南京中学生抑郁症状现状及其与父母职业状况的关系

Study on the prevalence of depressive symptom and the association of parental occupational status with depression among high school students in Nanjing

目的了解南京市中学生抑郁症状流行现状,并探讨父母职业状况与抑郁症状的关联。方法采用分层整群随机抽样方法,使用抑郁自评量表(SDS),于2009年从南京市6个主城区中随机选取白下区,抽取5所中学(初中3所、高中2所)所有初一和高一年级,共53个班级2202名在校中学生开展抑郁基线调查。于2010年和2011年分别针对同一样本人群进行连续2年随访调查。父母职业状况分为父母均有工作、父亲失业、母亲失业、父母均失业4类。基线实际调查2160名中学生,调查率为98.1%。1年后、2年后随访调查2118名和2032名中学生,随访率分别为98.1%、94.1%。结果 3次调查相比,抑郁症状检出率差异无显著性(P=0.108),但中度、重度抑郁比例有所提高,差异有显著性(P=0.002)。父母均失业的中学生SDS标准总分、抑郁症状检出率及中重度抑郁症状所占比例均最高。经多因素Logistic回归分析,与父母均有工作的中学生相比,父母均失业的中学生基线、1年后随访、2年后随访罹患抑郁的风险逐渐增大,仅2年后随访差异有统计学意义。广义估计方程回归分析表明,父母职业状况与中学生抑郁症状有关联,父或母失业、父母均失业是抑郁症状的危险因素,差异均有统计学意义。结论南京中学生抑郁症状的比例较高,且父母职业状况是中学生抑郁症状的影响因素。

Objective To learn the prevalence of depressive symptom and to analyze the relationship between parental occupational status and depression among high school students in Nanjing.Methods With a stratified cluster random sampling method,the baseline survey was conducted in 2202 high school students chosen 53 classes from 5 schools（3 junior high schools and 2 senior high schools） in baixia district chosen from 6 urban districts in 2009.The same samples were followed up in 2010 and 2011.Depressive symptoms were assessed using Zung Self-rating Depression Scale（SDS）.Parental occupational status was categorized into four groups,both employed,father unemployed,mother unemployed,and both unemployed.The total number of respondents was of 2160 in the baseline survey,with a response rate of 98.1%,in which 2118（98.1%） and 2032（94.1%） were followed up in 2010 and 2011,respectively.Results There was no significant difference in the positive rate of depressive symptom in the baseline and consecutive 2-year follow-up surveys（P=0.108）,while the proportions of moderate and severe depression were most highest in 2011（P=0.002）.SDS index score and the positive rate of depression were most highest in students with parents both unemployed.Multivariate logistic analysis indicated that parental occupational status was significantly linked to depressive symptoms among students.The regression coefficients of generalized estimating equation（GEE） were statistically significant between parental occupational status and depression.Conclusion Depressive symptoms is a common in high school student in Nanjing.Parental occupational status may be associated to depressive symptoms and much attention should be paid by health officers and instructive staff.