| 冯连启,刘杰,王娟.抑郁症 185例自杀意念、行为的危险因素分析[J].安徽医药,2024,28(1):84-89. |
| 抑郁症 185例自杀意念、行为的危险因素分析 |
| Risk factor analysis of suicidal ideation and behavior in patients with depression |
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| DOI：10.3969/j.issn.1009-6469.2024.01.018 |
| 中文关键词: 抑郁症 自杀意念 自杀 脑源性神经营养因子 基因多态性 危险因素 |
| 英文关键词: Depressive disorder Suicidal ideation Suicide Brain-derived neurotrophic factor Gene polymorphisms Risk factors |
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| 中文摘要: |
| 目的分析抑郁症病人自杀意念、行为的危险因素。方法选取商丘市第二人民医院 2020年 1月至 2021年 8月 185例抑郁症初诊病人(研究组)采用倾向值匹配法另选取 185例健康志愿者(对照组)。采用聚合酶链式反应 -限制性片段长度多态性( PCR-RFLP)检测两组脑，源性神经营养因子( BDNF)基因多态性并比较；分别采用自杀意念自评量表( SIOSS)和专家访谈方式调查研究组的自杀意念、行为，采用 logistic多元回归法分析自杀意念、行为的影响因素。结果两组 BDNF第 66个氨基酸处的缬氨酸突变为蛋氨酸( Val66Met)基因型分布与等位基因频率比较差异无统计学意义( P>0.05)且均符合遗传平衡规律(P>0.05)；研究组离婚 /丧偶病人 SIOSS评分高于未婚、已婚［(12.86±3.05)分比( 8.73±1.98)分、(10.02±2.，01)分］(P<0.05)，无业病人 SIOSS评分高于在编人员、普通职员 /个体户［( 13.63±3.04)分比( 8.04±1.95)分、(9.78±2.04)分］(P<0.05)，收入水平 <3 000元/月 SIOSS评分高于 3 000~5 000、>5 000元/月［(13.12±3.08)分比(9.45±1.76)分、(8.10±1.52)分］(P<0.05)，独居、无家庭支持、无社会支持 SIOSS评分均高于非独居、有家庭支持、有社会支持［( 19.22±3.36)分比( 8.12±1.88)分、(9.10±2.14)分比( 14.09±2.35)分、(9.25±2.08)分比( 12.17±2.44)分］(P<0.05)BDNF Val66Met GG基因型 SIOSS评分高于 AA、AG基因型［(11.29±2.50)分比( 7.65±1.77)分、(10.02±2.48)分］(P<0.05)；研究组，有自杀意念占比 44.32%(82/185)，离婚 /丧偶、无业、 <3 000元/月、独居、无家庭支持、无社会支持、 BDNF Val66Met GG基因型均是研究组有自杀意念的危险因素( OR=4.13、4.74、7.19、6.06、4.66、4.75、7.48，P<0.05)；研究组有自杀行为占比 17.84%(33/185)，<3 000元/月、无家庭支持、 BDNF Val66Met GG基因型均是研究组有自杀行为的危险因素(OR=5.05、3.41、6.72，P<0.05)。结论 BDNF Val66Met GG基因型与抑郁症病人自杀意念、行为均有关。 |
| 英文摘要: |
| Objective To analyze the risk factors for suicidal ideation and behavior in patients with depression.Methods A total of 185 patients with depression initially diagnosed in the Second People's Hospital of Shangqiu City from January 2020 to August 2021were selected (study group), and another 185 healthy volunteers were selected by propensity value matching (control group). Polymerasechain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect polymorphisms of the brain-derived neuro- trophic factor (BDNF) gene in the two groups and compared them. Suicidal ideation and behavior of the study groups were investigatedby using the Self-rating Idea of Suicide Scale (SIOSS) and expert interviews, respectively, and the influencing factors of suicidal ide-ation and behavior were analyzed by the logistic multiple regression method.Results There were no significant differences in the geno-type distribution and allele frequency of valine mutated to methionine (Val66Met) at amino acid 66 of BDNF between the two groups (P > 0.05), and all of them were in accordance with the law of genetic equilibrium (P > 0.05). The SIOSS score of divorced/widowed pa-tients in the study group was higher than that of unmarried and married patients [(12.86±3.05) scores vs. (8.73±1.98) scores, (10.02± 2.01) scores] (P < 0.05). The SIOSS score of unemployed patients was higher than that of the workforce, ordinary employees/self-em- ployed [(13.63±3.04) scores vs. (8.04±1.95) scores, (9.78±2.04) scores] (P < 0.05). The SIOSS scores were higher (P< 0.05) for income level < 3 000 yuan/month than for 3 000 to 5 000 and > 5 000 yuan/month [(13.12 ± 3.08) score vs. (9.45 ± 1.76) score, (8.10 ± 1.52) score], and the SIOSS scores were higher (P < 0.05) for living alone, without family support, and without social support than for not liv-ing alone, with family support, and with social support [(19.22 ± 3.36) points vs. (8.12 ± 1.88) points, (9.10 ± 2.14) points vs. (14.09 ± 2.35) points, and (9.25 ± 2.08) points vs. (12.17 ± 2.44) points] (P < 0.05). The SIOSS score of the BDNF Val66Met GG genotype was higher than that of the AA and AG genotypes [(11.29±2.50) points vs. (7.65±1.77) points and (10.02±2.48) points] (P < 0.05). The pro-portion of the study group with suicidal ideation was 44.32% (82/185), and divorced/widowed, unemployed, < 3 000 month, livingalone, no family support, no social support, and BDNF Val66Met GG genotypes were all risk factors for suicidal ideation in the studygroup (OR=4.13, 4.74, 7.19, 6.06, 4.66, 4.75, 7.48, P < 0.05). The percentage of suicidal behavior in the study group was 17.84% (33/185), and < 3 000 RMB/month, no family support, and the BDNF Val66Met GG genotype were risk factors for suicidal behavior in thestudy group (OR=5.05, 3.41, 6.72, P < 0.05).Conclusion The BDNF Val66Met GG genotype is associated with suicidal ideation and behavior in patients with depression. |
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