Gender Difference In Factors Related To Suicidal Ideation In Patients With Depression

Objective: In China, suicide is the fifth leading cause of death in thepopulation, and especially in the population aged15to34-year-old, suicide isthe first cause of death. China is the only country reporting that femalesuicidal rate is higher than the male,s. There are many suicidal factors, inwhich mental disorders is one of the main reasons leading to suicide, and inparticular, there is the the highest suicidal rate in patients with depression. Therelationship of depression and suicide is consistent with research results inboth domestic and foreign, and approximately90%of depressed patientscommit suicide. Suicidal ideation means wanting to take one's own life orthinking about suicide without actually making plans to commit suicide.Asking whether or not having the intent to commit suicide is an important stepto prevent suicide. There are gender differences in both suicide and depression,and therefore, to investigate gender differences of the factors related tosuicidal ideation in patients with depression will provide more evidence insuicidal intervention and prevention.Methods: We randomly selected122depressive patients consistent withDSM-IV Axis diagnosis from Hebei Medical University-Institute of MentalHealth, and the depressive patients were divided into two groups based ongender, and given clinical assessment. Inclusion criteria:(1)Consistent withDSM-IV Axis diagnosis, and HAMD scores≥17;(2)BDI scores related tosuicidal ideation≥1;(3)Aged18-60, and above middle school;(4)Enoughability to cooperate investigation;(5)Voluntary participation and follow theinformed consent principle. Exclusion criteria:(1)Not consistent with theinclusion criteria;(2)Any psychotic disorders;(3)Had serious organic illnesses;(4)Using psychoactive substance. The people in each group should be givenneuropsychological Investigation, including Negative life events Investigation, Beck Depression Inventory (BDI), Hamilton depression scale (HAMD),Hamilton Anxiety Scale (HAMA), Eysenck Personality Questionnaire(EPQ),Social Science Research Solutions(SSRS), Simplified Coping StyleQuestionnaire, Family Environment Scale-Chinese version. According toSPSS13.0Software, the enumeration data were analyzed by Chi-square testand the ranked data were analyzed by nonparametric test. Finally, the relatedfactors were analyzed by regression.Results:1In terms of age, age of onset, the frequency and severity of attacks,course of disease, family history of mental disorders and suicide, there is nosignificant difference in the two groups(P>0.05); In terms of marital status,degree of education, occupation, income, previous history of suicide, suicideideation and form, there are significant differences in the two groups(P<0.05).2The result differences of HAMD and HAMA between female groupand male group are not statistically significant (P>0.05).3The results of LES are statistically significant. Female patientsexperienced more frequently negative life events. There are significant genderdifferences between male and female patients in types of events, in whichmore career problems are common in male patients, while marital problems infemale patients.4The result differences of P, E and N in male patients are statisticallysignificant (P<0.05). The scores of P, N are higher than normal, but the scoreof E is lower than that in normal; The result differences of P, E and N in malepatients are statistically significant (P<0.05). The scores of P, N are higherthan normal, but the score of E is lower than that in normal; Compared withfemale patients, the score of E is higher than that in female, but the scores of E,N is lower than that in female.5Compared with the norm, sum of social support score, subjectivesupport score, objective support score and the availability of support score aresignificantly lower than normal(P<0.05). But there is no significant differencein the two groups(P>0.05). 6Compared with the norm, the score of positive coping style andnegative coping style are significantly lower than normal(P<0.05). But there isno significant difference in the two groups(P>0.05).7The results of cohesion, expressiveness, conflict, independence,achievement orientation, intellectual-cultural orientation, active-recreationalorientation and organization in FES-CV in the two groups are significantlylower than normal(P<0.05). Compared with female patients, the score of malein independence is higher than that of female, but the score of male in conflictis lower than that of female(P<0.05).8Age, age of onset, social support, positive copying style andindependence of the family are negative correlation with suicidal ideation inmale patients with depression; Depression, anxiety and conflict of the familyare positive correlation with suicidal ideation in male patients with depression.Age, age of onset, social support, positive copying style, cohesion of thefamily are negative correlation with suicidal ideation in female patients withdepression; Previous history of suicide, anxiety, negative life events,psychoticism and neuroticism are positive correlation with suicidal ideation infemale patients with depression.9Regression analysis: Age of onset, anxiety, social support, positivecopying style, independence of the family have significantly effect in maledepression patient's suicidal ideation. Age of onset, previous history of suicide,anxiety, negative life events, psychoticism, neuroticism, social support,positive copying style and cohesion of the family are the factors in femalegroup.Conclusions:1Female patients experienced more frequently negative life events.Negative life events such as occupation problems versus suicidal ideation inmale patients with depression; It is the marital problems in female patients.2Both of male and female depression patients have significant charactersrelated to their suicidal ideation, such as their psychoticism, neuroticism and introversion. In male group, this kind of character is introversion; In femalegroup, those characters are psychoticism and neuroticism.3Depression, anxiety and bad family environment are dangerous factors,but positive copying style and good social support are protective factors bothin male and female group.4Early onset, negative life events and low cohesion of the family aredangerous factors in female patients; Depression, low self-confidence andindependence of the family are dangerous factors in male patients.