青少年抑郁障碍患者述情障碍与自杀未遂的相关性

王硕; 杨荣; 胡淑文; 曹小梅; 钟慧

doi:10.12100/j.issn.2096-5494.223033

心理学通讯 >

2023 , Vol. 6 >Issue 4: 212 - 218

DOI: https://doi.org/10.12100/j.issn.2096-5494.223033

论著

青少年抑郁障碍患者述情障碍与自杀未遂的相关性

王硕 ,
杨荣 ,
胡淑文 ,
曹小梅 ,
钟慧

展开

¹安徽医科大学精神卫生与心理科学学院,合肥 230000;
²合肥市第四人民医院儿童青少年心理科,合肥 230000;
³安徽医科大学附属心理医院儿童青少年心理科,合肥 230000;
⁴安徽省精神卫生中心儿童青少年心理科,合肥 230000

王硕,2021年入学安徽医科大学研究生学院精神病与精神卫生专业,研究兴趣为青少年抑郁障碍自杀行为相关因素及干预。

^*钟慧 313956777@qq.com

网络出版日期: 2024-06-20

基金资助

合肥市第七周期重点培育专科（儿童青少年心理科）; 安徽省临床重点专科（临床心理科）; 安徽省重点研发计划项目“青少年抑郁障碍经颅直流电刺激tDCS临床评价研究”（202204295107020005）

收起

Correlation Between Alexithymia and Suicide Attempts in Adolescents With Depressive Disorders

WANG Shuo ,
YANG Rong ,
HU Shuwen ,
CAO Xiaomei ,
ZHONG Hui

Expand

¹School of Mental Health and Psychological Science, Anhui Medical University, Hefei 230000, China;
²Department of Children and Adolescents, Affiliated Psychological Hospital of Anhui Medical University, Hefei 230000, China;
³Department of Children and Adolescents, Anhui Mental Health Center, Hefei 230000, China;
⁴Department of Children and Adolescents, Hefei Fourth People’s Hospital, Hefei 230000, China

^*ZHONG Hui, 313956777@qq.com

Online published: 2024-06-20

Fold

摘要

目的：探讨自杀未遂和未发生自杀行为的青少年抑郁障碍患者述情障碍的差异及其与抑郁严重程度的相关性。
方法：纳入2019—2021年40例自杀未遂的青少年抑郁障碍患者（自杀未遂组）,68例未发生自杀行为的青少年抑郁障碍患者（非自杀未遂组）,以及23名性别、年龄和受教育年限相匹配的健康对照者（健康对照组）。采用17项汉密尔顿抑郁量表（17-item hamilton depression scale,HAMD-17）、多伦多述情障碍量表（26-item Toronto Alexthymia Scale,TAS-26）、儿童期创伤问卷（Childhood Trauma Questinnaire,CTQ）,对三组被试进行评估。
结果：自杀未遂组、非自杀未遂组与健康对照组在TAS-26总分及描述情感的能力、认识和区分情感与躯体感受的能力、外向性思维因子得分中差异存在统计学意义。两组抑郁障碍被试的TAS-26总分及描述情感的能力、认识和区分情感与躯体感受的能力、外向性思维因子得分高于对照组,自杀未遂组的外向性思维得分高于非自杀未遂组。三组之间童年创伤无差异。自杀未遂组TAS-26中外向性思维与CTQ中情感无视分量表得分呈正相关（r=0.361,p=0.028）;非自杀未遂组青少年外向性思维得分与CTQ情感无视分量表得分也呈正相关（r=0.260,p=0.021）。
结论：述情障碍可能会增加青少年抑郁障碍患者的自杀风险,而童年创伤对预测青少年抑郁障碍患者的自杀未遂行为缺乏足够的证据。

关键词： 自杀未遂; 抑郁障碍; 述情障碍; 童年创伤; 青少年

本文引用格式

王硕 , 杨荣 , 胡淑文 , 曹小梅 , 钟慧 . 青少年抑郁障碍患者述情障碍与自杀未遂的相关性[J]. 心理学通讯, 2023 , 6(4) : 212 -218 . DOI: 10.12100/j.issn.2096-5494.223033

