精神分裂症患者攻击行为相关因素分析

目的:探讨精神分裂症患者发生攻击行为的相关因素及预测因子。方法:将132例精神分裂症患者按修改版外显攻击行为量表(MOAS)得分分为伴攻击行为(研究组)64例和不伴攻击行为(对照组)68例,分别进行一般人口学资料、阳性和阴性症状量表(PANSS)及气质性格问卷(TCI)的测定。结果:一般人口学资料中既往攻击行为史两组间差异有统计学意义(P=0.001)。PANSS分量表中阳性症状分、思维障碍、激活性及偏执条目分值研究组明显高于对照组(t=-6.90,t=-3.41,t=-4.43,t=-4.40;P均≤0.001)。TCI各维度中寻求新奇得分(t=-6.74)研究组高于对照组,合作性、自我定向得分低于对照组(t=3.42,t=5.96;P均≤0.001)。Logistic回归分析显示,寻求新奇、阳性症状和合作性对攻击行为的发生有预测意义(P0.05或P0.01)。结论:精神分裂症患者的阳性症状、思维障碍、激活性及偏执是引起攻击行为的重要因素;寻求新奇和低合作性可较好地预测患者的攻击行为。

Analysis of related factors associated with aggressive behavior in schizophrenic patients

Objective：To explore the related factors and predictors associated with aggressive behavior in schizophrenic patients. Method：According to the score of modified overt aggression scale（MOAS）,132 pa-tients with schizophrenia were divided into research group（64 cases）with aggressive behavior and control group （68 cases）without aggressive behavior. All objects were collected with general demographic data,evaluated by positive and negative syndrome scale（PANSS）and temperament and character inventory（TCI）. Results：In those common items,there was no significant difference between the two groups except past aggressive behavior （P = 0. 001）. The total score of positive symptom,thought disorder,activation and paranoid showed significantly higher than those in control group（t = - 6. 90,t = - 3. 41,t = - 4. 43,t = - 4. 40;all P≤0. 001）. In TCI nov-elty seeking scores in reseach group were higher than those in control group（t = - 6. 74,P≤0. 001）,while co-operativeness and self-directedness scores were lower than those in the control group（t = 3. 42,t = 5. 96;all P≤0. 001）. Logistic regression analysis results showed that novelty seeking,positive symptoms and cooperative can forecast the aggressive behavior（P ﹤ 0. 05 or P ﹤ 0. 01）. Conclusion：Positive symptom,thought disorder,ac-tivation and paranoid are the important factors that cause aggressive behavior in schizophrenic patients. Novelty seeking and low cooperative can predict the patients′ aggressive behavior better.