中国临床心理学杂志

湖南省岳阳县青少年抑郁的流行病学调查

作者：杨文辉¹ 周烃¹ 彭芳¹ 刘海洪²

单位：1. 湖南师范大学心理学系长沙 410081
2. 中南大学湘雅医院临床心理中心长沙 410008

分类号：R395.2

出版年,卷(期):页码：2013,21(6):937-941

摘要：

目的:了解湖南省岳阳县青少年抑郁症状和抑郁症的发生情况及其特征。方法:抽取湖南省岳阳县11～19岁具有代表性的青少年样本2731人,采用两阶段调查法。第一阶段应用流调用抑郁量表(CES-D)筛查抑郁症状;第二阶段对CES-D总分≥20分的青少年采用学龄期儿童情感障碍和精神分裂症问卷(K-SADS)访谈,以美国精神障碍诊断与统计手册第4版(DSM-IV)为标准做出抑郁症诊断。结果:①抑郁症状发生率为22.81%,其中14～15岁(24.71%)、16～19岁(24.92%)年龄段高于11～13岁(20.17%,P<0.05),16～19岁年龄段女性(29.35%)高于男性(21.17%,P<0.05);单亲家庭青少年(30.97%)高于双亲(23.32%)和大家庭(20.36%,Ps<0.05);②抑郁症时点患病率为2.26%,其中14～15岁(2.89%)、16～19岁(3.45%)年龄段高于11～13岁(1.00%,P<0.01),16～19岁年龄段女性(5.95%)高于男性(1.39%,P<0.01)。结论:在岳阳县青少年中抑郁症状和抑郁症以14岁为界,呈现显著上升现象,16岁后出现性别差异,家庭环境与抑郁的发生有关。

Objective:The present study investigated the prevalence of dysphoria and major depression disorder(MDD)in adolescents in Yueyang county of Hunan Province.Methods:Two-phase surveys were taken. A representative sample of2731 adolescents aged from 11 to 19 years at intake was assessed for dysphoria by Center for Epidemiological Studies De pression Scale(CES-D) firstly. Then the adolescents whose CES-D scores were equal or above 20 were interviewed for MDD utilizing the Schedule for Affective Disorder and Schizophrenia for School-age Children(K-SADS) and the diagnosis of MDD was made based on the criteria of DSM-IV.Results:①The prevalence of dysphoria averaged 22.81%. The preva lence was higher in adolescents both aged from 14 to 15 years(24.71%) and 16 from to 19 years(24.92%) than adolescents aged from 11 to 13 years(20.17%, P<0.05), and the prevalence in females(29.35%) was higher than males(21.17%, P<0.05)aged from 16 to 19 year. Further, the depression prevalence was higher in adolescents from single-parent families(30.97%)than adolescents from two-parents families(23.32%) and big families(20.36%, P<0.05) as well. ②The time-point preva lence of MDD averaged 2.26%. The time-point prevalence of MDD was higher in adolescents both aged from 14 to 15 years(2.89%) and from 16 to 19 years(3.45%) than adolescents aged from 11 to 13 years(1.00%, P<0.01), and in females(5.95%)than in males(1.39%, P<0.01) aged from 16 to 19 years.Conclusion:Depression is a common mental health problem in ad olescents in Yueyang county. The prevalence of depression rises sharply in the time point of 14 years old and the difference in gender presents after age 16 years old. Family Environment is a risk factor of depression in adolescents.

基金项目：

湖南省自然科学基金项目(11JJ3027);湖南省教育科学规划重点课题项目(XJK011AXL002);国家自然科学基金青年科学基金(81000587);国家自然科学基金面上项目(31171003)资助;高等学校博士学科点专项科研基金(20100162120048)

