Associations of rumination with suicidal ideation and suicide attempts amongst individuals with major depressive disorder: A 12-month longitudinal study in China

IF 4.3 2区 医学 Q1 PSYCHIATRY Comprehensive psychiatry Pub Date : 2024-03-11 DOI:10.1016/j.comppsych.2024.152472
Xinyu Huang , Beifang Fan , Yingcheng Jiang , Yanzhi Li , Ya Chen , Hao Zhao , Yunbin Jiang , Wanxin Wang , Lan Guo , Yan Chen , Yifeng Liu , Zehui Li , Sabrina Wong , Roger S. McIntyre , Xue Han , Ciyong Lu
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Abstract

Background

This study aimed to explore the longitudinal associations of rumination with suicidal ideation and suicide attempts in individuals with major depressive disorder (MDD).

Methods

Participants were derived from the Depression Cohort in China study (DCC). Those who completed at least one follow-up visit during the 12 months were included in the analysis. Dimensions of rumination including brooding and reflection were each measured using five items of the Ruminative Responses Scale. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. Suicide attempts were also assessed and all were analyzed with generalized estimating equations.

Results

Our final sample included 532 participants aged 18 to 59 years (mean [SD], 26.91 [6.94] years) consisting of 148 (27.8%) males and 384 (72.2%) females. After adjusting for temporal trend and potential confounders, individuals with higher levels of reflection were more likely to report suicidal ideation (AOR =1.11, 95% CI:1.01–1.22). However, no statistically significant association was found between brooding and suicidal ideation (AOR =1.06, 95% CI:0.96–1.17). Conversely, individuals with higher levels of brooding were more likely to report suicide attempts (AOR =1.13, 95% CI:1.02–1.24), while no statistically significant association was observed between reflection and suicide attempts (AOR =0.91, 95% CI:0.82–1.01).

Conclusion

Rumination reflects a disturbance in cognitive emotional processing and manifests in different dimensions. Our findings suggest that high levels of reflection and brooding may be associated with a higher likelihood of having suicidal ideation and suicide attempts, respectively. However, it should be interpreted with caution, given that effect sizes are small.

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重度抑郁障碍患者的反刍与自杀意念和自杀企图的关系:为期12个月的中国纵向研究
本研究旨在探讨重度抑郁障碍(MDD)患者的反刍与自杀意念和自杀企图之间的纵向联系。研究对象来自中国抑郁症队列研究(DCC)。在12个月内至少完成一次随访的参与者被纳入分析。反刍反应量表(Ruminative Responses Scale)的五个项目分别测量了反刍的各个维度,包括沉思和反省。自杀意念采用贝克自杀意念量表(Beck Scale for Suicide Ideation)进行评估。此外,还对自杀企图进行了评估,并使用广义估计方程对所有自杀企图进行了分析。我们的最终样本包括 532 名 18 至 59 岁的参与者(平均 [SD] 26.91 [6.94] 岁),其中男性 148 名(27.8%),女性 384 名(72.2%)。在对时间趋势和潜在混杂因素进行调整后,反思水平较高的人更有可能报告有自杀倾向(AOR =1.11,95% CI:1.01-1.22)。然而,在 "忧郁 "与自杀意念之间并没有发现有统计学意义的关联(AOR =1.06,95% CI:0.96-1.17)。相反,耿耿于怀程度较高的人更有可能报告自杀未遂(AOR =1.13,95% CI:1.02-1.24),而反思与自杀未遂之间没有统计学意义上的显著关联(AOR =0.91,95% CI:0.82-1.01)。反思反映了认知情绪处理过程中的紊乱,表现在不同的方面。我们的研究结果表明,高水平的反思和沉思可能分别与较高的自杀意念和自杀未遂可能性相关。然而,由于效应大小较小,在解释时应谨慎。
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来源期刊
Comprehensive psychiatry
Comprehensive psychiatry 医学-精神病学
CiteScore
12.50
自引率
1.40%
发文量
64
审稿时长
29 days
期刊介绍: "Comprehensive Psychiatry" is an open access, peer-reviewed journal dedicated to the field of psychiatry and mental health. Its primary mission is to share the latest advancements in knowledge to enhance patient care and deepen the understanding of mental illnesses. The journal is supported by a diverse team of international editors and peer reviewers, ensuring the publication of high-quality research with a strong focus on clinical relevance and the implications for psychopathology. "Comprehensive Psychiatry" encourages authors to present their research in an accessible manner, facilitating engagement with clinicians, policymakers, and the broader public. By embracing an open access policy, the journal aims to maximize the global impact of its content, making it readily available to a wide audience and fostering scientific collaboration and public awareness beyond the traditional academic community. This approach is designed to promote a more inclusive and informed dialogue on mental health, contributing to the overall progress in the field.
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