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双相障碍女性患者童年创伤、社会支持、认知功能与自杀意念的相关性。

Association of childhood trauma, social support, cognition, and suicidality in females with bipolar disorder.

机构信息

Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.

Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, 410011, Changsha, Hunan, China.

出版信息

BMC Psychiatry. 2024 Apr 2;24(1):243. doi: 10.1186/s12888-024-05672-9.

Abstract

BACKGROUND

Bipolar disorder (BD) is a severe mental disorder with heavy disease burden. Females with BD are special populations who suffer a lot from childhood trauma, social support, cognitive deficits, and suicidality. In this study, the relationship among childhood trauma, social support, and clinical symptoms of BD was investigated and the risk factors for suicidality were explored in female patients with BD.

METHODS

This study included 57 drug-naive female BD patients, 64 female BD patients with long-term medication, and 50 age-matched female healthy controls. Childhood trauma, social support, clinical symptoms, cognition, and suicidality (suicide ideation, suicide plan, suicide attempt, suicide frequency) were measured with scales.

RESULTS

Compared with healthy controls, females with BD showed higher levels of childhood trauma and suicidality, and lower levels of social support and cognitive deficits. In the drug-naïve BD group, social support mediated the relationship between childhood trauma and insomnia symptoms (indirect effect: ab = 0.025). In the BD with long-term medication group, mania symptom was associated with suicide plan (OR = 1.127, p = 0.030), childhood trauma was associated with suicide attempt (OR = 1.088, p = 0.018), and years of education (OR = 0.773, p = 0.028), childhood trauma (OR = 1.059, p = 0.009), and delayed memory (OR= 1.091, p= 0.016) was associated with suicide frequency (OR = 1.091, p = 0.016).

CONCLUSIONS

This study provides initial evidence that social support partially explains the relationship between childhood trauma and clinical symptoms in females with BD. Additionally, mania symptoms, childhood trauma, and delayed memory were risk factors for suicidality. Interventions providing social support and improving cognitive function may be beneficial for females with BD who are exposed to childhood trauma and with high suicide risk.

摘要

背景

双相情感障碍(BD)是一种严重的精神疾病,疾病负担沉重。患有 BD 的女性是一个特殊的群体,她们在童年创伤、社会支持、认知缺陷和自杀意念方面遭受了很多痛苦。在这项研究中,我们调查了童年创伤、社会支持与 BD 临床症状之间的关系,并探讨了女性 BD 患者自杀意念的危险因素。

方法

本研究纳入了 57 例未经药物治疗的女性 BD 患者、64 例长期药物治疗的女性 BD 患者和 50 名年龄匹配的女性健康对照者。采用量表评估童年创伤、社会支持、临床症状、认知功能和自杀意念(自杀意念、自杀计划、自杀尝试、自杀频率)。

结果

与健康对照组相比,BD 女性患者的童年创伤和自杀意念水平较高,社会支持和认知缺陷水平较低。在未经药物治疗的 BD 组中,社会支持在童年创伤与失眠症状之间起中介作用(间接效应:ab=0.025)。在长期药物治疗的 BD 组中,躁狂症状与自杀计划相关(OR=1.127,p=0.030),童年创伤与自杀尝试相关(OR=1.088,p=0.018),受教育年限(OR=0.773,p=0.028)、童年创伤(OR=1.059,p=0.009)和延迟记忆(OR=1.091,p=0.016)与自杀频率相关(OR=1.091,p=0.016)。

结论

本研究初步证明了社会支持部分解释了女性 BD 患者童年创伤与临床症状之间的关系。此外,躁狂症状、童年创伤和延迟记忆是女性 BD 患者自杀意念的危险因素。提供社会支持和改善认知功能的干预措施可能对遭受童年创伤和自杀风险高的女性 BD 患者有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6663/10986031/5bf046fc6546/12888_2024_5672_Fig1_HTML.jpg

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