常德地区严重精神障碍患者暴力攻击行为研究

目的了解常德市严重精神障碍患者的暴力攻击行为现状,探索暴力攻击行为的危险因素,为优化对这一人群的管控策略提供参考。方法于2017年7月-12月,在常德市康复医院接受暴力危险性评估的2 362例疑似精神障碍患者中,采用Excel生成随机整数的方式,随机选出790名被试,并将其中757例符合入组标准的患者纳入本研究,收集其一般人口学资料和临床资料,并进行修订版外显攻击行为量表(MOAS)评定。将MOAS加权总分≥5分者定义为研究组(n=505),MOAS加权总分5分者定义为对照组(n=252),比较两组一般人口学资料和临床资料,采用二元Logistic回归分析探索暴力攻击行为的独立相关因素。结果研究组中男性、年龄相对较小、单身、近半年无业、不(规律)服药、存在被关锁情况、伴有反社会人格特征者所占比例高于对照组(P0.05或0.01)。二元Logistic回归分析显示,不(规律)服药(OR=2.659,95%CI:1.892～3.738)、年龄≤30岁(OR=1.845,95%CI:1.163～2.926)、男性(OR=1.486,95%CI:1.085～2.036)、无业(OR=1.621,95%CI:1.069～2.457)与高暴力攻击风险呈独立正相关(P0.05或0.01)。结论常德市严重精神障碍患者发生暴力攻击行为的危险因素主要包括不(规律)服药、年龄≤30岁、男性、无业。

Study on violent aggressive behaviors of patients with severe mental disorders in Changde area

Objective To investigate the current situation of violent aggressive behaviors of patients with severe mental disorders in Changde city, and to explore the risk factors of violent aggressive behaviors, so as to provide references for optimizing the management and control strategies for this population. Methods Between July and December 2017, 790 subjects were randomly selected from a total of 2 362 patients who suspected had mental disorders in Changde Rehabilitation Hospital. Only 757 patients who met the inclusion criteria were included in analysis. They filled both demographic and clinical information and Modified Overt Aggression Scales ( MOAS) . Patients with MOAS scored 5 and more were defined as the study group ( n = 505) , while those with less than 5 were defined as the control group ( n = 252) . Differences in demographic and clinical characteristics between two groups were compared, and the independent related factors of violent aggressive behaviors were explored using binary Logistic regression analyses. Results The study group had more males and they were younger than control group. Besides, they tended to be single, unemployed for at least half a year, irregular taking medicine, locked at home, accompanied with anti - social personality than the control group ( P < 0. 05 or 0. 01 ) . Binary Logistic regression analysis showed that not ( regularly) taking medicine ( OR = 2. 659, 95% CI: 1 . 892 ~ 3. 738) , younger than 30 years old ( OR = 1 . 845, 95% CI: 1 . 163 ~ 2. 926) , male ( OR = 1 . 486, 95% CI: 1 . 085 ~ 2. 036) and unemployment ( OR = 1 . 621 , 95% CI: 1 . 069 ~ 2. 457) were independently and positively correlated with violent aggressive behaviors ( P < 0. 05 or 0. 01 ) . Conclusion Risk factors for violent aggressive behaviors in patients with severe mental disorders in Changde area including not ( regularly) taking medicine, younger than 30 years old, male and unemployed.