Ren Lina, Dong Yeqing, Zhou Xiaojing, Zhang Chuhao, Gao Jiajia, Li Lulu, Zhang Xiao, Zeng Min, Luo Guoshuai, Zhang Xiangyang
Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China.
BMC Psychiatry. 2025 Jan 9;25(1):31. doi: 10.1186/s12888-025-06472-5.
Major depressive disorder (MDD) is a recurrent and persistent mental illness. However, there is a lack of research that distinguishes the severity of comorbid anxiety disorders in MDD, and insufficient evidence exists regarding the prevalence of MDD patients with comorbid moderate-to-severe anxiety in the Chinese population.
The study included 1718 MDD patients (894 with moderate-to-severe anxiety symptoms and 824 without moderate-to-severe anxiety symptoms). Clinical symptoms and development were assessed using the Hamilton Depression Rating Scale-17 (HAMD-17), Hamilton Anxiety Rating Scale-14 (HAMA-14), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression (CGI). The blood pressure and thyroid hormone levels were measured.
We found that the incidence of MDD patients with moderate-to-severe anxiety symptoms was 52.04%. The prevalence of recent suicide attempts in MDD comorbid moderate-to-severe anxiety patients was 31.8%, which was 4.24 times higher than that in patients without moderate-to-severe anxiety. Additionally, suicide attempters had elevated levels of thyroid stimulating hormone (TSH), anti-thyroglobulin (TgAb), thyroid peroxidases antibody (TPOAb), systolic blood pressure (SBP), and diastolic blood pressure (DBP) compared to non-suicide attempters. We further identified CGI score, TSH, TPOAb, and DBP as influential factors for recent suicide attempts in MDD individuals who had moderate-to-severe anxiety symptoms. These indexes could distinguish between suicide attempts and non-suicide attempts in MDD patients with moderate-to-severe anxiety symptoms.
Our findings mainly indicated a high prevalence of recent suicide attempts in MDD patients with moderate-to-severe anxiety. Several clinical correlates, thyroid hormones, and blood pressure might contribute to recent suicide attempts in MDD patients with moderate-to-severe anxiety symptoms.
重度抑郁症（MDD）是一种复发性和持续性精神疾病。然而，缺乏区分MDD中共病焦虑症严重程度的研究，且关于中国人群中合并中重度焦虑的MDD患者患病率的证据不足。
该研究纳入了1718例MDD患者（894例有中重度焦虑症状，824例无中重度焦虑症状）。使用汉密尔顿抑郁量表17项版（HAMD - 17）、汉密尔顿焦虑量表14项版（HAMA - 14）、阳性和阴性症状量表（PANSS）以及临床总体印象量表（CGI）评估临床症状和病情发展。测量血压和甲状腺激素水平。
我们发现有中重度焦虑症状的MDD患者发生率为52.04%。MDD合并中重度焦虑患者近期自杀未遂的患病率为31.8%，是无中重度焦虑患者的4.24倍。此外，与未自杀未遂者相比，自杀未遂者的促甲状腺激素（TSH）、抗甲状腺球蛋白（TgAb）、甲状腺过氧化物酶抗体（TPOAb）、收缩压（SBP）和舒张压（DBP）水平升高。我们进一步确定CGI评分、TSH、TPOAb和DBP是有中重度焦虑症状的MDD个体近期自杀未遂的影响因素。这些指标可区分有中重度焦虑症状的MDD患者的自杀未遂和未自杀未遂情况。
我们的研究结果主要表明有中重度焦虑的MDD患者近期自杀未遂的患病率较高。一些临床相关因素、甲状腺激素和血压可能导致有中重度焦虑症状的MDD患者近期自杀未遂。
