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首发精神病患者暴力受害的 10 年随访研究:风险和保护因素。

A 10-year follow-up study of violent victimization in first episode psychosis: Risk and protective factors.

机构信息

Center for Clinical Psychosis Research, TIPS, Stavanger University Hospital, 4008 Stavanger, Norway; Department of Research and Development, Rogaland A-senter, 4028 Stavanger, Norway.

Molde University College, PO.Box 2110, 6402 Molde, Norway; Division of Mental Health and Addiction, Oslo University Hospital, P.O. 4959 Nydalen, N-0424 Oslo, Norway.

出版信息

Psychiatry Res. 2018 Jan;259:545-549. doi: 10.1016/j.psychres.2017.11.013. Epub 2017 Nov 7.

Abstract

Violent victimization in persons with severe mental illness has long-term adverse consequences. Little is known about the long-term prevalence of victimization in first episode psychosis, or about factors affecting victimization throughout the course of illness. To assess the prevalence of violent victimization during a 10-year follow-up period in a group of first episode psychosis (FEP) patients, and to identify early predictors and risk factors for victimization. A prospective design was used with comprehensive assessments of violent victimization, treatment variables and functioning at baseline and during 10-year follow-up. A clinical epidemiological sample of FEP patients (n = 298) was studied. FEP patients in our study were at a 3.5 times greater risk of victimization as compared to the normal population. During the 10-year follow-up period, 23% of subjects fell victim to one or more violent assaults. Victimized patients were younger and reported less occupational activity. At 10-year follow-up, victimization was associated with more concomitant drug use, alcohol misuse and violent behavior, but not with a worse clinical or functional outcome. Treatment programs should focus on risk factors for victimization and develop behavioral alternatives to mitigate risk in FEP patients.

摘要

严重精神疾病患者遭受暴力侵害会产生长期的不良后果。鲜为人知的是,首发精神病患者在整个病程中遭受侵害的长期流行率,以及影响侵害的因素。本研究旨在评估首发精神病(FEP)患者在 10 年随访期间遭受暴力侵害的流行率,并确定易受侵害的早期预测因素和风险因素。本研究采用前瞻性设计,在基线和 10 年随访期间全面评估了暴力侵害、治疗变量和功能。研究纳入了 298 例 FEP 患者的临床流行病学样本。与普通人群相比,FEP 患者遭受暴力侵害的风险高出 3.5 倍。在 10 年随访期间,23%的受试者遭受了一次或多次暴力袭击。受侵害的患者年龄较小,职业活动较少。在 10 年随访时,受侵害与更多同时存在的药物使用、酒精滥用和暴力行为有关,但与更差的临床或功能结局无关。治疗方案应侧重于易受侵害的风险因素,并为 FEP 患者制定减轻风险的行为替代方案。

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