文章摘要
张博宇, ，程夏龙, ，陈龙, ，刘卉, ，朱春燕, ，靳胜春,.甲状腺激素水平和抑郁症患者自杀尝试行为及自杀意念的相关性研究[J].神经损伤功能重建,2024,(10):559-563
甲状腺激素水平和抑郁症患者自杀尝试行为及自杀意念的相关性研究
Study on the Correlation between Thyroid Hormones and Suicidal Attempts, Suicide Ideationin Patients with Depression
  
DOI：
中文关键词: 抑郁症、甲状腺激素、自杀尝试、自杀意念、临床特征
英文关键词: depression  thyroid hormones  suicide attempts  suicidal ideation  clinical features
基金项目:省属高校与人工智 能研究院协同创新 项目（认知行为-神 经影像在精神心理 疾病诊断中的应用， No. GXXT-2021-00 3）
作者单位
张博宇1,2 ，程夏龙1,2 ，陈龙1,2 ，刘卉1,2 ，朱春燕1,3 ，靳胜春1,2 1. 安徽医科大学精 神卫生与心理科学 学院 2. 安徽医科大学附 属 心 理 医 院/安 徽 省精神卫生中心/ 合肥市第四人民医 院 3. 合肥综合性国家 科学中心人工智能 研究院 
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中文摘要:
      目的：探究甲状腺激素水平与抑郁症患者自杀尝试行为、自杀意念及临床表现的关系，为临床干预提 供参考依据。方法：纳入2020年1月至2023年7月于本院就诊的抑郁症患者1229例。依据现病史，将近1 月内有自杀意念及行为者578例纳入自杀尝试组（尝试组），近1月内有自杀意念而无行为者306例纳入自 杀意念组（意念组），近1月内无自杀行为及意念者345例纳入无自杀行为意念组（对照组）。分析3组基线 资料、甲状腺激素水平，尝试组、意念组甲状腺激素水平及其与抑郁症临床症状的相关性。结果：尝试组汉 密尔顿抑郁量表（HAMD）中认知障碍、绝望感因子得分明显高于意念组（均P＜0.01），尝试组的认知障碍 因子得分高于对照组（P＜0.05）；3组间血清T3、FT3、FT4水平，尝试组＜意念组＜对照组（均P＜0.05），尝 试组血清 T3、FT3、FT4 水平显著低于对照组（均 P＜0.05），意念组血清 FT3 水平显著低于对照组（P＜ 0.05）。尝试组和意念组血清FT4水平与HAMD量表总分、汉密尔顿焦虑量表（HAMA）总分呈正相关（P＜ 0.05）；尝试组 T3、FT3 水平也与 HAMD 量表总分呈正相关（P＜0.05）。Logistic 回归显示，FT3 水平和 HAMD中认知障碍因子是抑郁症患者产生自杀尝试的独立危险因素（P＜0.01），FT3水平和HAMD中绝望 感因子是抑郁症患者出现自杀意念的独立危险因素（P＜0.01）。结论：有自杀尝试及意念的抑郁症患者与 无自杀尝试及意念的抑郁症患者血清 T3、FT3、FT4 水平存在显著性差异；自杀尝试组、自杀意念组血清 FT4水平与HAMD、HAMA量表总分呈正相关；抑郁症患者中，血清FT3水平是出现自杀尝试及意念的生 物学独立危险因素，HAMD评分中的认知障碍因子是出现自杀尝试的独立危险因素，绝望感因子是出现自 杀意念的独立危险因素。
英文摘要:
      To explore the relationship between thyroid hormone levels and suicide attempts, suicidal ideation, and clinical characteristics of patients with depression, providing a reference for clinical intervention. Methods: 1229 patients with depression who received treatment in Hefei Fourth People’s Hospital from January 2020 to July 2023 were recruited. Based on the medical history, 578 patients with suicidal thoughts and behaviors within the past month were included in the suicide attempt group (attempt group), 306 patients with suicidal thoughts without behaviors within the past month were included in the suicide ideation group (ideation group), and 345 patients without suicidal behaviors or thoughts within the past month were included in the no suicide behavior and ideation group (control group). We analyzed the baseline data of the three groups and the levels of thyroid hormones, as well as the correlations between the levels of thyroid hormones in the attempt group and ideation group and depressive clinical symptoms. Results: The HAMD cognitive impairment and hopelessness factor scores in the attempt group were significantly higher than those in the ideation group (both P<0.01), and the cognitive impairment factor score in the attempt group was higher than that in the control group (P<0.05). Among the three groups, the serum levels of T3, FT3, and FT4 were lower in the attempt group＜ideation group＜control group (all P<0.05), with serum T3, FT3, and FT4 levels in the attempt group being significantly lower than those in the control group (all P<0.05) serum FT3 level in the ideation group was significantly lower than that in the control group (P<0.05). Serum FT4 levels in both attempt and ideation groups correlated positively with the total scores on the HAMD and HAMA scales (P<0.05), while serum T3 and FT3 levels in the attempt group also correlated positively with the total scores on the HAMD scale (P<0.05). Logistic regression showed that FT3 levels and cognitive impairment factors in HAMD were independent risk factors for suicidal attempts among depressive patients (P<0.01), and FT3 levels and hopelessness factors in HAMD were independent risk factors for suicide ideation among depressive patients (P<0.01). Conclusion: There are significant differences in serum T3, FT3 and FT4 levels between patients with suicide attempts and ideation and those without. Serum FT4 levels in both the attempt and ideation groups correlated positively with the total scores on the HAMD and HAMA scales. Among depressive patients, serum FT3 level is an independent biological risk factor for suicide attempts and ideation, while cognitive impairment factor in HAMD score is an independent risk factor for suicide attempts, and hopelessness factor is an independent risk factor for suicidal ideation.
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