精神疾病患者家庭暴力行为及其相关因素研究

Acomparative study on domestic violence in psychotics and its related factors

目的:明确家庭暴力行为特点及其相关因素,为家庭暴力的预测和干预的研究积累资料和进行方法学的探索。方法:应用人口学资料、既往史调查表、家庭暴力行为调查表、简明精神病评定量表(BPRS)、明尼苏达多相人格调查表(MMPI)、人格诊断问卷第4版(PDQ4+)、早年(18岁以前)不良家庭环境问卷,测试分析具有家庭暴力和无家庭暴力精神病患者的暴力行为特点及其相关因素。结果:(1)38例精神疾病患者家庭暴力造成67人伤亡,其中伤28人,亡39人。(2)两组的既往攻击行为史及酒精滥用史;早年不良家庭环境中家庭结构不完整、曾受父母虐待、不良教养方式;疾病类型中精神分裂症、抑郁症;BPRS的总分及其敌对猜疑、焦虑抑郁;MMPI测试中的F、D、Hs、Hy、Pa分;PDQ4+测定中的偏执型、依赖型、被动攻击型、抑郁型人格障碍方面存在差异,且有统计学意义(P<0.05)。(3)经Logistic回归分析结果显示既往攻击行为史、MMPI的D、Pa高分和BPRS的总分、敌对猜疑、焦虑抑郁因子高分及早年遭受父母虐待、家庭结构不完整以及PDQ4+抑郁型高分可作为精神病患者家庭暴力行为的预测因子。结论:精神疾病患者家庭暴力后果极为严重,精神分裂症及抑郁症患者家庭暴力行为发生率较高,应引起临床、社会高度重视;心理社会因素、病理性人格和精神病理症状是患者家庭暴力行为的始动因素,可作为家庭暴力行为的预测因子和指导干预的方向。

Objective：To study the features of domestic violence of psychosis patients and its related factors. Methods：Demographic information questionnaire, past history questionnaire, Minnesota Muhiphasic Personality Inventory（ MMPI ）, Personality Diagnostic Questionnaire - 4th Version（ PDQ4 ＋ ）, early deviant family environment questionnaire （ before 18 years old）, BPRS and Family Envi- ronment Scale - Chinese version（ FFE-CV） were used to analyze the features of domestic violence and its related factors. Results ： （ 1 ） There were 39 deaths and 28 injuries caused by 38 cases of domestic violence. （2） There were more cases with history of aggressive behavior in psychosis than without domestic violent behavior. There were more cases with history of alcohol abuse, parental unsound rearing styles, suffering parental abut. and family defect in early years in domestic violent patients than patients without . Diagnoses included more schizophrenia and depression in patients with domestic violence than patients without . Psychosis patients with domestic violent behavior had higher F, D, Hs, Hy, Pa scores of MMPI than patients without. Significant differences were found in cohesion, affection expression, entertainment Compareal with non- domestic violence patients, domestic violence patients had higher scores in paranoid, dependent, passive aggressive and depressive personality disorder of PDQ4 ＋ . There were deferences between two groups in total score , hostile-suspiciousne.ss and anxiety-depression of the BPRSo （3） Logistic regression analyses suggested that the main risk factors for violent behavior of psychosis patients were the history of aggressive behavior, the D.Pa scores of MMPI and total score ,hostile-suspiciousness and anxiety-depression of the BPRS,parental abuse.parental unsound rearing styles, depressive personality disorder of PDQ4＋ .Conclusion ：The domestic violence of psychosis patients brings about serous results. The high incidence among schizophrenic and depress patients should arouse the clinical and social awareness. Psychosocial factor .personality disorder and symptom of psychopathology are causing factors of domestic violence , which can be considered to predict and direct intervention.