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精神分裂症患者自杀意念与神经认知功能关联的性别差异。

Sex differences in the association between suicidal ideation and neurocognitive function in Chinese patients with schizophrenia.

机构信息

Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Rd, Liwan District, Guangzhou, 510370, China.

Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2024 Sep;274(6):1355-1363. doi: 10.1007/s00406-023-01616-8. Epub 2023 May 15.

Abstract

There is increasing evidence that sex differences exist in many clinical manifestations of patients with schizophrenia, including suicidal ideation (SI) and neurocognitive function. The present study was performed to explore the sex differences in the association between SI and neurocognitive function in Chinese patients with schizophrenia. A total of 1188 inpatients with schizophrenia were recruited from multicenter psychiatric hospitals. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was utilized to evaluate the neurocognitive function of all patients. The Positive and Negative Syndrome Scale (PANSS) was utilized to assess the psychopathology of patients. The Beck Scale for Suicide Ideation (BSSI) was used to assess the severity of SI. In male patients, the suicide risk score was significantly associated with PANSS negative symptoms (r = 0.167, p = 0.043), visuospatial subscale (r = - 0.261, p = 0.001), and RBANS total scores (r = - 0.172, p = 0.037). Furthermore, multivariate linear regression analysis showed that the visuospatial subscale (β = - 0.490, t = - 3.273, p = 0.001) was independently associated with the suicide risk score in male patients. In female patients, the suicide risk score was significantly correlated with PANSS positive symptoms (r = 0.249, p = 0.021), negative symptoms (r = 0.394, p < 0.001), general psychopathology (r = 0.276, p = 0.01) and PANSS total score (r = 0.365, p = 0.001). Multivariate linear regression analysis showed that PANSS negative symptoms (β = 1.849, t = 3.933, p = 0.001) were significantly associated with suicide risk scores in female patients. Our findings indicate that there are sex differences in the association between SI and neurocognitive function in patients with schizophrenia. Based on the findings of our study, gender-specific prevention and intervention strategies may make a difference in reducing SI in Chinese schizophrenia patients.

摘要

越来越多的证据表明,精神分裂症患者的许多临床表现存在性别差异,包括自杀意念 (SI) 和神经认知功能。本研究旨在探讨中国精神分裂症患者 SI 与神经认知功能之间关联的性别差异。共招募了来自多家精神科医院的 1188 名住院精神分裂症患者。使用重复认知评估量表 (RBANS) 评估所有患者的神经认知功能。阳性和阴性症状量表 (PANSS) 用于评估患者的精神病理学。贝克自杀意念量表 (BSSI) 用于评估 SI 的严重程度。在男性患者中,自杀风险评分与 PANSS 阴性症状 (r = 0.167,p = 0.043)、视空间分量表 (r = -0.261,p = 0.001) 和 RBANS 总分 (r = -0.172,p = 0.037) 显著相关。此外,多元线性回归分析表明,视空间分量表 (β = -0.490,t = -3.273,p = 0.001) 与男性患者的自杀风险评分独立相关。在女性患者中,自杀风险评分与 PANSS 阳性症状 (r = 0.249,p = 0.021)、阴性症状 (r = 0.394,p < 0.001)、一般精神病理症状 (r = 0.276,p = 0.01) 和 PANSS 总分 (r = 0.365,p = 0.001) 显著相关。多元线性回归分析表明,PANSS 阴性症状 (β = 1.849,t = 3.933,p = 0.001) 与女性患者的自杀风险评分显著相关。我们的发现表明,精神分裂症患者 SI 与神经认知功能之间的关联存在性别差异。基于我们的研究结果,针对不同性别的预防和干预策略可能会对降低中国精神分裂症患者的 SI 产生影响。

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