Ergenlik Döneminde Dürtüsel İntihar Girişimleri: Eski Hikayeye Yeni Bir Bakış

Year 2025, Volume: 6 Issue: 3, 295 - 304, 28.09.2025

Ayşe Burcu Erdoğdu Yıldırım , Başak Usta Gündüz , Gözde Özden Bilim , Günay Budagova , İrem Cihanyurdu Erdem

https://doi.org/10.47482/acmr.1662615

Abstract

Arkaplan: Ergenlerde intihar davranışının ortak risk faktörleri psikolojik, davranışsal, bilişsel, kişilerarası veya bireysel nitelikte olabilir. Majör depresif bozukluk ve dürtüsel davranış, intihar riskinin önemli birer belirleyicisi ya da aracı faktörüdür. Bu çalışma, ergenlerde intihar davranışını öngören faktörler arasındaki çok yönlü ilişkileri ortaya koymayı amaçlamaktadır.
Yöntemler: Çalışmaya intihar girişimi olan 49 ergen (15.82±1.24 yaş) ve 41 sağlıklı kontrol (15.67±1.40 yaş) dahil edilmiştir. Veri toplama araçları olarak sosyodemografik bilgi formu ve Barratt Dürtüsellik Ölçeği-11 (BIS-11) kullanılmıştır. Psikiyatrik tanılar, Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi (Kiddie Schedule for Affective Disorders and Schizophrenia) ile değerlendirilmiştir.
Bulgular: İntihar girişiminde bulunanların %93,9’u (n=46), kontrol grubunun ise %58,5’i (n=24) kadındır (χ²=16.131, p<0.001). İntihar girişiminde bulunan grupta motor, bilişsel ve plan yapmama şeklinde dürtüsellik problemleri, majör depresif bozukluk ve ailede intihar girişimi öyküsü, kontrol grubuna göre daha sık gözlenmiştir (p<0.05). Lojistik regresyon analizlerinde bilişsel dürtüsellik, majör depresif bozukluk ve ailede intihar öyküsünün intihar davranışını yordadığı bulunmuştur. Aracı değişken analizine göre, depresyonun veya ailedeki intihar öyküsünün intihar davranışı üzerindeki etkisinde bilişsel dürtüselliğin aracı rol oynamadığı saptanmıştır.
Sonuçlar: Her ne kadar bilişsel dürtüsellik, depresyon ve ailede intihar öyküsü intihar riskini doğrudan artırsa da depresyon veya aile öyküsünün intihar davranışına etkisi, bilişsel dürtüsellik üzerinden dolaylı olarak gerçekleşmemektedir. Çalışmamız, ergenlerde intihar riskini belirleyen en iyi bilinen risk faktörlerini yeniden incelemeye ve bu faktörlere yeni bir bakış açısıyla yaklaşmayı sağlamıştır. İntihar girişimlerinin çok boyutlu risk faktörlerinin anlaşılması, ergenlerde tamamlanmış intiharların azaltılmasına yardımcı olabilir.

Keywords

ergenlik , intihar , dürtüsellik , depresif bozukluk

Impulsivity and Suicide Attempts in Adolescence: A New Perspective on the Old Story

Abstract

Background: The common risk factors of suicidality in adolescents could be psychological, behavioral, cognitive, interpersonal, and personal. Major depressive disorder and impulsive behavior are crucial predictors or mediators for suicidality. This study aims to show the multidirectional links between the predictors of suicidality in adolescents.
Methods: The study included 49 suicide attempters (15.82±1.24 years) and 41 controls (15.67±1.40 years). The instruments were sociodemographic form and Barratt Impulsivity Scale-11 (BIS-11). The Kiddie Schedule for Affective Disorders and Schizophrenia was used to assess the psychiatric diagnoses.
Results: Among the suicide attempters, 93.9% (n = 46) were female, while 58.5% (n = 24) of the control group were female (χ2=16.131, p<0.001). More adolescents in suicide attempters had motor, cognitive and non-planning impulsivity problems, major depressive disorder, and family history of suicide attempt than in the control (p<0.05). Cognitive impulsivity, major depressive disorder, and family history of suicide were found to predict suicidality in logistic regression analyses. The mediation model reveals that effect of depression or family history of suicide on suicidality were not mediated through the severity of cognitive impulsivity.
Conclusion: Although cognitive impulsivity, depression, and family history of suicide directly enhance suicidality, the indirect path between depression/family history of suicide and suicidality were not mediated by cognitive impulsivity. This study provides a novel perspective on established risk factors that have been shown to predict suicide in adolescents and helps clarifying their role. Understanding multidimensional risk factors of suicide attempts might ultimately help to reduce completed suicide in adolescents.

Keywords

Adolescence , Suicide , Impulsivity , Depressive disorder

Ethical Statement

The study protocol was approved by the Ethics Committee of Marmara University School of Medicine (Approval Number: 09.2024.1334). The study protocol was performed in accordance with the ethical standards of the institutional and national research committee, and with the 1964 Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study. No animal data were used in this study.

Supporting Institution

This research did not receive any funding.

Thanks

There are no sources of supports for this study. The authors thank all the children and their families whose participation made this study possible.

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