|
目的：了解长沙市中学生抑郁检出率及性别差异、随年龄变化趋势。探讨青少年抑郁伴/不伴焦虑临床特征的差别。方法：采取整群抽样法抽取长沙10所中学3965名学生(11~18岁),完成自评情绪和感受问卷(MFQ-C)、儿童焦虑性情绪障碍筛查量表(SCARED)、长处和困难问卷(SDQ)。结果：①抑郁症状者总检出率为30.70%,男性检出率为26.8%,女性为34.6%,女性检出率较男性高。青春早期(11~12岁)检出率为18%,青春中期(13~15岁)为30.9%,青春晚期(16~18岁)为36.5%。青春中期较青春早期检出率显著上升(LRχ2=40.70,P<0.001),青春晚期较青春中期检出率进一步上升(LRχ2=11.41,P=0.001)。②抑郁伴焦虑者占总抑郁症状人数的55.3%,抑郁不伴焦虑者占44.7%。抑郁伴焦虑的发生率高于抑郁不伴焦虑(LRχ2=73.64,P<0.001);存在抑郁的男生中有47%伴焦虑,而存在抑郁的女生有61.9%伴焦虑,女生抑郁伴焦虑的发生率高于男生(Pearsonχ2=26.79,P<0.001)。③伴焦虑组学生SDQ情绪症状(t=14.33,P<0.001)、品行问题(t=3.2,P=0.001)、同伴交往问题(t=2.39,P=0.017)、多动注意缺陷问题(t=3.17,P=0.002)、总困难得分(t=10.51,P<0.001)均显著高于不伴焦虑组。结论 :①11~18岁中学生MFQ-C抑郁总检出率为30.70%,女性检出率较男性高。检出率呈现由青春早期至青春晚期逐渐上升的趋势。抑郁伴焦虑的发生率高于抑郁不伴焦虑,女生抑郁伴焦虑的发生率高于男生。②与抑郁不伴焦虑的学生相比,抑郁伴焦虑的学生具有更高的抑郁水平、更多的品行问题、多动注意缺陷问题及同伴相处困难。
|
|
Objective: To describe the prevalence of depression in middle school students, and to explore the clinical characteristics of anxious and non-anxious depressive adolescents. Methods: A sampe of 3965 students(ages 11-18 years)in Changsha were screened using cluster sampling. Child Mood and Feelings Questionnaire(MFQ-C), Child Anxiety Related Emotional Disorders(SCARED), strength and difficulty questionnaire(SDQ) were used. Results: ①Prevalence rate of subjects over MFQ-C cut-off point is 30.70%, 26.8% in males and 34.6% in females, prevalence in females is higher than that in males. The prevalence rate is 18% in early adolescence(11-12 years), 30.9% in middle adolescence(13-15 years),36.5% in late adolescence(16-18 years). Prevalence in middle adolescence is higher than early adolescence, and prevalence in late adolescence is even higher. ②55.3% of potential depressive students are anxious-depression, and 44.7% are non-anxious depression. The prevalence of anxious depression is higher than non-anxious depression, with females higher than males. ③Anxious depressive students scored higher than non-anxious depressive students on SDQ emotional symptoms, conduct problems, peer relationship problems, attention deficit and hyperactivity problems, total difficulty score;Anxious depressive students scored higher than non-anxious depressive students on MFQ-C. Conclusion: ①Prevalence rate of depression in 11-to-18 year-old adolescents is 30.70%, prevalence in females is higher than that in males. There is an increase trend from early adolescence to late adolescence. The prevalence rate of anxious depression is higher than non-anxious depression, with females higher than males. ② Anxious depressive students have more severe depressive symptom, behavioral problems, attention deficit, hyperactivity problems, and peer relationship problems.
