【摘要】 目的 研究双相Ⅰ型与双相Ⅱ型抑郁障碍患者自伤自杀的特点。方法 97例住院双相抑郁障碍患者，其中双相Ⅰ型43例(44.33%),双相Ⅱ型54例(55.67%);对患者自伤的频度、自伤的方式、自杀意念、自杀次数、自杀方式进行问卷评定；采用汉密尔顿抑郁量表-17、汉密尔顿焦虑量表、32项轻躁狂症状清单评定患者的临床症状，用DSM-Ⅳ-TR轴Ⅱ障碍临床定式检查边缘性人格障碍的诊断条目进行评定。结果 双相Ⅱ型抑郁障碍患者自伤自杀意念和行为发生率为77.78%,高于双相Ⅰ型患者的39.54%(χ~2=14.693,P<0.01)。双相Ⅱ型抑郁障碍患者自伤行为发生率为64.82%,高于双相Ⅰ型患者的23.26%(χ~2=18.093,P<0.01)。双相Ⅱ型抑郁障碍患者自杀次数为1(0, 1.25)次，高于双相Ⅰ型患者的0(0, 1)次(Z=2.289,P=0.022)。双相Ⅱ型抑郁障碍患者用刀和利器割刺自己、抠或抓自己、用力拔扯自己的头发、用力咬自己等发生率高于双相Ⅰ型患者(P<0.05);在自杀方式上双相Ⅱ型抑郁障碍患者过量服用治疗药物、跳落更突出(P<0.05)。双相Ⅱ型抑郁障碍患者伴边缘性人格占62.96%,高于双相Ⅰ型患者的18.60%(χ~2=19.185,P<0.01)。结论 双相Ⅱ型抑郁障碍患者自伤自杀的发生率较双相Ⅰ型患者更高，自伤自杀方式与双相Ⅰ型患者明显不同，伴边缘性人格及自伤自杀问题突出。更多还原

【Abstract】 Objective To study the characteristics and related factors of self-injury and suicide in bipolarⅠand bipolarⅡdepression.Methods 97 hospitalized patients with bipolar depression met the diagnostic criteria of DSM-5 bipolar disorder as major depressive episode were selected,including 43 cases of bipolarⅠtype(44.33%) and54 cases ofbipolarⅡtype (55.67%).The frequency of self-injury,ways of self-injury,suicida l ideation,times of suicide and ways of suicide were evaluated by questionnaire.The clinical symptoms of thepatients were assessed using the Hamilton Depression Scale-17,Hamilton Anxiety Scale and 32-item Hypoman ia Checklist.The diagnosis items of borderline personality disorder in the DSM-Ⅳ-TR AxisⅡDisorder ClinicalStandard Examination were assessed.Results 77.78%of bipolarⅡpatients had significantly higher rate of self-injury and suicide than 39.54%of bipolar I patients (χ~2=14.693,P<0.01).The proportion of bipolarⅡtype with self-injury was 64.82%,which was significantly higher than that of bipolar I type (23.26%)(χ~2=18.093,P<0.01).The suicide frequency of bipolarⅡdepression patients was 1(0,1.25) times,which was signif icantlyhigher than that of bipolar I depression patients 0(0,1) times (Z=2.289,P=0.022).The waysof self-injury in bipolarⅡdepression patients were significantly higher than those in bipolar I depression patie ntsin⑴cutting themselves with knives and sharp tools,⑵picking or scratching themselves,pulling their hairfor cibly,⑶biting themselves forcibly (P<0.05).Patients with bipolarⅡdepression were more likely to commitsuicide by taking medication and jumping off (P<0.05).Borderline personality was higher in bipolarⅡ(62.96%) than bipolarⅠ(18.60%)(χ~2=19.185,P<0.01).Conclusion The incidence of self-injury andsuicide in bipolarⅡdepression patients is higher than that in bipolar I depression patients.The way of selfinjury and suicide is obviously different between them.The problem of self-injury and suicide in patients with borderlinepersonality is prominent.更多还原