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性别因素对有自杀意念的重性抑郁障碍患者躯体症状多个维度的影响作用:来自中国国家心境障碍和精神药理学研究(NSSD)的见解。

The role of gender factors influencing multiple dimensions of somatic symptoms in major depressive disorder patients with suicidal ideation: insights from the Chinese NSSD study.

机构信息

Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Shanghai Huangpu District Mental Health Center, Shanghai, China.

出版信息

BMC Psychiatry. 2024 Oct 25;24(1):732. doi: 10.1186/s12888-024-06172-6.

Abstract

BACKGROUND

The study aimed to explore the influence of gender on the prevalence of various somatic symptoms and their associations with suicidal ideation (SI) among patients with major depressive disorder (MDD).

METHODS

We recruited 3,275 patients with MDD from the National Survey on Symptomatology of Depression (NSSD), among whom 1,745 patients had SI. The clinical characteristics and the prevalence of somatic symptoms across 20 dimensions in MDD patients with SI were compared between male and female patients. Spearman correlation analysis and logistic regression analysis were used to explore the relationship between somatic symptoms and SI.

RESULTS

In patients with SI, 32.2% of female participants attributed the onset of MDD to physical concerns, whereas 27% of male patients held a similar perspective (P = 0.032). Female patients exhibited a higher prevalence of early insomnia (64.6% vs. 70.2%) and a lower prevalence of hypersomnia (17.2% vs. 12.9%) and urinary system symptoms (25.0% vs. 17.8%). Logistic regression analysis indicated that female patients displayed a broader range of somatic symptoms identified as risk factors for SI, including increased appetite, respiratory symptoms, circulatory system symptoms, limb pain, and various others.

CONCLUSION

This study unveils gender-specific patterns in somatic symptoms among MDD patients with SI, highlighting the clinical significance of these symptoms in diagnosis and intervention. Understanding how physical concerns contribute to MDD, especially among females, underscores the need for tailored clinical approaches. Recognizing and addressing these symptoms could guide more effective suicide prevention strategies and enhance MDD management in clinical practice.

摘要

背景

本研究旨在探讨性别对各种躯体症状的发生率的影响,以及这些症状与患有重度抑郁症(MDD)患者自杀意念(SI)的关联。

方法

我们从全国症状调查(NSSD)中招募了 3275 名 MDD 患者,其中 1745 名患者有 SI。我们比较了 MDD 伴 SI 患者中男女患者之间的临床特征以及 20 个维度的躯体症状发生率。采用 Spearman 相关分析和 logistic 回归分析来探讨躯体症状与 SI 之间的关系。

结果

在伴 SI 的患者中,32.2%的女性患者将 MDD 的发病归因于身体问题,而 27%的男性患者持有类似观点(P=0.032)。女性患者更早出现失眠(64.6% vs. 70.2%),而嗜睡(17.2% vs. 12.9%)和泌尿系统症状(25.0% vs. 17.8%)的发生率较低。logistic 回归分析表明,女性患者表现出更广泛的躯体症状,这些症状被认为是 SI 的危险因素,包括食欲增加、呼吸症状、循环系统症状、肢体疼痛等。

结论

本研究揭示了伴 SI 的 MDD 患者中躯体症状的性别特异性模式,凸显了这些症状在诊断和干预中的临床意义。了解身体问题如何导致 MDD,特别是在女性中,突显了需要采用个性化的临床方法。识别和处理这些症状可以指导更有效的自杀预防策略,并在临床实践中改善 MDD 的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df74/11515138/13957bb67498/12888_2024_6172_Fig1_HTML.jpg

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