CAJ | 학술논문

目的：了解精神分裂症患者住院期间自杀自伤行为的检出率和特征，比较住院期间有自杀自伤行为和无自杀自伤行为的精神分裂症患者的临床特征，探讨预测和防范精神分裂症患者住院期间发生自杀自伤行为的策略。方法采用自行设计的一般情况调查表、简明精神病评定量表（BPRS）、汉密尔顿抑郁量表17项版（HAMD -17）、临床疗效总评量表（CGIS）对197例连续住院的精神分裂症患者的自杀自伤行为进行研究，将在住院期间有自杀自伤行为的39例患者（自杀自伤行为组）与158例无自杀自伤行为的患者（无自杀自伤行为组）进行比较。结果①精神分裂症患者住院期间的自杀自伤行为检出率为19.80%；②自杀自伤行为组在无职业、经济状况差、社会支持差、入院前2周内有明显应激事件、有物质滥用或依赖、有精神病家族史、既往有自杀未遂史、自杀自伤行为时有幻觉或妄想、分裂症偏执型等与无自杀自伤行为组比较，差异有统计学意义（P <0.05或0.01），Logistic 回归分析显示，经济状况差、入院前2周内有明显应激事件、既往有自杀未遂史是住院期间发生自杀行为的危险因素；③入院时、住院第2、4周末两组 BPRS 总评分、HAMD -17总评分比较差异均有统计学意义（P <0.01），住院第2周末，两组 CGI 评分差异有统计学意义（P <0.01）。结论精神分裂症患者住院期间的自杀自伤行为检出率较高，应高度重视，并重点关注经济状况较差、入院前2周内有明显应激事件、既往有自杀未遂史和 HAMD -17高分的患者。
목적：료해정신분렬증환자주원기간자살자상행위적검출솔화특정，비교주원기간유자살자상행위화무자살자상행위적정신분렬증환자적림상특정，탐토예측화방범정신분렬증환자주원기간발생자살자상행위적책략。방법채용자행설계적일반정황조사표、간명정신병평정량표（BPRS）、한밀이돈억욱량표17항판（HAMD -17）、림상료효총평량표（CGIS）대197례련속주원적정신분렬증환자적자살자상행위진행연구，장재주원기간유자살자상행위적39례환자（자살자상행위조）여158례무자살자상행위적환자（무자살자상행위조）진행비교。결과①정신분렬증환자주원기간적자살자상행위검출솔위19.80%；②자살자상행위조재무직업、경제상황차、사회지지차、입원전2주내유명현응격사건、유물질람용혹의뢰、유정신병가족사、기왕유자살미수사、자살자상행위시유환각혹망상、분렬증편집형등여무자살자상행위조비교，차이유통계학의의（P <0.05혹0.01），Logistic 회귀분석현시，경제상황차、입원전2주내유명현응격사건、기왕유자살미수사시주원기간발생자살행위적위험인소；③입원시、주원제2、4주말량조 BPRS 총평분、HAMD -17총평분비교차이균유통계학의의（P <0.01），주원제2주말，량조 CGI 평분차이유통계학의의（P <0.01）。결론정신분렬증환자주원기간적자살자상행위검출솔교고，응고도중시，병중점관주경제상황교차、입원전2주내유명현응격사건、기왕유자살미수사화 HAMD -17고분적환자。
Objective To investigate the detection rate and characteristics of suicide or self - injurious behaviors in schizophren-ic inpatientsin order to predict and prevent thosein schizophrenic patients during hospitalization. Methods 197 consecutive inpatients with schizophrenia were investigated with self - made inventory,the Brief Psychiatric Rating Scale(BPRS),Hamilton Depression Scale- 17 item(HAMD - 17),Clinical Global Impression(CGIS),which were divided into two groups according to with or without suicide or self - injurious behaviors. Results ①The detection rate of suicide or self - injurious behaviors of schizophrenic inpatients was 19. 80% . ②Compared with non - suicide or self - injurious behaviors group during hospitalization,the prevalent of the incidence of no career(25. 6% ),poor economic conditions(25. 6% ),poor social support(56. 4% ),positive family history(48. 7% ),history of at-tempted suicide(79. 5% ),having obvious stress events two weeks before admission(46. 2% ),comorbiding with substance abuse (25. 6% ),with hallucinations or delusions(89. 7% ),paranoid type(53. 8% )in suicide or self - injurious behaviors group were sig-nificantly higher(P < 0. 05 or 0. 01). Logistic regression analysis showed that poor economic conditions,obvious stress events two weeks before admission,history of suicide attempts were the risk factors for suicide or self - injurious behaviors. ③Total scores of BPRS、HAMD - 17 in suicide or self - injurious behaviors group were significantly higher than those in non - suicide or self - injurious behaviors group at the time of admission and the 2nd ,4th weekend(P < 0. 01). The score of CGI in suicide or self - injurious behaviors group were significantly higher than those in non - suicide or self - injurious behaviors group in the second weekend(P < 0. 01). Con-clusion The detection rate of suicide or self - injurious behaviors of schizophrenic inpatients is high. We should attach great impor-tance to suicide or self - injury suicide behaviors in the schizophrenia inpatients,especially the patients with poor economic conditions, 2 weeks prior to admission with obvious stress events,history of attempted suicide and high HAMD - 17 scores.