25(OH)D、IGF-I及焦虑、抑郁症状与门诊青少年精神障碍患者非自杀性自伤的关系

doi:10.6040/j.issn.1671-7554.0.2024.0760

摘要/Abstract

摘要： 目的探讨25羟维生素D［25(OH)D］、胰岛素样生长因子-I(insulin-like growth factor I, IGF-I)和焦虑、抑郁症状对门诊青少年精神障碍患者非自杀性自伤(non-suicidal self-injury, NSSI)的影响。方法选取234例门诊青少年精神障碍患者作为观察对象,根据是否伴有NSSI行为分为不伴NSSI组86例和伴NSSI组148例,采用汉密尔顿抑郁量表24项(Hamilton Depression Rating Scale-24 items, HAMD-24)、汉密尔顿焦虑量表(Hamilton Anxiety Rating Scale, HAMA)对患者进行评估,同时测定入组患者血清25(OH)D、IGF-I水平,比较两组患者各变量间的差异性。采用二元Logistic回归确定NSSI的影响因素,受试者工作特征(receiver operating characteristic, ROC)曲线分析估计最佳临界值。结果伴NSSI组患者HAMA、HAMD 评分显著高于不伴NSSI组(P<0.001),25(OH)D水平显著低于不伴NSSI组(P=0.001)。回归分析结果显示,抑郁症状程度(OR=1.186,95%CI=1.089~1.292,P<0.001)和25(OH)D水平(OR=0.921,95%CI=0.857~0.990,P=0.026)是门诊青少年精神障碍患者NSSI行为发生的影响因素。ROC分析显示,25(OH)D≤13.06 ng/mL、HAMD≥18.50是诊断青少年精神障碍患者NSSI的最佳临界值。结论 25(OH)D水平和抑郁症状程度是门诊青少年精神障碍患者发生NSSI的影响因素,两者联合检测显示出良好的诊断预测价值。

关键词: 非自杀性自伤, 25羟维生素D, 胰岛素样生长因子-I, 焦虑症状, 抑郁症状

Abstract: Objective To investigate the effects of 25-hydroxyvitamin D ［25(OH)D］, insulin-like growth factor I(IGF-I), and anxiety and depression symptoms on non-suicidal self-injury(NSSI)in outpatient adolescents with psychiatric disorders. Methods A total of 234 outpatient adolescents with psychiatric disorders were selected for observation. They were divided into two groups based on the presence of NSSI: a non-NSSI group(86 cases)and an NSSI group(148 cases). The patients were assessed using the Hamilton Depression Rating Scale(HAMD)and the Hamilton Anxiety Rating Scale(HAMA). Serum levels of 25(OH)D and IGF-I were measured. Differences in variables between the two groups were compared. Binary Logistic regression was used to determine the risk factors for NSSI, and receiver operating characteristic(ROC)curve analysis was conducted to estimate the optimal cut-off values. Results The HAMA and HAMD scores in the NSSI group were significantly higher than those in the non-NSSI group(P<0.001), and the 25(OH)D levels were significantly lower in the NSSI group(P=0.001). Regression analysis revealed that the severity of depression symptoms(OR=1.186, 95%CI=1.089-1.292, P<0.001)and 25(OH)D levels(OR=0.921, 95%CI=0.857-0.990, P=0.026)were the influencing factors for NSSI in outpatient adolescents with psychiatric disorders. ROC analysis indicated that 25(OH)D level ≤13.06 ng/mL and HAMD score ≥18.50 were the best cut-off values for the diagnosis of NSSI. Conclusion The levels of 25(OH)D and the severity of depression symptoms are the influencing factors for NSSI in outpatient adolescents with psychiatric disorders. Combined testing of these factors demonstrates good diagnostic predictive value.

Key words: Non-suicidal self-injury, 25-hydroxyvitamin D, Insulin-like growth factor-I, Anxiety symptoms, Depression symptoms

中图分类号:

R395.1

王新起,徐晶晶,许旺旺,张洋,高进. 25(OH)D、IGF-I及焦虑、抑郁症状与门诊青少年精神障碍患者非自杀性自伤的关系[J]. 山东大学学报 (医学版), 2024, 62(12): 59-64.

WANG Xinqi, XU Jingjing, XU Wangwang, ZHANG Yang, GAO Jin. Association of 25(OH)D, IGF-I, anxiety and depression symptoms with non-suicidal self-injury in outpatient adolescents with psychiatric disorders[J]. Journal of Shandong University (Health Sciences), 2024, 62(12): 59-64.

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