The Relationship Between The Life Events And Suicide Risk In Patients With Major Depressive Disorder

ObjectiveTo explore the relationship between life events,distress tolerance,resilience and suicide risk in patients with major depressive disorder(MDD),and to investigate whether distress tolerance and resilience mediate the relationship between life events and suicide risk,with the aim of understanding the pathways by which distress tolerance and resilience influence suicide risk.MethodsA total of 136 patients with MDD who attended the Guangdong Mental Health Center from December 2021 to October 2022 were included in the study.Suicide risk was assessed using the suicide module of the MINI-International Neuropsychiatric Interview(MINI)5.0 Chinese version,and patients with a score ≥6 were included in the suicide risk group(102 cases)and those with a score<6 were included in the non-suicide risk group(34 cases)based on the interview results.The 17-item Hamilton Depression Scale(HAMD-17)was used to assess the severity of patients’depressive conditions,and the Life Events Scale(LES)was used to assess patients’mental stress from life events,the Distress Tolerance Scale(DTS)was used to assess patients’ levels of distress tolerance and the 10-item Connor-Davidson Resilience Scale(CD-RISC-10)was used to assess patients’ levels of resilience.Pearson correlation analysis and multiple linear regression analysis were performed using SPSS 26.0,and Model 4 and Model 6 in the SPSS macro program PROCESS were selected to test for mediating effect.Results(1)Pearson correlation analysis showed a significant positive correlation between total score of LES and total score of MINI suicide module(r=0.198,P<0.05),while both total score of DTS and total score of CD-RISC-10 were negatively correlated with total score of MINI suicide module(r=-0.335,-0.373,P<0.01).(2)Regression analysis showed that life events negatively predicted suicide risk(β=0.034,P<0.05);distress tolerance negatively predicted suicide risk(β=-0.355,P<0.01);and resilience negatively predicted suicide risk(β=-0.533,P<0.001)(3)The mediation effect analysis showed that the total effect of life events on suicide risk was significant(β=0.034,P<0.05),the direct effect was not significant(β=0.017,P>0.05),and the mediation effect of distress tolerance between life events and suicide risk was significant(β=0.017,P<0.05),in the model of mediation effect of distress tolerance between life events and suicide risk,and the amount of mediating effect of distress tolerance accounted for 50.00%.The total effect of life events on suicide risk was significant(β=0.034,P<0.05),the direct effect was not significant(β=0.023,P>0.05),the mediation effect of resilience between life events and suicide risk was significant(β=0.011,P<0.05),in the model of mediation effect of resilience between life events and suicide risk,and the amount of mediating effect of resilience accounted for 32.35%.The chain mediation model of distress tolerance and resilience on the relationship between life events and suicide risk showed that the total effect in the chain mediated model was significant(β=0.034,P<0.05),the direct effect of life events on suicide risk was not significant(β=0.016,P>0.05),the indirect effect was significant(β=0.018,P<0.05),and life events mainly influenced patients with MDD through the chain mediated pathway(life events→distress tolerance→resilience→suicide risk)to suicide risk(β=0.008,P<0.05),with the total mediating effect accounting for 52.94%of the total effect and the chain mediating effect accounting for 23.53%of the total effect.Conclusion(1)The more life events patients with MDD experienced,the increased risk of suicide;the higher the levels of distress tolerance and the higher the levels of resilience of patients with MDD,the lower the risk to suicide.And both distress tolerance and resilience negatively predicted suicide risk..(2)Distress tolerance in patients with MDD played a completely mediating role in the relationship between life events and suicide risk.(3)Resilience in patients with MDD played a completely mediated role in the relationship between life events and suicide risk(4)Distress tolerance,resilience in MDD patients played a chain mediating role in the relationship between life events and suicide risk.