Abstract: Objective To explore the status and influencing factors of troublemaking in patients with severe mental disorders in Hebei Province, to provide the reference for the management of patients with severe mental disorders. Methods A convenience sampling method was used to select patients with severe mental disorders in Hebei Province who were registered and entered into the National Severe Mental Disorders Management Information System from June 2022 to June 2023. These patients were divided into two groups based on whether they had troublemaking behaviors：the occurrence group and the non-occurrence group. General data of patients were collected, and Social Support Rating Scale (SSRS), modified Explicit Aggressive Behavior Scale (MOAS), and mini-Mental State Examination (MMSE) were used to evaluate the social support degree and severity of patients' disease. The occurrence status of troublemaking behaviors was investigated, and univariate and multivariate logistic regression were used for influencing factors analyses. Results The incidence rate of troublemaking behaviors in patients with severe mental disorders was 12.87% (69/536). There were significant differences between the two groups in gender, age, duration of medication, number of visits in recent three years, parental criminal record, awareness of social assistance policies, SSRS score, MOAS score, and MMSE score (all P<0.01). Multivariate logistic regression analysis showed that gender (OR=0.421), duration of medication (OR=0.513), awareness of social assistance policies (OR=0.317), SSRS score (OR=0.536), and MMSE score (OR=0.584) were protective factors for troublemaking behaviors in patients with severe mental disorders (all P<0.05), while MOAS score (OR=3.651) was a risk factor (P<0.05). Conclusions Patients with severe mental disorders in Hebei Province have a certain risk of troublemaking, mainly influenced by factors such as gender, duration of medication, and awareness of social assistance policies. It is necessary to strengthen the treatment and management of such patients to reduce the occurrence of troublemaking behaviors.

Key words: Severe mental disorders, Troublemaking, Influencing factor