Development and validation of risk prediction model for aggressive behaviors of community patients with schizophrenia
Journal Title: Shanghai Journal of Preventive Medicine - Year 2022, Vol 34, Issue 10
Abstract
ObjectiveTo determine the factors associated with aggressive behaviors of patients with schizophrenia by gender in communities in Shanghaiï¼ and further develop and validate the prediction model.MethodsA total of 7 955 community patients with schizophrenia were investigated in Xuhui Districtï¼ Hongkou District and Jiading District of Shanghai. Baseline information was collected from April 2018 and follow-up was conducted every 3 months for 6 months. Multivariate logistic regression was used to calculate the odd ratio ï¼ORï¼ and 95% CIï¼ and determine the factors associated with aggressive behaviors of patients. The risk score for each patient was developed based on the β coefficientï¼ and the best cut-off value was determined by the Youden index. For the modelsï¼ predictive ability was determined using area under the curve ï¼AUCï¼ of receiver operator characteristic curve ï¼ROC curveï¼ï¼ and internal validation ability was evaluated by the ten-fold cross validation method.ResultsThere were 3 563 males in this study with an average age of ï¼54.83±13.72ï¼ years oldï¼ and the incidence of aggressive behaviors was 2.55%.There were 4 392 females with an average age of ï¼57.20±14.98ï¼ yearsï¼ and the incidence of aggressive behaviors was 2.64%. For male patients with schizophreniaï¼ single/divorced status ï¼OR=2.04ï¼ 95%CIï¼ 1.15â3.61ï¼ï¼ low economic status ï¼OR=2.79ï¼ 95%CIï¼ 1.71â4.54ï¼ï¼ irregular medication ï¼OR=4.35ï¼ 95%CIï¼2.23â8.47ï¼ï¼ no medication ï¼OR=1.83ï¼ 95%CIï¼1.03â3.26ï¼ï¼ incomplete/no insight ï¼OR=1.97ï¼ 95%CIï¼0.99â3.94ï¼ï¼ adverse drug reaction ï¼OR=2.61ï¼ 95%CIï¼1.27â5.37ï¼ï¼ psychiatric symptoms involving violence ï¼OR=2.06ï¼ 95%CIï¼1.01â4.18ï¼ï¼ history of aggression ï¼OR=5.29ï¼ 95%CIï¼2.33â11.98ï¼ and recent stress events ï¼OR=8.36ï¼ 95%CIï¼4.13â16.92ï¼ were associated with aggressive behaviors. In contrastï¼ for female patientsï¼ age less than 60 years ï¼50â59 yearsï¼ OR=2.09ï¼ 95%CIï¼ 1.13â3.87ï¼ 40â49 yearsï¼ OR=2.74ï¼ 95%CIï¼ 1.46â5.17ï¼ 30â39 yearsï¼OR=2.88ï¼ 95%CIï¼ 1.48â5.60ï¼ 18â29 yearsï¼ OR=5.71ï¼ 95%CIï¼ 2.44â13.37ï¼ï¼ educational level of high school and above ï¼senior high schoolï¼ OR=3.30ï¼ 95%CIï¼ 1.46â7.49ï¼ college and universityï¼ OR=2.88ï¼ 95%CIï¼ 1.21â6.82ï¼ï¼ unemployed status ï¼OR=1.81ï¼ 95%CI=1.17â2.82ï¼ï¼ irregular medication ï¼OR=7.87ï¼ 95%CIï¼4.75â13.05ï¼ï¼ no medication ï¼OR=2.11ï¼ 95%CIï¼1.24â3.62ï¼ï¼ adverse drug reaction ï¼OR=2.75ï¼ 95%CIï¼1.50â5.04ï¼ï¼ psychiatric symptoms involving violence ï¼OR=3.08ï¼ 95%CIï¼1.77â5.37ï¼ï¼ social function ï¼OR=3.51ï¼ 95%CIï¼2.07â5.94ï¼ and recent stress events ï¼OR=5.92ï¼ 95%CIï¼ 2.82â12.44ï¼ were risk factors. In both male and femaleï¼ the prediction models for aggressive behaviors of community patients with schizophrenia had strong predictive ability ï¼AUC=0.779ï¼ 95%CIï¼ 0.725â0.834ï¼ AUC=0.822ï¼ 95%CIï¼ 0.780â0.863ï¼.ConclusionThis study suggests that diverse risk factors should be considered for community patients with schizophrenia by gender to prevent the aggressive behaviors.
Authors and Affiliations
JIANG Yizhou,CHEN Chunmei,ZHU Youwei,HE Siyuan,CAI Jun,XIE Bin,ZHANG Weibo,WANG Na,
Keywords
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