中国住院精神分裂症患者攻击行为相关因素的meta分析

A meta-analysis of related factors of aggressive behavior in hospitalized Chinese patients with schizophrenia

目的:系统分析中国住院精神分裂症患者攻击行为的相关因素。方法:检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane Library、Embase数据库,收集建库至2023年6月发表的有关我国住院精神分裂症患者攻击行为相关因素的病例对照研究。使用Review Manager5.3进行分析,计算合并OR(95%CI)值。结果:共纳入33篇研究。医疗保护(OR=3.86,95%CI:2.75~5.43)、失业(OR=1.44,95%CI:1.14~1.81)、家族史阳性(OR=2.97,95%CI:2.29~3.87)、药物依从性差(OR=4.37,95%CI:3.36~5.69)、年轻(OR=3.13,95%CI:2.66~3.69)、非自愿住院(OR=3.34,95%CI:2.81~3.97)、抑郁(OR=2.11,95%CI:1.68~2.66)、遭受到情感虐待(OR=1.13,95%CI:1.04~1.23)、男性(OR=2.70,95%CI:2.20~3.31)、妄想(OR=2.14,95%CI:1.69~2.71)、幻听(OR=2.23,95%CI:1.70~2.94)、遭遇重大生活事件(OR=3.21,95%CI:1.90~5.42)、既往有攻击行为史(OR=2.20,95%CI:2.06~2.34)为攻击行为的危险因素,社会支持(OR=0.46,95%CI:0.31~0.67)为其保护因素。结论:中国住院精神分裂症患者攻击行为相关因素多样,医护人员应根据相关因素早期识别高危人群。

Objective:To systematically review the factors related to the aggressive behavior of hospitalized patients with schizophrenia in China.Methods:CNKI,Wanfang,VIP,China Biomedical Literature Database,PubMed,Cochrane Library,and Embase databases were searched to collect case-control studies on factors related to aggression in hospitalized patients with schizophrenia in China from its inception to June 2023.Analysis was performed using ReviewManager 5.3 to calculate pooled OR(95%CI)values.Results:Thirty-three studies were included.Medical staff coercive measures(OR=3.86,95%CI:2.75-5.43),unemployment(OR=1.44,95%CI:1.14-1.81),positive family history(OR=2.97,95%CI:2.29-3.87),poor medication compliance(OR=4.37,95%CI:3.36-5.69),young age(OR=3.13,95%CI:2.66-3.69),involuntary hospitalization(OR=3.34,95%CI:2.81-3.97),depression(OR=2.11,95%CI:1.68-2.66),emotional abuse(OR=1.13,95%CI:1.04-1.23),male(OR=2.70,95%CI:2.20-3.31),delusions(OR=2.14,95%CI:1.69-2.71),auditory hallucinations(OR=2.23,95%CI:1.70-2.94),and major life events(OR=3.21,95%CI:1.90-5.42)and previous history of aggressive behavior(OR=2.20,95%CI:2.06-2.34)were risk factors associated with aggressive behavior in Chinese patients with schizophrenia,and social support(OR=0.46,95%CI:0.31-0.67)was a protective factor.Conclusion:There are various factors related to aggressive behavior in hospitalized Chinese patients with schizophrenia,and medical staff should identify high-risk groups early according to the relevant factors,and effectively intervene in controllable factors to reduce the occurrence of aggressive behavior.