| Objective:(1)Understand the distribution of medical constitution in patients with schizophrenia,analyze the relationship between traditional Chinese medicine constitution and schizophrenia recurrence,and provide data support for clinical differentiation and emotional care of schizophrenia patients.(2)The risk factors related to recurrence in patients with schizophrenia were analyzed,a risk prediction model for recurrence of schizophrenia was constructed based on binary logistic regression,the risk prediction model was presented with a nomogram,and the scientific nature of the risk prediction model for recurrence of schizophrenia was evaluated by ROC and H-L tests.Based on this,the schizophrenia recurrence risk model is of great significance for the early identification,early prevention,early intervention and promotion of social integration of patients.Methods:According to the inclusion criteria and exclusion criteria,patients with schizophrenia who were in a stable period during hospitalization in four hospitals in Hunan Province from March～July 2022 were selected as research subjects,and the number of required samples was selected according to the proportion of 1/5 according to the method of systematic sampling.920questionnaires were distributed in this study,and 900 were valid.SPSS26.0 was used to collect the data,and according to the scores of the relapse aura scale,patients with schizophrenia were divided into relapse group(n=421)with scores greater than 21.5 and non-relapse group with scores less than or equal to 21.5(n=479).The method of first single and then many was used to screen the risk factors of schizophrenia relapse.The risk prediction model of schizophrenia relapse was constructed by Logistic regression.The recurrence risk prediction model was visualized in the form of a column graph.Receiver Operating Characteristic Curve was used to evaluate the model performance,Area under the Curve and test of goodness of fit.Results:(1)The results of general data showed that the differences between occupation,education level,place of residence,marital status,and employment after discharge were statistically significant in the relapsed and non-relapsed groups(P<0.05),while the differences between age,gender,course of disease and medical insurance type in the relapsed and non-relapsed groups were not statistically significant(P>0.05).(2)Relapse status of patients with schizophrenia:the score of 900 patients with schizophrenia was 24.42±19.71,the maximum value was 97,the minimum value was 0,and 21.5 was divided into relapse group and non-recurrence group,with 421(46.78%)relapse and 479(53.22%)relapse.(3)Distribution of Chinese constitution in patients with schizophrenia:peaceful quality 492(54.67%),qi deficiency121(13.44%),yang deficiency 63(7.00%),yin deficiency 54(6.00%),phlegm wet matter 38(4.22%),humid heat quality 17(1.89%),blood stasis 27(3.00%),qi depression 66(7.33%),special substance 22(2.44%).Binary Logistic regression analysis showed that education level and medication compliance were the influencing factors of relapse in patients with peace and quality.Educational level,course of disease and medication compliance were the factors affecting the recurrence of qi deficiency patients.The course of disease and medication compliance are the influencing factors of relapse in patients with Yang deficiency.(4)Univariate analysis showed that occupation,education level,residence,marital status,employment after discharge were statistically significant differences between the relapse group and non-relapse group(P<0.05).There were no significant differences in age,gender),course of disease and type of insurance insurance between the relapsing and non-relapsing groups(P<0.05);There was significant difference between TCM constitution and schizophrenia relapse group and non-relapse group(P<0.001).There were statistically significant differences in medication compliance,perceived social support,and relapse and non-relapse groups(P<0.001).(5)The results of multi-factor analysis showed that:Education level Junior high school,senior high school or technical secondary school,junior college,Bachelor’s degree or above,place of residence,Statistically significant variables such as employment after discharge,constitution of traditional Chinese medicine(P<0.001),medication compliance(P<0.001),etc.,were used as predictors of schizophrenia relapse risk.A model containing the above risk predictors was constructed based on Logistic regression,and the model was visualized by using a column graph.(6)Internal verification results showed that the AUC of schizophrenia relapse risk prediction model=0.821(95%CI:0.7935-0.8489),the Yoden index at the optimal cut-off value of 0.428was 0.537,the sensitivity and specificity were 0.767 and 0.770,respectively,and the H-L goodness of fit test showedχ~2=12.078,P=0.1478.Conclusion:(1)The recurrence rate of 900 patients with schizophrenia in this study was 46.78%,and the constitution of traditional Chinese medicine was mainly peaceful and peaceful,and the rest of the biased constitution accounted for relatively small.(2)Binary logistic regression analysis found that the risk factors for recurrence in schizophrenia patients in this study included education level,place of residence,employment after discharge,traditional Chinese medicine constitution,and medication compliance,and based on the above recurrence risk factors,a recurrence risk prediction model for schizophrenia was constructed.(3)The accuracy of the schizophrenia recurrence risk prediction model constructed in this study is 76.6%,and the differentiation and calibration of the schizophrenia recurrence risk prediction model are good,which can provide a reference for screening the risk of schizophrenia recurrence,and also provide a theoretical and practical basis for early identification,early prevention and precise intervention. |
PDF Full Text Request