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Sex differences and risk factors of self-reported suicide attempts in middle-aged Chinese Han patients with first-episode drug-naïve anxious depression: a large-scale cross-sectional study

  • Psychiatry and Preclinical Psychiatric Studies - Original Article
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Abstract

This study aims to investigate sex differences and risk factors for self-reported suicide attempts among Chinese Han middle-aged patients with first-episode drug-naïve (FEDN) anxious depression (AD). A total of 1796 patients with FEDN major depressive disorder were enrolled in this study, including 341 middle-aged patients with AD. We compared the prevalence, demographics, and clinical characteristics of suicide attempts between male and female patients with FEDN middle-aged AD. We also explored the risk factors for self-reported suicide attempts in this population using binary logistic regression analysis. The male/female ratio was 91/250 and the age of onset was 51.50 ± 4.13. Our results showed that there were no significant sex differences in the prevalence of self-reported suicide attempts in middle-aged patients with FEDN AD. However, we did find significant differences in several demographic and clinical characteristics between self-reported suicide attempters and non-suicide attempters. Moreover, severe anxiety, measured by the Hamilton Anxiety Rating Scale score, was identified as a risk factor for self-reported suicide attempts in female middle-aged AD patients. Additionally, elevated thyroid peroxidase antibody (TPOAb) levels were linked to self-reported suicide attempts in male AD patients. Our findings suggest that there are no significant sex differences in the prevalence of self-reported suicide attempts in this population, but there may be sex-specific risk factors for self-reported suicide attempts in middle-aged AD. Clinical psychiatrists need to pay attention to thyroid hormone levels in middle-aged anxious depression.

Highlights

This study explores sex differences in self-reported suicide attempts among Chinese Han middle-aged patients with first-episode drug-naïve (FEDN) major depressive disorder (MDD) and anxious depression (AD).

1. No significant sex differences in the prevalence of self-reported suicide attempts were observed; however, important demographic and clinical differences between suicide attempters and non-suicide attempters were identified.

2. Middle-aged depression is associated with increased self-reported suicide attempts risk during ages 45–60 due to mood swings and hormonal changes.

3. Psychotic symptoms in MDD patients are linked to higher suicide risk, and severe anxiety, measured by the HAMA score, is a risk factor for self-reported suicide attempts in female middle-aged AD patients.

4. Elevated TPOAb levels are associated with self-reported suicide attempts in male AD patients.

These findings emphasize the need for further research on sex-specific risk factors in middle-aged anxious depression to enhance suicide prevention strategies.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to show their great gratitude to all the patients who participated in this study for their participation.

Funding

This study was supported by the National Key R&D Program of China (2020YFC2003100) and the hospital-level project by Tianjin Anding Hospital (ADYKHT2021012).

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Author notes

  1. Guoshuai Luo, Shuo Wang and Lei Gou contributed equally to the article.

  2. Guoshuai Luo, Shuo Wang and Lei Gou considered as Joint First-authors.

Authors and Affiliations

  1. Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China

    Guoshuai Luo, Shuo Wang, Lei Gou, Cong Yao, Yifan Jing, Zaimina Xuekelaiti & Jie Li

  2. Department of Civil Engineering, Nanjing Technical Vocational College, 58 Huangshan Rd, Nanjing, 210019, China

    Cui Li

  3. Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China

    Xiang-yang Zhang

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  1. Guoshuai Luo
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Luo, G., Wang, S., Gou, L. et al. Sex differences and risk factors of self-reported suicide attempts in middle-aged Chinese Han patients with first-episode drug-naïve anxious depression: a large-scale cross-sectional study. J Neural Transm (2024). https://doi.org/10.1007/s00702-024-02779-x

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