Prevalence and Correlates of Suicide Attempts in Chinese Outpatients With First-Episode and Drug-Naïve Psychotic Major Depressive Disorder at Different Ages of Onset

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry Pub Date : 2025-04-08 DOI:10.1111/eip.70036

ZhaoXuan Shang, ChunQing Fang, Xiao E Lang, XiangYang Zhang

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Abstract

Background

Prior research has shown varying suicide attempt rates based on the age of onset in major depressive disorder (MDD) patients. However, there is a paucity of research on psychotic major depressive disorder (PMD) patients. This study aimed to assess the prevalence and correlates of suicide attempts in PMD patients stratified by age of onset.

Methods

Totally, 1718 first-episode drug-naïve MDD outpatients were recruited, divided into early-age onset (EAO) and middle-age onset (MAO) based on the first episode before age 45/after age 45. Clinical severity was assessed using the Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Rating Scale (HAMA) and the Positive and Negative Syndrome Scale (PANSS) positive subscale. In addition, thyroid hormone and glucolipid metabolism indicators were measured.

Results

In EAO PMD patients, HAMA scale score and thyroid-stimulating hormone (TSH) levels were associated with suicide attempts. The area under the receiver operating characteristic curve (AUROC) was 0.892. In MAO PMD patients, TSH and diastolic blood pressure were associated with suicide attempts. The AUROC was 0.862.

Conclusion

This study demonstrates that the prevalence and correlates of suicide attempts vary among PMD patients with different ages of onset. Age of onset should be considered in the prevention and treatment of suicide attempts in patients with PMD.

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中国不同发病年龄精神病性重性抑郁首发和Drug-Naïve门诊患者自杀倾向及其相关因素

背景先前的研究表明，重度抑郁症（MDD）患者的自杀企图率因发病年龄的不同而不同。然而，对精神病性重性抑郁症（PMD）患者的研究却很少。本研究旨在评估按发病年龄分层的PMD患者自杀企图的患病率及其相关因素。方法共招募1718例首发drug-naïve MDD门诊患者，按45岁前/ 45岁后首发分为早发（EAO）和中发（MAO）两组。临床严重程度采用汉密尔顿抑郁评定量表（HAMD）、汉密尔顿焦虑评定量表（HAMA）和正、负综合征量表（PANSS）阳性分量表进行评定。测定甲状腺激素和糖脂代谢指标。结果在EAO PMD患者中，HAMA量表评分和促甲状腺激素（TSH）水平与自杀企图相关。受试者工作特征曲线下面积（AUROC）为0.892。在MAO PMD患者中，TSH和舒张压与自杀企图有关。AUROC为0.862。结论不同发病年龄的PMD患者自杀倾向及相关因素存在差异。在预防和治疗PMD患者自杀企图时应考虑发病年龄。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Early Intervention in Psychiatry 医学-精神病学

CiteScore

4.80

自引率

5.00%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.