探讨精神分裂症患者住院治疗过程中药物使用的违规行为

IF 1.1 4区 医学 Q3 CRIMINOLOGY & PENOLOGY
Martina Sonnweber, Johannes Kirchebner, Moritz Philipp Günther, Johannes Rene Kappes, Steffen Lau
{"title":"探讨精神分裂症患者住院治疗过程中药物使用的违规行为","authors":"Martina Sonnweber,&nbsp;Johannes Kirchebner,&nbsp;Moritz Philipp Günther,&nbsp;Johannes Rene Kappes,&nbsp;Steffen Lau","doi":"10.1002/cbm.2245","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Rule-violating behaviour in the form of substance misuse has been studied primarily within the context of prison settings, but not in forensic psychiatric settings.</p>\n </section>\n \n <section>\n \n <h3> Aims</h3>\n \n <p>Our aim was to explore factors that are associated with substance misuse during hospitalisation in patients among those patients in a Swiss forensic psychiatric inpatient unit who were suffering from a disorder along the schizophrenia spectrum.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>From a database of demographic, clinical and offending data on all residents at any time between 1982 and 2016 in the forensic psychiatric hospital in Zurich, 364 cases fulfilled diagnostic criteria for schizophrenia or a schizophrenia-like illness and formed our sample. Any confirmed use of alcohol or illicit substances during admission (yes/no) was the dependent variable. Its relationship to all 507 other variables was explored by machine learning. To counteract overfitting, data were divided into training and validation set. The best model from the training set was tested on the validation set.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Substance use as a secure hospital inpatient was unusual (15, 14%). Prior substance use disorder accounted for so much of the variance (AUC 0.92) that it was noted but excluded from further models. In the resulting model of best fit, variables related to rule breaking, younger age overall and at onset of schizophrenia and nature of offending behaviour, substance misuse as a minor and having records of complications in prior psychiatric treatment were associated with substance misuse during hospitalisation, as was length of inpatient treatment. In the initial model the AUC was 0.92. Even after removal of substance use disorder from the final model, performance indicators were meaningful with a balanced accuracy of 67.95, an AUC of 0.735, a sensitivity of 81.48% and a specificity of 57.58%.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Substance misuse in secure forensic psychiatric hospitals is unusual but worthy of clinical and research consideration because of its association with other rule violations and longer hospitalisation. More knowledge is needed about effective interventions and rehabilitation for this group.</p>\n </section>\n </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cbm.2245","citationCount":"4","resultStr":"{\"title\":\"Exploring substance use as rule-violating behaviour during inpatient treatment of offender patients with schizophrenia\",\"authors\":\"Martina Sonnweber,&nbsp;Johannes Kirchebner,&nbsp;Moritz Philipp Günther,&nbsp;Johannes Rene Kappes,&nbsp;Steffen Lau\",\"doi\":\"10.1002/cbm.2245\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Rule-violating behaviour in the form of substance misuse has been studied primarily within the context of prison settings, but not in forensic psychiatric settings.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>Our aim was to explore factors that are associated with substance misuse during hospitalisation in patients among those patients in a Swiss forensic psychiatric inpatient unit who were suffering from a disorder along the schizophrenia spectrum.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>From a database of demographic, clinical and offending data on all residents at any time between 1982 and 2016 in the forensic psychiatric hospital in Zurich, 364 cases fulfilled diagnostic criteria for schizophrenia or a schizophrenia-like illness and formed our sample. Any confirmed use of alcohol or illicit substances during admission (yes/no) was the dependent variable. Its relationship to all 507 other variables was explored by machine learning. To counteract overfitting, data were divided into training and validation set. The best model from the training set was tested on the validation set.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Substance use as a secure hospital inpatient was unusual (15, 14%). Prior substance use disorder accounted for so much of the variance (AUC 0.92) that it was noted but excluded from further models. In the resulting model of best fit, variables related to rule breaking, younger age overall and at onset of schizophrenia and nature of offending behaviour, substance misuse as a minor and having records of complications in prior psychiatric treatment were associated with substance misuse during hospitalisation, as was length of inpatient treatment. In the initial model the AUC was 0.92. Even after removal of substance use disorder from the final model, performance indicators were meaningful with a balanced accuracy of 67.95, an AUC of 0.735, a sensitivity of 81.48% and a specificity of 57.58%.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Substance misuse in secure forensic psychiatric hospitals is unusual but worthy of clinical and research consideration because of its association with other rule violations and longer hospitalisation. More knowledge is needed about effective interventions and rehabilitation for this group.</p>\\n </section>\\n </div>\",\"PeriodicalId\":47362,\"journal\":{\"name\":\"Criminal Behaviour and Mental Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2022-06-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cbm.2245\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Criminal Behaviour and Mental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/cbm.2245\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRIMINOLOGY & PENOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Criminal Behaviour and Mental Health","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cbm.2245","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRIMINOLOGY & PENOLOGY","Score":null,"Total":0}
引用次数: 4

