传染性非典型性肺炎流行期间内蒙古5所高等院校1041名大学生心理健康水平与全国常模的比较

Comparison of the mental health level during severe acute respiratory syndrome between 1 041 students of five colleges in Inner Mongolia and national norms

目的:了解传染性非典型性肺炎流行对高校大学生心理健康水平的影响,并与全国常模标准比较。方法:对2003年4月中下旬传染性非典型性肺炎爆发期间内蒙古大学、内蒙古工业大学、内蒙古农业大学、内蒙古师范大学及内蒙古医学院等5所高等院校就读的大学生进行分层整群抽样调查,参与者均自愿参加。测评工具为症状自评量表(以躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性9个因子作为观察指标,按照0～4的5级评分,0=无,l=轻度,2=中度,3=相当重,4=严重)评定参与者的心理状态,应用简易应对方式量表(积极应对和消极应对两个维度分量表组成。积极应对维度重点反映了积极应对的特点,消极应对维度重点反映了消极应对的特点)评估参与者对突发事件的应对方式。测定大学生人群症状自评量表评分与全国常模数据相比较,并进行应对方式与症状自评量表总分、各因子分、阳性项目数及阳性痛苦水平的相关性分析。结果:共发放问卷1052份,有11份问卷填写潦草无法辨认而视为废卷,进入结果分析问卷1041份。①在传染性非典型性肺炎流行期间高校大学生群体症状自评量表各因子评分及总分、总均分均高于全国常模犤躯体化(1.70±0.71,1.37±0.48),强迫(1.83±0.77,1.62±0.58),人际敏感(1.75±0.76,1.65±0.51),抑郁(1.68±0.71,1.50±0.59),焦虑(1.71±0.81,1.39±0.43),敌对(1.75±0.76,1.48±0.56),恐怖(1.64±0.77,1.23±0.41),偏执(1.67±0.70,1.43±0.57),精神病性(1.62±0.74,1.29±0.42),总分(144.05±62.17,129.96±38.76),总均分(1.69±0.71,1.44±0.43)犦。②大学生症状自评量表总分、各因子分、阳性症状及阳性痛苦水平均与个体的应对方式相关,与积极应对成负相关,而与消极应对成正相关。结论:面对传染性非典型性肺炎这一突发重大公共卫生事件,高等院校大学生群体中出现焦虑、恐怖、敌对、偏执、抑郁等心理问题,并且其严重程度与个体的应对方式相关。积极应对下的人群其症状自评量表总分、总均分、阳性症状、阳性项目数及痛苦水平,均低于消极应对下的人群的相同指标,故而应对方式不同,突发事件对心理变化的影响也是不同的。

AIM： To investigate the prevalence of severe acute respiratory syndrome on the mental health level of university students, and compare with the standard of national norms.METHODS： A stratified cluster sampling investigation was undertaken among the students studying in Inner Mongolia University, Inner Mongolia University of Technology, Inner Mongolia Agrieultural University, Inner Mongolia Normal University and Inner Mongolia Medical College during the prevalence of severe acute respiratory syndrome in the middle and last 10 days of April 2004. All the subjects took part in the investigation voluntarily, their mental status was assessed with the symptom checklist-90（9 factors of somatization, obsession-compulsion, interpersonal sensitivity,depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism were taken as the observational indexes; 5-grade scoring of 0 to 4 points was used, 0 as none, 1 as mild, 2 as moderate, 3 as quite severe, 4 as severe）; Their ,coping style to the sudden events was evaluated with the simple coping style scale （including 2 dimensions of active and passive coping suhseales; Active and passive coping reflected the characteristics of active and passive coping styles respectively）. The scores of symptom checklist-90 in the university students were compared with the data of national norms; The correlations between the coping style and the total score, factor scores, number of positive items and positive distress level of the symptom checklist-90 were analyzed.RESULTS： Totally 1 052 questionnaires were sent out, 11 of them were taken as invalid for they were illegibly completion, and 1 041 questionnaires were involved in the analysis of results. ① During the prevalence of severe acute respiratory syndrome, the factor scores and total score of symptom checklist-90 were all higher in university students than the national norms [somatization （1.70±0.71, 1.37±0.48）, obsessioncompulsion （1.83±0.77, 1.62±0.58）, interpersonal sensitivity （1.75±0.76,1.65±0.51）, depression （1.68±0.71, 1.50±0.59）, anxiety （1.71±0.81. 1.39±0.43）.hostility （1.75±0.76, 1.48±0.56）, phobic anxiety （1.64±0.77,1.23±0.41）,paranoid ideation （1.67±0.70, 1.43±0.57）, psychoticism （1.62±0.74, 1.29±0.42）,total score （144.05±62.17, 129.96±38.76）, average total score （1.69±0.71,1.44±0.43）]. ② The total score, factor scores, positive symptoms and positive distress level of symptom checklist-90 were all negatively correlated with positive coping but positively with negative coping.CONCLUSION： For the great sudden public health event ot severe acute respiratory syndrome, the mental problems of anxiety, phobic anxiety,hostility, paranoid ideation and depression occur among university students,and the severities are correlated with the coping style of individuals. The total score, factor scores, positive symptoms, number of positive items and positive distress level of symptom checklist-90 are all lower in the students with positive coping than in those with negative coping; If coping styles are different, the influence of sudden events on the mental changes is also different.