痛经介导了日间嗜睡与自杀风险之间的关联：一项前瞻性研究。

Menstrual pain mediated the association between daytime sleepiness and suicidal risk: A prospective study.

作者信息

Dong Qiu-Yue, Yang Xiao-Fan, Liu Bao-Peng, Zhang Ying-Ying, Wan Li-Peng, Jia Cun-Xian

机构信息

Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.

出版信息

J Affect Disord. 2023 May 1;328:238-244. doi: 10.1016/j.jad.2023.02.041. Epub 2023 Feb 17.

DOI:10.1016/j.jad.2023.02.041

PMID:36806594

Abstract

BACKGROUND

Adolescents with daytime sleepiness have been demonstrated to have a higher level of suicidal risk than those without. Currently, few studies had examined the pathway from daytime sleepiness to suicidal risk among female adolescents. This study aimed to explore the association among menstrual pain, daytime sleepiness, and suicidal risk among female adolescents in China.

METHODS

Of 7072 adolescents who participated in the follow-up survey of Shandong Adolescents Behavior & Health Cohort (SABHC), 3001 were female adolescents who had begun to menstruate and included for the analysis. A structured self-administrated questionnaire was used to measure menstrual pain, daytime sleepiness, suicidal risk and demographic characteristics. Participants were first surveyed in November-December 2015 and resurveyed 1 year later.

RESULTS

Of 3001 participants, 11.43 % had suicidal risk, 79.8 % experienced menstrual pain. Cross-lagged analysis showed that there was cause-and-effect relationship between menstrual pain and daytime sleepiness. Moderate (OR = 1.79, 95%CI: 1.22-2.63) and severe (OR = 2.73, 95%CI: 1.80-4.12) menstrual pain (follow-up) were associated with suicidal risk (follow-up). Daytime sleepiness (baseline: OR = 1.04, 95%CI: 1.02-1.06, follow-up: OR = 1.07, 95%CI: 1.05-1.09) had effects on suicidal risk (follow-up). Mediation analysis showed that menstrual pain played a partially mediating role between daytime sleepiness and suicidal risk, with the indirect effect being 0.002 (95%CI: 0.001-0.004).

LIMITATIONS

All data were self-reported.

CONCLUSIONS

Menstrual pain and daytime sleepiness had effects on each other, and they both were the risk factors of suicidal risk. Among female adolescents, the association between daytime sleepiness and suicidal risk could be partially mediated by menstrual pain. Releasing the menstrual pain of female adolescents with daytime sleepiness could reduce their suicidal risk.

摘要

背景

有研究表明，白天嗜睡的青少年自杀风险高于无此症状者。目前，很少有研究探讨女性青少年中从白天嗜睡到自杀风险的路径。本研究旨在探讨中国女性青少年月经疼痛、白天嗜睡与自杀风险之间的关联。

方法

在参与山东青少年行为与健康队列（SABHC）随访调查的7072名青少年中，3001名是已开始月经来潮的女性青少年并纳入分析。采用结构化自填问卷来测量月经疼痛、白天嗜睡、自杀风险和人口统计学特征。参与者于2015年11月至12月首次接受调查，并在1年后再次接受调查。

结果

在3001名参与者中，11.43%有自杀风险，79.8%经历过月经疼痛。交叉滞后分析表明，月经疼痛与白天嗜睡之间存在因果关系。中度（OR = 1.79，95%CI：1.22 - 2.63）和重度（OR = 2.73，95%CI：1.80 - 4.12）月经疼痛（随访时）与自杀风险（随访时）相关。白天嗜睡（基线：OR = 1.04，95%CI：1.02 - 1.06，随访：OR = 1.07，95%CI：1.05 - 1.09）对自杀风险（随访时）有影响。中介分析表明，月经疼痛在白天嗜睡和自杀风险之间起部分中介作用，间接效应为0.002（95%CI：0.001 - 0.004）。