摘要

以药物滥用为形式的违反规则行为主要是在监狱环境中进行研究,而不是在法医精神病学环境中进行研究。我们的目的是探索在瑞士法医精神科住院病房中患有精神分裂症谱系障碍的患者住院期间与药物滥用相关的因素。方法从1982年至2016年苏黎世法医精神病院所有住院患者的人口学、临床和犯罪数据数据库中,选出364例符合精神分裂症或精神分裂症样疾病诊断标准的患者作为样本。入院期间任何确认使用酒精或非法物质(是/否)是因变量。它与所有507个其他变量的关系是通过机器学习来探索的。为了防止过拟合,将数据分为训练集和验证集。在验证集上对训练集中的最佳模型进行测试。结果作为安全住院患者的药物使用不常见(15.14%)。先前的物质使用障碍占了很大的方差(AUC 0.92),因此它被注意到了,但被排除在进一步的模型之外。在得到的最佳拟合模型中,与违反规则、总体年龄更小、精神分裂症发病年龄和犯罪行为的性质、未成年人滥用药物以及在先前的精神治疗中有并发症记录等相关的变量与住院期间的药物滥用有关,住院治疗时间也与药物滥用有关。初始模型的AUC为0.92。即使在最终模型中去除物质使用障碍后,性能指标仍具有意义,平衡精度为67.95,AUC为0.735,灵敏度为81.48%,特异性为57.58%。结论:在安全的法医精神病院中,药物滥用是不寻常的,但值得临床和研究考虑,因为它与其他违反规则和住院时间较长有关。对这一群体的有效干预和康复需要更多的知识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Exploring substance use as rule-violating behaviour during inpatient treatment of offender patients with schizophrenia

Exploring substance use as rule-violating behaviour during inpatient treatment of offender patients with schizophrenia

Background

Rule-violating behaviour in the form of substance misuse has been studied primarily within the context of prison settings, but not in forensic psychiatric settings.

Aims

Our aim was to explore factors that are associated with substance misuse during hospitalisation in patients among those patients in a Swiss forensic psychiatric inpatient unit who were suffering from a disorder along the schizophrenia spectrum.

Methods

From a database of demographic, clinical and offending data on all residents at any time between 1982 and 2016 in the forensic psychiatric hospital in Zurich, 364 cases fulfilled diagnostic criteria for schizophrenia or a schizophrenia-like illness and formed our sample. Any confirmed use of alcohol or illicit substances during admission (yes/no) was the dependent variable. Its relationship to all 507 other variables was explored by machine learning. To counteract overfitting, data were divided into training and validation set. The best model from the training set was tested on the validation set.

Results

Substance use as a secure hospital inpatient was unusual (15, 14%). Prior substance use disorder accounted for so much of the variance (AUC 0.92) that it was noted but excluded from further models. In the resulting model of best fit, variables related to rule breaking, younger age overall and at onset of schizophrenia and nature of offending behaviour, substance misuse as a minor and having records of complications in prior psychiatric treatment were associated with substance misuse during hospitalisation, as was length of inpatient treatment. In the initial model the AUC was 0.92. Even after removal of substance use disorder from the final model, performance indicators were meaningful with a balanced accuracy of 67.95, an AUC of 0.735, a sensitivity of 81.48% and a specificity of 57.58%.

Conclusions

Substance misuse in secure forensic psychiatric hospitals is unusual but worthy of clinical and research consideration because of its association with other rule violations and longer hospitalisation. More knowledge is needed about effective interventions and rehabilitation for this group.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
1.60
自引率
0.00%
发文量
40
期刊介绍: Criminal Behaviour & Mental Health – CBMH – aims to publish original material on any aspect of the relationship between mental state and criminal behaviour. Thus, we are interested in mental mechanisms associated with offending, regardless of whether the individual concerned has a mental disorder or not. We are interested in factors that influence such relationships, and particularly welcome studies about pathways into and out of crime. These will include studies of normal and abnormal development, of mental disorder and how that may lead to offending for a subgroup of sufferers, together with information about factors which mediate such a relationship.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信