摘要
目的探究精神分裂症患者不同等级暴力风险下事件相关电位P300的变化特点及精神分裂症患者暴力行为的影响因素。方法收集2019年1月至2020年8月就诊于石河子市绿洲医院的精神分裂症患者158例,并对其进行为期3 d的暴力风险评估,将符合纳入标准的患者按照评估结果分为低风险组(n=78)、中风险组(n=51)和高风险组(n=29),各组患者在3 d内完成听觉P300的检测,并观察1周内患者是否发生暴力攻击行为。采用SPSS 20.0软件进行数据处理,使用方差分析研究不同暴力风险分组P300的变化,使用Logistic回归分析研究精神分裂症患者暴力行为的影响因素。结果三组患者的P300的潜伏期差异无统计学意义(χ^(2)=4.71,P=0.10),波幅差异有统计学意义(F=6.67,P<0.01)。两两比较发现,与低风险组[(12.14±9.19)μV]比较,中风险组[(8.25±7.13)μV]和高风险组[(6.71±4.97)μV]患者的P300波幅均降低,差异有统计学意义(t=-3.14,-5.45,均P<0.05)。高风险组与中风险组比较,两组患者的P300波幅差异无统计学意义(t=-2.31,P>0.05)。发生暴力行为的精神分裂症患者与未发生暴力行为的患者相比,其P300潜伏期和波幅差异均有统计学意义(Z=-6.30,9.78,均P<0.01)。BVC等级高(与高风险组相比,低风险组:OR=0.03,95%CI:0.00~0.35;中风险组:OR=0.09,95%CI:0.01~0.62)、P300潜伏期(OR=1.30,95%CI:1.13~1.48)延长和波幅降低(OR=0.50,95%CI:0.36~0.70)、有被害妄想(OR=0.12,95%CI:0.02~0.76)是发生暴力行为的危险因素。结论P300的潜伏期和波幅可以作为评估精神分裂症患者暴力风险的可靠性神经电生理指标,对于评估精神分裂症患者的暴力行为有重要的临床应用价值。
Objective To explore the change characteristics of event-related potential P300 in different violence risk levels of schizophrenic patients and analyze the risk factors of violence in schizophrenic patients.Methods Totally 158 schizophrenic patients in Lyuzhou hospital of Shihezi City from January 2019 to August 2020 were collected and assessed with the violence risk scale for 3 days.According to the assessment results,the patients who met the inclusion criteria were divided into low-risk group(n=78),medium-risk group(n=51)and high-risk group(n=29).The auditory P300 of patients in each group was completed within 3 days and act of violence was observed and recorded within one week.Data analysis was carried out by SPSS 20.0 software.The changes of P300 in different violence risk groups were analyzed by ANOVA,and the influencing factors of violence in patients with schizophrenia were analyzed by logistic regression.Results There was no significant difference in latency of P300 among the three groups(χ^(2)=4.71,P=0.10),but there was significant difference in amplitude of P300(F=6.67,P<0.01).Compared with the low-risk group((12.14±9.19)μV),the amplitude of P300 in medium-risk group((8.25±7.13)μV)and high risk group((6.71±4.97)μV)decreased significantly(t=-3.14,-5.45,both P<0.05).There was no significant difference in amplitude of P300 between the high-risk group and the middle-risk group(t=-2.31,P>0.05).The latency and amplitude of schizophrenia patients with violent behavior were significantly different from those without violent behavior(Z=-6.30,9.78,both P<0.01).High BVC grade(compared with high-risk group,low-risk group:OR=0.03,95%CI:0.00-0.35;the middle risk group:OR=0.09,95%CI:0.01-0.62),prolonged P300 latency(OR=1.30,95%CI:1.13-1.48)and decreased P300 amplitude(OR=0.50,95%CI:0.36-0.70),delusion of victimization(OR=0.12,95%CI:0.02-0.76)were the risk factors for violent behavior.Conclusion The latency and amplitude of P300 can be used as the reliable neuroelectrophysiological indicators for evaluating violence risk in patients with schizophrenia.It has important clinical application value for evaluating violence in patients with schizophrenia.
作者
李丹玉
刘超猛
王梅子
肖兰
张桂青
Li Danyu;Liu Chaomeng;Wang Meizi;Xiao Lan;Zhang Guiqing(Medical College of Shihezi University,Shihezi 832000,China;Department of Psychiatry,Beijing Anding Hospital Affiliated to Capital Medical University,Beijing 100088,China;Department of Rehabilitation Psychology,the First Affiliated Hospital of Medical College of Shihezi University,Shihezi 832000,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2021年第8期722-727,共6页
Chinese Journal of Behavioral Medicine and Brain Science
基金
新疆生产建设兵团科技攻关项目(2018AB201)。