HCR-20量表在社区精神分裂症患者中的初步测评

An analysis of the application of HCR-20 among patients with schizophrenia in community

目的：初步测评HCR-20量表在社区精神分裂症患者攻击行为风险评估中的使用情况，验证量表的主要性能指标。方法：使用HCR-20对社区精神分裂症患者进行攻击风险评估，随访记录研究对象3个月内攻击行为的发生情况。结果：155名研究对象进行了量表测评，136名参与了随访。研究结果发现，HCR-20量表具有较好的预测效度，评估者间一致性程度佳（ICC=0.72）。在准确性方面，ROC曲线分析提示，量表的曲线下面积为0.78（95%CI：0.56～0.96）。结论：HCR-20量表在社区精神分裂症患者攻击风险评估中的适用性较好，量表具有较好的信效度，对患者攻击风险的预测较为准确。建议通过纳入多种指标，构建攻击风险评估体系，以提高评估准确性。

Objective： To explore the application of an violence risk assessment instrument HCR-20 among schizophrenia in community and examine its psychometric indexes. Methods： Participants from seven community health center in Beijing were recruited to do violence risk assessment using HCR-20. Follow-up was done during three month to record the occurrence of aggression. Results： Totally 136 of the 155 participants had been followed. Statistics revealed a satisifed predictive validity and inter-rater reliability, with the ICC of 0.72. As for accuracy, ROC analysis indicated the area under the curve of 0.78 （95% CI： 0.56-0.96）. Conclusion： The application of HCR-20 among psychiatric patients deems to be successful with good validity, reliability and accuracy in violence prediction. In future, through the inclusion of a variety of violence indicators, the assessment or evaluation system could be established to further improve the accuracy of violence risk assessment.