| ObjectiveForeign studies have shown that there was a certain connection between hopelessness, impulsiveness, aggressiveness and suicide behavior in patients with depressive disorder. But it has not been systematically studied, especially in the domestic, less research in this area currently. So we explore the relationship between hopelessness, impulsiveness, aggressiveness and suicide behavior in patients with depressive disorder systematically in this study and expect to provide a theoretical basis for clinical prediction and prevention of suicide behavior in patients with depressive disorder.Methods120patients (male/female,47/73) came from Shandong Mental health Center in the period from November2010to November2011were studied. All subjects were tested by a self-made general information questionnaire (included gender, age, years of education, family type and so on) and a disease information questionnaire (included Disease duration, disease severity, family history of mental illness and suicide, suicide history before and after the illness). All subjects were assessed by Beck hopelessness scale (BHS), Chinese version of Barratt impulsiveness scale (BIS-CV), Chinese version of Buss&Perry Aggression Questionnaire (AQ-CV), Beck scale for suicide ideation-Chinese version (BSI-CV), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA). All patients were diagnosed by two or more deputy chief or chief physician used the criteria of CCMD-3and ICD-10. Assessment were completed when patients admitted to hospital1-5days. To resurvey20patients selected randomly in3to5days after the initial assessment. All items of self-rating scales were read to the patients one by one by a trained psychiatrist, to be assessed according to patients’answer. Rating scales were assessed by a trained psychiatrist based on performance of patients when interviewed and medical information. All statistical analyses were performed using SPSS18.0software. Chi-square test, Independent-Samples T Test, One-Way ANOVA analysis and Multivariate logistic regression models were applied in this study.Results1. The incidence of attempted suicide in patients with depression was35.8%, including the incidence of one suicide attempt was22.5%and the incidence of multiple attempted suicide (≥2times) was13.3%. The incidence of attempted suicide of male patients was25.5%, female’s was42.5%in patients with depressive disorder.2. The incidences of attempted suicide in patients with worst and best educated were higher than patients’with middle educated (66.7%,35.9%vs.28.8%). The discrepancies was statistically significant (P<0.05). The incidences of one suicide attempt and multiple attempted suicide (≥2times) in female patients were both higher than male patients’. The discrepancies was statistically significant (P<0.05). The discrepancies on incidences of patients with depressive disorder with different age, occupation, marital status, family type, degree of family harmony and family economic situation were not statistically significant (P>0.05).3. The incidence of attempted suicide in patients with positive family history of mental illness was higher than patients with negative history in depressive disorder (51.4%vs.29.4%; P<0.05). The incidence of attempted suicide in patients with multiple times of hospitalization was higher than the first-time hospitalized patients (48.0%,47.5%vs.21.8%; P<0.05). The discrepancies on incidences of patients with depressive disorder with different family history of suicide, types of depressive disorder, total duration of a disease and current duration of a disease were not statistically significant (P>0.05).4. Times of attempted suicide in patients with depressive disorder were positively correlated to factors and total scores of BHS, BIS-CV and BSI-CV (r=0.5-0.6, P< 0.01; r=0.4-0.7, P<0.01; r=0.5-0.7, P<0.01) and to factors (Anger, Hostility and point to the self) and total scores of AQ-CV (r=0.2-0.5, P<0.05).5. The discrepancies in factors (Anxiety/Somatization, Cognitive impairment and hopelessness) and total scores of HAMD and factors and total scores of HAMA in different attempted suicide groups of patients with depressive disorder were statistically significant (P<0.05).6. Multivariate logistic regression analysis showed that the more the scores of factor (motor impulsiveness) and total score of BIS-CV and total score of BHS patients with depressive disorder are, the higher the risk of suicidal behavior they have. However the more the scores of factor (verbal aggression) and total score of AQ-CV are, the lower the risk of suicidal behavior they have.Conclusions1. The patients with depressive disorder have a high incidence of attempted suicide. The incidence of attempted suicide of female patients is higher than male patients.2. The incidence of attempted suicide is related to the years of education of patients with depressive disorder, but is not related to age, occupation, marital status, family type, degree of family harmony and family economic situation.3. Patients with depressive disorder with a positive family history and more times of hospitalization have high incidence of attempted suicide. There are no significant relationship between attempted suicide and different family history of suicide, types of depressive disorder, total duration of a disease or current duration of a disease.4. Patients with depressive disorder with more strongly of suicide ideation, hopelessness or impulsiveness have a high risk of attempted suicide.5. Impulsive behavior and hopelessness are strong risk factors for suicide behavior in patients with depressive disorder. However, strong verbal aggression is a protective factor for suicide behavior in patients with depressive disorder.6. Hopelessness, impulsiveness and aggression are more effective than degree of depression or anxiety as predictive indicators of suicide risk in patients with depressive disorder. |
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