男性住院精神分裂症患者的攻击行为特征研究（英文）

Characteristics of aggressive behavior among male inpatients with schizophrenia

背景:精神分裂症等重性精神障碍患者攻击行为发生率高于普通人群,相关因素的探讨对于该人群攻击行为的预防和干预有重要意义。目的:了解某综合医院精神科男性住院精神分裂症患者的攻击行为特征。方法:采用连续取样法,收集了75例自2015年8月至2016年2月在中南大学湘雅二医院精神科男病房住院的精神分裂症患者。使用自编的一般情况调查问卷、修订版外显攻击行为量表(MOAS)、暴力历史、临床、风险评估量表(HCR-20)、精神病态清单(PCL-R)、阳性与阴性症状量表(PANSS)在入院后3天内对患者进行评估。根据MOAS各项的得分,将研究对象分为攻击组(39例)和非攻击组(36例),比较两组间在社会人口学特征以及各个评估工具上得分的差异。结果:HCR-20中的H1(既往暴力事件)、H2(年轻时的暴力事件)、H10(既往不服从管教)、C4(冲动性),PCL-R的反社会因子,PANSS的激活性症状群、偏执症状群、抑郁症状群在攻击组得分高于非攻击组,且差异有统计学显著性。结论:有暴力行为史,既往不服管教,具有反社会人格特征,表现冲动,伴有焦虑抑郁情绪可能是男性住院精神分裂症患者发生攻击行为的相关因素。

Background： The incidence of the aggressive behavior is higher among the patients with severe mental disorder such as schizophrenia than the general population. The study of factors related to aggressive behavior has great meaning in designing prevention and intervention methods with this population of patients. Aims： To understand the characteristics of assaultive behavior of male patients with schizophrenia who have been hospitalized. Methods： Using a continuous sampling method, data from 75 male inpatients with a diagnosis of schizophrenia was collected at the psychiatric unit of Central South University Second Xiangya Hospital （Changsha, China） from August 2015 to February 2016.On the third day after hospitalization participants were given a general questionnaire as well as being assessed using the modified overt aggression scale （MOAS）, historical clinical risk management-20 （HCR-20） questionnaire, hare psychopathic checklist-revised （PCL-R）, and positive and negative syndrome scale （PANSS）.Based on results of the MOAS participants were group into an ＇aggressive behavior＇ group （39 cases） and ＇non-aggressive behavior＇ group （36 cases）. The differences in socio-demographic characteristics and scores on the other evaluation tools were then compared between these two groups. Results： Participants in the ＇aggressive behavior＇ group had significantly different scores in the HCR-20 in the H1 （past violence events）, H2 （violent events when young）, H10 （disobedience in the past）, and C4 （impulsiveness） sections; as well in the anti-social section of PCL-R; and significantly higher PANSS scores in the positive symptom, depressive symptoms and paranoid symptom sections than those in the ＇non- aggressive behavior＇ group. Conclusions： A combination of adverse and traumatic life events such as a history of violence, vulnerabilities in ones personality （e.g. impulsive or antisocial tendencies） and psychopathology of current illness （e.g. significant anxiety and depressive symptoms） contribute to aggressive behavior in male inpatients with schizophrenia. Our results contribute to the literature that will hopefully aid in ensuring patient and staff safety, as well as providing more information in working with this vulnerable population.