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Title: Association between Perceived Stressfulness of Stressful Life Events and the Suicidal Risk in Chinese Patients with Major Depressive Disorder.
Author: Lin JY, Huang Y, Su YA, Yu X, Lyu XZ, Liu Q, Si TM.
Journal: Chin Med J (Engl); 2018 Apr 20; 131(8):912-919. PubMed ID: 29664050.
Abstract:
BACKGROUND: Patients with major depressive disorder (MDD) usually have high risk of suicidality. Few studies have investigated the effects of stressful life events (SLEs) on the risk of suicide in Chinese patients who have developed MDD. This study aimed to investigate the impact of SLEs on suicidal risk in Chinese patients with MDD. METHODS: In total, 1029 patients with MDD were included from nine psychiatric hospitals to evaluate the impact of SLEs on suicidal risk. Patients fulfilling the Mini-International Neuropsychiatric Interview (MINI) criteria for MDD were included in the study. Patients were excluded if they had lifetime or current diagnoses of psychotic disorder, bipolar disorder, and alcohol or substance dependence. Depressive symptoms were assessed by the 17-item Hamilton Depression Scale (HAMD-17). The suicidal risk of MDD patients was determined by the suicide risk module of MINI. SLEs were assessed by the Life Events Scale. RESULTS: No gender difference was found for suicidal risk in MDD patients. Patients with suicidal risk had younger ages, lower education levels, more drinking behavior, and lower marriage rate, and fewer people had child and more severe depressive symptoms than nonsuicidal risk group. High-level perceived stressfulness (HPS) and number of SLEs that patients were exposed to were significantly greater in patients with suicidal risk than patients without. In multivariate logistic analysis, HPS of SLEs (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16-2.05, P = 0.003) and depressive symptoms (OR = 1.08, 95% CI: 1.05-1.11, P < 0.001) were associated with suicidal risk even after adjustment of gender, age, marriage, drinking behavior, and childless. CONCLUSIONS: HPS of SLEs is associated with suicide risk in Chinese patients with MDD. Further suicide prevention programs targeting this risk factor are needed. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02023567; https://clinicaltrials.gov/ct2/show/NCT02023567?term=NCT02023567&rank=1. 中国抑郁症患者自杀风险与应激性生活事件感知压力水平的研究摘要背景：抑郁症患者常有很高的自杀风险，但少有研究去探索中国抑郁症患者应激性生活事件对其自杀风险的影响。 方法学：研究对象为来自我国9家精神卫生专科机构或综合医院精神科的1029名抑郁症患者，经简明国际神经精神访谈（MINI）检查，符合抑郁症诊断标准。排除标准为终身或现患的精神病性障碍、双相情感障碍、酒精或药物依赖。抑郁疾病严重度用17项汉密尔顿抑郁评定量表（HAMD-17）评估，自杀风险以MINI的自杀风险评估模块来判断。患者所经历的应激性生活事件由生活事件量表（LES）进行评估。 结果：在抑郁症患者中，并未发现自杀风险存在男女性别差异。与低自杀风险的抑郁症患者相比，有自杀风险的抑郁症患者，其抑郁症状更加严重、起病年龄较小、教育程度更低、有更高比例的饮酒行为、结婚和有子女比例少。在应激性生活事件方面，与无自杀风险组相比，有自杀风险的患者遭遇应激性生活事件的次数更多，感知到的压力更重。在逻辑回归模型中，通过校正性别、年龄、婚姻状况、饮酒行为和有无子女，发现抑郁症患者的自杀风险与对应激性生活事件感知到的高水平压力（OR = 1.54, 95%CI:1.16-2.05, P = 0.003）以及抑郁症状严重度显著相关(OR = 1.08, 95%CI:1.05-1.11, P < 0.001)。 结论：在中国抑郁症患者中，自杀风险与患者遭遇应激性生活事件后感知到的高水平压力显著相关。在制定中国抑郁症自杀风险防治策略时，应当考虑到该危险因素，并针对性地进行监测和干预，以降低抑郁症患者的自杀风险。.

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