融入方面表现较差但家庭活动或生产力水平较好的参与者有更高的自杀风险，包括自杀意念和总体自杀风险。
家庭、社会和生产力方面的社区融入水平与总体自杀风险和近期自杀意念方面的自杀倾向相关。促进家庭社区融入和生活安排可能会降低难治性抑郁症患者的自杀风险。
