European Journal of Psychiatry最新文献_第4页

Association between neutrophil-to-lymphocyte ratio and bipolar disorder: A systematic review and meta-analysis 中性粒细胞与淋巴细胞比率与双相情感障碍之间的关系：一项系统综述和荟萃分析

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-04-01 DOI: 10.1016/j.ejpsy.2025.100308

Ling Gui , Haiyan Yu , Yuxin Wei , Qichao Huang , Yuyao Liu , Yixiao Fu

Objective

The neutrophil-to-lymphocyte ratio (NLR), a systemic indicator of inflammation and stress, shows inconsistent associations with bipolar disorder (BD). This meta-analysis will investigate NLR's diagnostic, prognostic, and therapeutic relevance in BD.

Methods

A systematic search across PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library, using key terms ‘bipolar disorder’, ‘neutrophils’, ‘lymphocytes’, and ‘ratio’ yielded 31 studies assessed via Newcastle-Ottawa Scale. Sensitivity analyses, subgroup analyses and publication bias assessments were conducted to explore heterogeneity sources and result stability.

Results

The NLR values in BDs were significantly higher than those in healthy controls (HCs) (standardized mean difference [SMD] = 0.51, 95 % confidence interval [CI]: 0.40–0.62, p < 0.0001; odds ratio [OR] = 1.87, 95 % CI: 1.27–2.74, p = 0.001). The association was most pronounced between bipolar mania (BDM) and HC (SMD = 0.67, 95 % CI: 0.57–0.76, p < 0.0001, I² = 47 %). Additionally, BDM exhibited higher NLR than bipolar depression (BDD) and bipolar patients in euthymic episode (BDE) (SMD = 0.22, 95 % CI: 0.07–0.38, p = 0.04, I² = 42 %; SMD = 0.31, 95 % CI: 0.15–0.48, p = 0.0001, I² = 60 %, respectively). No significant differences were observed between BDD and HC (SMD = 0.30, 95 % CI: -0.05–0.64, p = 0.09). Subgroup analyses suggested that age may influence the association between NLR and BD.

Conclusion

An elevated NLR value is found in BD, particularly in BDM. However, the difference between BDD and HC is not statistically significant. NLR may be a potent biomarker for the identification and evaluation of BD.

目的中性粒细胞与淋巴细胞比率（NLR）是炎症和应激的系统性指标，与双相情感障碍（BD）的相关性不一致。本荟萃分析将调查NLR在bd中的诊断、预后和治疗相关性。方法系统搜索PubMed、Embase、Web of Science、PsycINFO和Cochrane图书馆，使用关键词“双相情感障碍”、“中性粒细胞”、“淋巴细胞”和“比率”，获得31项研究，通过纽卡斯尔-渥太华量表进行评估。通过敏感性分析、亚组分析和发表偏倚评估来探索异质性来源和结果稳定性。结果bd组NLR值显著高于健康对照组（HCs）(标准化平均差值[SMD] = 0.51, 95%可信区间[CI]: 0.40 ~ 0.62, p <；0.0001;优势比[OR] = 1.87, 95% CI: 1.27-2.74, p = 0.001)。双相躁狂症（BDM）与HC的相关性最为显著(SMD = 0.67, 95% CI: 0.57-0.76, p <；0.0001, i²= 47%)。此外，BDM患者的NLR高于双相抑郁症（BDD）和双相心境发作（BDE）患者(SMD = 0.22, 95% CI: 0.07-0.38, p = 0.04, I²= 42%；SMD = 0.31, 95% CI: 0.15 ~ 0.48, p = 0.0001, I²= 60%)。BDD与HC之间无显著差异（SMD = 0.30, 95% CI: -0.05 ~ 0.64, p = 0.09）。亚组分析显示，年龄可能影响NLR与BD之间的关系。结论NLR值在BD中升高，尤其是在BDM中。然而，BDD和HC之间的差异没有统计学意义。NLR可能是识别和评估双相障碍的有效生物标志物。

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引用次数: 0

Gender differences in 4466 mood disorder patients 4466例情绪障碍患者的性别差异

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-03-29 DOI: 10.1016/j.ejpsy.2025.100303

Alessandro Miola , Leonardo Tondo , Ross J. Baldessarini

Background and Objectives

Characteristics of women and men with bipolar disorder (BD) or major depressive disorder (MDD) have been described with inconsistent findings requiring additional assessment.

