Trajectory Classes of Violent Behavior in Schizophrenia Inpatients and Their Relations to Lipid Levels

• Main Authors: Ni-Hsuan Chu, 朱倪萱
• Other Authors: Wei-Jen Chen
• Format: Others
• Language: en_US
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/86963750237408341259

碩士 === 國立臺灣大學 === 流行病學與預防醫學研究所 === 100 === Background/Aims: The present study aimed to (a) characterize trajectory patterns of violence in schizophrenia inpatients, (b) explore the relationship between violence trajectories and lipid levels, and (c) further generate a model to predict more violent behavior in schizophrenia inpatients. Method: In a prospective study of schizophrenia inpatients from 2002 to 2003 (n=107), violent behavior was assessed using an 18-item Chinese version of the Violence Scale. Lipid levels at admission, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), were retrospectively collected from chart review in 2012. In trajectory analysis, we adopted the zero-inflated Poisson (ZIP) model to classify subjects based on their violent information. After trajectory analysis was conducted, multinomial logistic regression analyses were performed to clarify the association between violence trajectories and lipid levels. Finally, we conducted stepwise logistic regression to select the best predictor variables for violence and used the area under the curve (AUC) of the receiver operative characteristics (ROC) analysis to assess the predictive validity of predictor variables. Results: We identified four distinctive trajectories of violent behavior: class 1 (no violence, 37.4%); class 2 (low-leveling off, 39.2%); class 3 (high-falling sharply, 10.3%); and class 4 (high-falling slowly, 13.1%). The result of multinomial logistic regression analysis indicated that no significant differences in lipid levels were found among the classes of violence trajectories in schizophrenia inpatients. Yet, it seemed that triglycerides showed borderline descending trend with higher level of violent behavior. The best predictive model for more violence in schizophrenia inpatients was -1.21 + [1.90 x female] – [0.10 x age at onset] + [0.20 x positive symptoms scores] – [0.10 x negative symptoms scores] – [0.90 x total cholesterol level] (AUC=0.85, 95% CI=0.72-0.97, p<0.0001). Conclusion: Distinct violence trajectories existed in schizophrenia inpatients, but no significant associations were found between violence trajectory classes and lipid levels. Some clinical variables including female, earlier age at onset, severe positive symptoms, mild negative symptoms, and lower total cholesterol level might effectively predict more violent behavior in schizophrenia patient during hospitalization to achieve the early prevention.