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中国社区重度精神障碍患者肇事肇祸风险评估工具的构建

Construction of a troublemaking risk assessment tool for patients with severe mental disorders in community of China.

作者信息

Li Shiming, Yin Jieyun, Yang Queping, Ji Yingying, Zhu Haohao, Yin Qitao

机构信息

Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, 214151, Jiangsu, China.

School of Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China.

出版信息

Sci Rep. 2025 Jan 3;15(1):663. doi: 10.1038/s41598-024-84486-x.

Abstract

OBJECTIVE

Construction a troublemaking risk assessment tool to predict the risk of troublemaking for patients with severe mental disorders in the community of China.

METHODS

28,000 cases registered in the Jiangsu Provincial Severe Mental Disorder Management System from January 2017 to December 2019 were collected. The risk factors of troublemaking among patients with severe mental disorders in the community were analyzed through Logistic regression analysis, then the troublemaking risk assessment tool was established and verified.

RESULTS

The incidence of troublemaking among patients with severe mental disorders in the community was 7.15%. The results of multivariate logistic regression analysis showed that males, ≤ 44 years old, duration of disease ≤ 14 years, high school education and below, unemployed, subsistence allowances, schizophrenia, major symptoms > 1, psychiatric visits ≥ 1 time per year, unwilling to participate in community management and community rehabilitation activities, and delayed diagnosis < 2 months were risk factors for troublemaking. The above factors were incorporated into the nomogram model, and the area under the ROC curve of the nomogram model was 0.688 (95%CI: 0.563-0.726). The calibration curve proved that the probability predicted by the model was in good agreement with the actual probability.

CONCLUSION

The established troublemaking risk assessment tool for patients with severe mental disorders in the community based on Logistic regression analysis had good predictive performance, which could be applied to assess the probability of troublemaking among patients with severe mental disorders in the community.

摘要

目的

构建一个寻衅滋事风险评估工具,以预测中国社区中重症精神障碍患者的寻衅滋事风险。

方法

收集2017年1月至2019年12月在江苏省重症精神障碍管理系统中登记的28000例病例。通过Logistic回归分析社区中重症精神障碍患者寻衅滋事的危险因素,然后建立并验证寻衅滋事风险评估工具。

结果

社区中重症精神障碍患者寻衅滋事的发生率为7.15%。多因素Logistic回归分析结果显示,男性、年龄≤44岁、病程≤14年、高中及以下文化程度、无业、享受低保、精神分裂症、主要症状>1项、每年精神科就诊≥1次、不愿参与社区管理及社区康复活动、诊断延误<2个月是寻衅滋事的危险因素。将上述因素纳入列线图模型,列线图模型的ROC曲线下面积为0.688(95%CI:0.563-0.726)。校准曲线证明模型预测概率与实际概率吻合良好。

结论

基于Logistic回归分析建立的社区重症精神障碍患者寻衅滋事风险评估工具具有良好的预测性能,可用于评估社区重症精神障碍患者寻衅滋事的概率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b591/11698903/a19a816b7dfa/41598_2024_84486_Fig1_HTML.jpg

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