Methods

We evaluated clinical characteristics in 4466 consecutive, extensively evaluated mood disorder patients (1491 BD, 2975 MDD; 2795 women, 1671 men) using standard bivariate statistics and multivariable logistic regression modeling.

Results

Diagnosis of MDD occurred 2.28- (women) to 1.62- (men) times more than BD, but prevalence of type II BD (BD2) and type I (BD1) did not differ by gender. BD women had more familial mood disorders, early sexual abuse, anxious or cyclothymic temperament, depressive first episodes, depression–[hypo]mania–interval (DMI) and rapid-cycling course, as well as greater %-time depressed in prospective follow-up, with more suicide attempts but fewer suicides than BD men. BD women also showed more co-occurring anxiety disorder, eating disorder and medical comorbidity, including metabolic disorders and cancer, but lower rates of ADHD and substance-abuse than BD men. MDD women experienced more religious activity, sexual abuse, anxious or cyclothymic temperament, co-occurring eating disorder and medical comorbidity as well as less substance-abuse and ADHD than MDD men but did not differ from men in measures of prospective morbidity.

Conclusions

Many characteristics were selectively associated with women with mood disorders, but prospective morbidity was similar by gender except for greater %-time depressed among BD women. Limited ethnic diversity and treatment in specialized centers may affect generalizability of these findings to other settings.

背景和目的双相情感障碍（BD）或重度抑郁症（MDD）的女性和男性的特征已被描述，但发现不一致，需要进一步评估。方法对4466例连续、广泛评估的心境障碍患者的临床特征进行评估(1491例BD， 2975例MDD；2795名女性，1671名男性)，采用标准双变量统计和多变量logistic回归模型。结果MDD的诊出率是BD的2.28- 1.62倍（女性），但II型（BD2）和I型（BD1）的患病率无性别差异。在前瞻性随访中，BD女性有更多的家族性情绪障碍、早期性虐待、焦虑或循环性气质、抑郁首发、抑郁-[低]躁狂间歇期（DMI）和快速循环病程，抑郁的百分比时间更长，自杀企图多于BD男性，自杀率低于BD男性。患有双相障碍的女性也表现出更多的焦虑障碍、饮食障碍和医疗共病，包括代谢障碍和癌症，但ADHD和药物滥用的比例低于患有双相障碍的男性。与MDD男性相比，MDD女性经历了更多的宗教活动、性虐待、焦虑或周期性气质、同时发生的饮食失调和医疗共病，以及更少的药物滥用和ADHD，但在预期发病率方面与男性没有差异。结论许多特征选择性地与女性情绪障碍相关，但除了双相障碍女性抑郁时间较高外，性别间的预期发病率相似。有限的种族多样性和专业中心的治疗可能会影响这些发现在其他情况下的普遍性。

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引用次数: 0

Psychological interventions to improve cognitive biases in people with schizophrenia: A systematic review 改善精神分裂症患者认知偏差的心理干预：系统综述

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-03-28 DOI: 10.1016/j.ejpsy.2025.100304

Marcel Gratacós-Torras , Esther Pousa , Susana Ochoa , Josep Manel Santos

Introduction

Individuals with schizophrenia commonly exhibit cognitive biases that are related to the disorder's symptoms.

Objective

To review the current evidence on the characteristics and efficacy of psychological interventions targeting cognitive biases in individuals with schizophrenia.

Method

Systematic review registered in PROSPERO. A bibliographic search was conducted in PsycINFO, PubMed, Scopus, and Web of Science up to January 2024. The search focused on quantitative studies using the following keyword sequence: (schizophreni* OR psychosis OR psychoses OR psychotic*) AND (cogniti* OR think*) AND (bias* OR error*) AND (treatment OR therapy OR intervention OR training).

Results

A total of 38 studies assessed psychological interventions targeting cognitive biases in schizophrenia, with most focusing on Metacognitive Training (MCT). These interventions were found to significantly improve cognitive biases and positive symptoms, with promising effects on other symptoms,such as insight, negative symptoms, or self-esteem.

Conclusions

The evidence linking cognitive biases to schizophrenia symptomatology is reinforced. Additionally, it is shown that improving cognitive biases may be an important therapeutic goal in the treatment of the disorder.

