南京市白下区中学生抑郁障碍与健康危险行为的关系

Relationship between Depression and Risk Behaviors among High School Students of Baixia District of Nanjing

目的了解南京市白下区中学生人群中主要健康危险行为的发生率及其与抑郁障碍的关系。方法采用横断面调查，研究对象来自南京白下区9个学校的27个班级1102名在校的初一至高三的中学生，其中初中生占63．6％，高中生占36．4％；男生为45．0％，女生为55．0％。调查的有效应答率为94．2％。结果该样本人群中5种健康危险行为：吸烟、饮酒、网吧上网、逃学、离家出走的发生率分别为4．3％、33．6％、8．0％、6．5％和4．5％，男生均高于女生，高三学生的发生率为最高，高中学生的健康危险行为的发生率高于初中学生，18岁以上年龄组的学生中，各种健康危险行为的发生率均为最高。罹患抑郁障碍的学生发生健康危险行为的可能性均大于非抑郁障碍患者，针对上述5种健康危险行为的OR值分别为3．30（95％CI=1．67～6．55），1．86（95％CI=1．27～2．73），2．78（95％CI=1．57～4．93），3．82（95％CI=2．15～6．81）和5．53（95％CI=2．95～10．40）。发生健康危险行为者（网吧上网者、逃学者和离家出走者）寻求心理医生进行疏导的比例显著高于未发生健康危险行为者，但两类学生与老师交流沟通的比例则无差异。结论健康危险行为的发生、抑郁障碍已成为中学生人群中一个越来越重要的公共卫生问题，有关职责部门应制定有针对性的预防控制措施。

[ Objective] To learn the relationship between depression and risk behaviors among high school students of Baixia District of Nanjing. [ Methods] Population- based cross- sectional study was conducted on 1 102 high school students, 63.6% and 36.4% of which were junior and senior high school students respectively, the percentages of male and female students were 45.0% and 55.0% respectively; 94.2% of the questionnaires were valid. [ Results] The 5 major risk behaviors among the population were smoking （4.3%）, drinking （33.6%）, internet -surfing （8.0%）, playing truant （6.5%） and escaping from home （4.5%） ; these risk behaviors were more likely to occur among the male students and senior high school students than among the female and junior high school students; students with depression had more possibility to have these risk behaviors. The OR values of the five risk behaviors were 3.30 （95%; CI=1.67～6.55）, 1.86 （95%; CI=1.27～2.73）, 2. 78 （95%; CI=1.57～4.93）, 3. 82 （95% ; CI = 2. 15 ～ 6. 81 ） and 5.53 （95% ; CI = 2.95 ～ 10.40） respectively. Students with risk behaviors were more likely to seek psychological help from the mental health practitioners than those without risk behaviors; however there was no significant difference between them in the communication with their teachers for help. [ Conclusion] The issue of taking risk behaviors and depression is a public health problem with increasing importance among high school students; effective measures should be taken for prevention.