Steinert T, Wiebe C, Gebhardt R P
Department for Acute Psychiatry at the Weissenau Center for Psychiatry of the University of Ulm, Germany.
Psychiatr Serv. 1999 Jan;50(1):85-90. doi: 10.1176/ps.50.1.85.
Aggressive behavior directed against self and others was examined in a sample of patients with schizophrenia during their first hospitalization and during any subsequent hospitalizations over the next two years.
The charts of 138 patients (77 men and 61 women) with a first episode of schizophrenia or schizoaffective disorder admitted to a psychiatric hospital in Weissenau, Germany, were reviewed to obtain information about four types of aggressive behavior (verbal aggression and aggression against objects, self, and others). Similar chart reviews were conducted for 83 patients (47 men and 36 women) who were rehospitalized during the next two years. The severity of the four types of behavior was rated using the Modified Overt Aggression Scale. Stepwise multiple regression was used to identify predictors of the number and duration of rehospitalizations.
Seventy-five percent of the men and 53 percent of the women in the sample exhibited some type of aggressive behavior during the first or subsequent admissions. Seventeen percent of men and 26 percent of women attempted suicide. Among the predictors of rehospitalization that were examined, which did not include medication compliance, only aggressive behavior against self and against others were significant predictors during the two years after first admission. Predictors of aggressive behavior against others were male sex, number of hospitalizations, and alcohol abuse (among men only). Self-directed aggressive behavior was correlated with days of hospitalization but not with number of rehospitalizations.
Aggressive behavior against self and others is a frequent symptom of schizophrenia in the first two years of illness and plays a major role in rehospitalization.
在首次住院期间以及随后两年内的任何后续住院期间，对一组精神分裂症患者针对自身和他人的攻击性行为进行研究。
回顾了德国魏森瑙一家精神病院收治的138例首次发作精神分裂症或分裂情感性障碍患者（77名男性和61名女性）的病历，以获取有关四种攻击性行为（言语攻击以及针对物体、自身和他人的攻击）的信息。对接下来两年内再次住院的83例患者（47名男性和36名女性）进行了类似的病历回顾。使用改良的公开攻击量表对四种行为的严重程度进行评分。采用逐步多元回归来确定再次住院次数和住院时长的预测因素。
样本中75%的男性和53%的女性在首次或后续入院期间表现出某种类型的攻击性行为。17%的男性和26%的女性曾试图自杀。在研究的再次住院预测因素中（不包括药物依从性），仅针对自身和他人的攻击性行为是首次入院后两年内的显著预测因素。针对他人的攻击性行为的预测因素为男性、住院次数以及酒精滥用（仅针对男性）。自我导向的攻击性行为与住院天数相关，但与再次住院次数无关。
针对自身和他人的攻击性行为是精神分裂症发病头两年的常见症状，并且在再次住院中起主要作用。