精神分裂症患者通常表现出与疾病症状相关的认知偏差。目的综述针对精神分裂症患者认知偏差的心理干预的特点和效果。方法在PROSPERO注册系统评价。在PsycINFO， PubMed， Scopus和Web of Science中进行了文献检索，截止到2024年1月。搜索集中于使用以下关键字序列的定量研究：（精神分裂症*或精神病或精神病或精神病*）和（认知*或思考*）和（偏差*或错误*）和（治疗或治疗或干预或培训）。结果共有38项研究评估了针对精神分裂症认知偏差的心理干预措施，其中大部分集中在元认知训练（MCT）上。研究发现，这些干预措施显著改善了认知偏差和阳性症状，对其他症状（如洞察力、阴性症状或自尊）也有希望产生效果。结论认知偏差与精神分裂症症状学联系的证据得到加强。此外，研究表明，改善认知偏差可能是治疗该疾病的重要治疗目标。

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引用次数: 0

Mental illness discussion variations on X: Topic modelling and sentiment analysis X上的精神疾病讨论变异：话题建模和情感分析

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-03-21 DOI: 10.1016/j.ejpsy.2025.100300

Javier Domingo-Espiñeira , Andrea Varaona-Santos , Francisco J. Lara Abelenda , María Montero , Emilio Fernandez-Egea , Leticia I Muñoz-Manchado , Miguel A. Ortega , Melchor Álvarez-Mon , Miguel Ángel Álvarez-Mon

Background and objectives

Social Media Listening has become essential for understanding societal attitudes about mental health. However, there is a lack of studies focusing on Spanish-language discussions and long-term analyses. This study aims to investigate the evolution of Spanish and English public discourse on nine psychiatric disorders over 15 years on X, identifying frequently addressed topics and associated emotions.

Methods

We collected and analyzed tweets in English and Spanish from 2007 to 2022, referring to nine psychiatric disorders (autism, ADHD, schizophrenia, bipolar disorder, depressive episode, anxiety, addictions, insomnia, and suicide). Advanced topic modeling and sentiment analysis were applied.

Results

The study revealed differences in tweet volumes across disorders and languages. Anxiety was the most prevalent term in both Spanish and English tweets. Spanish discussions emphasized insomnia and suicide attempts, while English tweets highlighted autism and schizophrenia. Tweets about bipolar disorder, depressive episode, and addictions were consistently low in both languages. Over time, Spanish tweets on insomnia, anxiety, and suicide attempts increased, while English tweets on autism, anxiety, suicide attempts, and schizophrenia spiked in 2018 and 2019. Topic modeling indicated that Spanish tweets focused on personal experiences with mental disorders and their impact on life, primarily associated with anger, fear, sadness, and joy. English tweets centered on social awareness and advocacy, eliciting fear, followed by treatment and prevention, associated with fear and sadness.

Conclusions

Despite fewer discussions on X about severe mental disorders like bipolar disorder, schizophrenia, and addictions, X serves as a supportive environment for mental health discourse. Spanish-speaking users share personal experiences, fostering self-expression, while English users promote social awareness and advocacy. This highlights X's role in normalizing mental health conversations, reducing stigma, and increasing support.

背景和目的社交媒体倾听对于理解社会对心理健康的态度已经变得至关重要。然而，缺乏关注西班牙语讨论和长期分析的研究。本研究旨在调查15年来西班牙语和英语关于9种精神疾病的公共话语的演变，确定经常被提及的话题和相关情绪。方法收集并分析2007年至2022年9种精神疾病（自闭症、多动症、精神分裂症、双相情感障碍、抑郁发作、焦虑、成瘾、失眠和自杀）的英语和西班牙语推文。应用了先进的主题建模和情感分析。研究揭示了不同疾病和语言的推特数量的差异。焦虑是西班牙语和英语推特中最普遍的词汇。西班牙语的讨论强调失眠和自杀企图，而英语的推文则强调自闭症和精神分裂症。两种语言中关于双相情感障碍、抑郁发作和成瘾的推文一直很低。随着时间的推移，关于失眠、焦虑和自杀企图的西班牙语推文增加了，而关于自闭症、焦虑、自杀企图和精神分裂症的英语推文在2018年和2019年激增。话题建模表明，西班牙语推文关注的是精神障碍的个人经历及其对生活的影响，主要与愤怒、恐惧、悲伤和快乐有关。英语推文以社会意识和倡导为中心，引发恐惧，其次是治疗和预防，与恐惧和悲伤有关。尽管关于严重精神障碍如双相情感障碍、精神分裂症和成瘾的X讨论较少，但X为精神健康话语提供了一个支持性环境。讲西班牙语的用户分享个人经历，培养自我表达，而英语用户则促进社会意识和倡导。这突出了X在使心理健康对话正常化、减少耻辱感和增加支持方面的作用。

