Risk factors of criminal behavior in persons with schizophrenia in a rural Chinese community

Abstract

目的:探討農村社區中精神分裂癥患者犯罪行為的發生率及其相關因素。方法:對成都市新津縣農村社區中510例精神分裂癥患者的犯罪行為及其臨床癥狀、社會功能、治療、照管等情況進行了14年(1994-2008年)的隨訪調查。調查工具包括精神現況檢查第9版(Present State Examination,PSE-9)、社會功能缺陷篩查表(Social Disability Screening Schedule,SDSS),以及陽性與陰性癥狀量表(Positive and Negative Syndrome,PANSS)等。結果:在14年的隨訪調查中有489例患者(95.9%)完成了隨訪。隨訪患者終身犯罪行為的發生率為13.5%。犯罪行為在未婚(19.1%)、較年輕[平均年齡(41.2±16.6)歲]、發病年齡較早的精神分裂癥患者[平均發病年齡(28.4±10.4)歲]中較常發生。隨訪資料中,患者家庭經濟狀況較差(16.6%)、缺乏監護照管人(28.6%)、無家可歸(25.0%),及PANSS總分(68.7±28.7)和陽性(14.1±7.4)、陰性(19.3±10.2)分較高的患者中犯罪行為的發生率較高(P<0.05)。結論:精神分裂癥患者的犯罪行為在農村社區中較為常見,其影響因素是多方面的。在制定社區精神衛生服務政策、提供精神衛生服務及家庭干預時,應考慮社區中精神分裂癥患者的犯罪行為及其危險因素(如患者的婚姻、家庭及監護照管狀態、社會支持系統等)。 Objective:To examine the prevalence and risk factors of criminal behavior among persons with schizophrenia in a rural area.Methods:A 14-year prospective follow-up study(1994-2008) was conducted on criminal behavior,clinical symptoms,social functioning,treatment and caring status among 510 persons with schizophrenia in Xinjin County,Chengdu.The instruments included the Present State Examination(PSE-9),Social Disability Screening Schedule(SDSS),and Positive and Negative Syndrome(PANSS).Results:Totally 489 patients(95.9%) were followed up.The life-time prevalence of criminal behavior among these patients was 13.5%.Criminal behavior was more likely to happen among the persons who were unmarried(19.1%),younger [(41.2±16.6) years old],and had earlier onset age [(28.4±10.4) years old].In the follow-up data,the rates of patients’ criminal behavior were relatively higher among these patients who had poor family economic status(16.6%),no caregiver(28.6%),homelessness(25.0%),and higher positive(14.1±7.4),negative(19.3±10.2) and total scores(68.7±28.7) of PANSS(P<0.05).Conclusion:The criminal behavior in patients with schizophrenia is common in rural areas and may be affected by multi-factors.The risk factors of criminal behavior in persons with schizophrenia,such as their marriage,family intervention and social support services,should be considered for community mental health policy making,community mental health services and family interventions.