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中文人群中有自杀意念或行为的重性抑郁障碍:当前疾病评估、负担、治疗和危险因素证据的范围综述。

Major depressive disorder with suicidal ideation or behavior in Chinese population: A scoping review of current evidence on disease assessment, burden, treatment and risk factors.

机构信息

Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.

Xi'an Janssen Pharmaceutical Ltd, Beijing, China.

出版信息

J Affect Disord. 2023 Nov 1;340:732-742. doi: 10.1016/j.jad.2023.08.106. Epub 2023 Aug 22.

Abstract

BACKGROUND

Identifying and managing major depressive disorder (MDD) patients with suicidal ideation or behavior (MDSI) is critical for reducing the disease burden. This scoping review aims to map the existing evidence related to MDSI in the Chinese population.

METHOD

A scoping review was conducted to summarize the published evidence regarding epidemiology or disease burden, evaluation, diagnosis, management, and prognosis of MDSI. The search strategy imposed restriction on English or Chinese publications between 1 January 2011 and 28 February 2022.

RESULTS

Of the 14,005 identified records, 133 met the eligibility criteria and were included for analysis. The included studies were characterized as high heterogeneity in evaluation of suicidal ideation or behavior. Compared with MDD patients without suicidal ideation or behavior, MDSI patients were more likely to suffer from psychological and somatic symptoms, social function impairment, and lower quality of life. Younger age, female gender, longer disease course, and comorbid psychological or physical symptoms were consistently found to be risk factors of suicidal ideation or behavior. Relevant research gaps remain regarding comprehensive evaluation of standard clinical diagnosis, disease burden, social-cultural risk factors, and effectiveness of interventions targeting MDSI. Studies with large sample size, representative population are warranted to provide high-quality evidence.

CONCLUSIONS

MDD patients with suicidal ideation or behavior should be prioritized in treatment and resource allocation. Heterogeneity exists in the definition and evaluation of MDSI in different studies. To better inform clinical practice, it is imperative to establish a unified standard for evaluation and diagnosis of suicidal ideation or behavior among MDD population.

摘要

背景

识别和管理有自杀意念或行为(MDSI)的重度抑郁症(MDD)患者对于降低疾病负担至关重要。本范围综述旨在绘制与中国人群中 MDSI 相关的现有证据图谱。

方法

进行范围综述,以总结关于 MDSI 的流行病学或疾病负担、评估、诊断、管理和预后的已发表证据。该搜索策略对 2011 年 1 月 1 日至 2022 年 2 月 28 日期间的英文或中文出版物施加了限制。

结果

在 14005 条鉴定记录中,有 133 条符合入选标准并纳入分析。纳入的研究在评估自杀意念或行为方面表现出高度异质性。与无自杀意念或行为的 MDD 患者相比,MDSI 患者更可能出现心理和躯体症状、社会功能受损和生活质量降低。年龄较小、女性、疾病病程较长以及合并心理或躯体症状一直被发现是自杀意念或行为的风险因素。关于自杀意念或行为的综合评估、标准临床诊断、疾病负担、社会文化风险因素以及针对 MDSI 的干预措施的有效性,仍存在相关研究空白。需要开展具有大样本量、代表性人群的研究,以提供高质量的证据。

结论

应优先考虑有自杀意念或行为的 MDD 患者进行治疗和资源分配。不同研究中 MDSI 的定义和评估存在异质性。为了更好地为临床实践提供信息,必须建立 MDD 人群自杀意念或行为评估和诊断的统一标准。

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