癫痫伴发精神障碍患者攻击行为发生状况及高危因素

Occurrence and high risk factors of aggressive behaviors in patients with epilepsy and mental disorders

目的探究癫痫(EP)伴发精神障碍患者攻击行为发生状况及危险因素。方法选取上饶市第三人民医院于2018年6月至2022年1月收治的120例EP伴发精神障碍患者作为研究对象,采用修改版外显攻击行为量表(MOAS)对所有患者攻击行为发生状况进行评估,并根据患者是否有存在攻击行为分为发生组和未发生组(总分<4分为无攻击行为,总分≥4分为存在攻击行为),统计两组患者基线资料。采用logistic回归分析筛选EP伴发精神障碍患者攻击行为发生的危险因素。结果120例EP伴精神障碍患者中,共45例(37.50%)患者发生攻击行为,75例(62.50%)患者未发生攻击行为;单因素分析结果显示,EP伴精神障碍患者是否发生攻击行为与婚姻状况、受教育程度、社会支持程度、攻击行为史有关,差异有统计学意义(P<0.05);logistic回归模型进行多因素分析结果显示,社会支持(β=1.097,OR=2.995,95%CI=1.550~5.787)、受教育程度(β=1.159,OR=3.187,95%CI=1.424~7.132)、攻击行为史(β=0.963,OR=3.620,95%CI=1.276~5.378)、婚姻状况(β=1.067,OR=2.907,95%CI=1.123~7.520)是EP伴精神分裂患者发生攻击行为的独立危险因素(P<0.05)。结论EP伴发精神分裂患者攻击行为发生的危险因素为社会支持、受教育程度、攻击行为史、婚姻状况,社会应密切关注影响患者攻击行为发生的因素并降低患者攻击行为发生率。

Objective To explore the occurrence and risk factors of aggressive behaviors in patients with epilepsy(EP)and mental disorders.Methods A total of 120 patients with EP and mental disorders who were admitted to Shangrao Third People′s Hospital from June 2018 to January 2022 were selected as the research subjects.The modified overt aggression scale(MOAS)was used to assess the aggressive behaviors,and the patients were divided into occurrence group and non-occurrence group(total score<4 means no aggressive behaviour occurred,total score≥4 means aggressive behaviour occurred)according to the MOAS score.Baseline data of the two groups was collected to screen the risk factors of aggressive behaviors in patients with EP and mental disorders through logistic regression analysis.Results Among the 120 patients with EP and mental disorders,there were 45(37.50%)patients with aggressive behaviors and 75(62.50%)without aggressive behaviors.Baseline data analysis found that there were statistically significant differences between the two groups in marital status,education level,social support and history of aggressive behavior(P<0.05).Logistic regression analysis showed that social support(β=1.097,OR=2.995,95%CI=1.550-5.787),education level(β=1.159,OR=3.187,95%CI=1.424-7.132),history of aggressive behavior(β=0.963,OR=3.620,95%CI=1.276-5.378)and marital status(β=1.067,OR=2.907,95%CI=1.123-7.520)were independent risk factors of aggressive behaviors in patients with EP and mental disorders(P<0.05).Conclusion Social support,education level,history of aggressive behavior and marital status are risk factors of aggressive behaviors in patients with EP and mental disorders.Close attention should be paid to these factors to take measures to prevent aggressive behaviors timely.