| Objective: To explore the risk factors of depressive disorder in adolescents with high risk of suicide.Methods: Several hospitals in Anhui Province participated in the study.The subjects were adolescent depressive patients diagnosed by face-to-face interview with clinicians combined with Diagnostic and Statistical Manual of Mental Disorders（5th Edition）（DSM-5）from November 2020 to November 2021.The demographic data and clinical related scale data were collected for the patients who met the criteria for admission,including the filling of general social data,the evaluation of depressive symptoms,suicidal ideation scale（PANSI）and insomnia severity scale（ISI）.Firstly,the general data were analyzed,and then the correlation between different suicide risks and clinical symptoms was analyzed,and the differences of insomnia among patients with different suicide risks were compared.finally,suicide preparation and attempted suicide were used as dependent variables to explore the risk factors of suicide risk.Results:1.The sex ratio of adolescent depressive disorder is about 1:3,and the suicide risk shows that the prevalence rate of suicidal ideation is 49.6%（131/264）,the prevalence rate of suicide preparation is 25.7%（68/264）,and the incidence of attempted suicide is 25.4%（67/264）.2.The suicide risk of adolescent depressive disorder was correlated with clinical characteristics.Adolescent depressive patients with different suicide risk showed statistical differences in age,sex,insomnia type and depression degree.Adolescent depressive patients with attempted suicide have more difficulty in falling asleep,and teenagers who prepare for suicide have more symptoms of awakening and early awakening.3.Suicidal ideation in adolescent patients with depression in the past two weeks was negatively correlated with age（r =-0.305,P =0.000）,gender（male）（r =-0.246,P=0.000）and physical exercise（r =-0.215,P =0.000）.It was negatively correlated with learning stress（r =0.170,P =0.006）,family environment（r =0.348,P =0.000）and bullying（r =0.232,P =0.000）、moderate to severe sleep（r =0.215,P =0.000）/maintenance（r =0.301,P =0.000）/ early awakening（r =0.267,P =0.000）,insomnia ISI scale total score（r =0.377,P =0.000）,CSE-D total score（r =0.592,P=0.000）,suicidal ideation（r =0.185,P =0.003）,suicide preparation（r =0.262,P=0.000）,attempted suicide（r =0.347,P =0.000）.There was a positive correlation.4.Poor family relationship and the total score of CES-D depression scale are the risk factors of adolescent patients with depression preparing for suicide,and physical exercise（3-5 times per week）is the protective factor of adolescent preparation for suicide.Female is the risk factor of attempted suicide in adolescent depressive disorder,which is 2.5 times higher than that of male.However,the incidence of attempted suicide in adolescent patients with depression was 2.98 times higher than that in patients with moderate and severe difficulty in falling asleep.The total score of CSE-D scale was the risk factor of attempted suicide.Conclusion: There is a correlation between suicide risk and clinical symptoms in adolescent patients with depressive disorder with high risk of suicide.Most of the adolescent patients with depressive disorder have different degrees of insomnia.Correlation analysis showed that the total score of suicidal ideation scale（PANSI）in adolescent patients with depression in the past two weeks was related to age,sex,exercise,learning stress,family relationship,bullying,moderate and severe difficulty in falling asleep / difficulty in maintenance / early awakening,total score of ISI,suicidal thoughts,suicide preparation,attempted suicide and total score of CSE-D.Binary Logistic regression analysis showed that the worse the family relationship,the higher the total score of CSE-D,and the fewer times of physical exercise were the risk factors of preparing for suicide,while the female,moderate and severe difficulty in falling asleep and the higher total score of CSE-D were the risk factors of attempted suicide. |
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