Department of Neuroscience and Mental Health, Clinical Psychopharmacology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Milan, Italy.
Department of Biomedical and Clinical Sciences Luigi Sacco, Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milan, Italy.
CNS Spectr. 2019 Oct;24(5):564-573. doi: 10.1017/S1092852918001438.
Psychiatric disorders are often considered the leading cause of violence. This may be due to a stereotype created by media and general opinion.
The Modified Overt Aggression Scale (MOAS) was used to evaluate the severity of aggressive and violent behaviors in 400 patients who attended a post-acute psychiatric service in Milan from 2014 to 2016 and suffered from different psychiatric disorders. The psychopathological clinical picture was evaluated by Clinical Global Impression (CGI). The study also assessed the possible correlation between epidemiologic and sociodemographic factors, clinical variables, and aggression and violence.
Of the total number of subjects, 21.50% showed a MOAS score >0, 11.50% presented mild aggression (0-10 MOAS weighted score), 9% moderate aggression (11-20), and 1% severe aggression (MOAS >20). With respect to violent behaviors, 16% of patients showed a score >0 in one MOAS subscale other than verbal aggression according to violence definition. The severity of clinical picture seemed to be related to higher weighted MOAS score. Multivariate testing of different sociodemographic and clinical variables showed that violence was related to unemployment status, and significantly correlated to compulsory admission (TSO), suicide attempts (TS), and personality disorders, while the severity of clinical psychiatric picture seemed to play a secondary role.
Results have shown that personality disorders and sociodemographic factors, including economic factors, seem to be major determinants of violence among patients diagnosed with mental disorders.
精神障碍常被认为是暴力的主要原因。这可能是由于媒体和普遍观点所形成的刻板印象。
使用改良外显攻击量表（MOAS）评估 2014 年至 2016 年间米兰一家后急性精神病服务机构的 400 名患有不同精神障碍的患者的攻击和暴力行为的严重程度。通过临床总体印象（CGI）评估精神病理学临床情况。该研究还评估了流行病学和社会人口统计学因素、临床变量与攻击和暴力之间可能存在的相关性。
在所有研究对象中，21.50%的患者 MOAS 评分>0，11.50%表现为轻度攻击（0-10 MOAS 加权评分），9%为中度攻击（11-20），1%为重度攻击（MOAS>20）。根据暴力定义，16%的患者除言语攻击外，在 MOAS 子量表中的一个分量表上的评分>0。临床情况的严重程度似乎与更高的 MOAS 加权评分有关。对不同社会人口统计学和临床变量的多元检验显示，暴力与失业状况有关，与强制性入院（TSO）、自杀企图（TS）和人格障碍显著相关，而临床精神状况的严重程度似乎起次要作用。
结果表明，人格障碍和社会人口统计学因素，包括经济因素，似乎是精神障碍患者暴力行为的主要决定因素。
