抑郁障碍对儿童生活质量的影响研究

Quality of life in children with depressive disorder

目的探索抑郁障碍对儿童生活质量的影响。方法采用先填写量表和再进行访谈的二阶段调查法。第一阶段采用分层随机整群抽样法抽取上海市浦东新区的7所小学中3～5年级的共3685名学生作为研究对象，全部学生需填写儿童流调用抑郁评定量表（CES-DC）、儿童少年生活质量量表、一般情况凋查表，完成有效问卷的学生共有3628名。第二阶段对CES—Dc量表总分≥20分（判断有抑郁症状）的学生应用学龄期儿童情感障碍和精神分裂症问卷目前版进行一对一面谈，以美国精神障碍诊断与统计第四版手册（DSM—IV）为金标准做出诊断。共有55例符合DSM—IV抑郁障碍”诊断的儿童作为抑郁障碍组与对照组（54例正常儿童）进行儿童少年生活质量量表的比较研究。结果抑郁障碍组儿童的生活质量量表总分及师生关系、同伴关系、亲子关系、自我概念、躯体感觉、负性情绪、作业态度、生活便利性、活动机会性、运动能力、自我满意度因子分均明显低于对照组，差异具有统计学意义（P均〈O．01）。抑郁总分与生活质量总分呈负相关（r=-0．303，P-0．026）。逐步回归分析结果显示，影响儿童生活质量的因子按重要性依次为：抑郁总分、母亲文化程度、家庭氛嗣、居住条件、与父亲关系、与母亲关系、父亲文化程度、健康状况、性别。结论抑郁障碍儿童的生活质量较差，需引起多方关注。

Objective To explore the quality of life and the influential factors in children with depression. Methods Questionnaire survey and interview method were adopted in this study. Stratified random cluster sampling identified 3 685 grade 3 to grade 5 students from 7 primary schools of the Pudong district in Shanghai. Students were screened using the self- completion Center for Epidemiological Studies Depression Scale for Children （CEDC） hose who scored 20 were admin- istered the present state version of the Schedule for Affective Disorders and Schizophrenia for school-age children （K-SADS） by a clinician and subsequently diagnosed according to DSM-1V criteria. Finally a total of 55 children who met diagnostic cri- teria for depressive disorder as the depression group and 54 healthy children as the control group were assessed and com pared with the Children and Adolescents＂ Quality of Life Scale （CAQOL）; Results The overall CAQOL scores and most of the CAQOI. subscale scores （teacher-student relationship, peer relationShips, parent-child relationship, self-awareness, physical discomfort, negative emotions, attitude about homework, access to transportation from home, extra curricular activi-ties, athletic ability, self-esteem） in children with depressive disorder were significantly higher than those of health controls （P〉0.01）. Scores on CES-DC were negatively correlated with the overall CAQOL scores（r=--0. 303, P= 0. 026）. Utilizing multiple stepwise regression found that 9 factors impact on quality of life among children, such as CES-DC total scores,edu- cational level of mothers, family atmosphere, living conditions, mother-child relationship, father-child relationship, educational level of fathers,physical condition,gender. Conclusion The quality of life of children with depression is poor. This situa tion should attracted much attention.