精神分裂症患者肇事肇祸行为发生影响因素调查分析

Influencing factors for the occurrence of causing trouble and accident in schizophrenics:an investigated analysis

目的探讨精神分裂症患者发生肇事肇祸行为的影响因素、预警方法。方法选取在我院进行司法鉴定的肇事肇祸精神分裂症患者100例为研究组,选取同期在我院精神病科住院治疗的无肇事肇祸行为的精神分裂症患者86例为对照组。采用自制一般情况调查表、肇事肇祸行为调查表、简明精神病评定量表(BPRS)、生活事件量表(LES)、社会支持评定量表(SSRS)、早年不良家庭环境问卷、明尼苏达多项人格测验(MMPI-Mf、Pa、Sc、Si)量表等,对两组患者进行调查。结果两组患者的性别、年龄、文化程度、有无配偶情况、病程、服药依从性、住院治疗次数、冲动攻击行为史、酒精滥用情况等比较,差异均有统计学意义(P<0.05)。研究组患者的思维障碍、敌意猜测评分及总分均显著高于对照组,差异有统计学意义(P<0.05);研究组患者正性事件评分显著低于对照组,而负性事件评分、总分显著高于对照组,差异有统计学意义(P<0.05);研究组患者的社会支持评定量表各项评分及总分均显著低于对照组,差异有统计学意义(P<0.05);研究组患者属家庭结构不完整、遭受父母虐待的比例显著高于对照组,差异有统计学意义(P<0.05);研究组患者MMPI-Mf、Si量表评分显著低于对照组,差异有统计学意义(P<0.05)。结论精神分裂症患者肇事肇祸与其病情、人格特征、家庭情况、社会支持状况等因素有关,对这些因素进行综合评估、预警,或能在一定程度上减少不良事件的发生。

Objective To explore the influencing factors and early warning methods for causing trouble and accident behaviors in schizophrenics. Methods A total of 100 schizophrenics undergoing forensic authentication as causing trouble and accident were selected as study group, and 86 schizophrenics without causing trouble and accident who were hospitalized and treated in our hospital were selected as control group during the same period. Employing the self-made general status questionnaire, causing trouble and accident behavior questionnaire, brief psychiatric rating scale(BPRS), life event scale(LES), social support rating scale(SSRS), early adverse family environment questionnaire, Minnesota multiple personality tests(MMPI-Mf, Pa, Sc, Si) scales, etc. to investigate both groups. Results The differences between the two groups in gender, age, education, presence of a spouse, course of the disease, medication compliance, the number of hospitalizations, history of impulsive aggression, and alcohol abuse were statistically significant(P<0.05). The thinking disorder, hostile guess scores and total score of the study group were significantly higher than those of the control group, and the differences were statistically significant(P<0.05). The positive event scores of the study group were significantly lower than those of the control group, while the negative event scores and total score were significantly higher than those of the control group, with statistically significant differences(P<0.05). The various scores and total score of the SSRS in the study group were significantly lower than those in the control group, and the differences were statistically significant(P<0.05). The proportion of patients in the study group belonging to incomplete family structure, and be abused by parents was significantly higher than that in the control group, with a statistically significant difference(P<0.05). The scores of MMPI-Mf and Si scales in the study group were significantly lower than those in the control group, and the differences were statistically significant(P<0.05). Conclusion Schizophrenics causing trouble and accident are related to the conditions of disease, personality characteristics, family status, social support, and so on. Comprehensive evaluation and early warning of these factors may reduce the occurrence of adverse events to a certain extent.