双相Ⅰ型障碍患者攻击行为风险因素初步分析

Preliminary analysis on the risk factors of aggressive behavior in the patients with bipolar type Ⅰ disorder

目的:探讨双相Ⅰ型障碍患者攻击行为的风险因素。方法:根据修订版外显攻击行为量表(MOAS)评分将94例住院的双相Ⅰ型障碍患者分为攻击组(50例,加权分≥4分)和非攻击组(44例,加权分<4分);对入组者进行一般及临床情况调查、认知功能检测、社会支持评定量表(SSRS)及父母教养方式评价量表(EMBU)评定,血脂、血清肌酸激酶(CK)水平检测及脑地形图检查。结果:两组在职业、饮酒、发病间期缓解程度、入院方式、总发作次数、躁狂发作次数、威斯康星卡片分类测验成绩、SSRS评分、EMBU因子分、血清CK水平、脑电地形图结果差异有统计学意义(P<0.05或P<0.01);多因素Logistic回归分析筛选出非自愿住院(OR=54.341)、发病间期不完全缓解(OR=19.088)、无业/失业(OR=9.841)、总发作次数≥3次(OR=9.672)是攻击行为的高危因素。结论:多种因素与双相Ⅰ型障碍患者攻击行为有关,无业或失业、疾病反复发作、发病间期不全缓解及非自愿住院可增加攻击行为的发生风险,以非自愿住院相对风险最高。

Objective： To explore the risk factors of aggressive behavior in the patients with bipolar type Ⅰ disorder. Method： According to the score of revised overt aggression scale（ MOAS）,94 inpatients with bipolar Ⅰ disorder were divided into attack group（ 50 cases,weighted points of MOAS≥4） and the non-attack group（ 44 cases,weighted points of MOAS 〈4）. The general and clinical data were investigated,the executive function,social support rating scale（ SSRS）,egma minnen av bardndosnauppforstran（ EMBU） were assessed,the levels of serum lipid,creatine kinase（ CK）,and brain topographic map were detected in all the subjects.Results： The differences of vocation,drinking,remission situation,admission form,total episode times,the frequency of manic episode,level of serum CK,brain atlas,the results of Wisconsin card sorting test,the scores of SSRS and the factor scores of EMBU between the two groups had statistical significance（ P〈0. 05 or P〈0. 01）. Multivariate logistic regression analyses showed that involuntary admissions（ OR = 54. 341）,incomplete remission（ OR = 19. 088）,unemployment（ OR = 9. 841）,total episode ≥3 times（ OR = 9. 672） were risk factors. Conclusion： Aggressive behavior in patients with bipolar type Ⅰdisorder is related to many factors. Unemployment,recurrent episodes of mental disorders,incomplete remission and involuntary admissions increased aggressive risk. The relative risk of involuntary admissions is the highest.