Abstract

Objective: To explore the differences in alexithymia between adolescent patients with depressive disorders who have attempted suicide and those who have not, and its correlation with the severity of depression.
Methods: From 2019 to 2021, 40 adolescents with depressive disorders who had suicide attempts (suicide attempt group), 68 adolescents with depressive disorders who had no suicide attempts (non-suicide attempt group), and 23 healthy controls matched by gender, age, and years of education (healthy control group) were included in the study. The 17-item Hamilton Depression Inventory (HAMD-17), the 26-item Toronto Alexithymia Scale (TAS-26), and the Childhood Trauma Questionnaire (CTQ) were used to assess the three groups.
Results: Statistically significant differences were found among the suicide attempt group, the non-suicide attempt group, and the healthy control group in TAS-26 total score and some factor scores (ability to describe emotions, ability to recognize and differentiate emotions and bodily sensations, and extraversion thinking). Both groups of depressive disorder participants scored higher than the control group on TAS-26 total scores and some factor scores (ability to describe emotions, ability to recognize and differentiate emotions and bodily sensations, and extraversion thinking). Additionally, the suicide attempt group scored higher on extraversion thinking compared to the non-suicide attempt group. And there was no significant difference in childhood trauma among the three groups. In the suicide attempt group, there was a significant positive correlation between extraversion thinking scores in the TAS-26 and emotional neglect subscale scores in the CTQ (r=0.361, p=0.028). Similarly, in the non-suicide attempt group, adolescent extraversion thinking scores were also positively correlated with emotional neglect subscale scores in the CTQ (r=0.260, p=0.021).
Conclusion: Alexithymia disorders may increase the risk of suicide among adolescents with depressive disorders, and childhood trauma may not have a sufficiently clear effect on predicting suicide attempts in adolescents with depressive disorders.

Key words： suicide attempt; depressive disorder; alexithymia; childhood trauma; adolescent

