Suicidality in patients with various symptoms of major depressive disorder

Cilj Tijekom života čak 31% svih bolesnika s velikim depresivnim poremećajem (VDP) pokušat će suicid. VDP je heterogeni poremećaj i različite skupine bolesnika imaju različite profile depresivnih simptoma. Moguće je da su neki od tih simptoma više, a neki manje povezani s rizikom za suicid. Neki od simptoma VDP dostupni su sestrinskim intervencijama, a medicinske sestre su u prilici i prve prepoznati konfiguraciju depresivnih simptoma povezanu s višim rizikom za suicid. Stoga je ovim istraživanjem ispitivana povezanost suicidalnosti s pojedinim simptoma VDP. Materijali i metode Provedeno je unicentrično, opservacijsko, presječno (engl. cross-sectional) istraživanje na Klinici za psihijatriju Kliničkog bolničkog centra Sestre milosrdnice u Zagrebu u razdoblju od travnja do lipnja 2021. godine. Svaki ispitanik potpisao je obrazac informiranog pristanka prije bilo kakve istraživačke procedure. Istraživanje je provedeno u skladu s Helsinškom deklaracijom Svjetske zdravstvene organizacije, kako je modificirana 2013. godine. Identitet ispitanika bio je zakriven pomoću brojčanih šifri. Potpisane dokumente informiranog pristanka koji sadrže osobne podatke i ispunjene instrumente za prikupljanje anonimnih podataka čuvali smo odvojeno. Ishod je bio rezultat na Beckovoj ljestvici suicidalne ideacije. Nezavisna varijabla bili su pojedini simptomi VDP mjereni Beckovim inventarom za procjenu depresije-II. Rezultati Medijan dobi ispitanika bio je 53 (interkvartilni raspon 48-59) godina, a 47 (65,3%) ispitanika bilo je ženskog spola. Rezultat na Beckovoj ljestvici sudicalnih ideacija bio je statistički značajno povezan sa svim česticama Beckovog inventara depresije-II te s kognitivnom i somatskom dimenzijom VDP. Međutim, nakon uvođenja obje dimenzije u analizu, povezanost suicidalnih ideacija sa somatskom dimenzijom nije više bila statistički značajna. Za povezanost VDP sa suicidalnim ideacijama primarno je odgovorna kognitivna dimenzija VDP. Zaključak Povišeni rizik za suicid imaju bolesnici s dijagnosticiranim VDP i više izraženim kognitivnim simptomima. Medicinska sestra u svakodnevnom radu treba obratiti posebnu pozornost bolesnicima s takvim profilom simptoma VDP.Objective During their lifetime, up to 31% of all patients with major depressive disorder (MDD) will attempt suicide. MDD is a heterogeneous disorder and different groups of patients have different profiles of depressive symptoms. It is possible that some of these symptoms are more and some less associated with suicide risk. Some of the symptoms of MDD are available to nursing interventions, and nurses are able to be the first to recognize the configuration of depressive symptoms associated with a higher risk of suicide. Therefore, this study examined the association of suicidality with individual symptoms of MDD. Materials and methods A unicentric, observational, cross-sectional study was conducted at the Department for Psychiatry of the University Hospital Center Sestre milosrdnice in Zagreb in the period from April to June 2021. Each participant signed an informed consent form prior to any research procedure. The study was conducted in accordance with the Helsinki Declaration of the World Health Organization, as modified in 2013. The identity of the participants was concealed by numerical codes. Signed documents of informed consent containing personal data and completed instruments for collecting anonymous data were kept separate. The outcome was a result on Beck Suicidal Ideation Scale. The independent variable was the individual symptoms of MDD as measured by the Beck Depression Inventory-II. Results The median age of the participants was 53 (interquartile range 48-59) years, and 47 (65,3%) participants were women. Result of Beck Suicidal Ideation scale was statistically significantly associated with all items of the Beck Depression Inventory-II, and with congitive and somatic dimension of MDD. However, after the inclusion of both dimensions into the analysis, association of suicidal ideation with somatic dimension was no longer statistically significant. For the association of MDD with suicidal ideation the responsibility is primarily on cognitive dimension. Conclusion Patients diagnosed with MDD and more severe cognitive symptoms have an increased risk of suicide. The nurse in daily work should pay special attention to patients with such a profile of MDD symptoms