河南省某校初中生精神障碍的共病研究——1年随访

Study on comorbidities of mental disorders in junior middle school students of two schools in Henan Province-one year follow-up

目的了解青少年时期不同精神障碍之间的共病关系。方法采用整群随机抽样方法,对河南省唐河县城郊乡和舞阳县文烽乡的2所中学的初一、初二年级1 500名学生,采用长处和困难筛查问卷(学生版(SDQ)和自编增补问卷进行筛查,后依据《精神障碍诊断与统计手册(第5版)》(DSM-5)进行诊断,并随访1年。结果共查出六大类精神障碍患者80例,其中有7例共病患者,共病检出率为8.75%;注意缺陷/多动障碍与焦虑障碍、抑郁障碍与对立违抗障碍、焦虑障碍与应激障碍之间有共病;随访研究中又发现2例共病患者,和2种新的共病关系:抑郁障碍与强迫障碍、注意缺陷/多动障碍之间共病,共病检出率为11.25%;共病者比无共病者更易出现诊断改变(P=0.002)。结论初中生精神障碍共病明显存在,多种精神障碍之间有共病关系,其中焦虑障碍的共病关系较为明显,抑郁障碍共病发生较晚;共病者症状更多发生变化。

Objective To realize the coexistence of different mental disorders in teenagers.MethodsA total of1 500 junior middle school students of two middle schools in Henan Province were selected by the cluster random sampling method and they were interviewed for finding mental disorders by the Strengths and Difficulties Questionnaire(student edition) and a self-designed supplementary questionnaire, and the cases were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders(DSM-5), then they were followed-up for one year.ResultsTotally 80 students with mental disorders that belong to six types of mental disorders were found, including 7 students with comorbidities, and the detection rate of comorbidity was 8.75%. Comorbidities occurred between attention deficit/hyperactivity disorder and anxiety disorder(AD), depressive disorder(DD) and oppositional defiant disorder, and anxiety disorder and stress disorder. In the follow-up, 2 students with comorbidities and 2 kinds of new coexistence, DD and obsessive-compulsive disorder(OCD),and attention deficit/hyperactivity disorder, were found again, and the detection rate of comorbidity was 11.25%. The diagnosis changes of comorbidity patients were the more obvious than patients without comorbidities(P = 0.002).Conclusion Comorbidities are obvious in junior middle school students. The comorbidities of AD are more, and comorbidity of depression disorder occurs later. Comorbidity is associated with more changes in symptoms.