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引用次数: 0

Scale to measure dialectical thinking from dialectical behavior therapy perspective. 从辩证行为治疗的角度衡量辩证思维的量表。

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-03-21 DOI: 10.1016/j.ejpsy.2025.100305

Joaquim Soler , Maria Arqueros , Carlos Schmidt , Daniela Otero , Anna Soria-Madrid , María José Campins , Anna Catalan , Elisabet Casellas , Rocío Espeso , Juan Carlos Pascual

Background and Objectives

Dialectical thinking is a core component of dialectical behavior therapy (DBT), characterized by the synthesis of seemingly opposing ideas to develop a more comprehensive perspective. This study aimed to create a reliable and valid instrument for measuring dialectical thinking.

Method

We analyzed the psychometric properties of the Dialectical Thinking Scale in a mixed sample of 205 participants. Factor structure with both exploratory and confirmatory factor analyses, reliability, test-retest stability, sensitivity to change, and convergent validity were evaluated.

Results

The final resulting questionnaire consisted of a 5-item self-reported scale. The analyses revealed a distinct two-factor structure: "Both Sides" (the capacity to recognize and accept opposing perspectives as simultaneously valid, thereby fostering cognitive flexibility and reducing polarized thinking) and "Both Sides in Me" (the ability to integrate and accept internal contradictions). The scale exhibited high internal consistency (Cronbach's alpha = 0.81), and robust test-retest reliability (ICC = 0.82 for "Both Sides" and 0.64 for "Both Sides in Me"). The scale demonstrated satisfactory sensitivity to change after psychotherapeutic intervention and showed significant negative correlations with psychopathological symptoms.

Conclusions

This scale addresses a critical gap in clinical assessment tools for DBT and it holds promise for applications across mental disorders and social studies.

背景与目的辩证思维是辩证行为疗法（DBT）的核心组成部分，其特点是将看似对立的观点综合起来，形成更全面的视角。本研究旨在建立一种可靠有效的辩证思维测量工具。方法采用205人的混合样本，对辩证思维量表的心理测量特征进行分析。采用探索性和验证性因子分析评估因子结构、信度、重测稳定性、变化敏感性和收敛效度。结果最终问卷由5项自述量表组成。分析揭示了一个明显的双因素结构：“两面”（认识和接受对立观点同时有效的能力，从而促进认知灵活性和减少两极分化的思维）和“两面在我”（整合和接受内部矛盾的能力）。量表具有较高的内部一致性（Cronbach's alpha = 0.81）和稳健的重测信度（“双方”的ICC = 0.82，“我的双方”的ICC = 0.64）。该量表对心理治疗干预后的变化具有满意的敏感性，且与精神病理症状呈显著负相关。结论：该量表填补了DBT临床评估工具的一个关键空白，并有望在精神障碍和社会研究领域得到应用。

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引用次数: 0

"Fluctuations in mental health symptoms from recruitment to baseline: implications for eligibility in clinical trials" "从招募到基线期间心理健康症状的波动：对临床试验资格的影响"

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-03-14 DOI: 10.1016/j.ejpsy.2025.100306

Juliane Piasssechi de Bernardin Gonçalves , Homero Vallada , Giancarlo Lucchetti

引用次数: 0

A 12-month follow-up study of self-harming behaviors in a sample of adolescents 对青少年自我伤害行为进行为期 12 个月的跟踪研究

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-03-09 DOI: 10.1016/j.ejpsy.2025.100301

Javier Vera-Martínez , Francisco Díaz-Atienza , Pablo González-Domenech , Luis Gutiérrez-Rojas , Sara Jiménez-Fernández

引用次数: 0

Investigating an intervention program to reduce suicidal behavior in adolescents with psychiatric disorders: A protocol design 调查减少青少年精神疾病患者自杀行为的干预方案：方案设计

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-03-01 DOI: 10.1016/j.ejpsy.2025.100298

