抑郁症患者的家庭分型及其对自杀意念的影响研究

摘要

目的：探讨抑郁症患者家庭亲密度与家庭适应性及家庭分型，并分析其对自杀意念的影响。方法采取随机抽样的方法，选取2013年10月—2014年4月湖北医药学院附属人民医院住院的抑郁症患者108例，采用一般情况调查表和汉密尔顿抑郁量表（ HAMD ）、自杀意念自评量表（ SIOSS ）、家庭亲密度与适应性评定量表（ FACESⅡ-CV）对抑郁症患者进行调查，根据SIOSS评分分为有自杀意念组（ SIOSS≥12分）65例，无自杀意念组（ SIOSS＜12分）43例。比较两组患者一般情况、家庭亲密度、家庭适应性及家庭分型，采用多因素Logistic回归分析抑郁症患者自杀意念的影响因素。结果有自杀意念组与无自杀意念组患者年龄、性别、民族、婚姻状况、居住条件及工作时长比较，差异均无统计学意义（ P＞0.05）；两组患者受教育程度、职业、经济状况比较，差异有统计学意义（P＜0.05）。有自杀意念组患者FACESⅡ-CV家庭亲密度评分（58.1±13.3）分、家庭适应性评分（39.3±9.1）分，均低于无自杀意念组〔（69.6±9.7）分、（46.9±7.3）分， P＜0.05〕。有自杀意念组与无自杀意念组患者家庭分型分布情况比较，差异有统计学意义（χ2＝10.204， P＝0.006）。抑郁症患者自杀意念与受教育程度呈正相关（ r＝0.406， P＜0.001），与经济状况、家庭亲密度、家庭适应性呈负相关（r值分别为-0.268、-0.404和-0.396， P＜0.001）。多因素Logistic回归分析结果显示，受教育程度、经济状况、家庭亲密度与抑郁症患者自杀意念有回归关系（ P＜0.05）。结论有自杀意念的抑郁症患者家庭亲密度与家庭适应性更差，家庭分型多为极端型；受教育程度越高、经济条件越差、家庭亲密度越低的抑郁症患者自杀意念越强。%Objective To investigate the family intimacy , family adaptability and family typing of patients with depression and analyze their effect on suicide ideation .Methods Using random sampling method , enrolled 108 patients with depression who were admitted into Renmin Hospital , Hubei University of Medicine from October 2013 to April 2014.A questionnaire of general information , HAMD, SIOSS and FACESⅡ-CV were used on the subjects.According to SIOSS results, the subjects were divided into two groups: suicide ideation group ( SIOSS≥12 ) ( n =65 ) and non suicide ideation group ( SIOSS<12 ) ( n =43 ) .Comparison was made between the two groups in general information , family intimacy , family adaptability and family types .Multiple Logistic regression analysis was conducted to find the influencing factors for the suicide ideation of the subjects.Results The two group were not significantly different ( P >0.05) in age, gender, ethnic group, marital status, living condition and working hours; the two groups were significantly different (P<0.05) in education level, occupation and economic condition .The suicidal ideation group was lower than non suicidal ideation group in the score of family intimacy 〔 (58.1 ±13.3) vs.(69.6 ±9.7), P<0.05〕 and family adaptability 〔 (39.3 ±9.1) vs.(46.9 ±7.3), P<0.05〕 .The two group were significantly different in family typing (χ2 =10.204, P=0.006) .The suicidal ideation of the subjects was positively correlated with education level and was negatively correlated with economic condition , family intimacy, family adaptability ( r values were -0.268, -0.404 and -0.396 respectively, P <0.001 ) .The multivariate Logistic regression analysis showed that education level , economic condition , family intimacy had regression relationship with the suicidal ideation of the subjects ( P<0.05 ) .Conclusion Patients with suicidal ideation usually have poor family intimacy and family adaptability , and their family type is mostly extreme type .Stronger suicidal ideation of patients with depression is associated with higher education level , poorer economic condition and worse family intimacy .