多发梗死性痴呆患者的心理因素与攻击行为

B.D. Tsygankov, Yu.V. Dobrovolskaya, U.Kh. Gadzhieva, I.V. Stepanova
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摘要

本文旨在研究多发梗死性痴呆患者的心理因素与攻击行为的关系,以制定心理矫正方法,改善患者及其护理者的生活质量,提高治疗效果。材料与方法:49例诊断为多发梗死性痴呆(F01.1)并伴有攻击行为的患者(n=49)参与研究。采用临床-遗忘、临床-精神病理和心理测量诊断方法。结果:27例(87.1%)患者因家属日常护理执行不严谨导致肢体攻击发生率增高,导致肢体攻击发生的几率和严重程度增加,有统计学意义。在78.6%的病例(22名患者)中,身体攻击在违反日常生活习惯的情况下发生的频率显著增加,并与发展为身体攻击的风险和更严重程度相关。13名受试者(56.5%)因自身的无助感而易激惹性更常见,且易激惹性发展及其严重程度的几率更高。在17例(68%)患者中,言语攻击更常见,并且发生在患者对照顾者的诉求不被理解的情况下,这导致言语攻击发展及其严重程度的比值比增加。患者的攻击行为与护理者对患者的消极态度之间没有关系。结论:所得数据表明,多发梗死性痴呆患者最常表现为肢体攻击行为,这与“家属日常护理执行不认真”、“违反日常作息”等因素密切相关。此外,患者还表现为“自身在潜在疾病背景下的无助”而表现为易怒,“亲属不理解其诉求”时表现为言语攻击。
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Psychogenic factors and aggressive behavior in patients with multi-infarct dementia
The article is devoted to the study of the relationship between psychogenic factors and aggressive behavior in patients with multi-infarct dementia in order to develop methods of psychocorrection, improve the quality of lives of patients and those caring for them, as well as to increase the effectiveness of treatment. Material and methods: 49 patients (n=49) with a diagnosis of multi-infarct dementia (F01.1) and accompanying aggressive behavior took part in the study. Clinical-anamnestic, clinical-psychopathological, and psychometric diagnostic methods were used. Results: in 27 patients (87.1%), physical aggression was statistically significantly more common due to the relatives’ careless daily care implementation, which led to an increase in the chances of developing physical aggression and its severity. In 78.6% of cases (in 22 patients), physical aggression occurred statistically significantly more often with the violation of the daily routine and was associated with the risk of developing physical aggression and a greater degree of its severity. Irritability was statistically significantly more common in 13 subjects (56.5% of cases) due to their own helplessness and was associated with higher chances of the irritability development and its severity. In 17 patients (68%), verbal aggression was statistically significantly more common and occurred when the patients’ appeals to caregivers were not understood, which led to an increase in the odds ratio of the verbal aggression development and its severity. The relationship between the patients’ aggression and the caregivers’ negative attitude towards them was not found. Conclusions: the data obtained indicate that patients with multi-infarct dementia most often show physical aggression, which is closely related to such factors as "the relatives’ careless daily care implementation" and "the violation of the daily routine". In addition, the patients were characterized by the manifestation of irritability due to "their own helplessness against the background of the underlying disease" and the manifestation of verbal aggression when "the relatives did not understand their appeals".
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