中学生睡眠问题与自杀行为的相关性研究

Relations between problems on sleeping and suicidal behaviors in middle school students

目的了解中学生睡眠问题和自杀行为的发生情况并分析两者的相关性。方法采用整群抽样方法，在沈阳、新乡、重庆、广州市抽取中学生13817人为研究对象，调查内容包括一般人FI统计学指标、睡眠问题（匹兹堡睡眠质量指数量表，PSQI）、心理病理状态（青少年亚健康多维问卷，MSQA）和自杀行为等。比较不同特征的中学生睡眠问题、自杀行为检出率的差异，建立多因素logistic回归模型，分析睡眠问题对自杀行为的影响。结果中学生睡眠问题检出率为26．5％，女生（28．2％）高于男生（24．8％），初中生（17．9％）低于高中生（35．2％），差异有统计学意义（P〈0．001）。自杀意念、自杀计划、自杀未遂的检出率分别为16．6％、9．6％、4．7％，女生自杀意念的检出率高于男生，差异有统计学意义（P〈0．001），而自杀计划和自杀未遂检出率的性别差异无统计学意义。）[2检验显示，有睡眠问题的学生其自杀行为检出率显著高于无睡眠问题者；PSQI高得分组、睡眠时间≤5h／d的学生自杀行为检出率高，差异有统计学意义。多因素logistic回归分析发现，存在睡眠问题是自杀行为发生的独立影响因素，且随PSQI得分的增加，发生自杀行为的风险呈上升趋势；而睡眠时间≤5h／d组自杀行为的发生风险高于其他睡眠时间组。结论中学生睡眠问题是影响自杀行为发生的重要因素，改善其睡眠质量、合理安排睡眠时间对自杀行为的防控具有重要意义。

Objective To understand the epidemiological characteristics and possible associations between sleeping problems and suicidal behaviors among middle school students. Methods A total of 13 817 middle school students were selected in Shenyang, Xinxiang, Chongqing and Guangzhou cities and cluster sampling method was used. Questionnaires would include information on demographics, quality of sleep, psychopathological status and suicidal behaviors. Pittsburgh Sleep Quality index （PSQI） and Adolescent Multidimensional Sub-health Questionnaire （MSQA） were used to assess the quality of sleep and psychosomatic symptoms, respectively. Rates on sleeping problems and suicidal behaviors were compared in students with specific characteristics. Effects related to sleeping problems and suicidal behaviors were analyzed, using the multivariate logistic regression model. Results The overall prevalence of problems related to sleeping among middle school students was 26.5%. 28.2% of the girls and 35.2% of senior students reported as having more sleeping problems. Rates on suicide related ideation, planning and attempts were 16.6%, 9.6% and 4.7% , respectively. Girls reported more suicide ideation than boys. However, no gender differences were found in suicide planning or attempted suicide. It also suggested that the incidence of the suicidal behavior among students with sleeping problems was significantly higher than students without sleeping problems. Data from Multivariable logistic regression analysis showed that sleeping problems appeared as independent risk factors on suicidal behavior. Higher PSQI scores seemed coincide with the increased risk of suicidal behaviors. Students having sleeping time less than 5 hours per day showed higher risk of suicidal behaviors. Conclusion Problems on sleeping seemed a strong risk factor for suicidal behaviors among middle school students. Improvement on the quality of sleep and reasonable arrangement of sleeping time could help prevent related suicidal behaviors among middle school students.