参考文献

[1] 胡谦, 李如蓝, 夏仲. (2023). 青少年抑郁症患者儿童期创伤与非自杀性自伤行为的关系: 反刍思维和述情障碍的链式中介作用. 临床精神医学杂志,33(5), 395-398.
[2] 谯仁杰, 向涯洁, 彭柏清, 余妍洁, 张丽, 蒙华庆, 周新雨. (2022). 青少年自杀相关因素研究现状及进展分析. 国际精神病学杂志, 49(6), 961-963, 979. doi: 10.13479/j.cnki.jip.2022.06.050
[3] 唐开宏, 严琦, 张建标, 徐健. (2020). 伴自杀意念抑郁症患者人格特征、家庭环境与应对方式分析. 国际精神病学杂志,47(4), 686-689. doi: 10.13479/j.cnki.jip.2020.04.014
[4] 熊庆, 申秀云, 阳红, 王小华, 蚁金瑶, 朱熊兆. (2023). 述情障碍与青少年非自杀性自伤: 非适应性情绪调节和抑郁的链式中介作用. 中国临床心理学杂志, 31(3), 574-577, 582. doi: 10.16128/j.cnki.1005-3611.2023.03.013
[5] 颜慧, 杨龙腾, 徐佳婷, 吕思烨, 关可文. (2019). 抑郁症患者的述情障碍与焦虑、抑郁的相关研究.第四届之江精神医学交流会、浙江省医学会精神病学学术大会、浙江省医师协会精神科医师分会第十二届年会,衢州, 浙江.
[6] 杨程甲, 许明智. (2015). 抑郁症患者述情障碍与功能性躯体不适的关系. 广东医学,36(1), 16-19. doi: 10.13820/j.cnki.gdyx.2015.01.005
[7] 张梦雨, 林雪姣, 李冰, 李妮娜. (2020). 心理韧性在抑郁症患者童年创伤、抑郁中的中介作用. 中国健康心理学杂志,28(9), 1308-1313. doi: 10.13342/j.cnki.cjhp.2020.09.007
[8] Alphs L., Fu D., Williamson D., Turkoz I., Jamieson C., Revicki D., & Canuso C. (2020). Suicide ideation and behavior assessment tool (SIBAT): Evaluation of intra- and inter-rater reliability, validity, and mapping to Columbia classification algorithm of suicide assessment.Psychiatry research, 294, 113495. doi: 10.1016/j.psychres.2020.113495
[9] Bagby R., Taylor G., & Ryan D. (1986). Toronto Alexithymia Scale: relationship with personality and psychopathology measures.Psychotherapy and psychosomatics, 45(4), 207-215. doi: 10.1159/000287950
[10] Beilharz J., Paterson M., Fatt S., Wilson C., Burton A., Cvejic E., .. Vollmer-Conna U. (2020). The impact of childhood trauma on psychosocial functioning and physical health in a non-clinical community sample of young adults. The Australian and New Zealand journal of psychiatry, 54(2), 185-194. doi: 10.1177/0004867419881206
[11] Brodsky, B. (2016). Early Childhood Environment and Genetic Interactions: the Diathesis for Suicidal Behavior.Current psychiatry reports, 18(9), 86. doi: 10.1007/s11920-016-0716-z
[12] Cha C., Franz P., M Guzmán E., Glenn C., Kleiman E., & Nock M. (2018). Annual Research Review: Suicide among youth - epidemiology, (potential) etiology, and treatment. Journal of child psychology and psychiatry, and allied disciplines, 59(4), 460-482. doi: 10.1111/jcpp.12831
[13] De Berardis D., Fornaro M., Valchera A., Rapini G., Di Natale S., De Lauretis I., .. Di Giannantonio M. (2020). Alexithymia, resilience, somatic sensations and their relationships with suicide ideation in drug naïve patients with first-episode major depression: An exploratory study in the “real world” everyday clinical practice.Early intervention in psychiatry, 14(3), 336-342. doi: 10.1111/eip.12863
[14] Dong M., Zeng L., Lu L., Li X., Ungvari G., Ng C., .. Xiang Y. (2019). Prevalence of suicide attempt in individuals with major depressive disorder: a meta-analysis of observational surveys.Psychological medicine, 49(10), 1691-1704. doi: 10.1017/s0033291718002301
[15] Farges, Corcos M., Speranza M., Loas G., Perez-Diaz F., Venisse J., .. Jeammet P. (2004). Alexithymia, depression and drug addiction.L’Encephale, 30(3), 201-211. doi: 10.1016/s0013-7006(04)95431-0
[16] Hintikka J., Honkalampi K., Koivumaa-Honkanen H., Antikainen R., Tanskanen A., Haatainen K., & Viinamäki H. (2004). Alexithymia and suicidal ideation: a 12-month follow-up study in a general population.Comprehensive psychiatry, 45(5), 340-345. doi: 10.1016/j.comppsych.2004.06.008
[17] Honkalampi K., Hintikka J., Tanskanen A., Lehtonen J., & Viinamäki H. (2000). Depression is strongly associated with alexithymia in the general population.Journal of psychosomatic research, 48(1), 99-104. doi: 10.1016/s0022-3999(99)00083-5
[18] Iskric A., Ceniti A., Bergmans Y., McInerney S., & Rizvi S. (2020). Alexithymia and self-harm: A review of nonsuicidal self-injury, suicidal ideation, and suicide attempts. Psychiatry research, 288, 112920. doi: 10.1016/j.psychres.2020.112920
[19] Jones S., Pezzi C., Rodriguez-Lainz A., & Whittle L. (2016). Health Risk Behaviors by Length of Time in the United States Among High School Students in Five Sites. Journal of immigrant and minority health, 18(1), 150-160. doi: 10.1007/s10903-014-0151-3
[20] Kienhorst C., de Wilde E., Diekstra R., & Wolters W. (1992). Differences between adolescent suicide attempters and depressed adolescents.Acta psychiatrica Scandinavica, 85(3), 222-228. doi:10.1111/j.1600-0447.1992.tb08599.x
