[1]王汝杰,李静,梅俊华,等.新型冠状病毒肺炎患者自杀风险、睡眠、心理状况及影响因素[J].第三军医大学学报,2020,42(14):1462-1448.
 WANG Rujie,LI Jing,MEI Junhua,et al.Poor sleep quality, anxiety and depression are associated with an increased suicide risk in patients with coronavirus disease 2019[J].J Third Mil Med Univ,2020,42(14):1462-1448.
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新型冠状病毒肺炎患者自杀风险、睡眠、心理状况及影响因素(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第14期
页码:
1462-1448
栏目:
特别报道
出版日期:
2020-07-30

文章信息/Info

Title:
Poor sleep quality, anxiety and depression are associated with an increased suicide risk in patients with coronavirus disease 2019
作者:
王汝杰李静梅俊华肖明朝况利1宋波王亮 龚雪 王婧 尚雅楠曹婉龙香花杨显娟魏玲 张帆吴祖勤彭诗月秦赟
重庆,重庆医科大学附属第一医院:精神科1 ,神经内科4 ,武汉市第一医院神经内科2 ;重庆医科大学附属第一医院3 ;,重庆市大足区人民医院睡眠心身中心5;自贡市精神卫生中心精神科二病区6; 咸阳,陕西省核工业二一五医院精神心理科7;,重庆医科大学附属第二医院教务处8;,重庆市精神卫生中心歌乐山院区老年一科9;,重庆市精神卫生中心金紫山院区早期干预二科10
Author(s):
WANG  Rujie1 LI Jing1 MEI Junhua2 XIAO Mingzhao3 KUANG Li1 SONG Bo3 WANG Liang4 GONG Xue2 WANG Jing2 SHANG Yanan1 CAO Wan5 LONG Xianghua5 YANG Xianjuan5 WEI Ling6 ZHANG Fan7 WU Zuqin8 PENG Shiyue9 QIN Yun

Department of Psychiatry, 4Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016; 2Department of Neurology, First Hospital of Wuhan City, Wuhan, Hubei Province, 430022; 3the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016; 5Sleeping and Psychosomatic Center, Dazu District People’s Hospital, Chongqing, 402360; 6Second Ward of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan Province, 643020; 7Department of Psychology, Shaanxi Nuclear Geology 215 Hospital, Xianyang, Shaanxi Province, 712000; 8Academic Affairs Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010; 9First Psychogeriatric Ward, Gele  Mountain Hospital of Chongqing Mental Health Center, Chongqing, 400036; 10Second Ward of Early Intervention, Jinzi Mountain Hospital of Chongqing Mental Health Center, Chongqing, 401147, China

关键词:
新型冠状病毒肺炎自杀风险睡眠焦虑抑郁影响因素
Keywords:
coronavirus disease 2019 suicide risk sleep anxiety depression risk factors  
分类号:
R181.32; R395.2; R563.1
文献标志码:
A
摘要:

