Guo Yi, Yang Xianmei, Wang Dan, Fan Ruoxin, Liang Yiying, Wang Rongke, Xiang Hu, Liu Yuanyuan, Liu Xiang
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China.
Front Psychiatry. 2022 Jul 22;13:939329. doi: 10.3389/fpsyt.2022.939329. eCollection 2022.
Violence to others (hereinafter referred to as "violence-TO") is common in individuals with schizophrenia. The reported prevalence of violence-TO among schizophrenics ranges widely in existing studies. Improved prevalence estimates and identification of moderators are needed to guide future management and research.
We searched EBSCO, EMBASE, Medline, PubMed, Science Direct, Web of Science, CNKI, VIP, WANFANG data, and CBM for relevant articles published before June 5, 2022. Meanwhile, violence-TO was summarized into four categories: (a) violence-TO on the reviews of official criminal or psychiatric records (type I); (b) less serious forms of violence-TO (type II); (c) physical acts causing demonstrable harm to victims (type III); (d) homicide (type IV). We did meta-analysis for the above types of violence-TO, respectively, and applied subgroup analyses and meta-regression analyses to investigate the source of heterogeneity.
A total of 56 studies were eligible in this study and 34 of them were high-quality. The prevalence of type I to type IV in individuals with schizophrenia in China was 23.83% (95% CI: 18.38-29.75%), 23.16% (95% CI: 8.04-42.97%), 17.19% (95%CI: 8.52-28.04%), and 0.62% (95% CI: 0.08-1.54%) respectively. The results of the subgroup analysis showed that the prevalence of type I was higher among subjects in the inland than in the coastal non-economic zone, while the prevalence of type III was the highest in the coastal economic zone, followed by the inland region and the lowest in the coastal non-economic zone. The results of multivariate meta-regression analyses showed that: patient source in type I (β = 0.15, < 0.01), patient source (β = 0.47, < 0.01), and proportion of male (β = 0.19, < 0.01) in type II, age (β = 0.25, < 0.01), and GDP per capita (β = 0.05, = 0.01) in type III were statistically significant.
The prevalence of different types of violence-TO and their influencing factors varied. Therefore, the authorities should take different management measures. In addition to individual factors, regional factors may also affect violence-TO, which suggests the need for a multi-sectorial approach to prevention and treatment for subjects in different regions and adopting targeted control strategies.
[www.ClinicalTrials.gov], identifier [CRD42021269767].
对他人实施暴力行为（以下简称“对他人暴力行为”）在精神分裂症患者中很常见。在现有研究中，精神分裂症患者中报告的对他人暴力行为患病率差异很大。需要改进患病率估计并确定调节因素，以指导未来的管理和研究。
我们检索了EBSCO、EMBASE、Medline、PubMed、Science Direct、Web of Science、中国知网、维普资讯、万方数据和中国生物医学文献数据库，查找2022年6月5日前发表的相关文章。同时，将对他人暴力行为归纳为四类：（a）官方刑事或精神科记录审查中的对他人暴力行为（I型）；（b）不太严重的对他人暴力行为形式（II型）；（c）对受害者造成明显伤害的身体行为（III型）；（d）杀人行为（IV型）。我们分别对上述类型的对他人暴力行为进行了荟萃分析，并应用亚组分析和元回归分析来研究异质性来源。
本研究共纳入56项研究，其中34项为高质量研究。中国精神分裂症患者中I型至IV型的患病率分别为23.83%（95%CI：18.38 - 29.75%）、23.16%（95%CI：8.04 - 42.97%）、17.19%（95%CI：8.52 - 28.04%）和0.62%（95%CI：0.08 - 1.54%）。亚组分析结果显示，I型患病率在内陆地区高于沿海非经济区，而III型患病率在沿海经济区最高，其次是内陆地区，在沿海非经济区最低。多变量元回归分析结果显示：I型中的患者来源（β = 0.15，P < 0.01）、II型中的患者来源（β = 0.47，P < 0.01）和男性比例（β = 0.19，P < 0.01）、III型中的年龄（β = 0.25，P < 0.01）和人均GDP（β = 0.05，P = 0.01）具有统计学意义。
不同类型的对他人暴力行为患病率及其影响因素各不相同。因此，当局应采取不同的管理措施。除个体因素外，地区因素也可能影响对他人暴力行为，这表明需要针对不同地区的受试者采取多部门的预防和治疗方法，并采用有针对性的控制策略。
