CAJ | 학술논문

目的：探讨双相 I 型障碍患者攻击行为的风险因素。方法：根据修订版外显攻击行为量表（MOAS）评分将94例住院的双相 I 型障碍患者分为攻击组（50例，加权分≥4分）和非攻击组（44例，加权分﹤4分）；对入组者进行一般及临床情况调查、认知功能检测、社会支持评定量表（SSRS）及父母教养方式评价量表（EMBU）评定，血脂、血清肌酸激酶（CK）水平检测及脑地形图检查。结果：两组在职业、饮酒、发病间期缓解程度、入院方式、总发作次数、躁狂发作次数、威斯康星卡片分类测验成绩、SSRS评分、EMBU 因子分、血清 CK 水平、脑电地形图结果差异有统计学意义（P ﹤0.05或 P ﹤0.01）；多因素Logistic 回归分析筛选出非自愿住院（OR ＝54.341）、发病间期不完全缓解（ OR ＝19.088）、无业/失业（OR ＝9.841）、总发作次数≥3次（OR ＝9.672）是攻击行为的高危因素。结论：多种因素与双相 I 型障碍患者攻击行为有关，无业或失业、疾病反复发作、发病间期不全缓解及非自愿住院可增加攻击行为的发生风险，以非自愿住院相对风险最高。
목적：탐토쌍상 I 형장애환자공격행위적풍험인소。방법：근거수정판외현공격행위량표（MOAS）평분장94례주원적쌍상 I 형장애환자분위공격조（50례，가권분≥4분）화비공격조（44례，가권분﹤4분）；대입조자진행일반급림상정황조사、인지공능검측、사회지지평정량표（SSRS）급부모교양방식평개량표（EMBU）평정，혈지、혈청기산격매（CK）수평검측급뇌지형도검사。결과：량조재직업、음주、발병간기완해정도、입원방식、총발작차수、조광발작차수、위사강성잡편분류측험성적、SSRS평분、EMBU 인자분、혈청 CK 수평、뇌전지형도결과차이유통계학의의（P ﹤0.05혹 P ﹤0.01）；다인소Logistic 회귀분석사선출비자원주원（OR ＝54.341）、발병간기불완전완해（ OR ＝19.088）、무업/실업（OR ＝9.841）、총발작차수≥3차（OR ＝9.672）시공격행위적고위인소。결론：다충인소여쌍상 I 형장애환자공격행위유관，무업혹실업、질병반복발작、발병간기불전완해급비자원주원가증가공격행위적발생풍험，이비자원주원상대풍험최고。
Objective:To explore the risk factors of aggressive behavior in the patients with bipolar type I disorder. Method:According to the score of revised overt aggression scale(MOAS),94 inpatients with bi-polar I disorder were divided into attack group(50 cases,weighted points of MOAS≥4)and the non-attack group(44 cases,weighted points of MOAS ﹤ 4 ). The general and clinical data were investigated,the executive function,social support rating scale(SSRS),egma minnen av bardndosnauppforstran(EMBU)were assessed, the levels of serum lipid,creatine kinase(CK),and brain topographic map were detected in all the subjects. Results:The differences of vocation,drinking,remission situation,admission form,total episode times,the fre-quency of manic episode,level of serum CK,brain atlas,the results of Wisconsin card sorting test,the scores of SSRS and the factor scores of EMBU between the two groups had statistical significance( P ﹤ 0. 05 or P ﹤0. 01). Multivariate logistic regression analyses showed that involuntary admissions(OR = 54. 341),incomplete remission(OR = 19. 088),unemployment(OR = 9. 841),total episode ≥3 times(OR = 9. 672)were risk fac-tors. Conclusion:Aggressive behavior in patients with bipolar type I disorder is related to many factors. Un-employment,recurrent episodes of mental disorders,incomplete remission and involuntary admissions increased aggressive risk. The relative risk of involuntary admissions is the highest.