影响精神分裂症病人攻击行为的相关因素分析

Relevant influencing factors of aggressive behaviors in patients with schizophrenia

[目的]探究影响精神分裂症病人攻击行为的相关因素。[方法]招募251例精神分裂症病人,将修改版外显攻击行为量表(MOAS)≥4分的病人为攻击行为组,MOAS<4分的病人为非攻击行为组。给予两组病人MOAS、阳性和阴性症状量表(PANSS)、社会支持评定量表(SSRS)、童年创伤问卷(CTQ)、修订版精神病态清单(PCL R)评估,分析病人攻击行为的影响因素。[结果]攻击行为组病人在PANSS中的阳性症状量表、一般精神病理症状量表及激活性、偏执、攻击症状群的评分明显高于非攻击行为组;攻击行为组病人在SSRS中的客观支持、主观支持维度的评分明显低于非攻击行为组;攻击行为组病人在CTQ中的情感虐待和情感忽视维度的评分明显高于非攻击行为组;攻击行为组病人在PCL R中的反社会因子评分明显高于非攻击行为组;Logistic回归分析结果显示:阳性症状、激活性、偏执、攻击、情感虐待、反社会因子是攻击行为的危险因素,而客观支持是其保护性因素。[结论]临床评估精神分裂症病人的攻击行为中需要注意其相关的精神症状、童年创伤及主客观支持等复杂的相关因素。

Objective:To probe into the relevant factors that influence aggressive behaviors in patients with schizophrenia.Methods:A total of 251 patients with schizophrenia were recruited.The score of Modified Over Aggression Scale(MOAS)≥4 points was classified as the aggressive behaviors group,and the MOAS<4 points was classified into the non aggressive behaviors group.Two groups of patients were assessed by using the Modified Over Aggression Scale(MOAS),the Positive and Negative Symptoms Scale(PANSS),the Social Support Rating Scale(SSRS),the Childhood Trauma Questionnaire(CTQ)and the Psychopathy Checklist Revised(PCL R).And then,the influencing factors of patients'aggressive behaviors were analyzed.Results:The scores of the positive symptoms scale,the general psychopathological symptoms scale,and the activating,paranoid,and attack symptoms clusters in PANSS in the aggressive behaviors group were significantly higher than those in the non aggressive behaviors group.The patients'scores of objective and subjective support dimensions in SSRS in the aggressive behaviors group were significantly lower than those in the non aggressive behaviors group.The scores of emotional abuse and emotional neglect dimensions in CTQ in the aggressive behaviors group were significantly higher than those in the non aggressive behaviors group.The patients'anti social factor scores in PCL R in the aggressive behaviors group were significantly higher than those in the non aggressive behaviors group.Logistic regression analysis showed that the positive symptoms,activating,paranoia,attacks,emotional abuse and anti social factors were risk factors for causing aggressive behaviors,while objective support was a protective factor.Conclusion:In clinical evaluation of aggressive behaviors of schizophrenia patients,it is necessary to pay attention to the complicated related factors,such as relevant mental symptoms,childhood trauma and subjective and objective support.