关键词: 严重精神障碍, 精神疾病, 危险性评估, 暴力行为, 危险因素

Abstract: Objective To investigate the current situation of violence among patients with severe mental disorders in Hainan Province and analyze its influencing factors. Methods Taking the cases of severe mental disorders in Hainan Province as the research object, the risk level assessment was completed during the follow-up of the cases in charge in 2019. The basic information of the cases and the disease-related factors were derived from the information management system of severe mental disorders in Hainan Province. Descriptive epidemiological analysis method was used to analyze the occurrence of severe violence among the cases of severe mental disorders, and univariate and multivariate analysis methods were used to analyze the influencing factors of severe violence. Results In 2019, a total of 29 054 registered cases of severe mental disorders were followed up and their risk assessment was completed. The age of the cases was 15-95 years, with an average age of （39.87±16.54） years. The Han nationality accounted for 87.66%. The main diseases were 18 760 cases of schizophrenia （64.57%）, 4 273 cases of bipolar affective disorder （14.71%）, 4 157 cases of mental retardation with mental disorders （14.31%）. The evaluation results showed that there were 1 756 cases of severe mental disorders with severe violence, and the incidence rate was 6.04%. Mainly grade 3, accounting for 68.23% （1 198 cases）. Multivariate Logistic regression analysis showed that the patients with severe mental disorders aged 18 to <45 （OR=1.264）, 45 to <60 （OR=1.099）, were unemployed （OR=1.697）, with the more times of previous hospitalizations （OR=2.282）, the more times of previous emergency treatments （OR=3.360）, no antipsychotic treatment （OR=5.989）, risky behavior before file establishment （OR=7.815）, the onset form was subacute （OR=1.260） or acute （OR=1.575） were more likely to have severe violence. Conclusion The incidence of severe violence is relatively high among patients with severe mental disorders, and it can effectively prevent the occurrence of violence to carry out classification management according to the relevant risk factors as soon as possible.

Key words: Severe mental disorder, Mental disease, Risk assessment, Violence, Risk factor