目的探讨新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者自杀风险、睡眠、心理状况及影响因素。方法收集 2020年1月2日至2020年3月10日COVID-19住院患者和非COVID-19人群。感染组:376人(男性95人,女性281人),为COVID-19住院患者。对照组:501人(男性110人,女性391人),来自于基于微信、公众平台、朋友圈等的非COVID-19人群。采用线上和线下、自评结合精神科医师评估的方式进行调查。采用风险评估量表(the Nurses’ Global Assessment of Suicide Risk Scale,NGASR)、匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index, PSQI)、焦虑自评量表(Self-Rating Anxiety Scale, SAS)、抑郁自评量表(Self-rating Depression Scale,SDS)进行评估。对感染组和对照组年龄、自杀风险总分、PSQI总分及各因子分、SAS总分、SDS总分进行独立样本t检验;对两组性别、躯体疾病史、目前所在城市进行χ2检验,两组自杀风险、睡眠问题、焦虑、抑郁发生率比较和重度及以上自杀风险、睡眠问题、焦虑、抑郁发生率比较进行χ2检验;对感染组自杀风险总分、年龄、SAS总分、SDS总分、PSQI总分及各因子分进行Pearson相关分析;以感染组自杀风险总分为应变量,感染组性别、年龄、躯体疾病史、SDS总分、SAS总分、PSQI总分为自变量进行多元线性回归(stepwise 法)分析。应用 SPSS 22.0 软件完成数据统计。结果①感染组中度及以上自杀风险、睡眠质量差、焦虑、抑郁发生率分别为27.39%、63.03%、31.91%、54.26%,对照组中度及以上自杀风险、睡眠质量差、焦虑、抑郁发生率分别为7.98%、33.53% 、9.18% 、21.36%,差异有统计学意义(P<0.01)。感染组高自杀和极高自杀风险、睡眠质量很差、重度和极重度焦虑、重度和极重度抑郁发生率分别为9.57%、12.23%、4.79%、7.98%,对照组高自杀和极高自杀风险、睡眠质量很差、重度和极重度焦虑、重度和极重度抑郁发生率分别为3.79%、1.80%、0.80%、1.80%,差异有统计学意义(P<0.01)。②感染组自杀风险总分、PSQI总分及各因子分、SAS总分、SDS总分均比对照组高 (P<0.01)。③感染组自杀风险总分、SAS总分、SDS总分、PSQI总分及各因子均正相关。自杀风险总分还与年龄正相关。④睡眠问题焦虑、抑郁、年龄进入以自杀风险为应变量的回归方程。结论COVID-19患者自杀风险高,有严重的睡眠、心理问题。年龄、焦虑、抑郁、睡眠问题是自杀的主要危险因素,睡眠问题是最重要的危险因素。

Abstract:

ObjectiveTo evaluate suicide risk, sleep quality and psychological status of patients with coronavirus disease 2019 (COVID-19) and analyze the factors contributing to a high suicide risk in these patients. MethodsThis study was conducted in a cohort of 376 COVID-19 patients (including 95 male and 281 female patients) hospitalized between January 2 and March 10, 2020, with 501 subjects without COVID-19 (including 110 men and 391 women) recruited from different social media platforms as the control group. All the subjects were evaluated by online or face-to-face interview with either self-administered rating or assessment of psychiatrists using the Nurses’ Global Assessment of Suicide Risk scale (NGASR), Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). The patients’ age, the total score of suicide risk, total scores of PSQI, SAS, and SDS, and the factor scores of PSQI were compared between the case group and the control group. Chi-square test was used to compare gender distribution, history of physical illness, residence, suicide risks, sleep problems, anxiety, and depression between the 2 groups. Correlation analysis was performed for the patients’ age, total score of suicide risk, total scores of SAS, SDS, PSQI and factor score of PSQI in the case group. Stepwise multiple linear regression analysis was used to identify the risk factors associated with suicide risk in the patients with the total score of suicide risk as the dependent variable and gender, age, physical disease history, total scores of SDS, SAS and PSQI, and the factor score of PSQI as the independent variables. Results①In the patients with COVID-19, the incidences of a moderate or higher suicide risk, poor sleep quality, anxiety and depression were 27.39%, 63.03%, 31.91%, and 54.26%, respectively, significantly higher than those in the control group (7.98%, 33.53%, 9.18% and 21.36%, respectively; P<0.01). The rates of high and very high suicide risk, severe sleep problems, severe or extremely severe anxiety, and severe or extremely severe depression were also significantly higher in the case group (9.57%, 12.23%, 4.79% and 7.98%, respectively) than in the control group (3.79%, 1.80%, 0.80% and 1.80%, respectively; P<0.01). ②The total scores of suicide risk, PSQI, SAS, and SDS and the factor scores of PSQI were all higher in the case group than in the control group (P<0.01). ③The total scores of suicide risk, SAS, SDS, PSQI and the factor scores of PSQI were all positively correlated in COVID-19 patients, and the total score of suicide risk was also positively correlated with age. ④Sleep problems, anxiety, depression and age entered the regression equation with suicide risk as dependent variables. ConclusionPatients with COVID-19 have severe sleep and psychological problems, which contribute to a high suicide risk of the patients. Age, anxiety, depression and poor sleep quality were all risk factors for a high suicide risk in COVID-19 patients, and among them poor sleep quality was the most significant risk factor.

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更新日期/Last Update: 2020-07-23