安徽省长丰县中小学生抑郁症状及其相关因素两年纵向研究

赵雪; 杨林胜; 陈明春; 陈健; 吕晓玲; 蒋玉红; 孙莹; 孙业桓

Abstract

赵雪,杨林胜,陈明春,陈健,吕晓玲,蒋玉红,孙莹,孙业桓.安徽省长丰县中小学生抑郁症状及其相关因素两年纵向研究[J].Chinese journal of Epidemiology,2014,35(5):505-509

安徽省长丰县中小学生抑郁症状及其相关因素两年纵向研究

Depressive symptoms and related factors among primary and middle school students in Changfeng county of Anhui province: a two-year longitudinal study Zhao Xue

Received:September 25, 2013

DOI：10.3760/cma.j.issn.0254-6450.2014.05.008

KeyWord: 抑郁中小学生纵向研究广义估计方程

English Key Word: Depression Primary and middle school students Longitudinal study Generalized estimating equations

FundProject:国家自然科学基金(81172763)；安徽省自然科学基金(090413131)

Author Name	Affiliation	E-mail
Zhao Xue	Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, China
Yang Linsheng	Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, China
Chen Mingchun	Changfeng Center for Disease Control and Prevention
Chen Jian	Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, China
Lv Xiaoling	Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, China
Jiang Yuhong	Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, China
Sun Ying	Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, China
Sun Yehuan	Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, China	yhsun@sina.com

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Abstract:

目的探讨安徽省长丰县农村地区中小学生抑郁症状纵向发展趋势，并分析抑郁症状相关影响因素。方法以2009年12月整群抽取的长丰县3所中学和5所小学全体在校学生作为基线调查对象，对3～9年级所有学生进行问卷调查，纵向研究则以基线调查时3～4年级和7年级学生作为研究对象，每年随访1次，共随访2次，有816人参与了3次调查。采用自编的中小学生身心健康状况问卷，调查目标人群抑郁状况及相关因素。纵向研究采用广义估计方程分析抑郁症状的相关影响因素。结果 3次调查中小学生抑郁症状检出率分别是11.3%、 10.4%和8.5%。样本总人群与其中始终处于留守状态人群的抑郁症状得分，在随访中变化的差异有统计学意义（F＝13.423，P<0.001； F＝5.761，P＝0.003）。基线调查时有抑郁症状的学生，在随访1时有25.0% （23/92）仍存在抑郁症状；基线调查和随访1均有抑郁症状的学生，在随访2时有87.0% （20/23）仍有抑郁症状。广义估计方程结果显示，3年级、非独生子女、家庭功能障碍和自尊水平低的中小学生更易出现抑郁症状，性别、是否留守和父母文化程度与抑郁症状检出率无统计学关联。结论安徽省长丰县农村地区中小学生抑郁症状检出率在随访过程中呈下降趋势；纵向发展分析显示，抑郁症状检出率与自身特质、教育及家庭环境有关，提高家庭功能和个体的自尊水平有助于中小学生的心理健康。

English Abstract:

Objective To assess the prevalence of depressive symptoms，trends on its longitudinal development and related influencing factors among primary and middle school students in Changfeng county of Anhui province. Methods Through cluster sampling methods, all students from 3 to 9 grades in 5 primary schools and 3 middle schools in Changfeng county of Anhui province were investigated through questionnaire as subjects of baseline survey in December 2009. Subjects of this longitudinal study were students in grades 3, 4 and 7 at the time of the baseline survey and were contacted once a year for two years. At last, a total of 816 students participated in all the three surveys. A structured questionnaire including Children's Depression Inventory, socio-demographic characteristics and some potential influential factors was employed for this study. A Generalized Estimating Equation(GEE)was used to evaluate the related influencing factors of children's depressive symptoms in the longitudinal study. Results Prevalence rates of depressive symptoms were 11.3%, 10.4% and 8.5%, respectively, at the baseline, 1-year and 2-year follow-up studies, among primary and middle school students. Scores on depressive symptoms of total subjects and children who had always been left at home in the follow-up process showed significant differences at the three surveys(F＝13.423, P<0.001; F＝5.761, P＝0.003). 25 percent of the 92 students who showed depressive symptoms at the baseline survey remained those depressive symptoms at the 1-year follow-up study and 87 percent of the 23 students who had depressive symptoms at the baseline and 1-year follow-up surveys still showing depressive symptoms at the 2-year follow-up study. Results from the GEE program indicated that grade 3 students, having syblings, family with dysfunction or at low level of self-esteem etc., were prone to development while sex and parents' educational level were not correlated with depressive symptoms. Conclusion Prevalence of depressive symptoms among primary and middle school students in Changfeng county of Anhui province appeared a decreasing tendency during the follow-up process in our study. Through the longitudinal development, we noticed that the prevalence of depressive symptoms seemed to be related to the personal characteristics, education and family environment of the subjects under our study. Improving the level of family function as well as individual's self-esteem might positively contribute to mental health of those primary and middle school students.

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