Veronica Fernandez-Rodrigues , Wala Ayad-Ahmed , Paola Marin-Santos , Jose Manuel Lopez-Villatoro , Alejandro de la Torre-Luque , Teresa Bobes-Bascaran , Jose Luis Carrasco , Luis Olivares , Marina Diaz-Marsa

Introduction

Suicide is the leading cause of unnatural death in adolescents. In addition, between 7 and 17% of adolescents may engage in at least one suicide attempt, with prevalence being dramatically higher in adolescents with psychiatric pathology. Death by suicide is usually preceded by several attempts to take one's own life. Among the risk factors most consistently associated with suicidal intent is suicidal ideation. This study aims to evaluate the efficacy of the Self-Awareness of Mental Health (SAM) program enriching standard care, for adolescents at high suicide risk (mental disorder and high suicidal ideation).

Methodology

A randomized single-blind controlled clinical trial will be conducted with a sample of 116 adolescents with suicidal ideation and/or suicide attempt, referred by their psychiatrists from the Hospital Clínico San Carlos (Madrid, Spain). The cohort will be divided into two groups (an intervention group, in which the SAM intervention will be administered as an adjuvant to standard treatment; and a treatment-as-usual group). An extensive clinical assessment on risk factors for suicidal behavior and psychiatric symptoms will be applied up to four times: baseline, post (5 weeks), 3 and 6 months.

Results

Data collection is ongoing. This study will provide data on the effectiveness of the SAM intervention in reducing ideation, preventing the occurrence of suicide attempts, and mitigating emotional symptomatology, such as for anxiety and depression.

自杀是青少年非正常死亡的主要原因。此外，7%至17%的青少年可能至少有过一次自杀企图，而患有精神疾病的青少年的自杀率要高得多。自杀死亡之前通常会有几次自杀的企图。与自杀意图最一致的危险因素是自杀意念。本研究旨在评估心理健康自我意识（SAM）项目对高自杀风险青少年（精神障碍和高自杀意念）标准护理的效果。方法将对116名有自杀意念和/或自杀企图的青少年进行随机单盲对照临床试验，这些青少年由他们的精神科医生从Clínico San Carlos医院（马德里，西班牙）转介。该队列将分为两组(干预组，其中SAM干预将作为标准治疗的辅助手段；另一组是正常治疗组)。将对自杀行为和精神症状的危险因素进行多达四次的广泛临床评估：基线、后（5周）、3个月和6个月。数据收集正在进行中。本研究将提供有关SAM干预在减少意念、预防自杀企图发生和减轻情绪症状（如焦虑和抑郁）方面的有效性的数据。

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引用次数: 0

Genetic evidence of increased schizophrenia risk due to antidepressant use in European and East Asian populations 欧洲和东亚人群使用抗抑郁药导致精神分裂症风险增加的遗传证据

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-03-01 DOI: 10.1016/j.ejpsy.2025.100302

Zhiqiang Du , Xiangjun Zhou , Qin Zhou, Rongrong Lu, Ying Jiang, Haohao Zhu

Background and objectives

Understanding the relationship between antipsychotic drugs (ATDs) use and schizophrenia (SCZ) is crucial. Thus, the objective is to explore the bidirectional causal relationship between ATDs use and SCZ via Two-Sample Mendelian Randomization (TSMR) analysis, aiming to offer new insights for the clinical treatment of SCZ.

Methods

We employed data from Genome-Wide Association Studies (GWAS) and conducted TSMR analysis using the Inverse Variance Weighted (IVW) method. The results were evaluated using P-values, OR values, and 95% Confidence Intervals (95% CI) to assess the bidirectional causal relationship.

Results

At the genetic level, we found a bidirectional positive correlation between European ATDs use and SCZ [OR: 1.283, 95% CI: 1.136–1.449; P = 5.73E-05] and [OR: 1.130, 95% CI: 1.082–1.180; P = 4.27E-08]. East Asian ATDs use and SCZ also showed a positive correlation [OR: 1.174, 95% CI: 1.038–1.328; P = 0.011], while no significant causal relationship was found between East Asian SCZ and ATDs use [OR: 1.004, 95% CI: 0.999–1.009; P = 0.161]. Sensitivity analysis further supported the robustness and reliability of these findings.

Conclusion

At the genetic level, we found that European and East Asian ATDs use may increase the risk of developing SCZ. This can help in formulating clinical medication strategies, where more caution may be needed in deciding whether to prescribe ATDs to SCZ patients. Additionally, we discovered that European SCZ might increase ATDs use, whereas no such risk was found in East Asians.

