Post-traumatic stress disorder among adolescents with bipolar disorder and its relationship to suicidality
Post-traumatic stress disorder among adolescents with bipolar disorder and its relationship to suicidality
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DOI：
10.1111/j.1399-5618.2007.00396.x
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发表时间：
2007-09-01
影响因子：
5.4
通讯作者：
Akiskal, Kareen K.
中科院分区：
文献类型：
--
作者：
Dilsaver, Steven C.;Benazzi, Franco;Akiskal, Kareen K.
目的：本横断面初步研究的目的是确定双相情感障碍（BPD）和重度抑郁症（MDD）青少年与非情感性疾病患者的对照组相比，创伤后应激障碍（PTSD）的发生率，并确定PTSD是否与自杀意念和企图有关。这项研究的动力是出生的临床印象来自在常规的临床practice.Methods过程中：患者进行了筛选，由一个单一的面试官为BPD，MDD和PTSD，恐慌症，强迫症（OCD）和社交恐惧症使用适当的模块从结构化临床面试DSM-IV（SCID）和自杀意念和企图的历史。结果：共纳入BPD患者34例，MDD患者79例，非情感性精神障碍患者26例。BPD患者的PTSD风险显著高于MDD患者[比值比（OR）= 4.9，95%置信区间（CI）= 1.9-12.2，p = 0.001]。创伤后应激障碍患者自杀念头的风险无显着增加（OR = 2.8，95%CI = 0.9-8.9，p = 0.069），自杀企图的风险显着增加4.5倍（OR = 4.5，95%CI = 1.7-11.7，p = 0.002）。在排除了合并惊恐障碍、强迫症和社交恐怖的干扰因素后，PTSD与自杀未遂的相关性仍然显著（OR = 3.4，95%CI = 1.1-10.0，p = 0.023）。创伤后应激障碍与自杀企图史显著相关。
Objectives: The aims of this cross-sectional pilot study were to ascertain the rates of post-traumatic stress disorder (PTSD) among adolescents with bipolar disorder (BPD) and major depressive disorder (MDD) relative to a comparison group comprised of non-affectively ill patients, and to determine whether PTSD is related to suicidal ideation and attempts. The impetus for the study was born of clinical impressions derived in the course of routine clinical practice.Methods: Patients were screened by a single interviewer for BPD, MDD and PTSD, panic disorder, obsessive-compulsive disorder (OCD) and social phobia using the apposite modules from the Structured Clinical Interview for DSM-IV (SCID) and histories of suicidal ideation and attempts. The data were subjected to analysis using a logistic regression model.Results: The database included 34 patients with BPD, 79 with MDD and 26 with a non-affective disorder. The risk for PTSD for a patient with BPD significantly exceeded that for a patient with MDD [odds ratio (OR) = 4.9, 95% confidence interval (CI) = 1.9-12.2, p = 0.001]. Patients with PTSD had an insignificantly increased risk for suicidal ideation (OR = 2.8, 95% CI = 0.9-8.9, p = 0.069), and a 4.5-fold significantly increased risk of having had a suicide attempt (OR = 4.5, 95% CI = 1.7-11.7, p = 0.002). The relationship between PTSD and suicide attempts remained significant even after controlling for the confounding effects of concurrent panic disorder, OCD and social phobia (OR = 3.4, 95% CI = 1.1-10.0, p = 0.023).Conclusions: Patients with BPD have a greater risk for PTSD than those with MDD. Post-traumatic stress disorder is significantly related to history of suicide attempts.