南京市中学生抑郁症随访研究

A follow-up study of depressive disorders among middle school students in Nanjing

目的了解南京市中学生抑郁症的现状及动态变化,为制定干预措施提供依据。方法 2009年和2010年分别采用整群抽样方法随机选取南京市5所中学内所有1年级学生为研究对象,采用自行编制的《南京市青少年心理状况调查表》进行调查,其中抑郁症评估采用《SDS抑郁自评量表》。结果 2009年中学生SDS标准总分平均(48.51±9.77)分,2010年为(49.20±10.46)分,2010年得分高于2009年(P<0.05)。与2009年相比,2010年中学生忧郁、晨重晚轻、易哭、心悸、易倦、不安、绝望、无用感、生活空虚感、无价值感等10项单项评分有所升高(P<0.05),而食欲减退、性兴趣减退、体重减轻等3项评分则有所降低(P<0.05)。2009年抑郁检出率为44.0%,2010年为46.0%,差异无统计学意义(P>0.05)。多因素logistic分析结果显示,高中较初中、仅母亲失业较父母均在职、学习成绩越差、每周中等强度活动时间越短、每天睡眠时间越短、与家人/同学相处不好、喝酒、曾发生过意外伤害的学生患抑郁的风险越高(P<0.05)。结论中学生抑郁现况不容乐观,且受多种因素的影响,应联合社会、学校、家庭,加强中学生心理健康教育和心理咨询服务,提高其心理健康水平。

Objective To investigate the current situation and dynamics of depressive disorders among middle school students in Nanjing;to provide basis for making intervention measures.Methods From 2009to 2010,cluster sampling method was used to randomly select all first-year students in 5middle schools in Nanjing as survey subjects,self-designed Nanjing Adolescent Mental Status Questionnaire was used in survey,and SDS self-rating Depression Scale was used for evaluation of depressive disorders.Results Average general index score in 2010（49.20±10.46）was significant higher than that in 2009（48.51±9.77）（P〈.05）.Compared to situation in 2009,scores increased in 10items investigated in 2010（P〈.05）：depression,diurnal rhythm,easy to cry,palpitations,easy fatigue,anxiety,feeling hopelessness、uselessness、worthlessness、 living in emptiness.However,scores decreased in 3items（P〈.05）：loss of appetite、sexual interest and body weight.Depressive disorder accounted for 44.0%and 46.0%of all student in 2009and 2010,respectively,with no significant difference（P 0.05）.Multivariate logistic regression analysis showed that students had higher risk of depression if they were in senior high school,with only mother unemployed,worse academic performance,short weekly moderate-intensity activity time,shorter daily sleep time,or who can not get along with families or classmates,drinking,or had experience of accidental injuries（P 0.05）.Conclusion Depressive disorder is a serious problem for middle school students in Nanjing,which was influenced by many factors.Social organizations,schools and families should be united for enhanced mental health education and psychological counseling services to improve middle school studentsmental health.