Faculty of Sciences, Lebanese University, Fanar, Lebanon.
Psychiatr Danub. 2021 Spring;33(1):27-35. doi: 10.24869/psyd.2021.27.
The impact of command voices (CV) on violent behaviors in patients with schizophrenia remains unclear. The literature has produced mixed results, with no research existing on CV and violence among the Lebanese population. The study objecttives were to (1) evaluate the association between voice beliefs, psychosis severity, treatment, demographic factors and command voices, and (2) evaluate the association between command voices and violence among patients with schizophrenia in Lebanon.
A cross-sectional study, conducted between April and August 2019, enrolled 280 patients with schizophrenia.
The results showed that 111 (39.6%) patients with schizophrenia had auditory hallucinations, among whom 93 (83.8%) patients had command voices; from these 93 patients, 53 (57.0%) were compliant with voices. Higher positive (ORa=1.09) and general psychopathology (ORa=1.04) PANSS subscales scores were significantly associated with higher compliance to voices. A higher resistance to beliefs about voices (ORa=0.91) was significantly associated with lower compliance to voices.
The prevalence of CV in patients with schizophrenia that report auditory hallucinations, was high in our sample. The vast majority of violent acts committed by patients was in compliance to CV, with a significantly high rate of the violence committed being directed towards property. Our findings were able to connect positive symptoms to higher probability of compliance to CV.
命令性幻听（CV）对精神分裂症患者暴力行为的影响尚不清楚。文献研究结果不一，黎巴嫩人群中尚无关于 CV 和暴力的研究。本研究目的是：（1）评估幻听信念、精神病严重程度、治疗、人口统计学因素与命令性幻听之间的关系，（2）评估黎巴嫩精神分裂症患者中命令性幻听与暴力之间的关系。
这是一项横断面研究，于 2019 年 4 月至 8 月期间进行，共纳入 280 例精神分裂症患者。
结果显示，280 例精神分裂症患者中有 111 例（39.6%）存在幻听，其中 93 例（83.8%）存在命令性幻听；这 93 例患者中有 53 例（57.0%）对幻听顺从。较高的阳性症状（ORa=1.09）和一般精神病症状（ORa=1.04）PANSS 子量表评分与对幻听的顺从性显著相关。对幻听信念的抵抗力越高（ORa=0.91），对幻听的顺从性越低。
在报告有幻听的精神分裂症患者中，CV 的发生率很高。患者实施的绝大多数暴力行为是顺从 CV 进行的，而且暴力行为针对财产的比例非常高。我们的发现能够将阳性症状与对 CV 的顺从性的更高概率联系起来。
