The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA; Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, USA.
J Affect Disord. 2022 Jan 1;296:493-497. doi: 10.1016/j.jad.2021.09.071. Epub 2021 Sep 25.
Aggression is common and challenging in psychiatric emergency departments (PED). However, the prevalence of aggression and its correlates in PED patients are not well documented. This study compared the prevalence of aggression between patients with acute schizophrenia and manic episodes.
In this cross-sectional study, patients at a psychiatric emergency department were assessed with measurements of aggression, psychotic and manic symptoms.
A total of 4,172 patients were included. The prevalence of aggression was 54.8% (95%CI=53.3%-65.2%) in the whole sample, with 48.0% (95%CI=45.8%-50.1%) in patients with an acute schizophrenia episode, and 61.8% (95%CI=59.8%-63.9%) in patients with a manic episode. Multiple logistic regression analysis revealed that, within the acute schizophrenia episode group, male gender (OR=1.47, P<0.01), involuntary admission (OR=3.61, P<0.01) and more severe manic symptoms (OR=1.30, P<0.01) were significantly associated with aggression. Within the manic episode group, living in Beijing (OR=1.51, P<0.01), unemployment (OR=1.34, P=0.03), involuntary admission (OR=7.93, P<0.01), lower education (OR=0.95, P=0.01) and more severe psychotic symptoms (OR=1.05, P<0.01) were significantly associated with aggression.
In this study, aggression appeared to be more common among patients with a manic episode than those with an acute schizophrenia episode. Considering the significant risk of aggression on psychiatric emergency care, appropriate and effective management of aggression in this population group need to be developed.
在精神科急诊部（PED），攻击行为很常见且具有挑战性。然而，PED 患者的攻击行为发生率及其相关因素尚未得到很好的记录。本研究比较了急性精神分裂症和躁狂发作患者的攻击行为发生率。
在这项横断面研究中，对精神科急诊部的患者进行了攻击性、精神病和躁狂症状的评估。
共纳入 4172 名患者。整组样本的攻击行为发生率为 54.8%（95%CI=53.3%-65.2%），急性精神分裂症发作患者为 48.0%（95%CI=45.8%-50.1%），躁狂发作患者为 61.8%（95%CI=59.8%-63.9%）。多因素逻辑回归分析显示，在急性精神分裂症发作组中，男性（OR=1.47，P<0.01）、非自愿入院（OR=3.61，P<0.01）和更严重的躁狂症状（OR=1.30，P<0.01）与攻击行为显著相关。在躁狂发作组中，北京居住（OR=1.51，P<0.01）、失业（OR=1.34，P=0.03）、非自愿入院（OR=7.93，P<0.01）、受教育程度较低（OR=0.95，P=0.01）和更严重的精神病症状（OR=1.05，P<0.01）与攻击行为显著相关。
在本研究中，躁狂发作患者的攻击行为似乎比急性精神分裂症发作患者更为常见。鉴于攻击行为对精神科急诊护理的重大风险，需要针对这一人群制定适当且有效的攻击行为管理措施。
