青少年精神分裂症患者的健康相关危险行为

Health related risky behaviors in adolescents with schizophrenia

目的：探讨青少年精神分裂症患者的健康相关危险行为特点及危险因素。方法：按照疾病和有关健康问题的国际统计分类第十次修订本（ICD-10）诊断标准,纳入精神分裂症患者90例,年龄13~18岁,同时纳入性别、年龄相匹配的正常青少年对照180例,完成青少年健康相关危险行为问卷（AHRBI）评定。分别对AHRBI量表各因子分与精神分裂症的关系、精神分裂症患者各维度危险行为的风险因素进行logistic回归分析。结果：精神分裂症组AHRBI总分和健康妥协行为、破坏纪律行为、无保护性行为、自杀自伤行为、吸烟饮酒行为5项因子分均显著高于正常对照组[如总分,51.5（0,130）vs.47（38,79）;均P〈0.05]。Logistic回归分析显示青少年精神分裂症与健康妥协行为因子、破坏纪律行为因子、无保护性行为因子、自杀自伤行为因子关联（均P〈0.05）;破坏纪律行为是攻击与暴力行为（OR=1.57,95%CI：1.13~2.19）、无保护性行为（OR=1.32,95%CI：1.08~1.61）的危险因素,吸烟与饮酒行为是健康妥协行为（OR=2.79,95%CI：1.01~8.33）、无保护性行为（OR=1.83,95%CI：1.29~2.58）的危险因素,攻击与暴力行为是自杀自伤行为（OR=1.39,95%CI：1.15~1.68）的危险因素,抗精神病药物是自杀自伤行为（OR=0.12,95%CI：0.14~0.95）的保护因素,急性发病次数是吸烟饮酒行为（OR=0.95,95%CI：0.90~0.99）的保护因素,无保护性行为是吸烟饮酒行为（OR=2.38,95%CI：1.11~5.13）的危险因素。结论：青少年精神分裂症患者总体健康相关危险行为多于正常青少年,各危险行为间有一定关联。抗精神病药物是自杀自伤行为的保护因素,急性发病次数是吸烟饮酒行为的保护因素。

Objective： To explore the health related risky behavior in adolescents with schizophrenia and its risk factors. Methods： Ninety patients aged 13 - 18 years old who met criteria of the International Statistical Classi- fication of Diseases and Related Health Problems, Tenth Revision （ICD-10） for schizophrenia, and 180 gender and age matched healthy controls were enrolled. They were assessed with the Questionnaire for Adolescents Health relat- ed Risk Behavior Inventory （AHRBI）. Logistic regression analyses were used to analyze the relationship between five subscales scores of AHRBI and schizophrenia, and the risk factors of health related risky behaviors in adoles-cents with schizophrenia. Results： The schizophrenia group had higher total score and five subscales＇scores of AHR- BI than controls, including Health-Compromising Behavior （HCB）, Rule Breaking （RB）, Unprotected Sex （US）, Self-injury and Suicide （SS）, and Smoking and Drinking （SD） [Total scores, 51.5 （0, 130） vs. 47（38, 79）, Ps 〈 0. 05]. Logistic regression analyses of showed that schizophrenia of adolescents were associated with scores of HCB, RB, US and SS （Ps 〈0. 05） ; and RB was the risk factor of AV lattack and violence（OR = 1.57, 95% CI： 1.13 - 2. 19） and US（ OR = 1.32, 95% CI： 1.08 - 1.61 ）, SD was the risk factor of HCB（ OR = 2. 79, 95% CI： 1.01 - 8.33） and US（OR = 1.83,95% CI： 1.29 -2. 58）, AV was the risk factor of SS（OR = 1.39,95% CI： 1.15 - 1.68）, and the use of antipsychotic drugs was the protective factor of SS（ OR = 0. 12, 95% CI： O. 14 - 0. 95）, and the acute onset frequency was the protective factor of SD（ OR = 0. 95, 95% CI： 0. 90 - 0. 99） in adolescents with schizophrenia, and US was the risk factor of SD（ OR = 2. 38, 95% CI： 1.11 -5.13）. Conclusion： Adolescents with schizophrenia have more health related risk behaviors than normal controls. Health related risky behaviors are associated with each other. The use of antipsychotic drugs may be the protective factor of SS, and the acute onset frequency may be the protective factor of SD in adolescents with schizophrenia.