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创伤性脊髓损伤患者的自杀意念、创伤后应激障碍和抑郁:韧性告诉我们什么。

Suicidal ideation, post-traumatic stress disorder, and depression in traumatic spinal cord injury: What resilience tells us.

机构信息

Department of Psychiatry, University of Health Sciences, Erenköy Training and Research Hospital for Psychiatry and Neurological Diseases, Istanbul, Turkey.

Department of Psychiatry, Istanbul University- Cerrahpaşa, Cerrahpasa Medical School, Istanbul, Turkey.

出版信息

J Spinal Cord Med. 2023 Mar;46(2):309-316. doi: 10.1080/10790268.2022.2039856. Epub 2022 May 20.

Abstract

OBJECTIVE

Identification of unmet psychiatric needs, protective and risk factors for suicide are crucial for people with traumatic spinal cord injury (SCI). In this study, we aimed to explore depression, post-traumatic stress disorder (PTSD) status (non-PTSD, partial-PTSD, full-PTSD), resilience, suicidal ideation (SI) and to examine predictors and clinical correlates of current SI in traumatic SCI.

METHOD

Sixty-three individuals with traumatic SCI who were at least 3 months post-injury were included in the study. The participants were evaluated in terms of PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5), depression, SI, and resilience using the PCL-5, the Patient Health Questionnaire-9, the Brief Resilience Scale, and sociodemographic measures.

RESULTS

33% of our sample (n = 21) had SI over the past two weeks. 71.4% of the patients with SI (n = 15) had depression. A total of 52.4% of the patients with SI (n = 11) were diagnosed with full PTSD. Resilience was found to be significantly lower in individuals with depression and individuals with SI. While depression predicted SI in traumatic SCI, resilience stands as a protective factor against SI.

CONCLUSION

SI is quite common in individuals with traumatic SCI and is accompanied by substantial psychiatric comorbidities such as depression and PTSD. Along with depression and PTSD, resilience - which has protective and predictive values and is inversely associated with SI - constitutes a significant psychotherapeutic intervention and screening area.

摘要

目的

识别创伤性脊髓损伤(SCI)患者未满足的精神需求、自杀的保护和风险因素至关重要。本研究旨在探讨抑郁、创伤后应激障碍(PTSD)状态(非 PTSD、部分 PTSD、完全 PTSD)、韧性、自杀意念(SI),并研究创伤性 SCI 患者当前 SI 的预测因素和临床相关性。

方法

本研究纳入了 63 名创伤性 SCI 患者,他们至少在受伤后 3 个月。使用 PTSD 检查表诊断和统计手册,第五版(PCL-5)、抑郁、SI 和韧性评估患者的 PTSD 状况,使用 PCL-5、患者健康问卷-9、简短韧性量表和社会人口学措施评估。

结果

我们样本的 33%(n=21)在过去两周有过 SI。71.4%(n=15)有 SI 的患者患有抑郁。有 SI 的患者中,52.4%(n=11)被诊断为完全 PTSD。患有抑郁和 SI 的患者的韧性明显较低。抑郁可预测创伤性 SCI 中的 SI,而韧性是 SI 的保护因素。

结论

SI 在创伤性 SCI 患者中很常见,并且伴随着大量的精神共病,如抑郁和 PTSD。除了抑郁和 PTSD,具有保护和预测价值且与 SI 呈负相关的韧性是一个重要的心理治疗干预和筛查领域。

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