Abstract: Objective　To analyze the influencing factors of aggressive behaviors in inpatients with schizophrenia, and to explore the preventive effect of targeted rehabilitation intervention on their aggressive behaviors. Methods　Two hundred and forty-eight inpatients with schizophrenia admitted to Shandong Mental Health Center from January 2019 to August 2020 were selected, including 135 males and 113 females, and they were 23-67 (38.03±0.41) years old. According to the total weighted score of the modified version of the External Attack Behavior Scale (MOAS), they were divided into an attack group (MOAS score ≥ 4) and a non-aggression group (MOAS score < 4). The general clinical data and the scores of Positive and Negative Syndrome Scale-Excited Component (PANSS-EC), the Ambiguous Intentions Hostility Questionnaire-C (AIHQ-C), Social Support Rating Scale (SSRS), and the Mishel Disease Uncertainty Scale (MUIS-A) were compared between the two groups. The independent influencing factors of the patients' aggressive behaviors were analyzed by multi-variate logistic analysis, and the targeted rehabilitation plans were developed. Using the random number table method, 100 patients with schizophrenia admitted to Shandong Mental Health Center from September 2020 to September 2021 were divided into a control group and a study group. Among them, there were 57 males and 43 females, and they were 20-69 (38.38±2.51) years old. The control group took routine interventions, and the study group implemented the targeted rehabilitation plans on the basis of the control group. Two months after admission, the aggressive behaviors and scores of PANSS-EC, AIHQ-C, SSRS, and MUIS-A in the two groups before and after the intervention were compared. The research data were processed by SPSS 26.0 software. The measurement data were compared by t test, enumeration data by χ² test, and grade data by rank sum test. Results　Multivariate logistic analysis showed that male, a history of aggressive behaviors one month before admission, involuntary hospitalization, first hospitalization, PANSS-EC score, AIHQ-C hostile bias total score, AIHQ-C blame bias total score, AIHQ-C aggressive bias total score, SSRS objective support score, SSRS subjective support score, MUIS-A ambiguity score, and MUIS-A complexity score were the independent influencing factors of the aggressive behaviors in the patients with schizophrenia (all P<0.05). Two months after the patients were admitted to the hospital for targeted rehabilitation, the incidence of aggressive behaviors and the scores of MOAS, PANSS-EC, AIHQ-C, SSRS, and MUIS-A in the study group were better than those in the control group [16.00% (8/50) vs. 36.00% (18/50), (2.01±0.32) vs. (3.56±0.24), (9.20±0.32) vs. (11.21±0.28)), (13.48±1.11) vs. (17.46±1.29), (33.21±2.47) vs. (30.29±3.03), and (70.31±3.56) vs. (85.35±3.20)], with statistical differences (χ²=5.198 and t=27.400, 33.426, 16.537, 5.282, and 22.217; all P<0.05). Conclusions　Aggressive behaviors of patients with schizophrenia are affected by many factors. The intervention of targeted rehabilitation programs can effectively improve the inducement of aggressive behaviors and reduce the incidence of aggressive behaviors.

Key words: Schizophrenia, Influencing factors, Targeted rehabilitation programs, Aggressive behaviors

摘要： 目的　分析住院精神分裂症患者攻击行为的影响因素，探究针对性康复干预对患者攻击行为的预防效果。方法　选择2019年1月至2020年8月山东省精神卫生中心接收248例住院精神分裂症患者，其中男135例，女113例，年龄23～67（38.03±0.41）岁。根据修改版外显攻击行为量表（MOAS）总加权分划分为攻击组（MOAS≥4分）、非攻击组（MOAS<4分）。比较两组患者的一般临床资料、阴性及阳性症状量表的兴奋因子（PANSS-EC）与中文版模棱两可、目的和敌意问卷（AIHQ-C）、社会支持评定量表（SSRS）、疾病不确定感（MUIS-A）情况。多因素logistic分析患者攻击行为的独立影响因素，并制定针对性康复方案。采用随机数字表法将山东省精神卫生中心2020年9月至2021年9月接收的100例精神分裂症患者［男57例，女43例，年龄20～69（38.38±2.51）岁］划分为两组。对照组实施常规干预，研究组在对照组基础上联合实施针对性康复方案。入院两个月，比较两组干预前后的攻击行为情况以及PANSS-EC、AIHQ-C、SSRS、MUIS-A评分。研究数据应用SPSS 26.0软件处理，计量资料给予t检验，计数资料给予χ²检验，等级资料给予秩和检验。结果　多因素logistic分析显示，男性、入院前1个月有攻击行为史、非自愿住院、首次住院、PANSS-EC评分、AIHQ-C敌意偏向总分、AIHQ-C责备偏向总分、AIHQ-C攻击偏向总分、SSRS客观支持得分、SSRS主观支持得分、MUIS-A不明确性得分、MUIS-A复杂性得分是住院精神分裂症患者攻击行为的独立影响因素（均P<0.05）；患者入院两个月，实施针对性康复方案后，研究组攻击行为发生率（16.00%，8/50）低于对照组（36.00%，18/50），MOAS评分为（2.01±0.32）分，低于对照组的（3.56±0.24）分，两组比较，差异均有统计学意义（χ²=5.198，t=27.400，均P<0.05）；干预后，研究组PANSS-EC评分为（9.20±0.32）分、AIHQ-C评分为（13.48±1.11）分、SSRS评分为（33.21±2.47）分、MUIS-A评分为（70.31±3.56）分，均优于对照组［（11.21±0.28）分、（17.46±1.29）分、（30.29±3.03）分、（85.35±3.20）分］，两组比较，差异均有统计学意义（t=33.426、16.537、5.282、22.217，均P<0.05）。结论　精神分裂症患者攻击行为受多方面因素共同影响，针对性康复方案干预可有效改善患者攻击行为诱因，降低攻击行为发生率。

关键词: 精神分裂症, 影响因素, 针对性康复方案, 攻击行为