目的:探讨不同暴力程度老年精神分裂症患者事件相关电位P300的临床特点及严重暴力的危险因素。
方法:选取河北医科大学第一医院2020年1月至2021年12月收治的138例老年精神分裂症患者作为研究对象。根据暴力风险评估,61、102和145名患者被分为高危,中等风险,和低风险人群,分别。临床特征,P300延迟,比较三组之间的P300振幅,然后对患有严重暴力的老年精神分裂症患者进行逻辑回归分析。
结果:高危组的P300潜伏期高于低危组(p<.05)。高危组患者的P300波幅明显低于低危组(p<0.05)。单因素logistic回归分析显示,以前的暴力史,迫害的妄想,P300延迟,和振幅是老年精神分裂症患者严重暴力的独立影响因素(比值比[OR]:0.022,95%置信区间[CI]:0.007-0.067,p<.001;OR:0.118,95%CI:0.043-1.763,p=.037;OR:1.289,95%CI:1.142-1.673,p<.001;OR:0.049,95%CI:0.021<0.067调整性别后,年龄,和其他混杂因素,多因素logistic回归分析显示,迫害妄想,P300延迟,P300振幅与老年精神分裂症患者的严重暴力相关(OR:2.211,95%CI:0.061-4.067,p<.001;OR:2.006,95%CI:1.421-2.721,p=.017;OR:0.067,95%CI:0.037-0.276;p<.001)。
结论:P300的潜伏期和波幅可作为评估老年精神分裂症患者暴力程度的有效神经电生理指标。迫害的妄想,P300延迟,P300波幅是老年精神分裂症患者严重暴力的独立影响因素。
To investigate the clinical characteristics of event-related potential P300 in elderly schizophrenics with different levels of violence and the risk factors of severe violence.
A total of 138 elderly schizophrenic patients from January 2020 to December 2021 in the First Hospital of Hebei Medical University were enrolled in this retrospective analysis. Based on the violence risk assessment, 61, 102, and 145 patients were divided into high-risk, medium-risk, and low-risk groups, respectively. Clinical characteristics, P300 latency, and P300 amplitude were compared among the three groups followed by a logistic regression analysis of elderly schizophrenics with severe violence.
The latency of P300 in the high-risk group was higher than that in the low-risk group (p < .05). The P300 amplitude of patients in the high-risk group was significantly lower than that in the low-risk group (p < .05). Univariate logistic regression analysis showed that previous history of violence, delusion of persecution, P300 latency, and amplitude were independent influencing factors of severe violence in elderly schizophrenics (odds ratio [OR]: 0.022, 95% confidence interval [CI]: 0.007-0.067, p < .001; OR: 0.118, 95% CI: 0.043-1.763, p = .037; OR: 1.289, 95% CI: 1.142-1.673, p < .001; and OR: 0.049, 95% CI: 0.021-0.067, p < 0.001, respectively). After adjusting gender, age, and other confounding factors, multivariate logistic regression analysis showed that delusion of persecution, P300 latency, and P300 amplitude were associated with severe violence in elderly schizophrenics (OR: 2.211, 95% CI: 0.061-4.067, p < .001; OR: 2.006, 95% CI: 1.421-2.721, p = .017; and OR: 0.067, 95% CI: 0.037-0.276; p < .001; respectively).
The latency and amplitude of P300 can be used as effective neuroelectrophysiological indicators to evaluate the violence level of elderly schizophrenics. Delusion of persecution, P300 latency, and P300 amplitude were independent influencing factors of severe violence in elderly schizophrenics.