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目的 比较有和无自杀行为的双相情感障碍患者的临床特征,分析双相情感障碍患者自杀风险的危险因素.方法 2010年1月至2015年12月,将新入院的双相情感障碍患者共5452例连续入组,按照有无自杀行为将双相情感障碍患者分为自杀行为组(n=1739)和无自杀行为组(n=3713),比较其人口学和临床特征,通过Logistic回归分析探讨双相情感障碍患者自杀行为相关的危险因素.结果 与无自杀行为组相比,自杀行为组起病年龄更大[(34.8±13.6)岁比(33.3±12.8)岁,t=-3.46,P<0.01]、女性更多(58.3％比52.7％,χ2=14.83,P<0.01)、更多重大精神创伤史(10.6％比7.8％,χ2=10.72,P<0.01)、家族自杀史(6.7％比3.9％,χ2=20.22,P<0.01)、家族精神异常史(33.8％比29.6％,χ2=9.33,P<0.01)、既往自杀史(4.1％比0.1％,χ2=140.11,P<0.01),差异均具有统计学意义.Logistic回归分析显示,女性(OR:1.192,95％CI:1.043～1.363)、年龄大(OR:1.008,95％CI:1.003～1.013)、有重大精神创伤(OR:1.355,95％CI:1.083～1.696)、有自杀家族史(OR:1.648,95％CI:1.223～2.221)、既往自杀史(OR:39.139,95％CI:12.230～125.256)与双相情感障碍发生自杀行为均正相关.结论 女性、年龄大、有重大精神创伤、有自杀家族史、既往自杀史可能是双相情感障碍患者自杀行为的独立危险因素.

Objective To compare various risk factors of bipolar disorders with and without suicidal behavior. Methods A total of 5452 inpatients were divided into 2 groups; with (n=1739)and without (n=3713) suicidal behavior within 1 week. Socio-demographic and clinical data were compared between two groups. Multiple logistic regression models were used to assess risk factors of bipolar disorders with suicidal behavior. Results Compared to without suicidal behavior group, the suicidal behavior group had significantly higher rate of the following characteristics:older age [34.8±13.6 vs. 33.3±12.8, t=-3.46, P<0.01], female (58.3％vs. 52.7％,χ2=14.83, P<0.01), history of mental trauma (10.6％vs.7.8％,χ2=10.72, P<0.01), history of suicide (4.1％vs. 0.1％,χ2=140.11, P<0.01), family history of suicide (6.7％vs. 3.9％,χ2=20.22, P<0.01), family history of mental illness (33.8％vs. 29.6％,χ2=9.33, P<0.01) and history of suicide (4.1％ vs. 0.1％, χ2=140.11, P<0.01). Logistic regression analysis showed that female (OR: 1.192, 95％CI:1.043-1.363), older age (OR: 1.008, 95％CI: 1.003-1.013), history of mental trauma (OR: 1.355, 95％CI:1.083-1.696), history of suicide (OR:39.139, 95％CI:12.230-125.256) and family history of suicide (OR:1.648, 95％CI: 1.223-2.221) were significantly correlated with suicidal behavior in bipolar disorders. Conclusions The study indicates that female, older age, history of mental trauma, history of suicide and family history of suicide may be the key independent risk factors to suicidal behavior in bipolar disorders.