Prevalence and risk factors for violent behavior in young people presenting with first-episode psychosis in Hong Kong: A 3-year follow-up study
Prevalence and risk factors for violent behavior in young people presenting with first-episode psychosis in Hong Kong: A 3-year follow-up study
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DOI：
10.1177/0004867415603130
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发表时间：
2015-10-01
影响因子：
4.6
通讯作者：
Chen, Eric Yu Hai
中科院分区：
文献类型：
--
作者：
Chang, Wing Chung;Chan, Sherina Suet In;Chen, Eric Yu Hai
目的：本研究的目的是研究中国首发精神病（FEP）年轻人在治疗前和治疗后3年的暴力发生率，以及治疗后暴力的预测因素。方法：对2001年7月至2003年8月在香港连续参加区域性FEP早期干预计划的700例15-25岁患者进行研究。通过系统的医学档案回顾收集社会人口统计学、治疗前、基线和3年随访变量。暴力行为被定义为对他人的身体攻击，并进一步分为两个严重程度。结果：精神病发作后，6.7% （n=47）患者在治疗前表现出暴力行为。在3年治疗期间，9.4% （n=66）有暴力行为，4.3% （n=30）有严重暴力行为。在治疗前表现出暴力行为的患者中，有五分之二（40.4%）在服务接触后再次出现暴力行为。多因素回归分析显示，在3年随访期间，暴力史、男性性别和受教育程度较低与暴力风险增加显著相关。发现共病物质、男性性别、低文化程度和暴力史独立预测FEP治疗开始后严重暴力的发生。结论：在一个具有代表性的中国年轻FEP患者大队列中，治疗前后的暴力行为发生率相对低于文献报道。当前研究确定的暴力风险因素与之前在西方人群中进行的研究结果相当。密切监测有暴力史的患者，并针对尽量减少药物滥用进行具体治疗，可能有助于及早发现和干预高风险病例，以减少疾病早期的暴力风险。
Objective: The aim of the current study was to examine the rates of violence prior to and 3 years following treatment initiation, and predictors of post-treatment violence in Chinese young people presenting with first-episode psychosis (FEP).Method: Seven hundred patients aged 15-25 years consecutively enrolled in a territory-wide early intervention program for FEP in Hong Kong from July 2001 to August 2003 were studied. Socio-demographic, pre-treatment, baseline and 3-year follow-up variables were collected via systematic medical file review. Violent behavior was defined as physical aggression towards people and was further categorized at two levels of severity.Results: After onset of psychosis, 6.7% (n=47) patients exhibited violence before treatment. During 3-year treatment period, 9.4% (n=66) committed violent behavior and 4.3% (n=30) perpetrated serious violence. Two-fifths (40.4%) of patients who displayed pre-treatment violent behavior engaged in further act of violence after service contact. Multivariate regression analysis showed that previous violence, male gender and lower educational attainment were significantly associated with an increased risk of violence during 3-year follow-up. Comorbid substance, male gender, lower educational level and past history of violence were found to independently predict occurrence of serious violence after commencement of treatment for FEP.Conclusions: In a large representative cohort of Chinese young FEP patients, the rates of violent behavior before and after treatment were relatively lower than that reported in the literature. Risk factors for violence identified by the current study were comparable to the findings of previous research conducted in western populations. Close monitoring of patients with history of violence and specific treatments targeting at minimizing substance abuse may facilitate early identification and intervention of high-risk cases to reduce violence risk in the early course of illness.