双相情感障碍患者攻击行为的列线图预测模型构建

doi:10.3969/j.issn.1006-5725.2024.05.015

Abstract

Abstract:

Objective To explore the influencing factors of aggressive behavior in patients with bipolar disorder and to construct a nomogram prediction model. Method Eighty patients with bipolar disorder who were admitted to our hospital from March 2021 to April 2023 were selected as the research subjects. They were divided into non-aggressive and aggressive groups. Univariate analysis was performed on the data of the two groups， and factors with statistical significance were subjected to logistic regression analysis. A nomogram was drawn to determine the influencing factors of aggressive behavior in patients with bipolar disorder. Result A total of 80 patients were included， of which 28 were in the aggressive group （35.0%） and 52 were in the non-aggressive group （65.0%）. The proportion of patients who lived alone for a long time， the total hospitalization time， and the proportion of patients with a history of suicidal tendencies were higher in the aggressive group than in the non-aggressive group. Moreover， the scores of ITAQ and SSRS were lower in the aggressive group （P < 0.05）. Multivariate logistic regression analysis showed that living alone for a long time and having a history of suicidal tendencies were risk factors for aggressive behavior in patients with bipolar disorder， while high scores on ITAQ and SSRS were protective factors （P < 0.05）. A nomogram was constructed， which has good predictive value. Conclusion Long-term solitary living and a history of suicidal tendencies may increase the risk of aggressive behavior in patients with bipolar disorder.

Key words: bipolar disorder, aggressive behavior, risk factors, nomogram

CLC Number:

R749.41

Xilin WANG,Chanjuan YANG,Daomeng. CHENG. Construction of a nomogram prediction model for aggressive behavior in patients with bipolar disorder[J]. The Journal of Practical Medicine, 2024, 40(5): 677-681.