[21] Klonsky E., May A., & Saffer B. (2016). Suicide, Suicide Attempts, and Suicidal Ideation.Annual review of clinical psychology, 12, 307-330. doi: 10.1146/annurev-clinpsy-021815-093204
[22] Lai C., Fan Y., Man H., & Huang Y. (2023). Childhood adversity and depression in Chinese populations: A multilevel meta-analysis of studies using the Childhood Trauma Questionnaire (CTQ).Asian journal of psychiatry, 84, 103582. doi:10.1016/j.ajp.2023.103582
[23] Li H., Luo X., Ke X., Dai Q., Zheng W., Zhang C., .. Ning Y. (2017). Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population.PloS one, 12(10), e0186143. doi: 10.1371/journal.pone.0186143
[24] Li S., Zhang B., Guo Y., & Zhang J. (2015). The association between alexithymia as assessed by the 20-item Toronto Alexithymia Scale and depression: A meta-analysis.Psychiatry research, 227(1), 1-9. doi: 10.1016/j.psychres.2015.02.006
[25] Li X., Mu F., Liu D., Zhu J., Yue S., Liu M., . . Wang J. (2022). Predictors of suicidal ideation, suicide attempt and suicide death among people with major depressive disorder: A systematic review and meta-analysis of cohort studies. Journal of affective disorders, 302, 332-351. doi: 10.1016/j.jad.2022.01.103
[26] Li X., Wang X., Sun L., Hu Y., Xia L., Wang S., .. Liu H. (2023). Associations between childhood maltreatment and suicidal ideation in depressed adolescents: The mediating effect of alexithymia and insomnia.Child abuse & neglect, 135, 105990. doi: 10.1016/j.chiabu.2022.105990
[27] May A., Klonsky E., & Klein D. (2012). Predicting future suicide attempts among depressed suicide ideators: A 10-year longitudinal study.Journal of psychiatric research, 46(7), 946-952. doi: 10.1016/j.jpsychires.2012.04.009
[28] Miao H., Zhong S., Liu X., Lai S., He J., Zhu Y., .. Jia Y. (2022). Childhood trauma history is linked to abnormal brain metabolism of non-medicated adult patients with major depressive disorder.Journal of affective disorders, 302, 101-109. doi: 10.1016/j.jad.2021.12.103
[29] Ribeiro J., Huang X., Fox K., & Franklin J. (2018). Depression and hopelessness as risk factors for suicide ideation, attempts and death: meta-analysis of longitudinal studies.The British journal of psychiatry : the journal of mental science, 212(5), 279-286. doi: 10.1192/bjp.2018.27
[30] Rogerson O., Baguley T., & O’Connor D. (2023). Childhood Trauma and Suicide.Crisis, 44(5), 433-441. doi: 10.1027/0227-5910/a000886
[31] Su Y., Ye C., Xin Q., & Si T. (2023). Major depressive disorder with suicidal ideation or behavior in Chinese population: A scoping review of current evidence on disease assessment, burden, treatment and risk factors.Journal of affective disorders, 340, 732-742. doi: 10.1016/j.jad.2023.08.106
[32] Terock J., Van der Auwera S., Janowitz D., Homuth G., Hannemann A., Schmidt C., . . Grabe H. (2018). Childhood Trauma and Functional Variants of 5-HTTLPR Are Independently Associated with Alexithymia in 5,283 Subjects from the General Population.Psychotherapy and psychosomatics, 87(1), 58-61. doi: 10.1159/000484143
[33] Terock J., Van der Auwera S., Janowitz D., Wittfeld K., Frenzel S., Klinger-König J., & Grabe H. (2020). Childhood trauma and adult declarative memory performance in the general population: The mediating effect of alexithymia.Child abuse & neglect, 101, 104311. doi: 10.1016/j.chiabu.2019.104311
[34] Walter H., Abright A., Bukstein O., Diamond J., Keable H., Ripperger-Suhler J., & Rockhill C. (2023). Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders.Journal of the American Academy of Child and Adolescent Psychiatry, 62(5), 479-502. doi: 10.1016/j.jaac.2022.10.001
[35] Wang Y., Warmenhoven H., Feng Y., Wilson A., Guo D., & Chen R. (2022). The relationship between childhood trauma and suicidal ideation, the mediating role of identification of all humanity, indifference and loneliness. Journal of affective disorders, 299, 658-665. doi: 10.1016/j.jad.2021.12.052
[36] World Health Organization.(2021.Suicide worldwide in 2019: Global health estimates.Retrieved April 30, 2023, from 2021).Suicide worldwide in 2019: Global health estimates.Retrieved April 30, 2023, from http://apps.who.int/iris/handle/10665/341728.
[37] Zhang H., Yang C., Ou Y., Tan Y., Wu S., Hu M., .. Yang X. (2021). Relationship between childhood trauma and suicidal risk in prisoners: The mediating effect of alexithymia.Journal of Southern Medical University, 41(2), 299-304. doi: 10.12122/j.issn.1673-4254.2021.02.20

Options

文章导航

模态框（Modal）标题

摘要

本文引用格式

Abstract

参考文献