北京市高中一年级学生人格偏离的现况调查

A cross-sectional study of personality dysfunction among students of first-grade senior high schools in Beijing

目的 试测美国人格诊断问卷 (PDQ 4 )并调查北京市中学生人格偏离的检出率及其分布。方法 以ICD 10为金标准在 10 0例人格障碍患者、91例非人格障碍的精神病患者和 10 0名正常人中计算PDQ 4的灵敏度、特异度和重测一致性 ;以现况调查分层整群抽样的方法 ,采用PDQ 4调查北京市 10 0 39名高中一年级学生。结果 PDQ 4具有高灵敏度和中等特异度 ,重测一致率为 92 .2 %。正常成人样本PDQ 4量表总分为 18.9± 9.8,男性量表总分为 2 0 .6± 10 .1,女性量表总分为 17.1±9.2 ,差异有显著性 (t=2 .0 9,P <0 .0 5 )。各年龄组量表总分差异无显著性。北京市高一学生PDQ 4量表总分为 2 5 .4± 9.6 ,明显高于正常成人样本。该人群人格偏离的检出率为 5 .6 % ;检出率男生明显高于女生 ;城区学生明显低于乡镇学生 ;市重点学生最低 ,普通中学学生最高。结论 PDQ 4 (中文版 )可以作为效度和信度较好的人格障碍筛查工具 ;北京市中学生人格偏离有性别、城乡和学校类型的差异 ,是青春期值得重视的心理发育问题。

Objective To test validity and reliability of Personality Diagnostic Questionnaire fourth vision (PDQ 4) and a self report DSM Ⅳ axis Ⅱ personality disorder (PD) assessing instrument as well as to study the prevalence of personality dysfunction among students of first grade senior high schools in Beijing. Methods Among 100 PD patients, 91 non PD patients with mental disorder, and 100 normal people, sensitivity, specificity and consistency were tested by ICD 10 criteria. By means of stratified cluster sampling, 10 039 students from 25 senior high schools in urban and rural in Beijing were studied using PDQ 4. Results PDQ 4 had high sensitivity and moderate specificity for most axis Ⅱ disorders when compared with ICD 10. Among different samples, PDQ 4 yielded various levels of sensitivity and specificity. Meanwhile, the test retest consistency was 92.2 %. Among 130 adults, the total PDQ 4 score was 18.9± 9.8. The score in males was 20.6± 10.1 , versus 17.1± 9.2 in females with significant difference ( t = 2.09 , P < 0.05 ). Scores in different age groups were 21.5± 10.5 in age 16 25, 16.9± 11.3 in age 26 35, 16.4± 9.7 in age 36 45, 16.2± 7.9 in age 46 55, and 20.0± 7.8 in age 56 and over respectively. No statistical significant difference of scores at age groups was found ( F = 2.07 , P > 0.05 ). Among 9 547 students, the total PDQ 4 score was 25.4± 9.6 , being sighificantly higher than that of adult sample. The prevalence of personality dysfunction was 5.6 %. Regarding the distribution of personality dysfunction in gender, residential area, and type of school, data showed that the prevalence rates were higher in males, rural area and lower ranking schools. Conclusion PDQ 4 can be used as a PD screen tool in psychiatric institutions and community settings. The distributions of personality dysfunction in Beijing were significantly different on gender, residential area and type of schools. Attention should be paid to personality dysfunction during adolescence.