Figures/Tables 4

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References 25

1	朱肖飞. 喹硫平+碳酸锂对双相情感障碍躁狂患者认知功能的影响——评《精神障碍患者家属手册》［J］. 中国国境卫生检疫杂志， 2021，44（5）：后插2.
2	BELETE H， MULAT H， FANTA T，et al. Magnitude and associated factors of aggressive behaviour among patients with bipolar disorder at Amanual Mental Specialized Hospital， outpatient department， Addis Ababa， Ethiopia： cross-sectional study［J］. BMC Psychiatry， 2016，16（1）：443. doi:10.1186/s12888-016-1151-8 doi: 10.1186/s12888-016-1151-8
3	芹那尔·波拉提江，邹韶红.有冲动攻击行为的双相情感障碍患者与基因甲基化的研究新进展［J］.神经疾病与精神卫生，2017，17（6）：396-399.
4	顾艳虹，施忠英，李华，等. 基于情绪智力模型的情绪管理方案在双相情感障碍抑郁发作患者中的应用效果［J］. 中国护理管理， 2022，22（7）：1009-1014. doi:10.3969/j.issn.1672-1756.2022.07.010 doi: 10.3969/j.issn.1672-1756.2022.07.010
5	刘光伟，邓巧恩，赵栋，等. 童年创伤对缓解期双相情感障碍患者血浆中lncRNA 51A表达及情绪认知功能的影响［J］. 精神医学杂志， 2021，34（1）：20-24. doi:10.3969/j.issn.2095-9346.2021.01.005 doi: 10.3969/j.issn.2095-9346.2021.01.005
6	SLYEPCHENKO A， ALLEGA O R， LENG X， et al. Association of functioning and quality of life with objective and subjective measures of sleep and biological rhythms in major depressive and bipolar disorder［J］. Aust N Z J Psychiatry， 2019， 53（7）： 683-696. doi:10.1177/0004867419829228 doi: 10.1177/0004867419829228
7	黄俭，程小伟，朱向阳，等. 科拉奇分析法联合认知行为疗法在青少年非自杀性自伤行为中的应用及其对Barratt评分和MOAS的影响［J］. 实用医学杂志， 2022，38（3）：360-365. doi:10.3969/j.issn.1006-5725.2022.03.019 doi: 10.3969/j.issn.1006-5725.2022.03.019
8	高海波，王刚，陈莎莎，等. 双相情感障碍患者血清甲状腺素、泌乳素、多巴胺水平变化及与冲动攻击行为关系［J］. 临床误诊误治， 2022，35（5）：112-116. doi:10.3969/j.issn.1002-3429.2022.05.034 doi: 10.3969/j.issn.1002-3429.2022.05.034
9	沈小琴，张丞，刘若楠. 双相情感障碍患者内分泌代谢状况与冲动攻击行为的相关性［J］. 神经疾病与精神卫生， 2021，21（1）：15-20，封3. doi:10.3969/j.issn.1009-6574.2021.01.004 doi: 10.3969/j.issn.1009-6574.2021.01.004
10	徐丹，周广玉，夏海明. 双相情感障碍患者自知力水平与冲动攻击行为的相关性［J］. 皖南医学院学报， 2021，40（1）：79-82. doi:10.3969/j.issn.1002-0217.2021.01.022 doi: 10.3969/j.issn.1002-0217.2021.01.022
11	银燕，余建英，熊智. 影响精神分裂症病人攻击行为的相关因素分析［J］. 护理研究， 2019，33（21）：3667-3671. doi:10.12102/j.issn.1009-6493.2019.21.006 doi: 10.12102/j.issn.1009-6493.2019.21.006
12	赵伟，王玉玲，刘志华，等. 双相情感障碍患者生活质量评估及干预的研究进展［J］. 中华护理杂志， 2022，57（2）：170-175. doi:10.3761/j.issn.0254-1769.2022.02.007 doi: 10.3761/j.issn.0254-1769.2022.02.007
13	闫爱国，刘鑫子，尹冬青，等. 双相情感障碍复发相关的社会心理特征因素研究［J］. 首都医科大学学报， 2023，44（4）：602-608. doi:10.3969/j.issn.1006-7795.2023.04.016 doi: 10.3969/j.issn.1006-7795.2023.04.016
14	马海波，曹昱，张仁云，等. 双相躁狂患者童年期创伤对攻击行为及临床症状的影响［J］. 精神医学杂志， 2019，32（2）：104-107.
15	芦云平，崔伟，于超，等. 伴精神病性症状躁狂首发双相障碍Ⅰ型患者疾病特征及长期功能预后［J］. 中国神经精神疾病杂志， 2022，48（1）：34-39. doi:10.3969/j.issn.1002-0152.2022.01.006 doi: 10.3969/j.issn.1002-0152.2022.01.006
16	刘畅畅，陈方煜，戴媛媛，等. 人格特质及家庭功能对双相情感障碍患者冲动性的影响分析［J］. 精神医学杂志， 2021，34（5）：432-435. doi:10.3969/j.issn.2095-9346.2021.05.010 doi: 10.3969/j.issn.2095-9346.2021.05.010
17	SIMONETTI A， KURIAN S， SAXENA J， et al. Cortical Correlates of Impulsive Aggressive Behavior in Pediatric Bipolar Disorder［J］. Front Psychiatry， 2021， 12：674707. doi:10.3389/fpsyt.2021.674707 doi: 10.3389/fpsyt.2021.674707
18	TRIFU S C， TUDOR A， RADULESCU I. Aggressive behavior in psychiatric patients in relation to hormonal imbalance （Review）［J］. Exp Ther Med， 2020， 20（4）：3483-3487.
19	ZANARDI R， MANFREDI E， ATTANASIO F， et al. A blemish on bipolar disorder： aggressive behaviour［J］. Eur Psychiat， 2022， 65（S1）： S411. doi:10.1192/j.eurpsy.2022.1043 doi: 10.1192/j.eurpsy.2022.1043
20	BLIX I， BIRKELAND M S， THORESEN S. Worry and mental health in the Covid-19 pandemic： vulnerability factors in the general Norwegian population［J］. BMC Public Health， 2021， 21（1）： 928. doi:10.1186/s12889-021-10927-1 doi: 10.1186/s12889-021-10927-1
21	陈银虎，马静婕. 基于倾向性评分匹配法的社会参与对独居老人精神健康的影响［J］. 医学与社会， 2023，36（2）：69-73.
22	ANDERSSON H W， LILLEENG S E， RUUD T， et al. Suicidal ideation in patients with mental illness and concurrent substance use： analyses of national census data in Norway［J］. BMC Psychiatry， 2022， 22（1）：1. doi:10.1186/s12888-021-03663-8 doi: 10.1186/s12888-021-03663-8
23	丁佳豪，章梦琦，郝明霞，等. 孟德尔随机化研究精神分裂症与自杀或故意自残的因果关系［J］. 中华精神科杂志， 2023，56（1）：32-39. doi:10.3760/cma.j.cn113661-20220830-00242 doi: 10.3760/cma.j.cn113661-20220830-00242
24	梁肖，陈燕燕，曹俊，等. 短程强化门诊干预对精神分裂症患者社会功能和康复的影响［J］. 临床精神医学杂志， 2023，33（1）：51-54. doi:10.3969/j.issn.1005-3220.2023.01.012 doi: 10.3969/j.issn.1005-3220.2023.01.012
25	曹晓浪，王伟梁，宇虹，等. 基于干预映射理论构建的残疾时点匹配干预方案在精神分裂症残疾患者中的应用研究［J］. 中国全科医学， 2023，26（19）：2376-2384，2394. doi:10.12114/j.issn.1007-9572.2022.0849 doi: 10.12114/j.issn.1007-9572.2022.0849

