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青少年抑郁症住院病人非自杀性自伤行为现状及危险因素的分析
引用本文:李燕婷,韩柏,王彦芳.青少年抑郁症住院病人非自杀性自伤行为现状及危险因素的分析[J].安徽医药,2023,27(10):1975-1980.
作者姓名:李燕婷  韩柏  王彦芳
作者单位:山西医科大学第一临床医学院,山西太原,030001;山西医科大学第一医院精神科,山西太原 030001;山西医科大学第一医院精神科,山西太原 030001;北京市西城区平安医院精防科,北京 100055
基金项目:国家重点研发计划( 2016YFC1307103);山西省 136兴医工程项目
摘    要:目的探究住院抑郁症青少年非自杀性自伤行为的现状及其相关的风险因素。方法纳入 2021年 9月至 2022年 1月于山西医科大学第一医院住院治疗的首发中重度青少年抑郁症病人 120例,分为无自伤自杀行为组( n=29),非自杀性自伤(non-suicidal self-injury,NSSI)组(n=65),自杀未遂(suicide attempt,SA)组( n=26)。使用自制调查表收集一般资料;汉密尔顿焦虑量表( HAMA)、汉密尔顿抑郁量表( HAMD)-24评估病人的情绪状态;使用自尊量表( SES)艾森克人格问卷( EPQ)、儿童期虐待问卷( CTQ)、青少年生活事件量表( ASLEC)、网络成瘾测试( IAT)评估病人的社会心理因素,。结果无自伤自杀行为组、 NSSI组、 SA组抑郁、焦虑的得分逐渐增高, SA组 HAMD与 HAMA得分高于无自伤自杀行为组[( 27.6±4.54)分比( 22.83±4.80)分;(20.3±4.14)分比( 17.21±4.60)分,均 P<0.05]; NSSI组和 SA组 CTQ总分、情感虐待、躯体虐待、情感忽视、神经质、精神质、 ASLEC总分、人际关系、受惩罚、 IAT得分高于无自伤自杀行为组; NSSI组及 SA组内外向及 SES得分显著低于无自伤自杀行为组[( 37.33±3.10)分比( 35.98±2.34)分比( 39.70±3.37)分; 22.00(18.50,24.00)分比 17.50(15.00,22.00)分比 26.00(23.00,29.50)分,均 P<0.001)]; SA组躯体虐待、情感忽视、其他、 IAT得分高于 NSSI组[( 9.00(8.00,10.25)分比 8.00(7.00,9.00)分; 14.50(13.00,17.00)分比 13.00(12.00,14.00)分; 8.00(7.00,10.00)分比 6.00(6.00,8.00)分; 55.00(54.00,56.00)分比 53.00(51.00,54.00)分,均 P<0.001)]; NSSI组学习压力得分高于无自伤自杀行为组[(11.68±5.29)分比( 8.72±5.33)分, P<0.05],以上均差异有统计学意义(P<0.05)。logistic回归分析显示精神质、 IAT为 NSSI的危险因素, SES为保护性因素。结论青少年抑郁症病人 NSSI行为的患病率较高,精神质、网络成瘾是自伤自杀行为的危险因素,自尊的程度是保护因素。

关 键 词:抑郁症  青少年  精神质  网络成瘾  非自杀性自伤行为  危险因素

Analysis of the current status and risk factors for non-suicidal self-injury behavior in hospitalized adolescent depressive disorder patients
LI Yanting,HAN Bai,WANG Yanfang.Analysis of the current status and risk factors for non-suicidal self-injury behavior in hospitalized adolescent depressive disorder patients[J].Anhui Medical and Pharmaceutical Journal,2023,27(10):1975-1980.
Authors:LI Yanting  HAN Bai  WANG Yanfang
Affiliation:The First Clinical Medical College of Shanxi Medical University, Taiyuan,Shanxi 030001, China;Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001,China;Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001,China;Department of Psychiatric Prevention, Ping''an Hospital, Xicheng District, Beijing 100055,China
Abstract:Objective To investigate the current status of non-suicidal self-injurious behavior in hospitalized adolescents with major depressive disorder and its associated risk factors.Methods A total of 120 hospitalized adolescent patients with first-episode moderate to severe depression were enrolled in The First Hospital of Shanxi Medical University from September 2021 to January 2022. Theywere divided into the no self-injurious suicidal behavior group (n=29), NSSI group (n=65), and SA group (n=26). We used a self-made questionnaire to collect the general information. The Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD)-24 were used to assess the emotional state of patients.The self-esteem scale (SES), the Eysenck Personality Questionnaire (EPQ), the Childhood Abuse Questionnaire (CTQ), the Adolescent Life Events Scale (ASLEC), and the Internet Addiction Test (IAT) were used to assesspsychosocial factors.Results The scores of depression and anxiety in the no self-injurious suicidal behavior group, NSSI group and SA group were gradually increased, and the scores of the HAMD-24 and HAMA were higher in the SA group than in the no self-injurious suicidal behavior group (27.6±4.54) score vs. (22.83±4.80) score, (20.3±4.14) score vs. (17.21±4.60) score, P<0.05]. The NSSI and SAgroups had higher scores for CTQ, emotional abuse, physical abuse, emotional neglect, neuroticism, psychoticism, ASLEC total scores,interpersonal relationships, punishment, and IAT than the no self-injurious suicidal behavior group. The NSSI group and SA groups hadsignificantly lower scores for extroversion and SES than the no self-injurious suicidal behavior group (37.33±3.10) score vs. (35.98± 2.34) score vs. (39.70±3.37)score; 22.00 (18.50,24.00) score vs. 17.50 (15.00,22.00) score vs. 26.00 (23.00,29.50) score, P<0.001]. TheSA group had higher scores for physical abuse, emotional neglect, others and IAT than the NSSI group9.00 (8.00~10.25) score vs. 8.00 (7.00,9.00) score; 14.50 (13.00,17.00) score vs. 13.00 (12.00, 14.00) score; 8.00 (7.00, 10.00) score vs. 6.00 (6.00,8.00) score; 55.00 (54.00,56.00) score vs. 53.00 (51.00,54.00) score, P<0.001)], and the NSSI group had higher learning stress scores than the no self-injurious suicidal behavior group(11.68±5.29) score vs. (8.72±5.33) score, P=0.049]. The above differences were statistically significant (P <0.05). Logistic regression analysis showed that psychoticism and IAT were risk factors for NSSI, and SES was a protective factor.Con? clusion The prevalence of NSSI behavior is high in adolescent depression patients. Psychoticism and Internet addiction are risk factors for NSSI behavior, and the degree of self-esteem is a protective factor.
Keywords:Depressive disorder  Adolescent  Psychoticism  Risk factors
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