| 摘要 |
【摘要】探究失眠问题在青少年抑郁患者的抑郁水平和自杀意念（Suicidal ideation, SI）之间的作用，为青少年抑郁患者的SI干预提供依据。方法 本研究为横断面研究，共纳入739名来自华南地区数家精神病专科医院13-25岁的抑郁障碍患者。采用阿森斯失眠量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表17项分别对患者的失眠、焦虑、抑郁水平进行评估。根据哥伦比亚自杀严重程度量表评估结果将受试者分为SI组和非自杀意念组，比较组间差异性，通过相关分析检验失眠与焦虑、抑郁水平及SI严重程度的相关性，采用回归分析检验失眠对SI的影响，通过中介效应分析说明失眠在青少年抑郁和SI之间的中介作用。结果 该样本SI检出率为81.06%（599/739），Pearson相关分析显示失眠与焦虑、抑郁水平及SI严重程度呈显著相关性（P<0.01）；多因素回归分析显示：将年龄、性别、起病年龄、受教育程度、焦虑、抑郁纳入协变量后，失眠对SI风险的影响仍有显著性（OR=1.07, 95%CI:1.02, 1.12, P<0.01）；中介效应分析显示，失眠严重程度在抑郁水平和SI风险之间起部分中介作用，中介效应值为0.033，中介效应占比为41.10%。结论 在青少年抑郁障碍患者中，抑郁症状可通过失眠的中介作用间接影响SI风险。
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| Abstract |
【Abstract】Objective To explore the role of insomnia in adolescent depression and suicidal ideation (SI), and to provide evidence for the intervention of SI in adolescents with depression. Methods This is a cross-sectional study, A total of 739 patients aged 13-25 years with depressive disorder from several psychiatric hospitals in South China were enrolled. Athens Insomnia Scale, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale-17item were used to evaluate the insomnia, anxiety, and depression levels of the patients. According to the evaluation results of the Columbia - Suicide Severity Rating Scale, the subjects were divided into SI group and non-suicidal ideation group. The differences between the groups were compared. Correlation analysis was used to examine the correlation between insomnia, anxiety, depression and SI severity. Regression analysis was used to examine the influence of insomnia on SI, and mediation effect analysis was used to explain the mediating role of insomnia between depression and SI in adolescents. Results The detection rate of suicidal ideation in this sample was 81.06% (n=599). Correlation analysis showed that insomnia was significantly correlated with anxiety, depression, and SI. Multivariate regression analysis showed that: After age, gender, age of onset, education level, anxiety, and depression were included as covariates, insomnia severity was still significantly positively correlated with SI (OR=1.07, 95%CI:1.02, 1.12, P<0.01). The mediating effect of insomnia severity on the risk of depression and SI was 0.033, accounting for 41.10% of the total effect. Conclusion In adolescents with depression, depressive symptoms indirectly increase the risk of SI by aggravating insomnia symptoms.【Key words】Adolescent; Depressive disorder; Insomnia; Suicidal ideation
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