酒精相关精神障碍患者攻击行为危险因素研究

Risk Factors of Aggressive Behaviors in Patients with Alcohol-related Mental Disorders

目的探讨酒精相关精神障碍的男性住院患者发生攻击行为的社会环境、生物学及精神心理认知因素,为其发生攻击行为的预测和干预提供依据。方法选取2012—2013年于赣州市第三人民医院住院的酒精相关精神障碍的男性患者222例为研究对象。采用自制的一般资料调查表收集患者基本情况,包括人口学特征及饮酒情况、社会环境、生物学特征、精神心理认知情况;采用修订版外显攻击行为量表(MOAS)评价患者日常各类危险行为,根据MOAS总分,将患者分为攻击组(≥4分,113例)和非攻击组(<4分,109例)。结果两组患者居住模式、教育方式、幻觉、思维障碍、睡眠异常比较,差异均无统计学意义(P>0.05)。两组文化程度、住址、家庭结构完整性、儿童时期不良经历、既往攻击史、合并其他躯体疾病、诊断类型、接触异常、情感活动异常、伴发情绪障碍、易激惹、妄想比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,文化程度[OR=2.660,95%CI(1.045,6.769)]、儿童时期不良经历[OR=2.075,95%CI(1.113,3.869)]、既往攻击史[OR=3.232,95%CI(1.560,6.699)]、合并其他躯体疾病[OR=0.348,95%CI(0.183,0.622)]、诊断类型[OR=3.867,95%CI(1.005,14.883)]、接触异常[OR=2.774,95%CI(1.284,5.993)]是酒精相关精神障碍男性患者发生攻击行为的影响因素(P<0.05)。结论文化程度低、有儿童时期不良经历和既往攻击史、未合并其他躯体疾病、诊断类型为酒精所致精神病性障碍或行为障碍及接触异常的酒精相关精神障碍男性住院患者有较高的攻击行为风险。

Objective To explore the effect of social environment,biological characteristics,psychosocial cognition on aggressive behaviors in male hospitalized patients with alcohol-related mental disorders,and to provide reference for the prediction and intervention of their potential aggressive behaviors. Methods A total of 222 male patients with alcohol-related psychiatric disorders who had been hospitalized in the Third People＇s Hospital of Ganzhou from 2012 to 2013 were selected as the subjects. The basic information of the patients was collected by using the self-made general information questionnaire,including demographic characteristics,drinking,social environment,biological characteristics,psychosocial cognition. Then,we divided the patients into aggressive group（ ≥4 points,113 cases） and non-aggressive group（ 4 points,109 cases） by applying Modified Overt Aggression Scale（ MOAS） to evaluate the daily aggression behaviors of patients. Results There were no statistically significant differences in the mode of residence,education mode,hallucinations,dyslexia and sleep abnormality between the two groups（ P〈 0. 05）. However,there were statistically significant differences in the education level,resident area,family structure integrity,childhood bad experience,previous aggression history,combined with other physical illnesses,type of diagnosis,exposure to abnormalities,emotional activity abnormality,mood disorder,irritability and delusions between the two groups（ P〈 0. 05）. Multivariate Logistic regression analysis showed that education level [OR = 2. 660,95% CI（ 1. 045,6. 769） ],childhood bad experience [OR = 2. 075,95% CI（ 1. 113,3. 869） ],previous aggression history [OR= 3. 232,95% CI（ 1. 560,6. 699） ],combined with other physical illnesses [OR = 0. 348,95% CI（ 0. 183,0. 622） ],type of diagnosis [OR = 3. 867,95% CI（ 1. 005,14. 883） ],exposure to abnormalities [OR = 2. 774,95% CI（ 1. 284,5. 993） ]were influencing factors for aggressive behaviors in patients with alcohol-related mental disorders（ P〈 0. 05）.Conclusion The male hospitalized patients with alcohol-related mental disorders with the following factors are more likely to commit aggressive behavior,such as low level of education, childhood bad experience, previous aggression history, without combination of physical illnesses, diagnosis of alcohol-induced psychotic disorders or behavioral disorders and exposure to abnormalities.