Suicide attitude, ideation and their relationship with family environment in adolescents with depression

doi:10.11852/zgetbjzz2023-1047

Abstract

Abstract: Objective To investigate the suicidal attitude, ideation of adolescent patients with depression, and to analyze their relationships with family environment,in order to provide evidence for the clinical treatment of adolesent depression and to reduce the suicide rate. Methods Totally 376 adolescentsdiagnosed with depression in Lu'an area from March 2019 to October 2021 were selected as the case group, and 376 normal adolescents were selected as the control group.The suicide attitude questionnaire (QSA), Beck scale for suicide ideation (BSS) and family environment scale (FES-CV) were used to investigate the suicide attitude, suicidal ideation and family environmentof adolescents in two groups. Logistic regression analysis was used to analyze the influencing factors of suicide attitude and ideation of adolescent depression patients.Pearson correlation test was used to analyze the correlations between suicidal attitude, ideation and family environment of adolescent patients with depression. Results The scores of QSA and BSS in the case group were significantly higher than those in the control group(t=43.352, 96.527, P＜0.001).The scores of intimacy, emotional expression, knowledge and entertainment in FES-CV of the case group were lower than those of the control group(t=25.487, 14.573, 22.160, 18.906), the score of contradiction was higher than that of the control group (t=30.311),and the differences were statistically significant (P＜0.001).Logistic regression analysis showed that age of 20 - 25 years old (OR=2.016,2.261), severe illness (OR=2.115, 2.192), dwelling in city (OR=2.442, 2.557) were all risk factors for suicidal attitude and ideation in adolescent depression patients (P<0.05).The scores of QSA and BSS in the case group were negatively correlated with the scores of intimacy, emotional expression, knowledge and entertainment in FES-CV (QSA: r=-0.891,-0.933,-0.788,-0.698, BSS: r=-0.901,-0.832,-0.725,-0.637, P<0.05), but they were positively correlated with the score of contradiction (r=0.848, 0.883, P<0.05). Conclusions The suicidal attitude, ideation of adolescents with depression are higher than those of normal adolescents. Age, illness and growth environment are all influencing factors for suicidal attitudes and ideation in adolescent depression patients, of which the suicide attitude, ideation of patients are closely related to family environment.

Key words: adolescent, depression, suicidal attitude, suicidal ideation, family environment

摘要： 目的调查青少年抑郁症患者自杀态度、意念,并分析其与家庭环境的关系,旨在为临床治疗青少年抑郁症并降低其自杀率提供相关依据。方法选取2019年3月—2021年10月六安地区确诊的376例青少年抑郁症患者作为研究对象设为病例组,另选取376例正常青少年设为对照组。采用自杀态度调查问卷(QSA)、Beck自杀意念评估量表(BSS)、家庭环境量表(FES-CV)对两组青少年的自杀态度、自杀意念及家庭环境进行调查,并采用Logistic回归分析法分析青少年抑郁症患者自杀态度、意念的影响因素。采用Pearson相关性检验分析青少年抑郁症患者自杀态度、意念与家庭环境的相关性。结果病例组的QSA、BSS量表得分高于对照组(t=43.352、96.527,P＜0.001);病例组FES-CV量表中的亲密度、情感表达、知识性、娱乐性得分低于对照组(t=25.487、14.573、22.160、18.906,P＜0.001),矛盾性得分高于对照组(t=30.311),差异有统计学意义(P＜0.001)。Logistic回归分析显示,年龄20~25岁(OR=2.016、2.261)、病情重度(OR=2.115、2.192)、成长环境为城市(OR=2.442、2.557)均为青少年抑郁症患者对自杀持积极态度、自杀意念强的危险因素(P＜0.05)。病例组的QSA、BSS量表得分与FES-CV量表中的亲密度、情感表达、知识性、娱乐性得分均呈负相关(QSA:r=-0.891、-0.933、-0.788、-0.698,BSS:r=-0.901、-0.832、-0.725、-0.637,P＜0.05),与矛盾性得分呈正相关(r=0.848、0.883,P＜0.05)。结论青少年抑郁症患者的自杀态度、意念均高于正常青少年,年龄、病情、成长环境均为青少年抑郁症患者自杀态度、意念的影响因素,且患者自杀态度、意念与家庭环境密切相关。

关键词: 青少年, 抑郁症, 自杀态度, 自杀意念, 家庭环境

CLC Number:

R749.4

ZHAO Juanjuan, XIONG Zuping, WANG Kun, TANG Xinlong. Suicide attitude, ideation and their relationship with family environment in adolescents with depression[J]. Chinese Journal of Child Health Care, 2024, 32(3): 334-338.

赵娟娟, 熊祖平, 王昆, 唐新龙. 青少年抑郁症患者自杀态度、意念及其与家庭环境的关系[J]. 中国儿童保健杂志, 2024, 32(3): 334-338.

