阜阳地区登记在册精神分裂症患者高危险行为情况及其影响因素分析

doi:10.12183/j.scjpm.2023.0023

摘要/Abstract

摘要： 目的调查阜阳地区登记在册精神分裂症患者高危险行为发生情况及其影响因素。方法选取2018年1月至2021年12月阜阳市精神卫生防治工作信息管理系统中登记在册的1 264例精神分裂症患者为研究对象,收集人口学资料、临床资料、随访信息,采用单因素和多因素Logistic回归模型对影响精神分裂症患者高危险行为的因素进行分析。结果 1 264例精神分裂症患者中,男性703例,女性561例,平均年龄（42.15±14.06）岁。共102例患者危险性评估为3~5级,高危险行为发生率为8.07%。多因素Logistic回归分析结果显示,离婚/丧偶（OR=2.03）、未婚（OR=5.07）、未服用抗精神病药物（OR=3.16）、既往高危险行为史（OR=3.12）、未参加年度健康体检（OR=2.67）、每月社区面访次数≥5次（OR=1.30）是精神分裂症患者高危险行为的危险因素,每月社区面访次数1~2次（OR=0.57）、3~4次（OR=0.58）是精神分裂症患者高危险行为的保护因素。结论应加强对精神分裂症患者高危险行为相关因素的综合评估,及时采取分级分类管理,从而有效降低高危险行为发生率。

关键词: 精神分裂症, 高危险行为, 影响因素

Abstract: Objective To investigate the high-risk behavior of registered schizophrenic patients in the Fuyang area and its influencing factors. Methods A total of 1 264 patients with schizophrenia registered in the Mental Health Prevention and Treatment Information Management System of Fuyang City from January 2018 to December 2021 were selected. Demographic data, clinical data, and follow-up information were collected, and univariate and multivariate Logistic regression were used to analyze the factors affecting the high-risk behavior of patients with schizophrenia. Results Among the 1 264 patients with schizophrenia, 703 were males and 561 were females, with an average age of （42.15±14.06） years. The risk assessment of 102 patients was 3-5, and the incidence of high-risk behavior was 8.07%. The results of multivariate Logistic regression analysis showed that divorce/widowed （OR=2.03）, unmarried （OR=5.07）, not taking antipsychotic drugs （OR=3.16）, previous history of high-risk behavior （OR=3.12）, not participating in annual health checkup （OR=2.67）, and the number of community visits ≥5 times per month （OR=1.30） were risk factors for high-risk behavior in patients with schizophrenia. The number of community visits 1-2 times （OR=0.57） and 3-4 times （OR=0.58） per month were protective factors for high-risk behavior in patients with schizophrenia. Conclusion It is necessary to strengthen the comprehensive evaluation of the factors related to high-risk behavior in schizophrenia patients, and adopt the classification management in time, to effectively reduce the incidence of high-risk behavior.

Key words: Schizophrenia, High-risk behavior, Influencing factor

中图分类号:

R195

张贵香, 吴自芳, 蔡露醒, 闻庆云. 阜阳地区登记在册精神分裂症患者高危险行为情况及其影响因素分析[J]. 华南预防医学, 2023, 49(1): 23-27.

ZHANG Gui-xiang, WU Zi-Fang, CAI Lu-xing, WEN Qing-Yun. Analysis of high-risk behavior of registered schizophrenic patients in the Fuyang area and its influencing factors[J]. South China Journal of Preventive Medicine, 2023, 49(1): 23-27.

参考文献

[1] 甄文凤,马辛,林祥吉,等. 精神分裂症患者暴力犯罪行为相关因素研究[J].中国神经精神疾病杂志,2019,45(5):288-292.
[2] 张丽. 住院精神分裂症患者暴力行为的相关因素Logistic回归分析及对策[J] . 医学理论与实践, 2018, 31(23): 3598-3600.
[3] 姚晶, 谭淑平, 崔界峰, 等. 住院精神分裂症患者攻击行为的特征及相关风险因素[J].中国心理卫生杂志, 2018, 32(8): 636-641.
[4] 宋建鹏, 刘传新. 精神分裂症患者暴力攻击行为[J]. 济宁医学院学报, 2017, 40(2): 148-152.
[5] 胡天兰,何芳. 某社区严重精神障碍患者现状及其危险行为的影响因素分析[J]. 安徽医学,2017,38(3):354-356.
[6] Wang J,Zhang SM,Zhong SL,et al.Gender differences among homicide offenders with schizophrenia in Hunan Province,China[J]. Psychiatry Res,2019,271:124-130.
[7] 袁愫,韩丽娟,郑立谦,等.男性精神分裂症病人暴力犯罪行为相关社会心理因素分析[J].安徽医药,2020,24(6):1184-1186.
[8] Liu Y,Liu X,Wen H,et al.Risk behavior in patients with severe mental disorders:A prospective study of 121,830 patients managed in rural households of western China[J]. BMC Psychiatry, 2018, 18(1):134.
[9] 甄文凤,马辛,林祥吉,等.男性精神障碍患者肇事肇祸行为相关因素研究[J].中国全科医学,2020,23(14):1790-1795.
[10] 王轶虎,崔力军,潘鑫,等.湖州市精神分裂症患者肇事肇祸的影响因素及预防研究[J].中国公共卫生管理,2017,33(3):348-350.
[11] 刘勇,谢斌. 上海市社区非自愿随访严重精神障碍患者暴力行为相关因素[J].中国心理卫生杂志,2019,33(12):887-892.
[12] 罗邦安,秦露露,周蔚,等. 社区精神病性障碍患者危险性及影响因素分析[J]. 中华行为医学与脑科学杂志,2018,27(2):178-182.
[13] 刘成锋,卢楚虹,张泉水,等. 严重精神障碍患者高风险行为影响因素分析[J]. 预防医学,2019,31(1):56-59,63.
[14] Fazel S,Zetterqvist J,Larsson H,et al.Antipsychotics,mood stabilisers,and risk of violent crime[J]. Lancet,2014, 384(9949):1206-1214.
[15] 王舟, 方惠民 . 社区重性精神疾病患者暴力行为危险性评估及相关因素的logistic回归分析[J]. 中华行为医学与脑科学杂志, 2012, 21(11): 1029-1031.
[16] Becerra-García JA. Neuropsychology of domestic violence: A comparative preliminary study of executive functioning[J]. Med Sci Law, 2015, 55(1): 35-39.
[17] 彭小冬,周志坚,谢海燕,等. 社区严重精神障碍患者暴力行为的影响因素[J]. 中华行为医学与脑科学杂志,2020,29(12):1093-1099.
[18] Swanson JW,Swartz MS,Van Dorn RA,et al.A national study of violent behavior in persons with schizophrenia[J]. Arch Gen Psychiatry,2016,63(5):490-499.
[19] Burton A, Marougka S, Priebe S.Do financial incentives increase treatment adherence in people with severe mental illness? A systematic review[J]. Epidemiol Psichiatr Soc, 2010, 19(3):233-242.
[20] 陈润滋, 吴霞民, 马宁. 中国2009—2019年的精神卫生政策与实施[J]. 中国心理卫生杂志, 2020, 34(7):555-560.