三省区10052名正常成年群体心理健康状况及与1986年常模数据的比较

Mental health conditions of 10 052 normal adults from three provinces and autonomous region in comparison with the norms in 1986

目的:观察中国正常成年人群的心理健康状况并与1986版常模数据进行比较,同时评价症状自评量表的信度。方法:采用分层二阶段整群抽样的原则,对源自中国人生理、心理常数课题组2002/2004期间进行的河北省、浙江省和广西壮族自治区三省区10个城市70个调查现场的中国正常人群的生理常数调查,以省、自治区作为主层,城市和农村为2个分层,每个主层各整群抽取若干个社区和村,以抽到的社区和村的所有符合条件的正常成年人作为心理健康状况的调查对象。采用自制的一般人口学特征问卷和症状自评量表对三省区的10052名正常成年人进行调查。一般人口学特征问卷内容包括年龄、性别、职业、婚姻状况、教育水平等,症状自评量表包括躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性和其他共10个因子90个项目。每个项目采用5级计分制,记录总得分,因子得分和阳性项目数(评分在2～5的项目数)。并采用内部一致性信度和分半信度来评价量表的信度。结果:在符合条件的调查对象10052人中,收回合格问卷9107份,应答率为90.599%。①症状自评量表的各个因子和总量表的分半信度系数在0.57～0.94,Cronbach’sα系数在0.68～0.97。②不同年龄组间症状自评量表的10个因子、总得分和阳性项目数差异均有显著性意义,中年组症状自评量表的躯体化因子得分最高,其他各因子得分、阳性项目数和总得分均随年龄增大而降低。③不同性别间除强迫症状、人际关系敏感、敌对和精神病性外其他因子得分、阳性项目数和总得分的差异均有显著性意义,其中女性在症状自评量表的躯体化、抑郁、焦虑、恐怖及其他因子的得分、阳性项目数和总得分均高于男性,而男性偏执因子得分高于女性。④城乡之间症状自评量表的9个主要因子、阳性项目数和总分的差异均有显著性意义。城市成年人的躯体化健康状况显著好于农村成年人,但是容易出现强迫、偏执等症状以及人际关系敏感。⑤本次调查躯体化因子的得分显著高于1986版常模数据,而其他8个因子的得分低于1986版常模数据。结论:中年人的躯体化健康较脆弱;女性的心理健康状况尤为脆弱;城市成年人的躯体化健康状况好于农村成年人,但易出现强迫、偏执等症状以及人际关系敏感;除躯体化因子得分显著高于1986版常模数据外,症状自评量表的其他8个因子得分低于1986版常模,说明20年来中国正常成年人的心理健康状况发生了很多变化。

AIM： To study the mental health conditions of Chinese normal adults to compare it with the norms in 1986 and evaluate the reliability of Symptom Checklist （SCL-90）. METHODS＂ With two-stage cluster sampling method, subjects of the study came from the survey on physiological and psychological constants of Chinese adults in 2002-2004, which was conducted in ten cities of Hebei province, Zhejiang province and Guangxi Zhuang Autonomous Region, A： mong these cities, 70 communities and countryside were sampled as cluster units and all available normal adults were regarded as the survey subjects. 10 052 normal adults from three provinces and autonomous region were interviewed with demographic questionnaire and SCL-90. Demographic questionnaire included age, sex, occupation, marital status and education. SCL-90 included 90 items of 10 dimensions： Somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, photic anxiety, paranoid ideation, psychoticism and additional items. Each item was scored with 5 grades. Total score, factor score and number of positive item （number of items with 2-5 scores） were recorded and calculated. The reliability of SCL-90 was evaluated with internal consistency and split-half reliability. RESULTS： Among the 10 052 subjects, 9 107 valid questionnaires were retracted and the response rate was 90.599%. ①The split-half reliability coefficients of 10 factors and total score were from 0.57-0.94 and Cronbach＇s a from 0.68-0.97.②Scores of 10 factors, total scores and number of positive item were significantly different among age groups. The factor score of somatization was highest at middle-aged group and other scores were negatively correlated with age.③There were not significant difference between sexes in the factor scores of obsessive-compulsive, interpersonal sensitivity, hostility and psychoticism. The scores of somatization, depression, anxiety, phobic anxiety and other factors, number of positive items and total scores of females were all higher than those of males, but the factor score of paranoid ideation of males was higher than that of females. ④ All scores were statistically different between urban and suburban subjects. Physical health conditions of urban adults were better than that of suburban ones, but they were susceptible to suffer from obsessive-compulsive, paranoid ideation and interpersonal sensitivity. ⑤Most of the factor scores were significantly lower than those of the 1986＇s results, except for the factor of somatization. CONCLUSION： The somatization factor of the middle aged people are comparatively poor;, mental health condition of females was inferior;, somatization factor of urban adults is better than that of rural ones, but they are susceptible to suffer from obsessive-compulsive, paranoid ideation and interpersonal sensitivity; except for the factor of somatization, all the factor scores are significantly lower than those of the 1986＇s results, indicating great changes have happened in mental health conditions of Chinese normal adults.