摘要
目的探讨13~18岁青少年抑郁倾向影响因素,为开展青少年抑郁早期干预提供参考。方法于2019年9月11日—2020年12月31日,应用多中心现况调查方法,共抽取13~18岁学生6197人,筛查出青少年抑郁倾向患者;采用1:2配比病例对照研究方法,运用单因素和多因素条件logistic回归模型分析青少年抑郁倾向患者的影响因素。结果多中心现况调查共纳入13~18岁年龄组青少年6197人,296例患者新诊断为青少年抑郁倾向,其检出率为4.78%(95%CI=2.31%~6.59%)。单因素分析发现,有23个影响因素与青少年抑郁倾向有关(均P<0.05)。多因素条件logistic回归模型显示,精神疾病家族史(β=0.9942,OR=3.59,95%CI=1.59~5.98)、非双亲抚养的成长环境(β=0.2654,OR=1.69,95%CI=1.14~2.95)、独生子女(β=0.1359,OR=1.31,95%CI=1.02~2.57)、家庭成员关系不融洽(β=0.2885,OR=1.76,95%CI=1.12~3.05)、有学习问题(β=0.2305,OR=1.51,95%CI=1.03~2.91)、心理健康教育(β=-0.2049,OR=0.69,95%CI=0.24~0.96)、人际敏感因子得分(β=0.4621,OR=2.21,95%CI=1.42~4.77)、抑郁因子得分(β=1.2658,OR=4.81,95%CI=2.01~7.05)、焦虑因子得分(β=0.3429,OR=1.88,95%CI=1.16~3.84)、敌对因子得分(β=0.2452,OR=1.65,95%CI=1.09~3.06)、恐怖因子得分(β=0.2109,OR=1.46,95%CI=1.08~2.94)和精神质因子得分(β=0.4594,OR=2.15,95%CI=1.24~3.89)是青少年抑郁倾向发生的影响因素。结论青少年抑郁倾向是心理、遗传、学校和家庭环境等多因素共同作用结果。加强监测,早期干预青少年心理问题以及学校、家庭环境影响因素等是防控青少年抑郁倾向及抑郁的关键。
Objective To explore impact factors of depression tendency among high school students for providing references to the development of relevant interventions in adolescents.Methods The multicenter study was carried out in Hefei city of Gansu province and Hangzhou city of Zhejiang province from September 11,2019 to December 31,2020.First,on-site self-administered surveys were conducted among 6197 students(13-18 years old)recruited from 16 high schools with multistage complex sampling;a self-designed questionnaire was used to collect demographic information;Symptom Check List-90(SCL-90)and Beck's Depression Inventory(BDI)were adopted for mental status assessment and depression tendency screening.Then,a 1:2 age-,gender-and class-matched case-control study was carried out in 296 students assessed as with depression tendency based on BDI scores and diagnostic consultation of three psychiatrists for each case and in 597students with normal mental status and without psychiatric disease history matched to the cases.Univariate analysis and conditional multivariate logistic regression analysis were performed to examine impact factors of adolescents′depression tendency.Results The overall detection rate of depression tendency was 4.78%(95%confidence interval[CI]:2.31%-6.59%)among all the students surveyed.Totally 23 significant impact factors for depression tendency were identified with univariate analysis(P<0.05).The results of conditional multivariate logistic regression analysis revealed following independent predictors of depression tendency for the adolescents:family history of mental illness(β=0.9942,odds ratio[OR]=3.59,95%CI:1.59-5.98),non-parental rearing(β=0.2654,OR=1.69,95%CI:1.14-2.95),being only child(β=0.1359,OR=1.31,95%CI:1.02-2.57),poor relationship with family members(β=0.2885,OR=1.76,95%CI:1.12-3.05),learning problems(β=0.2305,OR=1.51,95%CI:1.03-2.91),mental health education(β=-0.2049,OR=0.69,95%CI:0.24-0.96),interpersonal sensitivity factor score(β=0.4621,OR=2.21,95%CI:1.42-4.77),depression factor score(β=1.2658,OR=4.81,95%CI:2.01-7.05),anxious factor score(β=0.3429,OR=1.88,95%CI:1.16-3.84),hostile factor score(β=0.2452,OR=1.65,95%CI:1.09-3.06),horrible factor score(β=0.2109,OR=1.46,95%CI:1.08-2.94),and spirituality factor score(β=0.4594,OR=2.15,95%CI:1.24-3.89).Conclusion The occurrence of depression tendency is influenced by multiple psychological,hereditary heredity,school and family environment factors among high school adolescents and surveillance for early detection and intervention on the mental health problem should be strengthened in the students.
作者
程庆林
谢立
王乐
吴亦斐
黄银燕
贾庆军
方子健
CHENG Qing-lin;XIE Li;WANG Le(Hangzhou Municipal Center for Disease Control and Prevention,Hangzhou,Zhejiang Prevention 310021,China)
出处
《中国公共卫生》
CSCD
北大核心
2022年第6期680-685,共6页
Chinese Journal of Public Health
基金
浙江省医药卫生科技计划项目(2020PY064)
杭州市卫生科技计划项目(0020190783)。
关键词
抑郁
倾向
心理
病例对照研究
青少年
depression
tendency
psychology
case-control study
adolescents
