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双相情感障碍中的感知孤独感与社会支持:与自杀意念及自杀未遂的关系

Perceived loneliness and social support in bipolar disorder: relation to suicidal ideation and attempts.

作者信息

Pike Chelsea K, Burdick Katherine E, Millett Caitlin, Lipschitz Jessica M

机构信息

Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA.

Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

出版信息

Int J Bipolar Disord. 2024 Mar 20;12(1):8. doi: 10.1186/s40345-024-00329-8.

Abstract

BACKGROUND

The suicide rate in bipolar disorder (BD) is among the highest across all psychiatric disorders. Identifying modifiable variables that relate to suicidal thoughts and behaviors (STBs) in BD may inform prevention strategies. Social connectedness is a modifiable variable found to relate to STBs in the general population, but differences exist across subgroups of the general population and findings specifically in BD have been equivocal. We aimed to clarify how perceived social connectedness relates to STBs in BD.

METHOD

146 adults (86 BD, 60 healthy controls) completed clinical interviews (Hamilton Depression Rating Scale; Structured Clinical Interview for DSM-5) and self-report measures of loneliness (UCLA Loneliness Scale) and social support (Interpersonal Support Evaluation List). Analyses explored differences in indicators of social connectedness (loneliness and social support) between BD participants and healthy controls, and explored relationships between STBs (lifetime suicide attempts and current suicidal ideation) and indicators of social connectedness in BD participants.

RESULTS

BD participants reported significantly higher loneliness and lower social support than healthy controls. In BD participants, perceived social support was significantly related to both ever having attempted suicide and number of lifetime attempts. Interestingly, perceived loneliness, but not social support, was significantly associated with current suicidal ideation.

CONCLUSIONS

Findings expand the evidence base supporting a relationship between perceived social connectedness and STBs in BD. They suggest that this modifiable variable could be a fruitful treatment target for preventing STBs in BD.

摘要

背景

双相情感障碍(BD)的自杀率在所有精神疾病中位居前列。确定与双相情感障碍中的自杀念头和行为(STB)相关的可改变变量可能为预防策略提供依据。社会联结是一个可改变的变量,在普通人群中发现其与自杀念头和行为有关,但普通人群各亚组之间存在差异,特别是在双相情感障碍中的研究结果一直存在争议。我们旨在阐明感知到的社会联结与双相情感障碍中的自杀念头和行为之间的关系。

方法

146名成年人(86名双相情感障碍患者,60名健康对照者)完成了临床访谈(汉密尔顿抑郁量表;DSM-5结构化临床访谈)以及孤独感(加州大学洛杉矶分校孤独量表)和社会支持(人际支持评估列表)的自我报告测量。分析探讨了双相情感障碍患者和健康对照者在社会联结指标(孤独感和社会支持)上的差异,并探讨了自杀念头和行为(终生自杀未遂和当前自杀意念)与双相情感障碍患者社会联结指标之间的关系。

结果

双相情感障碍患者报告的孤独感显著高于健康对照者,社会支持显著低于健康对照者。在双相情感障碍患者中,感知到的社会支持与曾有自杀未遂经历和终生自杀未遂次数均显著相关。有趣的是,感知到的孤独感而非社会支持与当前自杀意念显著相关。

结论

研究结果扩展了支持感知到的社会联结与双相情感障碍中的自杀念头和行为之间存在关联的证据基础。它们表明,这个可改变的变量可能是预防双相情感障碍中自杀念头和行为的一个富有成效的治疗靶点。

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