背景:双相情感障碍(BD)是一种严重的精神障碍,具有沉重的疾病负担。患有BD的女性是特殊人群,她们遭受了很多童年创伤,社会支持,认知缺陷,和自杀。在这项研究中,童年创伤之间的关系,社会支持,调查女性BD患者的临床症状,探讨女性BD患者自杀的危险因素。
方法:本研究包括57例未服用药物的女性BD患者,64名长期服药的女性BD患者,和50个年龄匹配的女性健康对照。童年创伤,社会支持,临床症状,认知,和自杀(自杀意念,自杀计划,自杀未遂,自杀频率)用量表测量。
结果:与健康对照组相比,患有BD的女性表现出更高水平的儿童创伤和自杀倾向,和较低水平的社会支持和认知缺陷。在药物幼稚BD组中,社会支持介导了童年创伤与失眠症状之间的关系(间接效应:ab=0.025)。在长期用药的BD组中,躁狂症状与自杀计划相关(OR=1.127,p=0.030),童年创伤与自杀未遂有关(OR=1.088,p=0.018),和受教育年限(OR=0.773,p=0.028),童年创伤(OR=1.059,p=0.009),延迟记忆(OR=1.091,p=0.016)与自杀频率(OR=1.091,p=0.016)相关。
结论:这项研究提供了初步证据,表明社会支持部分解释了BD女性的童年创伤与临床症状之间的关系。此外,躁狂症症状,童年创伤,和延迟记忆是自杀的危险因素。提供社会支持和改善认知功能的干预措施可能对暴露于童年创伤和高自杀风险的BD女性有益。
BACKGROUND: Bipolar disorder (BD) is a severe mental disorder with heavy disease burden. Females with BD are special populations who suffer a lot from childhood trauma, social support, cognitive deficits, and suicidality. In this study, the relationship among childhood trauma, social support, and clinical symptoms of BD was investigated and the risk factors for suicidality were explored in female patients with BD.
METHODS: This study included 57 drug-naive female BD patients, 64 female BD patients with long-term medication, and 50 age-matched female healthy controls. Childhood trauma, social support, clinical symptoms, cognition, and suicidality (suicide ideation, suicide plan, suicide attempt, suicide frequency) were measured with scales.
RESULTS: Compared with healthy controls, females with BD showed higher levels of childhood trauma and suicidality, and lower levels of social support and cognitive deficits. In the drug-naïve BD group, social support mediated the relationship between childhood trauma and insomnia symptoms (indirect effect: ab = 0.025). In the BD with long-term medication group,
mania symptom was associated with suicide plan (OR = 1.127, p = 0.030), childhood trauma was associated with suicide attempt (OR = 1.088, p = 0.018), and years of education (OR = 0.773, p = 0.028), childhood trauma (OR = 1.059, p = 0.009), and delayed memory (OR= 1.091, p= 0.016) was associated with suicide frequency (OR = 1.091, p = 0.016).
CONCLUSIONS: This study provides initial evidence that social support partially explains the relationship between childhood trauma and clinical symptoms in females with BD. Additionally,
mania symptoms, childhood trauma, and delayed memory were risk factors for suicidality. Interventions providing social support and improving cognitive function may be beneficial for females with BD who are exposed to childhood trauma and with high suicide risk.