Objective  To analyze clinical characteristics and influencing factors of troublemaking behavior among homeless psychiatric patients and explore new strategies for relief and management of the patients.

  Methods  We collected data on 2 332 homeless psychiatric patients having treatment in Nanning Municipal Social Welfare Hospital from 2008 through 2014 and divided the patients into a case and a control group according to their history of troublemaking behavior. Chi-square test and multivariate analysis were performed in data analyses with SPSS 22.0.

  Results  The prevalence of malnutrition and incidence of infectious diseases were higher in all the patients than those in general populations. Among the patients, 742 (31.8%) were identified with the history of troublemaking behavior; higher ratio of troublemaking behavior history was observed among the males, those from other provinces, and the divorced than among the females (P = 0.001), those with local residence (P < 0.001), and the married (P = 0.025). The patients with troublemaking behavior history were more likely to suffer from fracture compared to those without the history (P < 0.05). Of the patients with troublemaking behavior history, 75.9% were diagnosed with schizophrenia. The ratio of troublemaking behavior history was 54.4% among 68 patients with psychoactive substance use related to mental disorders and 52.4% among 42 mood disorder patients, significantly higher than the ratio (43.9%) among 1 283 schizophrenia patients (both P < 0.05). Among the patients with troublemaking behavior history, the prevalences of delusion, hallucination, negativism, irritability, passiveness, and elation were higher but the prevalences of apathy, poverty of thought, hypoprosexia, and mutism were lower compared to those among the patients without the history (P < 0.05 for all). The results of multivariate regression analysis revealed that divorce, unemployment, suffering from schizophrenia, irritability, hallucinations, and elation were risk factors of troublemaking behavior among the patients.

  Conclusion  Troublemaking behavior is prevalent among homeless psychiatric patients and the patients with troublemaking behaviors are of obvious clinical characteristics. Positive psychosis symptoms are risk factors of troublemaking behavior and the patients of divorced, unemployed, and diagnosed with schizophrenia are more likely to have troublemaking behavior.