Hsu Ju-Wei, Lin Wei-Chen, Tsai Shih-Jen, Cheng Chih-Ming, Chang Wen-Han, Bai Ya-Mei, Su Tung-Ping, Chen Tzeng-Ji, Chen Mu-Hong
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
J Affect Disord. 2025 Mar 15;373:459-464. doi: 10.1016/j.jad.2024.12.105. Epub 2024 Dec 31.
Multiple studies have indicated an association between somatic symptom disorder (SSD) and suicidal symptoms, particularly suicidal ideation. Nevertheless, whether SSD is associated with a risk of suicide mortality remains unclear. In addition, how SSD-related psychiatric comorbidities such as bipolar disorder and major depressive disorder influence the risk of suicide remains unknown.
In this study, 38,483 patients with SSD and 153,932 age- and sex-matched non-SSD individuals were followed up from 2003 to 2017. Suicide was evaluated within this study period, and major psychiatric disorders such as schizophrenia, bipolar disorder, major depression, alcohol use disorder (AUD), and substance use disorder (SUD) were identified. After these major psychiatric comorbidities were adjusted for, time-dependent Cox regression models were used to determine the influence of SSD on the risk of suicide.
Patients with SSD had a higher risk of suicide (hazard ratio [HR] = 3.41) compared with their non-SSD counterparts, regardless of their psychiatric comorbidities. Patients with SSD and comorbidities such as schizophrenia (HR = 5.55), bipolar disorder (HR = 5.99), major depression (HR = 10.24), AUD (HR = 4.33), and SUD (HR = 4.33) were at an increased risk of suicide.
Comorbid anxiety disorders with SSD were not assessed for the suicide risk in the present study.
SSD is an independent risk factor for suicide. Both SSD and its associated psychiatric comorbidities can be used to develop strategies aimed at suicide prevention.
多项研究表明，躯体症状障碍（SSD）与自杀症状之间存在关联，尤其是自杀意念。然而，SSD是否与自杀死亡风险相关仍不清楚。此外，SSD相关的精神共病，如双相情感障碍和重度抑郁症，如何影响自杀风险也尚不明确。
在本研究中，对38483例SSD患者和153932例年龄及性别匹配的非SSD个体进行了2003年至2017年的随访。在该研究期间评估自杀情况，并识别出精神分裂症、双相情感障碍、重度抑郁症、酒精使用障碍（AUD）和物质使用障碍（SUD）等主要精神疾病。在对这些主要精神共病进行调整后，使用时间依赖性Cox回归模型来确定SSD对自杀风险的影响。
与非SSD患者相比，SSD患者的自杀风险更高（风险比[HR]=3.41），无论其精神共病情况如何。患有SSD且伴有精神分裂症（HR=5.55）、双相情感障碍（HR=5.99）、重度抑郁症（HR=10.24）、AUD（HR=4.33）和SUD（HR=4.33）等共病的患者自杀风险增加。
本研究未评估伴有SSD的焦虑症共病的自杀风险。
SSD是自杀的独立危险因素。SSD及其相关的精神共病均可用于制定旨在预防自杀的策略。
