Caqueo-Urízar Alejandra, Fond Guillaume, Urzúa Alfonso, Boyer Laurent, Williams David R
Universidad de Tarapacá, Avenida 18 de Septiembre 2222, Arica, Chile; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States.
Université Paris Est-Créteil, Pôle de psychiatrie des hôpitaux universitaires H Mondor, INSERM U955, Eq Psychiatrie Translationnelle, DHU Pe-Psy, France; Fondation FondaMental Fondation de coopération scientifique en santé mentale, France.
Schizophr Res. 2016 Dec;178(1-3):23-28. doi: 10.1016/j.schres.2016.09.005. Epub 2016 Sep 8.
The aim of the present study was (i) to assess the prevalence of Violent Behavior in Schizophrenia (VBS) in a sample of community-dwelling outpatients in three middle-income countries of Latin America and (ii) to determine the clinical and socio-demographical risk factors associated with VBS and aggression level.
The study included 253 stabilized outpatients with schizophrenia and their principal caregivers from 3 public ambulatory psychiatric care centers in Bolivia (N=83), Chile (N=85), and Peru (N=85). VBS was defined according to the Overt Aggression Scale (OAS) score and the aggression level was measured by the aggression subscore of the Agitated Behavior Scale of Corrigan. We collected socio-demographic information and clinical data. Multiple linear and logistic regressions were performed to determine which variables were associated with VBS and aggression level.
The prevalence of VBS differed statistically between the three countries (p<0.001) with 3.5% in Chile, 14.6% in Peru and 55.4% in Bolivia. After adjustment for confounding factors, VBS was associated with a younger age, a more severe psychotic symptomatology, a lower family income and unemployment. After adjustment for confounding factors, aggression level was associated with a more severe psychotic symptomatology, a lower family income, a younger age at illness onset and higher number of hospitalizations in the last 3years.
These results may guide future health policies to specifically provide social support and rehabilitation care to VBS patients in middle-income countries, including psychoeducation and a more integrated work between the treating medical team and the social workers.
本研究的目的是（i）评估拉丁美洲三个中等收入国家社区门诊精神分裂症患者样本中暴力行为（VBS）的患病率，以及（ii）确定与VBS和攻击水平相关的临床和社会人口学风险因素。
该研究纳入了来自玻利维亚（N = 83）、智利（N = 85）和秘鲁（N = 85）3个公共门诊精神科护理中心的253名病情稳定的精神分裂症门诊患者及其主要照顾者。VBS根据公开攻击量表（OAS）评分定义，攻击水平通过科里根激越行为量表的攻击子评分来衡量。我们收集了社会人口学信息和临床数据。进行多元线性和逻辑回归以确定哪些变量与VBS和攻击水平相关。
三个国家之间VBS的患病率在统计学上存在差异（p < 0.001），智利为3.5%，秘鲁为14.6%，玻利维亚为55.4%。在对混杂因素进行调整后，VBS与较年轻的年龄、更严重的精神病症状、较低的家庭收入和失业有关。在对混杂因素进行调整后，攻击水平与更严重的精神病症状、较低的家庭收入、发病时较年轻的年龄以及过去3年较高的住院次数有关。
这些结果可能为未来的卫生政策提供指导，以便在中等收入国家为VBS患者专门提供社会支持和康复护理，包括心理教育以及治疗医疗团队和社会工作者之间更综合的工作。
