RESUMO
This study aimed to investigate the factors associated with suicidal ideation in schizophrenia patients in China using decision tree and logistic regression models. From October 2020 to March 2022, patients with schizophrenia were chosen from Chifeng Anding Hospital and Daqing Third Hospital in Heilongjiang Province. A total of 300 patients with schizophrenia who met the inclusion criteria were investigated by questionnaire. The questionnaire covered general data, suicidal ideation, childhood trauma, social support, depressive symptoms and psychological resilience. Logistic regression analysis revealed that childhood trauma and depressive symptoms were risk factors for suicidal ideation in schizophrenia (OR = 2.330, 95%CI: 1.177 ~ 4.614; OR = 10.619, 95%CI: 5.199 ~ 21.688), while psychological resilience was a protective factor for suicidal ideation in schizophrenia (OR = 0.173, 95%CI: 0.073 ~ 0.409). The results of the decision tree model analysis demonstrated that depressive symptoms, psychological resilience and childhood trauma were influential factors for suicidal ideation in patients with schizophrenia (p < 0.05). The area under the ROC for the logistic regression model and the decision tree model were 0.868 (95% CI: 0.821 ~ 0.916) and 0.863 (95% CI: 0.814 ~ 0.912) respectively, indicating excellent accuracy of the models. Meanwhile, the logistic regression model had a sensitivity of 0.834 and a specificity of 0.743 when the Youden index was at its maximum. The decision tree model had a sensitivity of 0.768 and a specificity of 0.8. Decision trees in combination with logistic regression models are of high value in the study of factors influencing suicidal ideation in schizophrenia patients.
Assuntos
Árvores de Decisões , Depressão , Resiliência Psicológica , Esquizofrenia , Ideação Suicida , Humanos , Feminino , Masculino , China/epidemiologia , Adulto , Esquizofrenia/epidemiologia , Modelos Logísticos , Pessoa de Meia-Idade , Fatores de Risco , Depressão/epidemiologia , Depressão/psicologia , Psicologia do Esquizofrênico , Apoio Social , Adulto Jovem , Inquéritos e Questionários , Experiências Adversas da Infância/estatística & dados numéricos , Experiências Adversas da Infância/psicologiaRESUMO
This study aimed to investigate the effect of a caregiver intensive education program (CIEP) on anxiety, depression, and quality of life (QOL) in patients with drug-resistant temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) who underwent cortico-amygdalohippocampectomy (CAH). Ninety patients with drug-resistant TLE-MTS who underwent CAH and their caregivers were recruited and randomly allocated to the CIEP group or control group as 1:1 ratio. Caregivers received the CIEP program or routine guidance/education (control group). Anxiety/depression and QOL in patients at month (M)0, M1, M3, and M6 were assessed by the Hospital Anxiety and Depression Scale (HADS) scale and the QOL in Epilepsy Inventory-31 (QOLIE-31), respectively. Treatment efficacy at M6 was assessed by Engel classification. The HADS-anxiety score at M3 (P=0.049) and M6 (P=0.028), HADS-anxiety score change (M6-M0) (P=0.001), percentage of anxiety patients at M6 (P=0.025), and anxiety severity at M6 (P=0.011) were all decreased in the CIEP group compared with the control group. The HADS-depression score at M6 (P=0.033) and HADS-depression score change (M6-M0) (P=0.022) were reduced, while percentage of depression patients at M6 (P=0.099) and depression severity at M6 (P=0.553) showed no difference in the CIEP group compared with the control group. The QOLIE-31 score at M6 (P=0.043) and QOLIE-31 score change (M6-M0) (P=0.010) were both elevated in the CIEP group compared with the control group. In conclusion, CIEP for caregivers contributed to the recovery of anxiety and depression as well as the improvement of QOL in patients with drug-resistant TLE-MTS who underwent CAH.