伴冲动行为的流浪救助精神病患者甲状腺激素水平及其人格特征分析

Evaluation of thyroid hormone levels and personality characteristics in homeless mentally ill patients with impulsive aggressive behavior

目的评估伴冲动行为的流浪救助精神病患者甲状腺激素水平及其人格特征,为流浪精神病患者的救助以及管理提供参考。方法选择佛山市南海区罗村医院心身医学科2018年3月至2019年3月间收治的伴冲动行为流浪精神病患者116例作为观察组,同时选取同一时期普通住院精神病患者116例作为对照组。分析伴冲动行为的流浪救助患者病谱分布、甲状腺激素水平异常情况以及两组患者的人格特征。结果116例流浪救助精神病患者中最常见的是精神分裂症,占50.00%;观察组患者的甲状腺激素检测结果显示,三碘甲状腺原氨酸(T3)水平异常者占25.00%,甲状腺素(T4)水平异常者占30.17%,游离三碘甲状腺原氨酸(FT3)水平异常者占22.41%,游离甲状腺素(FT4)水平异常者占16.38%,促甲状腺素(TSH)水平异常者占25.86%;观察组和对照组患者的言语攻击[(2.41±1.59)分vs(1.02±0.56)分]、财产攻击[(3.21±0.93)分vs(1.12±0.78)分]、自身攻击[(1.59±0.74)分vs(1.38±0.87)分]、体力攻击[(2.29±0.85)分vs(1.05±0.62)分]评分比较,观察组明显高于对照组,差异均具有统计学意义(P<0.05);观察组和对照组患者的说谎量表[(55.89±11.68)分vs(51.72±12.61)分]、疑病量表[(68.59±14.35)分vs(57.58±14.68)分]、抑郁量表[(68.11±15.58)分vs(55.15±8.85)分]、癔病量表[(64.25±15.55)分vs(57.25±13.25)分]、妄想狂量表[(68.25±13.85)分vs(61.25±11.58)分]、社会内向量表[(64.01±11.54)分vs(54.22±13.15)分]评分比较,观察组明显高于对照组,差异均有统计学意义(P<0.05)。结论伴冲动行为流浪精神病患者多存在甲状腺功能异常,因此在对患者治疗的过程中应关注患者甲状腺激素水平变化并根据患者人格特征进行早期干预,以确保患者得到及时有效的医疗援助。

Objective To assess thyroid hormone levels and personality characteristics of homeless mentally ill patients with impulse aggressive behaviors,and to provide a reference for the rescue and management of homeless mentally ill patients.Methods From March 2018 to March 2019,116 homeless mentally ill patients with impulse aggressive behaviors,whoa admitted to Department of Psychosomatic Medicine of Luocun Hospital of Nanhai District of Foshan City were selected as the observation group.At the same time,116 patients with ordinary inpatients with psychotic symptoms were selected as the control group.The distribution of disease spectrum,abnormal thyroid hormone levels and personality characteristics of the two groups were analyzed.Results Among 116 vagrant mentally ill patients,schizophrenia was the most common,accounting for 50.00%.The results of thyroid hormone test showed that 25.00%of the patients in the observation group had abnormal levels of triiodothyronine(T3),30.17%of them had abnormal levels of thyroxine(T4),22.41%of them had abnormal levels of free triiodothyronine(FT3),and 16.38%of them had abnormal levels of free thyroxine(FT4),25.86%of the patients had abnormal TSH level;the evaluated scores of speech attack,property attack,self-attack,physical attack of the observation group were(2.41±1.59)points,(3.21±0.93)points,(1.59±0.74)points,(2.29±0.85)points,respectively,which were significantly higher than corresponding(1.02±0.56)points,(1.12±0.78)points,(1.38±0.87)points,(1.05±0.62)points in the control group(all P<0.05);the evaluated scores of lying scale,hypochondriac scale,depression scale,Paranoia Scale,social introversion scale,and hysteria scale of the observation group were(55.89±11.68)points,(68.59±14.35)points,(68.11±15.58)points,(64.25±15.55)points,(68.25±13.85)points,(64.01±11.54)points,respectively,which were significantly higher than corresponding(51.72±12.61)points,(57.58±14.68)points,(55.15±8.85)points,(57.25±13.25)points,(61.25±11.58)points,(54.22±13.15)points of the control group(all P<0.05).Conclusion The homeless mentally ill patients with impulse aggressive behaviors often have thyroid dysfunction.Therefore,in the course of treating patients,we should be paid attention to the changes of thyroid hormone levels,and make early intervention based on the personality characteristics of patients,so as to ensure that patients receive timely and effective medical assistance.