目的:探讨双相障碍患者儿童期虐待、自尊、抑郁和自杀意念间的相关性，及自尊和抑郁在儿童期虐待和自杀意念间的中介作用。方法:选取符合美国精神障碍诊断与统计手册第5版(DSM-5)的292例双相障碍门诊患者，采用儿童期创伤问卷(CTQ)、Beck自杀意念量表(BSICV)、自尊量表(SES)、汉密顿抑郁量表-17项(HAMD-17)和杨氏躁狂量表(YMRS)分别评估儿童期虐待、自杀意念、自尊、抑郁及躁狂症状，采用SPSS PROCESS程序检验中介作用。结果:BSICV得分与CTQ、HAMD-17 得分呈正相关(r=0。37、0。53，均P＜0。010)，与 SES 得分呈负相关(r=-0。50，P＜0。010);SES得分和HAMD-17得分分别在CTQ和BSICV得分间起中介作用(95％CI:0。01～0。09、0。01～0。10)和链式中介作用(95％CI:0。02～0。06)。结论:儿童期虐待、低自尊、高抑郁水平可能是双相障碍患者自杀意念的相关因素。
Relationship and related factors between child abuse and suicidal ideation in patients with bipolar disorder
Objective:To explore the association between child abuse and suicidal ideation in patients with bi-polar disorder.The mediation of self-esteem and depression in this association was also investigated.Methods:A to-tal of 292 patients with bipolar disorder who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were enrolled.Their child abuse,suicidal ideation,self-esteem,depres-sion,and mania were assessed with the Childhood Trauma Questionnaire(CTQ),Beck Scale for Suicide Ideation-Chinese Version(BSICV),Self-Esteem Scale(SES),17-item Hamilton Depression Rating Scale(HAMD-17)and Young Mania Rating Scale(YMRS).The mediating effects were evaluated using PROCESS for SPSS.Results:The BSICV scores were positively associated with the scores of CTQ(r=0.37,P＜0.01)and HAMD-17(r=0.53,P＜0.01)and negatively associated with SES scores(r=-0.50,P＜0.01)in patients with bipolar disorder.Self-esteem and depression played mediating roles between child abuse and suicidal ideation,respectively(95％CI:0.01-0.09,0.01-0.10).Besides,self-esteem and depression sequentially mediated the relationship between child a-buse and suicidal ideation(95％CI:0.02-0.06).Conclusion:Child abuse,low self-esteem,and depression may be related factors of suicidal ideation in patients with bipolar disorder.
万方数据
维普
