杭州市大学生抑郁障碍发生风险因素及其作用机制

Risk factors of depression and the mechanism among college students in Hangzhou

目的了解大学生抑郁风险因素及其作用机制,为开展认知治疗等心理干预提供理论依据。方法对杭州市9所高校的1 427名大学生进行问卷调查,在6个月后通过邮件方式进行PHQ-9的随访,应用Logistic回归分析预测大学生6个月后抑郁障碍的风险因素,采用结构方程模型技术构建大学生抑郁初值、认知、人格、生活事件、SF-12心理功能与抑郁的关系模型。结果初测筛查有抑郁障碍大学生占被调查人数的12.6%,6个月后有抑郁障碍大学生占被调查人数的11.33%,差异无统计学意义(χ2=0.16,P=0.56)。Logistic回归分析结果显示,大学生6个月后抑郁障碍的预测因素有抑郁初值、人格、认知、生活事件及心理功能(P值均<0.01)。从结构方程模型可知,人格和认知对抑郁有直接作用,抑郁初值、生活事件和心理健康通过认知对抑郁有间接作用。结论大学生抑郁障碍的产生与多种因素有关。预防大学生抑郁障碍的关键在于改变不合理的认知。

Objective To explore risk factors of depression among college students,and to provide theoretical foundation of cognitive therapy for depression. Methods A total of 1 427 college students were randomly selected from 9 colleges in Hangzhou and assessed with questionnaire. About 653 students were followed up through E-mail and assessed with PHQ-9. Logistic regression analysis and structural equation model was used to explore relationships among depression, cognition, personality, life events, and SF-12 mental functioning. Results About 12.6% and 11.3% of college students had symptoms of depression in baseline and follow-up study. Stepwise logistic regression showed that baseline depression status, personality, cognitive factors, life events as well as mental functioning could predict follow-up depression. Personality and cognition had directed effects on depression; Baseline depression, life events and mental functioning had indirect effects on depression through cognition. Conclusion Multiple factors could affect depression among university students. Depression prevention among university students should emphasis on cognitive-behavioral therapy.