精神分裂症患者攻击行为与临床症状、记忆及智力的相关性

目的探讨精神分裂症患者攻击行为与临床症状、记忆及智力的相关性,分析临床症状、记忆及智力能否作为精神分裂症患者攻击行为的预测因子。方法以2014年5月-2016年5月在中山市第三人民医院早期干预科住院的符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者为研究对象,所有患者均处于急性发作期。依据既往暴力史和修订版外显攻击行为量表(MOAS)加权总分为5分区分攻击组和非攻击组,其中攻击组69例,非攻击组39例。采用阳性和阴性症状量表(PANSS)评估临床症状,采用韦氏记忆量表修订版(WMS-R)、韦氏成人智力量表中国修订版(WAIS-RC)评估记忆和智力,并对MOAS与PANSS、WMS-R和WAIS-RC评分进行相关分析。结果攻击组MOAS加权总分、言语攻击、对财产的攻击和体力攻击的评分均高于非攻击组,差异均有统计学意义(P0.05或0.01)。攻击组PANSS总评分和阳性症状评分均高于非攻击组,差异均有统计学意义(P0.05或0.01)。两组WMS-R和WAIS-RC评分比较差异均无统计学意义(P均0.05)。MOAS加权总分、体力攻击评分与PANSS总评分、阳性症状评分和一般精神病理评分呈正相关(r=0.203~0.535,P0.05或0.01),体力攻击评分与心智评分呈负相关(r=-0.343,P0.05)。结论与非攻击组相比,攻击组的攻击行为体现在言语攻击、对财产的攻击与体力攻击方面。PANSS总评分与阳性症状可能与精神分裂症患者的攻击行为相关。记忆和智力与精神分裂症患者的攻击行为不相关,不能作为攻击行为的预测因子。

Relationships among aggressive behavior and clinical symptoms, memory, intelligence in schizophrenic patients

Objective To explore the relationships among aggressive behavior and clinical symptoms, memory, intelligence, and to analyze whether clinical symptoms, memory and intelligence can be used as predictors of aggressive behavior in patients with schizophrenia.Methods These schizophrenic patients were chosen to participate in this study who admitting to the early intervention department of The Third People's Hospital of Zhongshan.All the patients met the diagnostic criteria for schizophrenia according to the International Classification of Diseases, tenth edition (ICD-10) and were in acute phase from May 2014 to May 2016.According to the past violence history and weighted total score of Modified Overt Aggression Scale(MOAS), patients were divided into aggressive group(n=69) and non-aggressive group(n=39).Positive and Negative Syndrome Scale (PANSS) was adopted to assess clinical symptoms, memory and intelligence were evaluated by Wechsler Memory Scale-Revised (WMS-R) and Wechsler Adult Intelligence Scale revised in China (WAIS-RC).Correlations among aggressive behavior, clinical symptoms, memory and intelligence were analyzed.Results Weighted total score of MOAS, verbal attack, attack on property and physical attack scores in aggressive group were higher than those of the non-aggressive group (P<0.05 or 0.01).Total score of PANSS and positive symptoms score in aggressive group were higher than those of the non-aggressive group (P<0.05 or 0.01).There was no significant difference in WMS-R or WAIS-RC socres between the two groups(P>0.05).Weighted total score of MOAS and physical attack score were positively correlated with PANSS total score, positive symptoms score and general psychopathology score(r=0.203~0.535, P<0.05 or 0.01).Physical attack score were negatively correlated with mental attack score(r=-0.343, P<0.05).Conclusion Compared with non-aggressive group, patients in aggressive group show significant aggression in verbal attack, property attack and physical attack in aggressive group.Total score of PANSS and positive symptoms may be related to aggression in schizophrenic patients.Otherwise, memory and intelligence are not related to aggression and can't be used as predictors of aggressive behavior in schizophrenic patients.