作者简介：

参考文献：

1 Costello EJ, Egger H, Angold A. 10-year research updatereview: The epidemiology of child and adolescent psychiat-ric disorders: I. Methods and public health burden. Journalof the American Academy of Child and Adolescent Psych-iatry, 2005, 44(10): 972-986
2 Costello EJ, Erkanli A, Angold A. Is there an epidemic ofchild or adolescent depression? Journal of Child Psychologyand Psychiatry, 2006, 47(12): 1263-1271
3 Thapar A, Collishaw S, Pine DS, et al. Depression in adoles-cence. The Lancet, 2012, 379: 1056-1067
4 黄莹，李燕，胡安艳，等. 云南省中学生抑郁症状流行特征分析. 中国学校卫生，2011，32(2)：241-242
5 冯正直，张大均. 中学生抑郁症状发展的性别、年龄、年级差异. 中国临床康复，2005，9(36)：32-34
6 罗英姿，王湘，朱熊兆，等. 高中生抑郁水平调查及其影响因素研究. 中国临床心理学杂志，2008，16(3)：274-277
7 Gotlib IH, Joormann J. Cognition and depression: Currentstatus and future directions. Annual Review of Clinical Psy-chology, 2010, 6: 285-312
8 Hankin BL, Fraley RC, Lahey BB, et al. Is depression bestviewed as a continuum or discrete category? A taxometricanalysis of childhood and adolescent depression in a popula-tion-based sample. Journal of Abnormal Psychology, 2005,114(1): 96-110
9 Cuijpers P, Smit F. Subthreshold depression as a risk indica-tor for major depressive disorder: A systematic review of pro-spective studies. Acta Psychiatrica Scandinavica, 2004, 109(5): 325-331
10 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
11 Clarke GN, Hawkins W, Murphy M, et al. Targeted preven-tion of unipolar depressive disorder in an at-risk sample ofhigh school adolescents: A randomized trial of a group cogni-tive intervention. Journal of the American Academy of Childand Adolescent Psychiatry, 1995, 34(3): 312-321
12 Horwath E, Johnson J, Klerman GL, et al. Depressive symp-toms as relative and attributable risk factors for first-onsetmajor depression. Archives of General Psychiatry, 1992, 49(10): 817-823
13 Radloff LS. The use of the center for epidemiologic studiesdepression scale in adolescents and young adults. Journal ofYouth and adolescence, 1991, 20(2): 149-166
14 张明园. 精神科评定量表手册.长沙：湖南科学技术出版社，1998. 27-31
15 Kaufman J, Birmaher B, Brent D, et al. Schedule for affec-tive disorders and schizophrenia for school-age children-present and lifetime version(K-SADS-PL): Initial reliabilityand validity data. Journal of the American Academy of Childand Adolescent Psychiatry, 1997, 36(7): 980-988
16 范娟，顾红亮，杨慧琳，等. 上海市浦东新区 8~12 岁儿童抑郁障碍的患病率调查. 上海精神医学，2010，22(6)：335-338
17 郭兰婷，张志群. 中学生抑郁情绪与童年经历，家庭和学校因素分析. 中国心理卫生杂志，2003，17(7)：458-461
18 Weissman MM, Bland RC, Canino GJ, et al. Cross-nationalepidemiology of major depression and bipolar disorder.JAMA: The Journal of the American Medical Association,1996, 276(4): 293-299
19 Yang HJ, Soong WT, Kuo PH, et al. Using the CES-D in atwo-phase survey for depressive disorders among nonreferr-ed adolescents in Taipei: a stratum-specific likelihood ratioanalysis. Journal of Affective Disorders, 2004, 82(3): 419-430
20 Costello EJ, Pine DS, Hammen C, et al. Development andnatural history of mood disorders. Biological psychiatry,2002, 52(6): 529-542
21 Kessler RC, Avenevoli S, Ries Merikangas K. Mood disor-ders in children and adolescents: An epidemiologic perspec-tive. Biological Psychiatry, 2001, 49(12): 1002-1014
22 Angold A, Costello EJ, Erkanli A, et al. Pubertal changes inhormone levels and depression in girls. Psychological medi-cine, 1999, 29(5): 1043-1053
23 Soares CN, Zitek B. Reproductive hormone sensitivity andrisk for depression across the female life cycle: A continuumof vulnerability? Journal of Psychiatry and Neuroscience,2008, 33(4): 331-343

服务与反馈：

【文章下载】【加入收藏】