不同家庭类型抑郁症患者自杀意念的差异性研究

摘要

Objective To explore the difference of suicidal ideation for patients with depression in different family types. Methods We used General Condition Questionnaire,Hamilton Depression Scale -24 item(HAMD -24),Self - rating Idea of Suicide Scale(SIOSS)and Family Adaptability and Cohesion Scale(FACESII - CV)to investigate 114 patients with depression episode who met the diagnostic criteria of ICD - 10 in the People’s Hospital of Xinjiang Uygur Autonomous Region. All patients were divided into three groups by standard of FACESII - CV,including extreme type(40 cases),intermediate type(43 cases)and balance type(31 cases). Results The incidence of suicidal ideation in the three groups were different,the extreme type was higher than the intermediate and bal-ance type(80. 0% vs. 46. 5% vs. 48. 4% ,P ﹤0. 05). The differences of SIOSS total score,despair factor,optimistic factor,sleep factor and mask factor scores were statistically significant in the three groups(P ﹤0. 05 or 0. 01). Further analysis found that the SIOSS total score,despair factor,optimistic factor and sleep factor scores in extreme type were significantly higher than the intermediate and balance type(P ﹤0. 05 or 0. 01). In intermediate type,the optimistic factor score was higher than the balance type and mask factor score was higher than the extreme type(P ﹤ 0. 01). It showed that the SIOSS score was positively correlated with education level and negatively correlated with those of economic conditions,family adaptability and cohesion score(P ﹤0. 05). Conclusion It reveals that the patients with depression in the extreme family type shows stronger sense of despair,worse optimism and sleep,higher risk of suicide. Further-more,patients with higher education level,worse economic conditions,worse family cohesion,shows higher risk of suicide.%目的：探讨不同家庭类型的抑郁症患者自杀意念的差异性。方法采用一般情况调查表、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）对新疆自治区人民医院临床心理科住院并愿意参与研究的114例符合《国际疾病分类（第10版）》（ICD -10）的心境障碍-抑郁发作诊断标准的患者进行调查，按照 FACESII - CV 评分标准，分为极端型40例，中间型43例，平衡型31例。结果三种家庭自杀意念发生率明显不同，极端型家庭自杀意念发生率高于中间型和平衡型家庭，差异有统计学意义（80.0% vs.46.5% vs.48.4%，P 均﹤0.05）。三种家庭类型患者的 SIOSS 总评分、绝望因子、乐观因子、睡眠因子、掩饰因子评分差异均有统计学意义（P ﹤0.05或0.01）。两两比较分析发现：极端型 SIOSS 总评分、绝望因子、乐观因子、睡眠因子评分高于中间型和平衡型，差异均有统计学意义（P ﹤0.05或0.01）；中间型乐观因子评分高于平衡型，掩饰因子评分高于极端型，差异均有统计学意义（ P 均﹤0.01）；三种家庭类型的其余各因子评分差异均无统计学意义（P 均﹥0.05）。抑郁症患者 SIOSS 评分与受教育程度呈正相关，与经济状况、家庭亲密度评分、家庭适应性评分呈负相关（P 均﹤0.05）。结论极端型家庭抑郁症患者的绝望感更强、乐观性更差、睡眠更差、自杀风险更高；受教育程度越高、经济状况越差、家庭亲密度越差，抑郁症患者自杀的风险越高。