Correlation of the personality traits and sociodemographic factors in patients with mood disorders and suicidal behavior

Cilj ovoga istraživanja je procjena i prepoznavanje specifičnih osobina ličnosti kod suicidalnih bolesnika sa poremećajem raspoloženja (povratni depresivni poremećaj i bipolarno afektivni poremećaj) i kod nesuicidalnih bolesnika sa navedenim poremećajem raspoloženja. Ispitanici i metode: Ovo istraživanje obuhvatilo je ukupno 119 bolesnika sa dijagnozom povratnog depresivnog poremećaja - depresivna epizoda bez psihotičnih simptoma i dijagnozom bipolarno afektivnog poremećaja - depresivna epizoda bez psihotičnih simptoma, prema dijagnostičkim kriterijima MKB-10. Provođeno je od studenog 2012. godine do rujna 2015. godine na Klinici za psihijatriju pri KBC Osijek. Bolesnici su podijeljeni u dvije skupine - eksperimentalnu (suicidalni bolesnici s poremećajem raspoloženja) i kontrolnu (nesuicidalni bolesnici sa poremećajem raspoloženja). Dimenzije ličnosti, težine poremećaja i suicidalnosti su procjenjivane 1. dan (unutar 72h od prijema) i 21. dan liječenja. Procjenski intrumenti primjenjivani u obje skupine su bili: „Temperament and Character Inventory“(TCI) za procjenu dimenzija ličnosti 1. i 21.dan; „Columbia-Suicide Severity Rating Scale“(C-SSRS) u skupini suicidalnih bolesnika 1. i 21. dan; „Reason for Living Inventory“(RFL) u obje skupine 1. dan; „Hamilton Depression Rating Scale“(HAM-D) u obje skupine 1. i 21. dan, te polu-strukturirani sociodemografski upitnik. Rezultati: U skupini bolesnika sa suicidalnim idejama (neovisno o poremećaju raspoloženja), kod prijema, dobili smo značajno više vrijednosti u dimenziji temperamenta i karaktera izbjegavanje štete (HA) (Mann Whitney U Test, P<0,001), a značajno niže vrijednosti za dimenziju upornost (P) (Mann Whitney U Test, P=0,04), samo-vođenja (SD) (Mann Whitney 130 U Test; P<0,001) te kod suradnje (C) (Mann Whitney U Test, P=0,001). Kod otpusta suicidalni bolesnici zadržavaju značajno više vrijednosti u dimenziji HA (Mann Whitney U Test, P<0,001), značajno niže vrijednosti dimenzije SD (Mann Whitney U Test, P<0,001) i dimenzije C (Mann Whitney U Test, P=0,002). Navedeni rezultati potvrđeni su detaljnom analizom suicidalnih bolesnika prema nesuicidalnima u odnosu na karakteristike ličnosti i intenzitet suicidalnog ponašanja. U skupini suicidalnih bolesnika, naspram skupine nesuicidalnih, dobili smo značajno niže vrijednosti na cijelom instrumentu procjene razloga za život (RFL) (Mann Whitney U Test, P<0,001). Na našem uzorku nismo dokazali utjecaj sociodemografskih čimbenika na suicidalno ponašanje.Suicide and mood disorders represent a major global public health problem. Depressive disorder and bipolar disorder are associated with increased risk for suicide. Beside the existing disorder, underlaying personality traits may be the factor which could influence the appearance of specific mood disorder and suicidal behavior. Aim of the research: The aim of this research was to evaluate and recognize the specific personality traits in patients with mood disorders (recurrent depressive disorder and bipolar disorder) who had suicidal ideation and attempt in comparison to non-suicidal patients with respective mood disorders. Participants and Methods: Our sample consisted of 119 unrelated patients (both male and female) who were suffering form recurrent depressive disorder - depressive episode without psychotic symptoms and bipolar disorder - depressive episode without psychotic symptoms, according to ICD-10 diagnostic criteria. The research was conducted from November 2012 to September 2015 on Deparment of Psychiatry, University Hospital Centre Osijek. The patients were divided in two groups, experimental (patients with mood disorder and suicide ideation/attempt) and control group (non-suicidal patients with mood disorder). Personality traits, severity of depression and suicidal ideation were assessed on the first day (within 72h upon addmittion) and on the 21st day of treatment. The battery of instruments used for assessment was: „Temperament and Character Inventory“(TCI) for personality traits on the 1st and 21st day; „Columbia-Suicide Severity Rating Scale“(C-SSRS) in the group od suicidal patients on the 1st and 21st day; „Reason for Living Inventory“(RFL) in both groups on the 1st day; „Hamilton Depression Rating Scale“(HAM-D) in both groups on 1st and 21st day and semi-structured sociodemographic questionnaire. 132 Results: In the group of suicidal patients (regradless the mood disorder), upon admittion, we found significantly higher scores on the harm-avoidance (HA) temperament dimension (Mann Whitney U Test, P<0,001) and significantly lower scores on persistence (P) (Mann Whitney U Test, P=0,04), self-directedness (SD) (Mann Whitney U Test; P<0,001) and on cooperativeness (C) (Mann Whitney U Test; P=0,001). On the 21st day in the group of suicidal patients there were stil significantly higher scores on HA dimension (Mann Whitney U Test, P<0,001) and significantly lower scores on SD dimension (Mann Whitney U Test, P<0,001) and C dimension (Mann Whitney U Test, P=0,002). These results were confirmed with detailed analysis of the suicidal and non-suicidal group in relation to personality traits and intensity of suicidal behavior. When compared to non-suicidal group, the group of patients with suicidal attempt had significantly lower scores on the complete RFL assessment instrument (Mann Whitney U Test, P