我国住院精神分裂症患者攻击行为的文献分析

目的:分析我国住院精神分裂症患者攻击行为发生情况,探讨应对和预防精神分裂症患者攻击行为的策略。方法:以精神分裂症和攻击行为等为主题词,运用计算机检索中国期刊全文数据库等国内主要文献数据库(1997年1月至2011年11月),同时辅以手工检索,并从参考文献中筛选收集有关精神分裂症患者攻击行为的文献。对符合要求的文献进行分析,总结既往对住院精神分裂症患者攻击行为的研究情况。结果:住院精神分裂症患者攻击行为的发生率最高为49.6%(95%CI:41.1,58.1),最低9.1%(95%CI:6.3,11.9),绝大部分研究报道的攻击行为发生率为20%~40%(平均28.0%);其攻击行为多发生于特定人群,与其个人素质、社会环境或精神症状等密切相关;对其攻击行为的发生,目前尚缺乏规范、可操作性的评估和干预方法。结论:我国住院精神分裂症病人攻击行为发生风险较高,目前迫切需要建立一套科学、规范、可操作的评估和处置规范。

Aggression of Chinese inpatients with schizophrenia: a systematic literature review

Objective: To systematically review and analyze literature on episodes of aggression in psychiatric wards and to determine the coping and preventive strategies employed to deal with aggression of patients with schizophrenia. Methods: We used the key words such as "schizophrenia" and "aggression" to collect literature citations, which were published between July 1997 and November 2011, by searching databases such as the Chinese Journal Full-text Database (CJFD). The literature reports of aggression by patients with schizophrenia were surveyed by computer-assisted searches, scanning of reference lists, and manual search of relevant journals. We analyzed the reports of episodes of aggression in psychiatric wards. Results: Prevalence of aggression in psychiatric wards was reported to range from 9.1% (95% CI: 6.3 to 11.9) to 49.6% (95% CI: 41.1 to 58.1), with most reports in the range of 20% to 40% (mean 28.0%). The aggressive behavior often occurred in special groups and typically bore a close relationship with the patient's personal qualities, social environment, or psychiatric symptoms. The aggressive behaviors can be attributed to a lack of standardized assessments and intervention instruments. Conclusion: There is a high risk of aggression in Chinese inpatients with schizophrenia, and it is urgent to establish the scientific, standardized, operational systems for assessing and treating the aggression of these patients.