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The Psychosocial Characteristics and Suicide Risks Among Patients with Treatment-Resistant Depression
摘要
Study Objectives:Suicide is a complex behavior and a significant health priority. Owing to the high-risk feature of suicide among patients with TRD, suicide prevention is of paramount importance for this population. This study aims to investigate the psychosocial characteristics and suicide risks among patients with TRD. Methods and Materials:A cross-sectional study with questionnaire investigation was performed in two general hospitals in northern Taiwan. Participants with TRD were recruited upon psychiatrists' referral from day-care ward, inpatients units or outpatient departments during January 2018 to October 2019. Socio-demographics, health and psychosocial characteristics, self-rated mental and physical health, personality, and mental distress were assessed. Suicide risk assessments of suicidality in different timeframe were documented, including past week, lifetime, or future intent. A high level of suicide risk was defined as when participants experienced both one-week suicidal ideation and a lifetime attempt; either or none of these two factors was defined as relatively low-risk. Results:There were 125 participants enrolled in the study with a mean age of 55.4 years. The majority of participants had suicidal ideation in their lifetime (n=118, 94.4%), 57.6% (n=72) had ever attempted suicide, 36.8% (n=46) revealed their future suicide intent.The mean score of BSRS-5 was 10.8, with 80.8% (n=101) had score ≧ 6. CMHC-9 score was 4.0 with 50.4% participants were categorized in high-risk suicide group (cut off score ≥4). Age and selfrated mental health were negatively and moderately correlated with suicide risk level; self-rated physical health showed small correlation with suicide risk (r=-0.276). However, the BSRS-5 (mental distress or psychopathology) and CMHC-9 (overall suicidality) total score were positively and strong correlated with suicide risk level. Stepwise linear regression model with one-week suicidal ideation revealed the BSRS5 total was significantly correlated with standardized coefficients of 0.486. , in which depression was the most significant predictor for one-week SI (P=0.001) among participants with TRD. Conclusion:This study revealed that younger age, depression, insomnia, and unpleasant family events significantly correlate with suicide risk in TRD. Psychopathology of BSRS-5 was important predictors in one-week suicide ideation, in which depression was the most significant factor. The findings of the study provided a preliminary understanding of the psychosocial characteristics and suicide risks among TRD patients in Taiwan.
延伸閱讀
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