项目	子项目	攻击组（n = 28）	未攻击组（n = 52）	t/χ²值	P值
年龄（岁）		29.31 ± 5.06	29.72 ± 5.13	0.343	0.733
性别［例（%）］	男	12（42.86）	24（46.15）	0.304	0.582
	女	16（57.14）	28（53.85）
BMI（kg/m²）		22.13 ± 2.42	22.48 ± 2.51	0.602	0.549
教育水平［例（%）］	初中及以下	10（35.71）	17（32.69）	0.074	0.785
	高中及以上	18（64.29）	35（67.31）
婚姻状况［例（%）］	有伴侣	20（71.43）	39（75.00）	0.120	0.729
	无伴侣	8（28.57）	13（25.00）
是否长期独居［例（%）］	是	15（53.57）	16（30.77）	3.990	0.046
	否	13（46.43）	36（69.23）
年收入占比［例（%）］	≥ 150%	6（21.43）	15（28.85）	0.549	0.760
	50% ~ 150%	9（32.14）	16（30.77）
	≤ 50%	13（46.43）	21（40.38）
吸烟史［例（%）］	无	16（57.14）	35（67.31）	0.814	0.367
	有	12（42.86）	17（32.69）
发病年龄（岁）		22.75 ± 7.66	23.29 ± 8.12	0.289	0.773
总病程［例（%）］	< 5年	12（42.86）	21（40.38）	0.046	0.830
	≥ 5年	16（57.14）	31（59.62）
总住院时间（月）		12.73 ± 2.80	6.25 ± 2.04	11.858	0.000
精神病家族史［例（%）］	有	7（25.00）	15（28.85）	0.135	0.713
	无	21（75.00）	37（71.15）
入院前服药状况［例（%）］	停药	12（42.56）	25（48.08）	0.245	0.885
	间断服药	10（35.71）	16（30.77）
	坚持服药	6（21.43）	11（21.15）
既往有无自杀倾向［例（%）］	有	15（53.57）	11（21.15）	8.720	0.03
	无	13（46.43）	41（78.85）
自知力水平（ITAQ评分）		10.07 ± 2.15	15.49 ± 2.73	9.088	< 0.01
社会支持情况（SSRS评分）		22.48 ± 3.28	29.00 ± 3.61	7.949	< 0.01

影响因素	赋值
是否长期独居	是=1，否=0
总住院时间	原值输入
既往有无自杀倾向	是=1，否=0
ITAQ评分	原值输入
SSRS评分	原值输入

影响因素	回归系数	标准误	Wald χ²值	P值	OR值	95% CI
常数	4.565	2.269	4.047	0.044	-	-
长期独居	1.220	0.580	4.415	0.036	3.386	1.085～10.563
总住院时间	0.282	0.078	12.936	0.000	1.325	1.137～1.545
自杀倾向	1.382	0.564	6.001	0.014	3.981	1.318～12.025
ITAQ评分	-0.276	0.091	9.196	0.002	0.759	0.634～0.907
SSRS评分	-0.209	0.074	7.966	0.005	0.811	0.702～0.938

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Construction of a nomogram prediction model for aggressive behavior in patients with bipolar disorder

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