暴力经历对双相障碍患者生活满意度及社会功能的影响
作者:
作者单位:

作者简介:

通讯作者:

基金项目:

北京市医院管理中心临床医学发展专项“扬帆”计划临床技术创新项目(XMLX202128);北京市属医院科研培育计划(PX2022076)


Influence of violence experience on life satisfaction and social function in patients with bipolar disorder
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
    摘要:

    目的 分析双相障碍发作前 6 个月内的暴力经历对患者生活满意度及社会功能的影响。 方法 选取 2014 年 6 月至 2017 年 6 月在首都医科大学附属北京安定医院就诊,经过 12 周急性期有效治 疗的 240 例双相障碍患者为研究对象。采用自编一般资料调查表收集人口学资料、临床资料。采用性 和躯体暴力问卷收集此次发作前 6 个月内遭受的暴力情况。在基线期、3 个月、6 个月分别采用 17 项汉 密尔顿抑郁量表(HAMD-17)、杨氏躁狂量表(YMRS)评估患者的残留症状,采用席汉残疾量表(SDS)、世 界卫生组织生活质量测定量表简表(WHOQOL-BREF)评估患者的社会功能及生活满意度。结果 发作 前 6 个月内有 38.8%(93/240)的患者遭受过暴力,其中 28.0%(26/93)的患者遭受过性暴力,72.0%(67/93) 的患者遭受过躯体暴力,80.6%(75/93)的患者遭受过性暴力和躯体暴力。有暴力经历与无暴力经历患者 的婚姻状态、自杀观念、自杀计划、近 3 年总发作次数比较,差异有统计学意义(P< 0.05)。3 个月随访时 纳入分析 194 例患者,6 个月随访时纳入分析 171 例患者。有暴力经历与无暴力经历患者基线期、3 个月 随访时的 HAMD-17 总分比较,差异有统计学意义(Z=-2.24、-1.99;P< 0.05),6 个月随访时的 HAMD-17 总分比较,差异无统计学意义(Z=-1.28,P> 0.05)。两组患者 3 个时间点的 YMRS 总分比较,差异均无 统计学意义(Z=-0.81、-1.13、-1.00;P> 0.05)。有暴力经历患者基线期、3 个月随访时 WHOQOL-BREF 中的心理、社会关系、环境领域得分低于无暴力经历患者,差异有统计学意义(Z=-3.65~-2.16;P< 0.05),其中社会关系领域得分在 6 个月随访时仍低于无暴力经历患者,差异有统计学意义(Z=-2.28,P< 0.05)。有暴力经历患者3个月随访时的工作/学习、社交生活、家庭生活受损例数占比高于无暴力经历患者, 差异有统计学意义(χ2 =4.22~6.63;P<0.05);两组基线期、6个月随访时的工作/学习、社交生活、家庭生 活受损情况比较,差异无统计学意义(χ2 =0.06~1.78;P>0.05)。结论 本次发作前6个月内有暴力经历 对双相障碍患者急性期治疗后3个月内的生活满意度及社会功能影响显著,6个月后影响逐渐减弱。

    Abstract:

    Objective To explore the influence of violence experience within 6 months prior to onset of bipolar disorder on life satisfaction and social function. Methods A total of 240 bipolar disorder patients who underwent 12 weeks of effective treatment in the acute phase from June 2014 to June 2017 at Beijing Anding Hospital affiliated with Capital Medical University were selected as the research subjects. A self-designed general data questionnaire was applied to collect demographic and clinical data. The Sexual and Physical Violence Questionnaire was applied to collect the violence experience within 6 months prior to the onset this time. Residual symptoms were assessed by 17-items Hamilton Depression Rating Scale (HAMD-17) and Young Mania Rating Scale (YMRS) and life satisfaction and social function were assessed by WHO Quality of Life-BREF (WHOQOL-BREF) and Sheehan Disability Scale (SDS) at baseline, 3 months and 6 months. Results Within 6 months prior to the onset, 38.8% (93/240) of patients experienced violence, of which 28.0% (26/93) had experienced sexual violence, 72.0% (67/93) had experienced physical violence, and 80.6% (75/93) had experienced sexual and physical violence. There is a statistically significant difference in marital status, suicidal attitudes, suicide plans, and total number of episodes in the past three years between patients with and without violent experiences (P< 0.05). A total of 194 patients were included in the analysis at a 3-month follow-up, and 171 patients were included in the analysis at a 6-month follow-up. There was a statistically significant difference in the total HAMD-17 score between patients with and without violent experiences at baseline and 3-month follow-up (Z=-2.24,-1.99;P < 0.05), while there was no statistically significant difference in the total HAMD-17 score at 6-month follow-up (Z=-1.28,P > 0.05). There was no statistically significant difference in the total YMRS scores between the two groups of patients at three time points (Z=-0.81,-1.13, -1.00;P> 0.05). Patients with violent experiences had lower scores in the psychological, social relations, and environmental fields in WHOQOL-BREF at baseline and 3-month follow-up compared to patients without violent experiences, with a statistically significant difference (Z=-3.65-2.16;P < 0.05). Among them, the scores in the social relations field were still lower than those in patients without violent experiences at 6-month follow-up, with a statistically significant difference (Z=-2.28, P< 0.05). The proportion of cases of work/study, social life, and family life damage in patients with violent experiences at 3-month follow-up is higher than that in patients without violent experiences, and the difference is statistically significant (χ2 =4.22-6.63; P < 0.05). There was no statistically significant difference in the work/study, social life, and family life damage between the two groups at baseline and 6-month follow-up (χ2 =0.06-1.78; P > 0.05). Conclusions The experience of violence within 6 months prior to this episode had a significant impact on the life satisfaction and social function of bipolar disorder patients in the acute phase within 3 months after treatment, and the impact gradually disappeared after 6 months.

    参考文献
    相似文献
    引证文献
引用本文

黄娟,吕楠,赵茜,付冰冰,张玲.暴力经历对双相障碍患者生活满意度及社会功能的影响[J].神经疾病与精神卫生,2023,23(9).
DOI :10.3969/j. issn.1009-6574.2023.09.002.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
历史
  • 收稿日期:
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2023-10-24