文章摘要
眭朝平,邓巧恩.青少年抑郁障碍患者非自杀性自伤行为的影响因素及风险模型构建[J].安徽医药,待发表.
青少年抑郁障碍患者非自杀性自伤行为的影响因素及风险模型构建
投稿时间:2024-04-16  录用日期:2024-05-31
DOI:
中文关键词: 青少年  抑郁障碍  非自杀性自伤行为  影响因素  预测模型
英文关键词: 
基金项目:河北省2024年度医学科学研究课题计划(编号:20241462)
作者单位邮编
眭朝平 石家庄市第八医院 050000
邓巧恩* 石家庄市第八医院 
摘要点击次数: 154
全文下载次数: 0
中文摘要:
      目的 探讨青少年抑郁障碍患者非自杀性自伤行为(NSSI)的影响因素,并构建风险预测模型。方法 将本院2019年1月~2023年12月收治的293例青少年抑郁障碍患者随机分为验证组(n=88)和建模组(n=205),并根据建模组NSSI发生情况分为NSSI组(n=78)和非NSSI组(n=127)。收集患者一般资料并采用多因素Logistic回归模型分析建模组患者发生NSSI的影响因素,ROC评价预测区分度;预测青少年抑郁障碍患者NSSI发生风险的列线图模型采用R4.3.1中的rms包构建,并利用rmda包绘制临床决策曲线(DCA)评估模型的临床应用价值。结果 建模组和验证组青少年抑郁障碍患者在居住地、独生子女、遭受校园暴力、抑郁程和童年创伤情况等方面比较均无显著差异(P<0.05)。NSSI组遭受校园暴力(2=7.107)、目睹家庭暴力(2=5.499)、孤独感强(2=4.210)、受到情感虐待(2=5.926)及情感忽视(2=5.237)的占比较非NSSI组显著升高(P<0.05)。多因素Logistic回归分析显示,遭受校园暴力(OR=7.296)、目睹家庭暴力(OR=9.707)、孤独感(OR=8.959)、情感虐待(OR=7.826)、情感忽视(OR=6.889)均为青少年抑郁患者发生NSSI的影响因素(P<0.05)。H-L拟合度检验中,建模组2=11.455,P=0.120,验证组2=5.447,P=0.709,且ROC曲线显示,建模组和验证组曲线下面积分别为0.827和0.888。DCA曲线显示,列线图模型预测的高风险阈值为0.16~0.97时临床应用价值较高。结论 遭受校园暴力、目睹家庭暴力、孤独感、情感虐待、情感忽视为青少年抑郁障碍患者发生NSSI的影响因素,基于上述五项指标构建的风险预测模型具有较好的一致性、区分度。
英文摘要:
      Objective To explore the influencing factors of non suicidal self injury (NSSI) in adolescent patients with depression, and to construct a risk prediction model. Methods: 293 adolescent depression patients admitted to our hospital from January 2019 to December 2023 were randomly divided into a validation group (n=88) and a modeling group (n=205), and were separated into NSSI group (n=78) and non NSSI group (n=127) based on the occurrence of NSSI in the modeling group. General patient information was collected and multivariate logistic regression model was applied to analyze the influencing factors of NSSI in the modeling group, while ROC was used to evaluate the predictive discrimination; the column chart model for predicting the risk of NSSI in adolescent depression patients was constructed using the RMS package in R4.3.1, and the rmda package was applied to draw the clinical decision curve (DCA) to evaluate the clinical application value of the model. Results There was no significant difference between the modeling group and the validation group in terms of place of residence, only child, exposure to campus violence, depression duration, and childhood trauma among adolescent depression patients (P<0.05). The proportions of suffering from campus violence (2=7.107), witnessing domestic violence (2=5.499), strong loneliness (2=4.210), emotional abuse (2=5.926), and emotional neglect (2=5.237) in NSSI group were greatly higher than those in non NSSI group (P<0.05). Multivariate Logistic regression analysis showed that suffering from campus violence (OR=7.296), witnessing domestic violence (OR=9.707), loneliness (OR=8.959), emotional abuse (OR=7.826), and emotional neglect (OR=6.889) were all influencing factors for adolescent depression patients to develop NSSI (P<0.05). In the H-L fit test, modeling group 2=11.455, P=0.120, validation group 2=5.447, P=0.709, and the ROC curve showed that the area under the curves for modeling and validation groups was 0.827 and 0.888, respectively. The DCA curve showed that when the predicted high-risk threshold of the column chart model was between 0.16 and 0.97, the clinical application value was higher. Conclusion: Suffering from campus violence, witnessing domestic violence, loneliness, emotional abuse, and emotional neglect are the influencing factors for the occurrence of NSSI in adolescent depression patients. The risk prediction model constructed based on the above five indicators has good consistency and discrimination.
  查看/发表评论  下载PDF阅读器
关闭

分享按钮