严重精神障碍患者肇事肇祸临床调查分析

Clinical investigation and analysis of troublemaking of patients with severe mental disorders

目的:探讨严重精神障碍患者肇事肇祸的危险因素。方法:将864例严重精神障碍患者连续入组,分为肇事肇祸组(380例)和非肇事肇祸组(484例)。采用自制调查表、简明精神病评定量表(BPRS),阳性和阴性症状量表评分表(PANSS)和日常生活功能量表(ADL)对两组患者进行横断面调查,并运用Logistic回归方法对影响严重精神障碍患者肇事肇祸的因素进行分析。结果:两组患者在BPRS总分、敌对猜疑、激活性和思维障碍三个因子得分及PANSS总分上差异明显(P<0.05);在焦虑抑郁及缺乏活力两个因子得分及ADL总分上差异无统计学意义(P>0.05)。性别(RR=19.2)、自知力(RR=3.7)、疾病严重程度(RR=2.1)是严重精神障碍患者肇事肇祸的相对危险因素。结论:严重精神障碍患者肇事肇祸发生率高,应加强对严重精神障碍患者的救治。

Objective： To explore risk factors of troublemaking of patients with severe mental disorders. Methods： A total of 864 consecutive patients with severe mental disorders were included and divided into troublemaking group （ n = 380） and non- trouble-making group （ n = 484 ）. They were cross - sectionally studied with a self - made questionnaire, brief psychiatric reacting scale （ BPRS） , positive and negative syndrome scale （ PANSS） and activity of daily living scale （ ADL）. Logistic regression method was used to explore the risk factors of troublemaking. Results ： There were significant differences in the PANSS and BPRS total scores and the factor scores of hostile suspicion, activation, thought disturbance （P 〈0.05） ; however, there were no significant differences in the factor scores of anxiety-depression and lack of vitality, and ADL total score （ P 〉0. 05）. Gender （ RR = 19. 2） , insight （ RR = 3.7）, and disease severity （RR = 2. 1） were the relative risk factors for the psychiatric patients＇ troublemaking. Conclusions ： The trouble-making rate of the patients with severe mental disorders is very high, and it should strengthen the treatment to them.