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Year : 2018  |  Volume : 131  |  Issue : 8  |  Page : 912-919

Association between Perceived Stressfulness of Stressful Life Events and the Suicidal Risk in Chinese Patients with Major Depressive Disorder

1 Clinical Psychopharmacology Division, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China
2 National Engineering Research Center for Software Engineering, Peking University, Beijing 100871, China

Correspondence Address:
Dr. Tian-Mei Si
Clinical Psychopharmacology Division, Institute of Mental Health, Peking University Sixth Hospital, No. 51 Huayuanbei Road, Beijing 100191
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0366-6999.229898

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Background: Patients with major depressive disorder (MDD) usually have high risk of suicidality. Few studies have investigated the effects of stressful life events (SLEs) on the risk of suicide in Chinese patients who have developed MDD. This study aimed to investigate the impact of SLEs on suicidal risk in Chinese patients with MDD. Methods: In total, 1029 patients with MDD were included from nine psychiatric hospitals to evaluate the impact of SLEs on suicidal risk. Patients fulfilling the Mini-International Neuropsychiatric Interview (MINI) criteria for MDD were included in the study. Patients were excluded if they had lifetime or current diagnoses of psychotic disorder, bipolar disorder, and alcohol or substance dependence. Depressive symptoms were assessed by the 17-item Hamilton Depression Scale (HAMD-17). The suicidal risk of MDD patients was determined by the suicide risk module of MINI. SLEs were assessed by the Life Events Scale. Results: No gender difference was found for suicidal risk in MDD patients. Patients with suicidal risk had younger ages, lower education levels, more drinking behavior, and lower marriage rate, and fewer people had child and more severe depressive symptoms than nonsuicidal risk group. High-level perceived stressfulness (HPS) and number of SLEs that patients were exposed to were significantly greater in patients with suicidal risk than patients without. In multivariate logistic analysis, HPS of SLEs (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16–2.05, P = 0.003) and depressive symptoms (OR = 1.08, 95% CI: 1.05–1.11, P < 0.001) were associated with suicidal risk even after adjustment of gender, age, marriage, drinking behavior, and childless. Conclusions: HPS of SLEs is associated with suicide risk in Chinese patients with MDD. Further suicide prevention programs targeting this risk factor are needed. Trial Registration: ClinicalTrials.gov: NCT02023567; https://clinicaltrials.gov/ct2/show/NCT02023567?term=NCT02023567&rank=1.


 Abstract in Chinese



结果:在抑郁症患者中,并未发现自杀风险存在男女性别差异。与低自杀风险的抑郁症患者相比,有自杀风险的抑郁症患者,其抑郁症状更加严重、起病年龄较小、教育程度更低、有更高比例的饮酒行为、结婚和有子女比例少。在应激性生活事件方面,与无自杀风险组相比,有自杀风险的患者遭遇应激性生活事件的次数更多,感知到的压力更重。在逻辑回归模型中,通过校正性别、年龄、婚姻状况、饮酒行为和有无子女,发现抑郁症患者的自杀风险与对应激性生活事件感知到的高水平压力(OR = 1.54, 95%CI:1.16-2.05, P = 0.003)以及抑郁症状 严重度显著相关(OR = 1.08, 95%CI:1.05-1.11, P < 0.001)。

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