Alexithymia, resilience, somatic sensations and their relationships with suicide ideation in drug naïve patients with first-episode major depression: An exploratory study in the "real world" everyday clinical practice

Alexithymia, resilience, somatic sensations and their<br> relationships with suicide ideation in drug naïve patients<br> with first-episode major depression: An exploratory study<br> in the “real world” everyday clinical practice Aim: The present study is aimed at revaluating alexithymia, somatic sensations, resilience<br> and their relationships with suicide ideation in drug naïve adult outpatients suffering<br> from first episode major depression (MD).<br> Methods: Data of 103 adult outpatients (49 men, 56 women) with a diagnostic and<br> statistical manual of mental disorders, 4th edition, text revision (DSM-IV-TR) diagnosis<br> of MD were analysed. Alexithymia was measured using the 20-item Toronto<br> Alexithymia Scale (TAS-20) and resilience with the 25 items Connor-Davidson Resilience<br> Scale (CD-RISC) whereas depression was evaluated using the 17-item Hamilton<br> Depression Rating Scale, somatic sensations with the Body Sensations Questionnaire<br> and suicide ideation with Scale of Suicide Ideation (SSI). Results: Gender comparisons between all demographic and clinical variables showed<br> no significant differences in all variables. Subjects who were found positive for<br> alexithymia showed higher scores on all clinical variables controlling for age, gender<br> and duration of the current episode. In a linear regression model, lower scores on<br> CD-RISC and Difficulty in Identifying Feelings dimension of TAS-20 were significantly<br> predictive of higher scores on SSI.<br> Conclusions: Alexithymia and low resilience were significant predictors of increased<br> suicide ideation in a first MD episode. However, study limitations must be considered<br> and future research needs are being discussed.首诊未用药首发重性抑郁症患者的述情障碍、韧性、躯体感受及其与自杀意念的关系：一项“真实世界”日常临床实践中的探索性研究 目的：本研究旨在重新评估首诊未用药的成人门诊首发重性抑郁症（Major Depression, MD）患者的述情障碍、躯体感受、韧性及其与自杀意念的关联。 方法：本研究分析了103名符合《精神障碍诊断与统计手册（第四版）修订版（Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, DSM-IV-TR）》重性抑郁症诊断标准的成人门诊患者数据，其中男性49例，女性56例。述情障碍采用20项多伦多述情障碍量表（20-item Toronto Alexithymia Scale, TAS-20）进行评估，韧性采用25项康纳-戴维森韧性量表（25-item Connor-Davidson Resilience Scale, CD-RISC）进行评估，抑郁症状采用17项汉密尔顿抑郁量表进行评定，躯体感受采用躯体感受问卷（Body Sensations Questionnaire）进行评估，自杀意念采用自杀意念量表（Scale of Suicide Ideation, SSI）进行评估。 结果：对所有人口学与临床变量的性别比较显示，各项变量均无显著组间差异。在控制年龄、性别与当前发作时长的情况下，述情障碍阳性受试者的各项临床变量得分更高。在线性回归模型中，CD-RISC得分更低以及TAS-20的情感识别困难维度得分更高，可显著预测SSI得分升高。 结论：述情障碍与低韧性是首诊重性抑郁症患者自杀意念升高的显著预测因子。本研究存在一定局限性，文末对未来研究需求进行了讨论。