女性严重精神障碍患者攻击行为与雄激素及甲状腺素相关性研究

Correlational Study between Aggressive Behavior and Androgen and Thyroxine in Female Patients with Severe Mental Disorders

目的:探讨女性严重精神障碍患者冲动行为与雄激素、甲状腺激素水平的相关因素。方法:选取2020年1月—2023年7月厦门市仙岳医院收治的99例女性严重精神障碍(精神分裂症、双相情感障碍)患者作为观察组,研究患者基线时修订版外显攻击行为量表(MOAS)评分、精神病态量表(PCL-R)评分与患者雄激素及甲状腺素水平的相关性,所有患者进行1个月的治疗观察,分析患者治疗前后雄激素及甲状腺素水平的变化,治疗后MOAS评分、PCL-R评分与基线时激素水平的关系,比较治疗1个月期间约束与否的患者基线激素水平。结果:患者的基线雄激素水平与基线MOAS1、MOAS2、MOAS4、MOAS总分、PCL-R3、PCL-R4、PCL-R6、PCL-R7、PCL-R10、PCL-R14、PCL-R15、PCL-R16、PCL总分均存在相关性。被试基线FT_(3)水平与基线MOAS1、MOAS2、MOAS4、MOAS总分、PCL-R1、PCL-R9、PCL-R14、PCL-R16、PCL-R总分均存在相关性,且治疗后MOAS1分、MOAS总分与基线雄激素水平均存在相关性(P<0.05),治疗前游离三碘甲状腺原氨酸(free triiodothyronine,FT_(3))、游离甲状腺素(free thyroxine,FT_(4))均高于治疗后,而治疗前促甲状腺激素(thyroid stimulating hormone,TSH)低于治疗后,差异均有统计学意义(P<0.05),按治疗过程中患者是否被约束进行分组比较,发现被约束组表现出较高的雄激素水平,差异有统计学意义(P<0.05)。结论:女性严重精神障碍患者冲动行为与其雄激素、甲状腺素水平有关,当其经治疗病情好转后,激素水平改善,基线时雄激素水平对患者治疗过程中攻击风险的预后评估、受约束风险具有预测作用。

Objective:To investigate the correlation factors between impulsive behavior and androgen and thyroid hormone levels in female patients with severe mental disorders.Method:A total of 99 female patients with severe mental disorders(schizophrenia and bipolar disorder)admitted to Xiamen Xianyue Hospital from January 2020 to July 2023 were selected as the observation group to study the correlation between baseline modified overt aggression scales(MOAS)scores,psychopathy checklist revised(PCL-R)scores and androgen and thyroxine levels of patients.All subjects were observed for one month,and the changes of androgen and thyroxine levels before and after treatment was compared,the relationship between MOAS score and PCL-R score after treatment and baseline hormone levels was analyzed,baseline hormone levels were compared in patients with or without restraint during 1 month of treatment.Result:Baseline androgen levels were associated with baseline MOAS1,MOAS2,MOAS4,total MOAS score,PCL-R3,PCL-R4,PCL-R6,PCL-R7,PCL-R10,PCL-R14,PCL-R15,PCL-R16,and total PCL score;baseline FT_(3)levels were correlated with baseline MOAS1,MOAS2,MOAS4,MOAS total score,PCL-R1,PCL-R9,PCL-R14,PCL-R16,and total PCL score,and there were correlation between baseline androgen level and MOAS1 score,MOAS total score after treatment(P<0.05).Free triiodothyronine(FT_(3))and free thyroxine(FT_(4))were higher before treatment than those after treatment,and the thyroid stimulating hormone(TSH)before treatment was lower than that after treatment,the differences were statistically significant(P<0.05).The subjects were grouped according to whether they were restrained or not during treatment,it was found that the restrained group showed higher androgen levels,the difference was statistically significant(P<0.05).Conclusion:The impulsive behavior of female patients with severe mental disorders is related to the levels of androgen and thyroxine,and the hormone levels improve after treatment.Baseline androgen levels can predict the prognosis of aggression risk and the risk of restraint during treatment.