基于两水平Logistic回归模型的资中县农村中学生抑郁症状相关因素

Influencing factors of depressive symptoms of rural middle school students in Zizhong County based on two-level Logistic regression model

目的了解四川资中县农村中学生抑郁症状现状,分析其主要影响因素。方法于2015年10月采用典型抽样和整群随机抽样相结合的方法,选取资中县农村的2所乡镇中学,对初一和高一年级2744名学生(其中男生1308名,女生1436名;初中生554名,高中生2190名)进行自填式问卷调查(一般人口学特征、抑郁量表、自尊量表和心理弹性量表),随后每学期开展一次追踪调查。根据使用的3次调查数据(基线数据、1年后的第3次追踪数据、2年后的第5次追踪数据)层次结构的特点,采用两水平Logistic回归模型分析中学生抑郁症状的影响因素。结果资中县农村中学生整体抑郁症状检出率为30.5%(基线调查为26.7%,第3次调查为35.7%,第5次调查为29.8%),女生抑郁症状检出率30.3%高于男生22.9%(χ^2=19.72,P<0.05)。影响四川农村中学生抑郁症状的主要因素有性别(β=0.201,P=0.001)、自觉老师喜欢与否(β=0.228,P=0.005)、自觉同学喜欢与否(β=0.488,P<0.001)、自觉与父母关系(β=0.201,P=0.001)、心理弹性的力量性(β=-0.046,P<0.001)和乐观性维度(β=-0.030,P=0.038)、自尊(β=-0.140,P<0.001)。结论资中县农村中学生抑郁症状与多种因素相关,自觉老师、同学不喜欢及与父母关系不好与青少年抑郁症状成正相关,而心理弹性和自尊成负相关。重复测量多水平模型适用于抑郁症状纵向研究影响因素及其变化规律分析。

OBJECTIVE To understand the prevalence of depressive symptoms of middle school students in rural areas of Zizhong County,and to analyze its main influencing factors.METHODS In October 2015,two rural middle schools in Zizhong County,Sichuan Province,were selected to conduct a self-administered questionnaire survey(general demographic characteristics,the center for epidemiological studies depression scale(CES-D),self-esteem scale(SES)and connor-davidson resilience scale(CD-RICS))on all the students(there were 2744 effective persons,including 1308 boys and 1436 girls,554 middle school students and 2190 high school students),and then carried out a follow-up survey every semester.RESULTS The prevalence of depressive symptoms was 30.5%(in the baseline survey,it was 26.7%,the third 35.7%and the fifth 29.8%),and the rate of female students was 30.3%,higher than that of male students 22.9%(χ^2=19.72,P<0.05).The main influencing factors of depressive symptoms of rural middle school students in Sichuan were gender(β=0.201,P=0.001),be aware of whether teacher liked or not(β=0.228,P=0.005),be aware of whether classmates liked or not(β=0.488,P<0.001),be aware of the relationship with parents(β=0.201,P=0.001),the power of the psychological resilience(β=0.046,P<0.001)and the optimism of the psychological resilience(β=-0.030,P=0.038),self-esteem(β=-0.140,P<0.001).CONCLUSION The depression symptoms of adolescents are related to many factors.The self-conscious teachers and classmates do not like himself(herself),and the bad relationship with parents are positively related to the depression symptoms of adolescents,while the psychological resilience and self-esteem are negatively related.The multi-level Model of repeated measurement is suitable for the analysis of the influencing factors and their changing rules in the longitudinal study of depression symptoms.