背景与目的了解抗精神病药物（ATDs）使用与精神分裂症（SCZ）之间的关系至关重要。因此，我们的目的是通过双样本孟德尔随机化（TSMR）分析，探讨ATDs使用与SCZ之间的双向因果关系，旨在为SCZ的临床治疗提供新的见解。方法采用全基因组关联研究（GWAS）数据，采用逆方差加权（IVW）方法进行TSMR分析。使用p值、OR值和95%置信区间（95% CI）对结果进行评估，以评估双向因果关系。结果在遗传水平上，我们发现欧洲人使用ATDs与SCZ呈双向正相关[OR: 1.283, 95% CI: 1.136-1.449；P = 5.73E-05]和[OR: 1.130, 95% CI: 1.082-1.180；P = 4.27e-08]。东亚地区ATDs使用与SCZ也呈正相关[OR: 1.174, 95% CI: 1.038 ~ 1.328；P = 0.011]，而东亚SCZ与ATDs使用无显著因果关系[OR: 1.004, 95% CI: 0.999-1.009；P = 0.161]。敏感性分析进一步支持了这些发现的稳健性和可靠性。结论在遗传水平上，我们发现欧洲和东亚使用ATDs可能增加SCZ发生的风险。这有助于制定临床用药策略，在决定是否给SCZ患者开ATDs时可能需要更加谨慎。此外，我们发现欧洲SCZ可能会增加ATDs的使用，而东亚人没有发现这种风险。

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引用次数: 0

Association between psychological pain and suicidal behaviour in a cohort of patients at high risk of suicide 一组自杀高风险患者的心理疼痛与自杀行为之间的关系

IF 2.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-02-23 DOI: 10.1016/j.ejpsy.2025.100299

Ana Pérez-Balaguer , Inmaculada Peñuelas-Calvo , Ana María de Granda-Beltrán , Jimena María Merayo-Cano , Berta Ezquerra , Adrián Alacreu-Crespo , Enrique Baca-García , Alejandro Porras-Segovia

Background and Objectives

Suicide is a major global public health issue. Pain, both psychological and physical, are potential risks factors for suicidal behaviour (SB). This study aims to explore the relationship between psychological and physical pain and SB in individuals at high risk of suicide.

Methods

This prospective cohort study included 322 participants recruited from emergency departments, psychiatric inpatient units, and outpatient mental health services in two hospitals in Madrid (Spain). Participants completed assessments at baseline and six months. Psychological and physical pain were measured using validated Visual Analog Scales (VAS). The primary outcome was the occurrence of suicidal events, documented through medical records and follow-up interviews. Kaplan-Meier survival analyses estimated the occurrence of suicidal events after 6 months of follow-up. Factors associated with suicidal events were analysed using univariate and multivariate Cox regression models to identify independent predictors of SB.

Results

Severe psychological pain in the previous 15 days was significantly associated with an increased risk of SB (p = 0.017), independently of depression severity. Younger age also emerged as a significant risk factor. No association was found between physical pain and SB.

Conclusions

Psychological pain is a key predictor of SB and should be a focus in suicide risk assessments. Further research is needed to improve measurement tools and develop targeted interventions in order to treat psychological pain effectively.

背景与目的自杀是一个重大的全球公共卫生问题。心理和生理上的疼痛都是自杀行为的潜在危险因素。本研究旨在探讨高自杀风险个体的心理和生理疼痛与SB的关系。方法本前瞻性队列研究纳入了来自马德里（西班牙）两家医院急诊科、精神科住院病房和门诊精神卫生服务部门的322名参与者。参与者在基线和六个月时完成评估。心理和生理疼痛采用经验证的视觉模拟量表（VAS）进行测量。主要结果是自杀事件的发生，通过医疗记录和随访访谈记录。Kaplan-Meier生存分析在随访6个月后估计自杀事件的发生。采用单变量和多变量Cox回归模型分析与自杀事件相关的因素，以确定SB的独立预测因子。结果过去15天内严重的心理疼痛与SB的风险增加显著相关（p = 0.017），与抑郁严重程度无关。年龄较小也是一个重要的风险因素。结论心理疼痛是SB的重要预测因子，应作为自杀风险评估的重点。为了有效地治疗心理疼痛，需要进一步的研究来改进测量工具和制定有针对性的干预措施。

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引用次数: 0