双相情感障碍患者自知力水平与冲动攻击行为的相关性

Self-perception level and impulsive aggressive behavior in patients with bipolar affective disorder

目的:观察并分析双相情感障碍患者自知力水平与冲动攻击行为的相关性。方法:选取沈阳市精神卫生中心和中国医科大学第一附属医院2018年7月~2019年9月接受治疗的双相情感障碍患者117例作为研究对象。所有患者均接受外显行为攻击量表(MOAS)、Barratt冲动量表11(BIS-11)、自知力与治疗态度问卷(ITAQ)调查。参照MOAS量表评分和BIS-11量表评分,根据双相情感障碍患者是否出现冲动攻击分为冲动组和非冲动组。分析双相情感障碍患者自知力水平与冲动攻击行为之间的关系。结果:117例患者中发生冲动攻击行为患者53例(45.30%);冲动组对疾病、住院、服药、疾病复发及求助方式认识和总分均低于非冲动组,差异有统计学意义(P<0.05);经双变量Pearson直线相关检验结果显示,双相情感障碍患者对疾病、对住院、对服药、对疾病复发及求助方式认识得分和总分与冲动攻击行为MOAS、BIS-11评分呈负相关(r<0,P<0.001);经Logistic回归分析结果显示,双相情感障碍患者对疾病、住院、服药、疾病复发及求助方式认识低可能是诱发冲动攻击行为的影响因素(OR>1,P<0.05)。结论:双相情感障碍患者普遍存在冲动攻击行为发生风险,可能与患者自知力水平低下有关,早期评估双相情感障碍患者自知力水平可能对早期冲动性攻击行为防御性干预措施制定有一定指导价值。

Objective:To observe and analyze the correlation of self-perception level with impulsive aggression in patients with bipolar affective disorder.Methods:One hundred and seventeen patients with bipolar affective disorder undergone treatment in the two institutions of the authors were included from July 2018 to September 2019.All patients underwent measurement with modified overt aggression scale(MOAS),Barratt impulsiveness scale 11(BIS-11),insight and treatment attitude questionnaire(ITAQ).Then the patients were divided into impulsive and non-impulsive groups based on the scores measured by MOAS and BIS-11 scales to analyze the relationship between the self-perception level and impulsive aggressive behaviors.Results:Of the 117 patients,53 patients(45.30%)had impulsive aggression.The awareness towards disease,treatment on hospital stay basis,medication,disease recurrence and means to seek help as well as total scores were lower than in patients from impulsive group than in those from non-impulsive group(P<0.05).Bivariate Pearson linear correlation test results showed that the patients′scoring on awareness towards disease,treatment on hospital stay basis,medication,disease recurrence and means to seek help as well as total scores was negatively correlated with MOAS and BIS-11 scores(r<0,P<0.001).Logistic regression analysis showed that lower awareness towards disease,treatment on hospital stay basis,medication,disease recurrence and means to seek help were important factors to induce impulsive aggressive behaviors in patients of bipolar affective disorder(OR>1,P<0.05).Conclusion:Risks of impulsive aggression remains in patients with bipolar affective disorder,which may be related to the lower level of self-insight.The findings suggest that early assessment of the self-perception level can be valuable for planning intervention measures to prevent impulsive aggression in patients with bipolar affective disorder.