Zhu Quanfeng, Wang Jinjin, Wang Yan, Zhang Xiang-Yang
Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China.
Affiliated Mental Health Center of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China.
BMC Psychiatry. 2025 Jul 1;25(1):600. doi: 10.1186/s12888-025-07059-w.
There are differences in some clinical symptoms among patients with schizophrenia at different ages of onset. However, the association of age at onset on the prevalence and associated factors of suicide attempts in schizophrenia is still unclear.
A total of 949 patients with chronic schizophrenia in stable phase were enrolled. The onset of schizophrenia at or before age of 25 years was regarded as youth-onset (YO), and the onset after age of 25 years was regarded as non-youth-onset (NYO). Insomnia Severity Index (ISI), Positive and Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index (IRI), Toronto Alexithymia Scale (TAS), Mini-mental State Examination (MMSE), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to assess insomnia, psychotic symptoms, empathy, narration, and cognitive abilities of the subjects, respectively.
There was no significant difference in the prevalence of suicide attempts between patients with YO and NYO (P > 0.05). Among YO patients, those with suicide attempts had significantly higher PANSS total scores, positive factor scores, excitability/hostility factor scores, and depression/anxiety factor scores (all P < 0.001), with the positive factor scores (P < 0.001, β = 0.18, OR = 1.19, 95%CI:1.10-1.30) and depression/anxiety factor scores (P < 0.001, β = 0.23, OR = 1.26, 95%CI:1.13-1.41) being independent risk factors for suicide attempts. However, the risk of suicide attempts in NYO patients was not significantly correlated with these factors.
There was no significant difference in the prevalence of suicide attempts between YO and NYO schizophrenic patients, whereas there was a significant difference in their associated influencing factors.
不同发病年龄的精神分裂症患者在某些临床症状上存在差异。然而，精神分裂症的发病年龄与自杀未遂患病率及相关因素之间的关联仍不明确。
共纳入949例处于稳定期的慢性精神分裂症患者。将25岁及以前发病的精神分裂症视为早发型（YO），25岁以后发病的视为非早发型（NYO）。采用失眠严重程度指数（ISI）、阳性和阴性症状量表（PANSS）、人际反应指数（IRI）、多伦多述情障碍量表（TAS）、简易精神状态检查表（MMSE）以及可重复性神经心理状态评估量表（RBANS）分别评估受试者的失眠情况、精神症状、共情能力、叙述能力和认知能力。
YO组和NYO组患者的自杀未遂患病率无显著差异（P>0.05）。在YO组患者中，有自杀未遂的患者PANSS总分、阳性因子分、激越/敌对因子分和抑郁/焦虑因子分均显著更高（均P<0.001），其中阳性因子分（P<0.001，β=0.18，OR=1.19，95%CI：1.10 - 1.30）和抑郁/焦虑因子分（P<0.001，β=0.23，OR=1.26，95%CI：1.13 - 1.41）是自杀未遂的独立危险因素。然而，NYO组患者自杀未遂的风险与这些因素无显著相关性。
YO组和NYO组精神分裂症患者的自杀未遂患病率无显著差异，但其相关影响因素存在显著差异。