References

[1] Benasi G, Fava GA, Guidi J.Prodromal symptoms in depression: A systematic review[J].Psychother Psychosom, 2021, 90(6):365-372.
[2] Miller L, Campo JV.Depression in adolescents[J].N Engl J Med, 2021, 385(5):445-449.
[3] Pavani NPM, Anirudh G, Kothia NR, et al.Depression, suicidal ideation, and suicidal behaviors among dental students of Neo-state capital region in India[J].J Educ Health Promot, 2021, 10:432.
[4] Fukai M, Kim S, Yun YH.Depression and suicidal ideation: Association of physical, mental, social, and spiritual health status[J].Qual Life Res, 2020, 29(10):2807-2814.
[5] Kim H, Choi SH, Lee SE, et al.Variables affecting attitudes toward suicide among the adolescent population[J].J Nerv Ment Dis, 2021, 209(1):59-64.
[6] Feng R, Bao W, Zhuo L, et al.Family conflict associated with intrinsic hippocampal-OFC connectivity in adolescent depressive disorder[J].Front Psychiatry, 2022, 12:797898.
[7] Greenberg J, Tesfazion AA, Robinson CS.Screening, diagnosis, and treatment of depression[J].Mil Med, 2012, 177(8):60-67.
[8] 肖水源,杨洪.自杀态度问卷的编制及信度与效度研究 (自杀系列研究之一)[J].中国心理卫生杂志,1999,13(4):250-251.
Xiao SY, Yang H.The development, reliability and validity of suicide attitude questionnaire (one of the series of suicide studies)[J].Chin Ment Health J, 1999, 13 (4):250-251.(in Chinese)
[9] Kliem S, Lohmann A, Mößle T, et al.German Beck Scale for Suicide Ideation (BSS):Psychometric properties from a representative population survey[J].BMC Psychiatry, 2017, 17(1):389.
[10] 刘丹,张志坤,傅茂笋,等.中文版家庭环境量表的因子结构分析[J].中国行为医学科学,2008,17(3):277-279.
Liu D, Zhang ZK, Fu MS, et al.Factor structure analysis of the Chinese family environment scale[J].Chin J Behav Med Sci, 2008, 17 (3):277-279.(in Chinese)
[11] Diener MJ, Gottdiener WH, Keefe JR, et al.Treatment of depression in children and adolescents[J].Lancet Psychiatry, 2021, 8(2):97.
[12] Rihmer Z, Rihmer A.Depression and suicide-the role of underlying bipolarity[J].Psychiatr Hung, 2019, 34(4):359-368.
[13] Gutiérrez-Rojas L, Porras-Segovia A, Dunne H, et al.Prevalence and correlates of major depressive disorder: A systematic review[J].Braz J Psychiatry, 2020, 42(6):657-672.
[14] Holman MS, Williams MN.Suicide risk and protective factors: A network approach[J].Arch Suicide Res, 2022, 26(1):137-154.
[15] Da Silva AHS, De Freitas LA, Shuhama R, et al.Family environment and depressive episode are associated with relapse after first-episode psychosis[J].J Psychiatr Ment Health Nurs, 2021, 28(6):1065-1078.
[16] Kautzky A, Bartova L, Fugger G, et al.Age as a moderating factor of treatment resistance in depression[J].Eur Psychiatry, 2023, 66(1):e35.
[17] 徐海婷,刘嫣然,吕婧,等.未治疗抑郁障碍患者自杀风险与认知情绪调节策略的关系[J].四川精神卫生,2020,33(1):44-48.
Xu HT, Liu YR, Lyu J, et al.Association between suicide risk and cognitive emotion regulation strategies in untreated depressive disorder patients[J].Sichuan Ment Health, 2020, 33(1):44-48.(in Chinese)
[18] Hartley K, Perazzo J, Brokamp C, et al.Residential surrounding greenness and self-reported symptoms of anxiety and depression in adolescents[J].Environ Res, 2021, 194:110628.
[19] 卢和丽,唐俊,黄泽文,等.抑郁症自杀行为简易预测模型构建及其预测价值研究[J].中国全科医学,2020,23(26):3247-3252.
Lu HL, TangG J, Huang ZW, et al.Development and value evaluation of a simple prediction model of suicidal behavior in depressive disorder[J].Chin Gen Pract, 2020, 23(26):3247-3252.(in Chinese)
[20] 向红宇,王欣,马星宇,等.伴自杀未遂的儿童青少年抑郁症患者的家庭功能特点[J].神经疾病与精神卫生,2020,20(5):326-332.
Xiang HY, Wang X, Ma XY, et al.Study on characteristics of family function in children and adolescents with major depressive disorder and suicide attempt[J].J Neur Ment Health, 2020, 23(26):3247-3252.(in Chinese)