CAJ | 학술논문

目的：探讨误诊为抑郁症的双相障碍Ⅱ型患者自杀风险的社会人口学及临床特征方面的危险因素。方法通过简明国际神经精神访谈（the Mini International Neuropsychiatric Interview，MINI）5.0中文版，对来自全国13个中心的1478例最初诊断为抑郁症的患者进行重新诊断，其中190例被诊断为双相障碍Ⅱ型，将这190例误诊患者按照有无自杀风险进行分组，从性别、年龄等社会人口学资料及起病年龄、是否伴有自杀观念等临床特征方面探讨被误诊患者自杀风险可能的危险因素。结果有自杀风险组共74例患者，无自杀风险组共116例。有自杀风险组与无自杀风险组相比，年龄更小[（34.45±11.18）vs.（37.23±13.22）]，起病年龄更早[（26.20±9.16）vs.（30.37±11.59）]，更常伴有自杀观念（82.4%vs.53.4%），差异均具有统计学意义（P<0.05）。Logis?tic回归分析显示，年龄（OR=0.969，95%CI：0.945~0.993）、伴有自杀观念（OR=4.129，95%CI：2.030~8.397）与误诊为抑郁症的双相障碍Ⅱ型患者发生自杀风险相关联（均P<0.05）。结论年龄小、伴有自杀观念可能是误诊为抑郁症的双相障碍Ⅱ型患者自杀风险的独立危险因素。
목적：탐토오진위억욱증적쌍상장애Ⅱ형환자자살풍험적사회인구학급림상특정방면적위험인소。방법통과간명국제신경정신방담（the Mini International Neuropsychiatric Interview，MINI）5.0중문판，대래자전국13개중심적1478례최초진단위억욱증적환자진행중신진단，기중190례피진단위쌍상장애Ⅱ형，장저190례오진환자안조유무자살풍험진행분조，종성별、년령등사회인구학자료급기병년령、시부반유자살관념등림상특정방면탐토피오진환자자살풍험가능적위험인소。결과유자살풍험조공74례환자，무자살풍험조공116례。유자살풍험조여무자살풍험조상비，년령경소[（34.45±11.18）vs.（37.23±13.22）]，기병년령경조[（26.20±9.16）vs.（30.37±11.59）]，경상반유자살관념（82.4%vs.53.4%），차이균구유통계학의의（P<0.05）。Logis?tic회귀분석현시，년령（OR=0.969，95%CI：0.945~0.993）、반유자살관념（OR=4.129，95%CI：2.030~8.397）여오진위억욱증적쌍상장애Ⅱ형환자발생자살풍험상관련（균P<0.05）。결론년령소、반유자살관념가능시오진위억욱증적쌍상장애Ⅱ형환자자살풍험적독립위험인소。
Objective To analyze the risk factors of socio-demographic and clinical characteristics related to sui?cide risk in misdiagnosed bipolar disorderⅡ(BPⅡ) treated for major depressive disorder. Methods A total of l478 con?secutive major depressive disorder patients were interviewed with the Mini International Neuropsychiatric Interview (MINI) in 13 major mental health centers in China. Of the 1478 patients, 190 patients were diagnosed BPⅡ, who were divided into two groups (nonsuicidal risk and suicidal risk) with the suicidality module of MINI. Logistic regression was performed to evaluate significant risk factors associated with suicide risk in misdiagnosed BPⅡtreated for major depres?sive disorder. Results Of the 190 patients, 116 were in the nonsuicidal risk group and 74 were in the suicidal risk group. In comparison to the nonsuicidal risk group, the suicidal risk group had younger age [(34.45 ± 11.18) vs.(37.23 ± 13.22), P=0.008], earlier age at onset [(26.20 ± 9.16) vs. (30.37 ± 11.59), P=0.007], and more suicidal ideation (82.4%vs. 53.4%, P=0.001). Logistic regression analysis showed that age (OR=0.969,95% CI:0.945~0.993) and depressive epi?sodes with suicidal ideation (OR=4.129,95%CI:2.030~8.397) were significantly associated with suicide risk in patients of misdiagnosed BPⅡtreated for major depressive disorder (P<0.05). Conclusions Younger age, severer suicidal ide?ation may be potential independent risk factors to suicide risk in BPⅡwith misdiagnosed with major depressive disor?der.