医学生心理健康状况与儿童期不良经历的关系探讨

Study on the relationship between adult mental health status and adverse childhood experiences among medical college students

目的了解医学生的心理健康状况及其人口学特征,探讨其与儿童期不良经历之间的关系,为进一步研究并开展有效的预防和治疗心理状况问题提供依据。方法采用症状自评量表(symptom checklist-90,SCL-90)和儿童期不良经历(adverse childhood experiences,ACEs)量表,使用分层整群抽样的方法,对475名医学生进行问卷调查。结果医学生心理状况异常检出率为35.58%。不同人口学特征的大学生心理状况异常检出率差异均无统计学意义(均有P>0.05)。单因素分析结果显示儿童期出现躯体虐待、情感虐待和性虐待经历的大学生,成年后发生心理状况异常的风险分别是无此经历大学生的2.42(95%CI:1.38～4.23)、2.65(95%CI:1.79～3.92)和1.66(95%CI:1.07～2.58)倍。儿童期有家庭暴力、家中有物质滥用者经历的大学生,成年后发生心理状况异常的风险是无此经历大学生的1.97(95%CI:1.31～2.96)、1.69(95%CI:1.13～2.54)倍。多因素结果分析显示:年龄每增加1岁,其发生心理状况异常的风险性就降低0.15(95%CI:0.01～0.27)倍;出现1种或多种ACEs经历的医学生分别是无ACEs经历医学生的1.89～6.97倍。结论儿童期各种不良经历是成年后各种心理问题的重要危险因素,儿童期不良经历对于成年期心理健康状况的影响是不容忽视的。

Objective To examine the status of mental health and explore the relationship between adverse chihthood experiences and adult mental health status among medical college students. Methods 475 medical college students were chosen by stratified cluster sampling and investigated by Symptom Checklist-90 （SCL-90） and adverse childhood experiences （ACEs） questionnaires. Results The prevalence rate of mental problem among the medical college studeuts was 35.58%. There were no statistical significant differences in the prevalence rates of mental prob- lem under different background variables. Single factor analysis showed that the risk were adult mental problems in medical college students with physical abuse, emotional abuse and sex abuse in childhood were respectively 2.42 （95% CI：I. 38-4.23）, 2.65（95% CI： 1.79-3.92） and 1.66（95% CI：1. 07-2. 58） times than the ones without such experiences ; The risk of adult mental problems in medical college students whose family had domestic violence or who had families with substance abuse experience in c, hildhood were respectively 1.97 （ 95% CI： 1.31-2. 96） and 1.69 （95% CI：1. 13-2.54）times than the ones without such experiences. Logistic regression analysis showed that adverse childhood experiences increased risk for adult mental problems, with adjusted odds ratios from 1.89 to 6. 97. Con- elusions Different adverse childhood experiences are important risk factors for adult mental problems. Adverse cbihlhood experiences are important risk factors for adult mental problems and they should not be ignored in preven- ting from psychological disorders and keeping mental health of them.