摘要
目的 比较精神分裂症患者伴强迫思维与伴强迫行为的暴力风险与治疗。方法 门诊收集46例伴强迫思维的精神分裂症患者和46例伴强迫行为的精神分裂症患者,对其进行暴力风险评定;患者用抗精神病药联合抗强迫药治疗12周,在治疗前及治疗第4、8、12周末,采用阳性与阴性症状量表(PANSS)评定精神症状、耶鲁-布朗强迫量表(Y-BOCS)评定强迫症状、改进版外显攻击行为量表(MOAS)评定暴力风险。结果 Logistic回归分析显示,伴强迫思维、精神病性症状不稳定、男性是暴力风险高的危险因素(OR=13.811,P=0.001;OR=34.183,P=0.002;OR=4.644,P=0.034)。治疗12周后,两组组内各时间点PANSS、Y-BOCS、MOAS总分随时间延长均呈下降趋势(P<0.05)。两组间比较,PANSS总分差异无统计学意义(F=1.52,P=0.221),Y-BOCS、MOAS总分差异有统计学意义(F=7.179,P=0.009;F=6.067,P=0.016)。两组PANSS、Y-BOCS、MOAS总分存在时间主效应(P均<0.001)和交互效应(P<0.05)。伴强迫思维组Y-BOCS、MOAS总分减少较伴强迫行为组明显。两组8、12周末比较,伴强迫行为组Y-BOCS总分高(P<0.01);两组治疗前、4周末比较,伴强迫思维组MOAS总分高(P<0.01)。结论 伴强迫思维的精神分裂症患者的暴力风险明显高于伴强迫行为者;抗精神病药联合抗强迫药治疗能降低伴强迫症状的精神分裂症患者的暴力风险。
Objective To compare the violent risk and clinical treatment of schizophrenia with obsessive-compulsive thinking versusobsessive-compulsive behavior.Methods A total of 46 outpatients with schizophrenia and obsessive-compulsive thinking and 46 outpatients with schizophrenia and obsessive-compulsive behavior were recruited.They were all treated with antipsychotics and anti-compulsions drugs for 12 weeks.Before the treatment,and at 4,8 and 12 weeks of treatment,patients were assessed using the the Positive and Negative Symptoms Scale(PANSS)for mental symptoms,the Yale-Brown Obsessive-Compulsive Scale(Y-BOCS)for obsessive-compulsive symptoms,and the modified explicit aggressive behavior scale(MOAS)for the violent risk.Results Logistic regression showed that obsessive-compulsive thinking(OR=13.811,P=0.001),unstable psychotic symptoms(OR=34.183,P=0.002)and male sex(OR=4.644,P=0.034)were the risk factors for violence in schizophrenia patients with obsessive-compulsive thinking and behavior.After 12 weeks of treatment,the total scores of PANSS,Y-BOCS,and MOAS at each time point in both groups were gradually reduced with time(P<0.05).There were no significant differences in the total PANSS scores between groups(F=1.52,P=0.221).There were significant differences in the total scores of Y-BOCS(F=7.179,P=0.009)and MOAS(F=6.067,P=0.016)between groups.Significant main effect of time(P<0.001)and interaction effect(P<0.05)were detected in the total scores of PANSS,Y-BOCS and MOAS between groups.The declines of the total scores of Y-BOCS and MOAS were more pronounced in schizophrenia patients with obsessive-compulsive thinking than those with obsessive-compulsive behavior.At 8 and 12 weeks,the total scores of Y-BOCS were significantly higher in schizophrenia patients with obsessive-compulsive behavior than those with obsessive-compulsive thinking(P<0.01).Before the treatment and at 4 weeks of treatment,the total scores of MOAS were significantly higher in schizophrenia patients with obsessive-compulsive thinking than those with ob
作者
林晓东
曲军民
于君
李金明
Lin Xiaodong;Qu Junmin;Yu Jun;Li Jinming(Second ward of psychiatry,Laizhou Rongjun Hospital,Laizhou 261400,China;First ward of psychiatry,Laizhou Rongjun Hospital,Laizhou 261400,China;Fourth ward of psychiatry,Laizhou Rongjun Hospital,Laizhou 261400,China)
出处
《临床荟萃》
CAS
2023年第3期255-259,共5页
Clinical Focus
关键词
精神分裂症
强迫思维
强迫行为
暴力风险
schizophrenia
obsessive thinking
compulsive behaviors
violent risk
