双相Ⅰ型与双相Ⅱ型抑郁障碍患者自伤自杀特点分析

doi:10.3969/j.issn.1674-490X.2023.02.002

医学研究与教育 ›› 2023, Vol. 40 ›› Issue (2): 10-17.DOI: 10.3969/j.issn.1674-490X.2023.02.002

双相Ⅰ型与双相Ⅱ型抑郁障碍患者自伤自杀特点分析

崔利军¹,杨永涛²,刘俞董¹,韩紫非¹,郭艳梅¹

1.河北省精神卫生中心精神科, 河北保定 071000;
2.珠海市慢性病防治中心精神科, 广东珠海 519000

收稿日期:2022-05-06 出版日期:2023-04-25 发布日期:2023-04-25
作者简介:崔利军(1962—),男,河北保定人,主任医师,硕士生导师,主要从事抑郁障碍、双相障碍、精神障碍流行病学研究。 E-mail: cuilijun2013@163.com
基金资助:
河北省财政厅、河北省卫生健康委政府资助临床医学优秀人才项目(361014)

Received:2022-05-06 Online:2023-04-25 Published:2023-04-25

摘要/Abstract

摘要： 目的研究双相Ⅰ型与双相Ⅱ型抑郁障碍患者自伤自杀的特点。方法 97例住院双相抑郁障碍患者,其中双相Ⅰ型43例(44.33%),双相Ⅱ型54例(55.67%);对患者自伤的频度、自伤的方式、自杀意念、自杀次数、自杀方式进行问卷评定;采用汉密尔顿抑郁量表-17、汉密尔顿焦虑量表、32项轻躁狂症状清单评定患者的临床症状,用DSM-Ⅳ-TR轴Ⅱ障碍临床定式检查边缘性人格障碍的诊断条目进行评定。结果双相Ⅱ型抑郁障碍患者自伤自杀意念和行为发生率为77.78%,高于双相Ⅰ型患者的39.54%(χ²=14.693, P<0.01)。双相Ⅱ型抑郁障碍患者自伤行为发生率为64.82%,高于双相Ⅰ型患者的23.26%(χ²=18.093, P<0.01)。双相Ⅱ型抑郁障碍患者自杀次数为1(0, 1.25)次,高于双相Ⅰ型患者的0(0, 1)次(Z=2.289, P=0.022)。双相Ⅱ型抑郁障碍患者用刀和利器割刺自己、抠或抓自己、用力拔扯自己的头发、用力咬自己等发生率高于双相Ⅰ型患者(P<0.05);在自杀方式上双相Ⅱ型抑郁障碍患者过量服用治疗药物、跳落更突出(P<0.05)。双相Ⅱ型抑郁障碍患者伴边缘性人格占62.96%,高于双相Ⅰ型患者的18.60%(χ²=19.185, P<0.01)。结论双相Ⅱ型抑郁障碍患者自伤自杀的发生率较双相Ⅰ型患者更高,自伤自杀方式与双相Ⅰ型患者明显不同,伴边缘性人格及自伤自杀问题突出。

关键词: 双相障碍, 自伤, 自杀, 边缘性人格障碍, 汉密尔顿抑郁量表

Abstract: Objective To study the characteristics and related factors of self-injury and suicide in bipolarⅠand bipolarⅡdepression. Methods 97 hospitalized patients with bipolar depression met the diagnostic criteria of DSM-5 bipolar disorder as major depressive episode were selected, including 43 cases of bipolarⅠtype(44.33%)and 54 cases of bipolarⅡtype(55.67%).The frequency of self-injury, ways of self-injury, suicidal ideation, times of suicide and ways of suicide were evaluated by questionnaire. The clinical symptoms of the patients were assessed using the Hamilton Depression Scale-17, Hamilton Anxiety Scale and 32-item Hypomania Checklist. The diagnosis items of borderline personality disorder in the DSM-Ⅳ-TR Axis Ⅱ Disorder Clinical Standard Examination were assessed. Results 77.78% of bipolarⅡpatients had significantly higher rate of self-injury and suicide than 39.54% of bipolar I patients(χ²=14.693,P<0.01).The proportion of bipolarⅡtype with self-injury was 64.82%, which was significantly higher than that of bipolar I type(23.26%)(χ²=18.093,P<0.01).The suicide frequency of bipolarⅡdepression patients was 1(0,1.25)times, which was significantly higher than that of bipolar I depression patients 0(0,1)times(Z=2.289,P=0.022).The ways of self-injury in bipolar Ⅱ depression patients were significantly higher than those in bipolar I depression patients in (1) cutting themselves with knives and sharp tools,(2) picking or scratching themselves, pulling their hair forcibly,(3) biting themselves forcibly(P<0.05).Patients with bipolar Ⅱ depression were more likely to commit suicide by taking medication and jumping off(P<0.05). Borderline personality was higher in bipolar Ⅱ(62.96%)than bipolar Ⅰ(18.60%)(χ²=19.185,P<0.01). Conclusion The incidence of self-injury and suicide in bipolarⅡdepression patients is higher than that in bipolar I depression patients. The way of self-injury and suicide is obviously different between them. The problem of self-injury and suicide in patients with borderline personality is prominent.

Key words: bipolar disorder, self-injury, suicide, borderline personality disorder, Hamilton Depression Scale

中图分类号:

崔利军,杨永涛,刘俞董,韩紫非,郭艳梅. 双相Ⅰ型与双相Ⅱ型抑郁障碍患者自伤自杀特点分析[J]. 医学研究与教育, 2023, 40(2): 10-17.

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双相Ⅰ型与双相Ⅱ型抑郁障碍患者自伤自杀特点分析

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