深圳市宝安区在册精神分裂症患者高风险行为影响因素交互作用分析  

Interaction analysis of factors influencing high-risk behaviors among registered schizophrenic patients in Bao’an District of Shenzhen City

作　　者：陈卿[1] 刘成锋[1] 程娟 卢楚虹 卿利 苏海云[1] 王永军 胡东生[3] 郭艳芳[1] CHEN Qing;LIU Cheng-feng;CHENG Juan;LU Chu-hong;QING Li;SU Hai-yun;WANG Yong-jun;HU Dong-sheng;GUO Yan-fang(Center of Mental Health,Bao'an Chronic Diseases Prevent and Cure Hospital,Shenzhen 518100,China;Center of Geriatrics,Shenzhen Kangning Hospital,Shenzhen 518118,China;School of Public Health,Shenzhen University,Shenzhen 518061,China)

机构地区：[1]深圳市宝安区慢性病防治院精神卫生中心,深圳518100 [2]深圳市康宁医院老年医学中心,深圳518118 [3]深圳大学公共卫生学院,深圳518061

出　　处：《中华疾病控制杂志》2022年第6期691-695,739,共6页Chinese Journal of Disease Control & Prevention

基　　金：深圳市宝安区科技创新局—2020年宝安区医疗卫生基础研究项目(2020JD099)。

摘　　要：目的了解精神分裂症患者高风险行为发生的影响因素及其交互作用。方法采用普查方法对深圳市宝安区在册精神分裂症患者进行自制危险行为问卷调查,并当面评估该人群危险状况。结果4731例在册精神分裂症患者中,高风险行为发生率为1.06%。多因素Logistic回归分析显示,既往住院次数1次或≥2次、既往有危险行为、社会人际交往能力较差和学习能力较差是精神分裂症患者发生高风险行为的危险因素(OR值分别为2.55、2.73、16.21、3.59和4.01,均有P<0.05)。既往有住院与既往发生过危险行为之间,存在相加交互作用,其交互作用相对超额危险度比(relative excess risk of interaction,RERI)、交互作用归因比(attributable proportion of interaction,API)和交互作用指数(synergy index,S)分别为33.59、0.78和4.96。而各因素之间未见相乘交互作用。结论既往有住院史、既往有危险行为、社会人际交往能力较差和学习能力较差是精神分裂症患者发生高风险行为的危险因素,应予以关注。在社区实际工作中,可将既往有住院和既往发生过危险行为等特征性因素作为精神分裂症患者风险防控的重点指标,及时进行监测和早期预警。Objective To understand the influencing factors and interaction of high-risk behaviors in patients with schizophrenia.Methods A self-designed risk behavior questionnaire was carried out among registered schizophrenic patients in Bao’an District of Shenzhen City using the census method.Their risk status was evaluated face-to-face by the psychiatrist.Results The incidence of high-risk behavior was 1.06%among 4731 registered schizophrenic patients.Multivariate Logistic regression analysis showed that the risk factors of high-risk behavior in schizophrenia patients were had 1 or more than 2 times previous hospitalizations,previous risk behaviors,poor interpersonal skills,and low learning abilities(OR values were 2.55,2.73,16.21,3.59 and 4.01,all P<0.05).There was an additive interaction between previous hospitalization and previous risk behaviors,and the related indexes relative excess risk of interaction(RERI),attributable proportion of interaction(API)and synergy index(S)were 33.59,0.78 and 4.96,respectively.However,there was no multiplicative interaction among the factors.Conclusions People with schizophrenia who have had previous hospitalizations,previously risky behaviors,poor interpersonal skills,and low learning abilities have significant risk factors of high-risk behaviors,which are worth evaluating.It is possible to identify the key factors involved in the prevention and management of schizophrenia through the community’s practical work,including characteristics such as previous hospitalizations and risk behaviors,and timely monitoring and early warning can be implemented.

关 键 词：精神分裂症 高风险 影响因素 交互作用 

分 类 号：R749.3[医药卫生—神经病学与精神病学]