非自杀性自伤与心境障碍症状及认知功能的关联

Associations between non-suicidal self-injury, clinical symptoms and cognitive function in mood disorder

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2023, 50(5)
作者
作者单位

孝感康复医院 ;
武汉大学人民医院 ;

摘要
研究非自杀性自伤(Nonsuicidal Self-injury, NSSI)行为与重性抑郁障碍(major depressive disorder,MDD)、双相情感障碍(bipolar disorder,BD)患者症状、认知功能间的关联。方法 本研究共入组242名受试者:55名MDD患者、66名BD Ⅰ型患者、59名BD Ⅱ型患者,以及62名健康对照;评定受试者NSSI行为评分、当前情绪及精神症状严重程度评分、神经/社会认知功能评分;探讨情绪及精神症状与NSSI行为之间的关联。结果 在MDD组,认知功能、临床症状对NSSI无显著影响(Ps>0.05)。在BD Ⅰ型患者中,连线测试A成绩(P=0.033,β=0.044),以及抑郁症状(P=0.002,β=-0.104)、焦虑症状(P=0.004,β=-0.099)、躁狂症状(P=0.011,β=-0.064)严重程度对NSSI行为发生有显著影响,而迷宫成绩对NSSI行为发生的影响呈边缘显著(P=0.065,β= -0.09)。BD Ⅱ型患者中抑郁症状(P=0.014,β= -0.111)及精神病性症状(P=0.002,β= -0.101)严重程度对NSSI行为发生有显著影响,情绪管理能力的损害程度对NSSI行为发生的影响呈边缘显著(P=0.092)。结论 与MDD相比,BD患者的自残与当前情绪症状、精神症状、认知功能的联系更紧密。在各认知维度中,神经认知可能影响BD Ⅰ型患者自残行为的发生;社会认知可能影响BD Ⅱ型患者自残行为的发生。
Abstract
【Abstract】Objective To investigate the associations between nonsuicidal self-injury (NSSI) with clinical symptoms and cognitive function in patients with major depressive disorder (MDD) and bipolar disorder (BD). Methods A total of 242 subjects were enrolled in this study, including 55 MDD patients, 66 BD Ⅰ patients, 59 BD Ⅱ patients, and 62 healthy controls. NSSI behavior score, current emotional and psychiatric symptom severity score, neurological/social cognitive function score were assessed to explore the association between emotional and psychiatric symptoms and NSSI behavior. Results In MDD group, cognitive function and clinical symptoms had no significant effect on NSSI (Ps>0.05). In BD Ⅰ patients, a score on the Trail Making Test (P=0.033, β=0.044), as well as the severity depressive symptoms (P=0.002, β=-0.104), anxiety symptoms (P=0.004, β=-0.099), mania symptoms (P=0.011, β=-0.064) had a significant effect on the occurrence of NSSI behavior, while maze score had a marginal significant effect on the occurrence of NSSI behavior (P=0.065, β= -0.09). In BD Ⅱ patients, the severity of depressive symptoms (P=0.014, β=-0.111) and psychotic symptoms (P=0.002, β=-0.101) had significant effects on the occurrence of NSSI behavior, and the impairment of emotional management ability had marginal significant effects on the occurrence of NSSI behavior (P=0.092). Conclusions Compared with MDD, self-harm in BD patients was more closely associated with current mood symptoms, psychiatric symptoms, and cognitive function. In each cognitive dimension, neurocognition may affect the occurrence of self-harm behavior in BD Ⅰ patients; Social cognition may affect the occurrence of self-harm behavior in BD Ⅱ patients.
关键词
【关键词】重性抑郁障碍;双相情感障碍;非自杀性自伤;认知功能;社会认知
KeyWord
【Key words】 Major depressive disorder; Bipolar disorder; Non-suicidal self-injury; Cognitive function; Social cognition
基金项目
页码 1002-1007
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彭欢,殷淑娴,魏方艳,董黎,宗小芬,胡茂林,徐顺生,王毅刚*. 非自杀性自伤与心境障碍症状及认知功能的关联 [J]. 国际精神病学杂志. 2023; 50; (5). 1002 - 1007.

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