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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
Poor sleep quality, anxiety and depression are associated with an increased suicide risk in patients with coronavirus disease 2019
- 第三军医大学学报 2020年42卷第14期 页码：1462-1468
- 作者机构：
1.400016 重庆, 重庆医科大学附属第一医院：精神科
2.430022 武汉, 武汉市第一医院神经内科
3.400016 重庆, 重庆医科大学附属第一医院
4.400016 重庆, 重庆医科大学附属第一医院：神经内科
5.402360 重庆, 重庆市大足区人民医院睡眠心身中心
6.643020 四川 自贡, 自贡市精神卫生中心精神科二病区
7.712000 陕西 咸阳, 陕西省核工业二一五医院精神心理科
8.400010 重庆, 重庆医科大学附属第二医院教务处
9.400036 重庆, 重庆市精神卫生中心歌乐山院区老年一科
10.401147 重庆, 重庆市精神卫生中心金紫山院区早期干预二科
- 作者简介：
[李静，E-mail:lijingjingjing222@163.comLI Jing, E-mail: lijingjingjing222@163.com
- 基金信息：
DOI：10.16016/j.1000-5404.202003229
中图分类号： R181.32;R395.2;R563.1收稿：2020-03-23，
修回：2020-04-20，
纸质出版：2020-07-30
- 稿件说明：
移动端阅览
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):1462-1468.
Rujie WANG, Jing LI, Junhua MEI, et al. Poor sleep quality, anxiety and depression are associated with an increased suicide risk in patients with coronavirus disease 2019[J]. Journal of Third Military Medical University, 2020, 42(14): 1462-1468.
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):1462-1468. DOI： 10.16016/j.1000-5404.202003229.
Rujie WANG, Jing LI, Junhua MEI, et al. Poor sleep quality, anxiety and depression are associated with an increased suicide risk in patients with coronavirus disease 2019[J]. Journal of Third Military Medical University, 2020, 42(14): 1462-1468. DOI： 10.16016/j.1000-5404.202003229.
摘要
目的
2
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
2
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
χ
2
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
χ
2
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
2
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
2
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
Objective
2
To 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.
Methods
2
This 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) recruit
ed 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.
Results
2
① In 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 cas
e 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.
Conclusion
2
Patients 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.
关键词
Keywords
references
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