严重精神障碍患者的高危行为风险因素分析  

Risk factors of high-risk behaviors in patients with severe mental disorders

作　　者：张宴萍 魏雪辉 姚晓萍 李俊 王文静 罗文秀[5] ZHANG Yan-ping;WEI Xue-hui;YAO Xiao-ping;LI Jun;WANG Wen-jing;LUO Wen-xiu(Prevention and Control Department of Jinshan District Mental Health Center,Shanghai 201515,China;不详)

机构地区：[1]上海市金山区精神卫生中心防治科,上海201515 [2]上海市金山工业区社区卫生服务中心院部 [3]上海市金山区朱泾镇社区卫生服务中心 [4]同济大学附属杨浦医院全科医学与社区发展中心 [5]上海市金山区精神卫生中心院部

出　　处：《现代预防医学》2021年第21期3935-3939,共5页Modern Preventive Medicine

基　　金：上海市金山区科委医药卫生类科技创新项目(2019-3-29)。

摘　　要：目的分析影响社区居家严重精神障碍患者的高危行为因素,为更好地开展风险监测、预警和干预模式提供依据。方法收集存在危害他人/自身安全行为或危险的严重精神障碍患者240例为病例组,近3年未出现过高危行为的患者240例为对照组。收集患者的基本信息、疾病情况、家庭及社区管理等因素进行病例对照研究。结果病例组以男性为主,精神分裂症居多(134例,55.83%),平均入院年龄(41.57±13.125)岁,病程(M)11.5年;两组在不同的婚姻状态、精神疾病家族史、病程、暴力行为史、就业状态、家庭经济状况、享受以奖代补政策、自知力程度上差异均有统计学意义(P<0.05)。丧偶或离异[OR(95%CI)=4.487(2.033~9.902)]、有精神疾病家族史[OR(95%CI)=2.017(1.091~4.311)]、无业[OR(95%CI)=2.152(1.053~4.399)]、家庭经济贫困[OR(95%CI)=2.631(1.205~5.742)]、有暴力行为史[OR(95%CI)=6.619(1.305~33.558)]是发生高危行为的影响因素。结论离异/丧偶状态、家族史阳性、家庭贫困、无业、有暴力行为史患者是严重精神障碍患者可能出现高危行为的风险人群。在社区服务中应加强管理,降低患者高危行为的发生。Objective To analyze the risk factors of high-risk behaviors of patients with severe mental disorders in community,and to provide basis for risk monitoring,early warning and intervention mode.Methods 240 patients with severe mental disorders who had behaviors or peril endangering others or themselves with the assistance of police were included in the study group,and 240 patients with severe mental disorders who had no high-risk behaviors in recent 3 years were included in the control group.The basic information of patients,disease condition,family and community management factors were collected for case-control study.Results Most of the patients with high-risk behaviors were male,schizophrenic patients were predominant(134 cases,55.83%).In study group,the average age was(41.57±13.125)years old,and the course of disease was 11.5 years.Marital status,family history of mental illness,the course of disease,history of violence,employment status,family economic status,reward instead of compensation policy and degree of insight in two groups were significantly different(P<0.05).Divorced/widowed[OR(95%CI)=4.487(2.033-9.902)],positive family history[OR(95%CI)=2.017(1.091-4.311)],jobless[OR(95%CI)=2.152(1.053-4.399)],family poverty[OR(95%CI)=2.631(1.205-5.742)],history of violence[OR(95%CI)=6.619(1.305-33.558)]were the influencing factors of high-risk behaviors.Conclusion People with divorced/widowed status,positive family history,poverty,unemployment,history of violence are the risk factors for high-risk behaviors in patients with severe mental disorders.In the community management service,more attention should be paid to the high-risk groups with static factors,and targeted measures should be taken to improve the dynamic variable factors,and reduce high-risk behaviors of patients.

关 键 词：严重精神障碍 高危行为 风险因素 病例对照研究 

分 类 号：R749[医药卫生—神经病学与精神病学]