|
|
1 马静，苏林雁，禹顺英，等. 三等位基因 5-HTTLPR 与青少年重性抑郁障碍的关联研究. 中国临床心理学杂志，2010，18(2)：142-145
2 王凯，苏林雁，朱焱，等. 儿童焦虑性情绪筛查表的中国城市常模. 中国临床心理学杂志，2002，10(4)：270-272
3 寇建华，杜亚松，夏黎明. 长处和困难问卷 ( 学生版 ) 上海常模的制订. 中国健康心理学杂志，2007，15(1)：3-5
4 Bahls SC. Epidemiology of depressive symptoms in adoles-cents of a public school in Curitiba, Brazil. Revista Brasil-eira de Psiquiatria, 2002, 24(2): 63-67
5 Bond L, Toumbourou JW, Thomas L, et al. Individual, fam-ily, school, and community risk and protective factors fordepressive symptoms in adolescents: A comparison of riskprofiles for substance use and depressive symptoms. Pre-ventive Science, 2005, 6(2):73-88
6 冯正直，张大均. 中学生抑郁症状的流行病学特征研究.中国行为医学科学，2005，14(2)：7-9
7 张郭莺，杨彦春. 儿童青少年抑郁情绪流行病学特征及相关因素研究．硕士学位论文. 成都：华西医科大学，2006
8 Rohde P, Beevers CG, Stice E, et al. Major and minor de-pression in female adolescents: onset, course, symptom pre-sentation, and demographic associations. Journal of ClinicalPsychology, 2009, 65(12): 1339-1349
9 Fleming JE, Offord DR. Epidemiology of childhood depres-sive disorders: A critical review. Journal of the American Academy of Child and Adolescent Psychiatry, 1990, 29(4):571-580
10 Kessler RC, Avenevoli S, Merikangas KR. Mood disordersin children and adolescents: An epidemiologic perspective.Biological Psychiatry, 2001, 49: 1002-1014
11 Petersen AC, Compas BE, Brooks-Gunn J, et al. Depress-ion in adolescence. American Psychologist, 1993, 48(2):155-168
12 Cole DA, Martin JM, Peeke LA, et al. Children over andunderestimation of academic competence: A longitudinalstudy of gender differences, depression, and anxiety. ChildDevelopment, 1999, 70(2): 459-473
13 Ge X, Lorenz FO, Conger RD, et al. Trajectories of stress-ful life events and depressive symptoms during adolesc-ence. Developmental Psychology, 1994, 30: 467-483
14 Wade TJ, Cairney J, Pevalin DJ. Emergence of gender diff-erences in depression during adolescence: National panelresults from three countries. Journal of the American Acad-emy of Child and Adolescent Psychiatry, 2002, 41(2): 190-198
15 Wichstrom L. The emergence of gender difference in dep-中国临床心理学杂志 2013 年第 21 卷第 5 期 · 711 ·ressed mood during adolescence: The role of intensifiedgender socialization. Developmental Psychology, 1999, 35(1): 232-245
16 Pine DS, Cohen E, Cohen P, et al. Adolescent depressivesymptoms as predictors of adult depression: Moodiness ormood disorder? American Journal of Psychiatry, 1999, 156(1): 133-135
17 Olsson G. Adolescent depression. Epidemiology, nosology,life stress and social network. Minireview based on a doc-toral thesis. Upsala Journal of Medical Science, 1998, 103(2): 77-145
18 Breslau N, Peterson E．Sex differences in depression: Arole for preexisting anxiety. Psychiatry Research, 1995, 58:1-12
19 Kuehner C．Gender differences in unipolar depression: Anupdate of epidemiological findings and possible explana-tions．Acta Psychiatrica Scandinavica, 2003, 108(31): 163-174
20 国效峰. 重性抑郁共病焦虑障碍的临床与心理特征研究.硕士学位论文. 长沙：中南大学，2007
21 Kovacs M, Devlin B. Internalizing disorders in childhood.Journal of Child Psychology and Psychiatry, 1998, 39(1):47-63
22 Peng Y, Guo WB, Wang GQ. Reiation ship among the anx-ious symptoms, coping styles and personalitytraits in pati-ents with depression. 中国 组织 工程 研究 与临 床康 复，2007，11(30)：6106-6108
23 孙海霞，杨蕴萍，施慎逊，等. 重性抑郁障碍与焦虑障碍共病的临床研究. 中国临床康复，2005，9(8)：1-3
24 Jeste ND, Hays JC, Steffens DC. Clinical correlates of anx-ious depression among elderly patients with depression.Journal of Affective Disorder, 2006, 90(1): 37-41
25 Basso MR, Lowery N, Ghormley C, et al. Comorbid anxietycorresponds with neuropsychological dysfunction in unipolar depression. Cognitive Neuropsychiatry, 2007, 12 (5):437-456
26 Mulsant BH, Reynolds CF 3rd, Shear MK, et al. Comorbidanxiety disorders in late-life depression. Anxiety, 1996, 2(5): 242-247
27 DeLuca AK, Lenze EJ, Mulsant BH，et al. Comorbid anxi-ety disorder in late life depression: association with memorydecline over four years. International Journal of GeriatricPsychiatry, 2005, 20(9): 848-854
28 Sherbourne CD, Wells KB. Course of depression in patientswith comorbid anxiety disorders. Journal of Affective Disor-der, 1997, 43(3): 245-250
29 Rohde P, Clarke GN, Lewinsohn PM, et al. Impact of co-morbidity on a cognitivebehavioral group treatment foradolescent depression. Journal of the American Academy ofChild and Adolescent Psychiatry, 2001, 40(7): 795-802
30 Costello EJ, Erkanli A, Federman E, et al. Development ofpsychiatric comorbidity with substance abuse in adolesc-ents: Effects of timing and sex. Journal of Clinical ChildPsychology, 1999, 28(3): 298-311
31 苏林雁，刘军，苏巧荣 , 等. 儿童青少年焦虑与抑郁障碍共病的临床研究. 中华精神科杂志，2005，38(4)：214-217
32 苏林雁，高雪屏，金宇，等：小学生焦虑抑郁共存的现状调查. 中国心理卫生杂志，2006，20(1)：1-4
|