中国儿童青少年抑郁症状性别差异的流行病学调查

Gender difference on depressive symptoms among Chinese children and adolescents

目的了解中国儿童青少年抑郁症状的流行特征和性别差异。方法采取整群抽样，在全国9个协作地区选取9．0～18．9岁汉族城乡各年龄组儿童青少年男女生各50人，每个地区最低样本量为2000人。采用儿童抑郁量表（CDI）评定小学四年级至高中三年级青少年的抑郁症状，评估第二性征（男女童阴毛、女童乳房和男童外生殖器）发育指标。结果中国青少年抑郁症状总检出率为14．81％，男女生抑郁症状检出率分别为15．35％和14．43％。农村地区儿童青少年抑郁症状检出率（16．41％）高于城市（13．23％）。10、11岁组男生抑郁症状检出率均高于同龄女生（χ2=11．625，P〈0．005；χ2=5．807，P〈0．005），17岁组女生抑郁症状检出率（21．5％）高于同龄男生（17．26％）（χ2=6．192，P〈0．005）。仅在Tanner发育Ⅱ期，男生抑郁检出率（18．4％）高于女生（15．8％），差异有统计学意义（χ2=6．593，P〈0．005）。结论在特殊年龄段和特定发育阶段，中国儿童青少年抑郁症状检出率存在性别差异，但还需要进一步纵向研究加以证实。

Objective To explore the epidemiological characteristics and gender difference of depressive symptoms among Chinese children and adolescents. Methods Based on the cluster sampling method, 50 boys and 50 girls from each 9.0-18.9 year-olds in both urban and rural areas, were recruited from each research center. Children＇ s Depression Inventory （CDI） was administered to all the participating students from grade 4 to 12 while physical examination indices including pubic hair were provided to both boys and girls. Development of breast in girls and genital development in boys were also measured. Results The overall prevalence on depressive symptoms was 14.81% for the Chinese adolescents. Boys reported more depressive symptoms （15.35%） than that of girls （ 14.43% ）. Prevalence related to depressive symptoms among children and adolescents from rural areas （16.41%） was higher than that of the urban areas （13.23%）. Prevalence of depression was higher in boys than in girls in both 10-year-old and 11-year-old groups （χ2= 11.625, P〈0.005; χ2= 5.807, P〈0.005）. In the 17 year-old group, prevalence of depression （21.5%） was seen higher in girls than in boys （17.26%） （ χ2=6.192, P〈0.005）. Only in the Tanner stage 11 , the gender difference of depression showed statistically significant （χ2 = 6.593, P 〈 0.005 ）, with boys as 18.4% and girls as 15.8%. Conclusion The gender differences of depression appeared in both special age groups and developmental stages in Chinese children that called for further longitudinal study to understand the nature of these findings.