Cheng Xinyu, Zhang Yi, Zhao Di, Yuan Ti-Fei, Qiu Jianyin
Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China.
Front Psychiatry. 2022 Jul 7;13:892442. doi: 10.3389/fpsyt.2022.892442. eCollection 2022.
Suicidality in patients with major depressive disorder (MDD) has been an urgent affair during the COVID-19 pandemic. It is well-established that impulsivity and trait anxiety are two risk factors for suicidal ideation. However, literature is still insufficient on the relationships among impulsivity, (state/trait) anxiety and suicidal ideation in individuals with MDD. The present study aims to explore the relationships of these three variables in MDD patients during the COVID-19 pandemic through three scales, including Barrett Impulsivity Scale (BIS), State-Trait Anxiety Scale (STAI) and Self-rating Idea of Suicide Scale (SIOSS). Sixty-three MDD patients (low SIOSS group and high SIOSS group, which were split by the mean score of SIOSS) and twenty-seven well-matched healthy controls were analyzed. Our results showed that the high SIOSS group had higher trait anxiety ( < 0.001, 95% CI = [-19.29, -5.02]) but there was no difference in state anxiety ( = 0.171, 95% CI = [-10.60, 1.25]), compared with the low SIOSS group. And the correlation between impulsivity and suicidal ideation was significant in MDD patients ( = 0.389, = 0.002), yet it was not significant in healthy controls ( = 0.285, = 0.167). Further, mediation analysis showed that trait anxiety significantly mediate impulsivity and suicidal ideation in patients with depression (total effect: β = 0.304, = 0.002, 95% CI = [0.120, 0.489]; direct effect: β = 0.154, = 0.076, 95% CI = [-0.169, 0.325]), indicating impulsivity influenced suicidal ideation through trait anxiety in MDD patients. In conclusion, our results suggested that trait anxiety might mediate the association of impulsivity and suicidal ideation in MDD patients. Clinicians may use symptoms of trait anxiety and impulsivity for screening when actively evaluating suicidal ideation in MDD patients, especially in the setting of COVID-19 pandemic.
在新冠疫情期间，重度抑郁症（MDD）患者的自杀倾向一直是个紧迫问题。众所周知，冲动性和特质焦虑是自杀意念的两个风险因素。然而，关于MDD患者中冲动性、（状态/特质）焦虑与自杀意念之间的关系，现有文献仍不充分。本研究旨在通过三个量表，即巴雷特冲动性量表（BIS）、状态-特质焦虑量表（STAI）和自杀自评量表（SIOSS），探讨新冠疫情期间MDD患者这三个变量之间的关系。对63例MDD患者（根据SIOSS平均分分为低SIOSS组和高SIOSS组）和27例匹配良好的健康对照者进行了分析。我们的结果显示，与低SIOSS组相比，高SIOSS组具有更高的特质焦虑（<0.001，95%CI = [-19.29, -5.02]），但状态焦虑无差异（=0.171，95%CI = [-10.60, 1.25]）。并且，冲动性与自杀意念之间的相关性在MDD患者中显著（=0.389，=0.002），而在健康对照者中不显著（=0.285，=0.167）。此外，中介分析表明，特质焦虑在抑郁症患者中显著介导了冲动性和自杀意念（总效应：β = 0.304，=0.002，95%CI = [0.120, 0.489]；直接效应：β = 0.154，=0.076，95%CI = [-0.169, 0.325]），表明在MDD患者中冲动性通过特质焦虑影响自杀意念。总之，我们的结果表明特质焦虑可能介导了MDD患者中冲动性与自杀意念之间的关联。临床医生在积极评估MDD患者的自杀意念时，尤其是在新冠疫情背景下，可利用特质焦虑和冲动性症状进行筛查。
