受艾滋病影响的凉山州青少年抑郁症状影响因素及其交互作用分析

Interaction of Related Influencing Factors on Depressive Symptoms Among Adolescents Affected by AIDS in Liangshan Prefecture

目的了解受艾滋病影响的凉山州青少年抑郁现状以及相关影响因素,探讨影响因素间的交互作用。方法2018-09选取艾滋病高流行区的凉山州4个县各1所学校为调查现场,使用简明抑郁症筛查量表(PHQ-2)、自制人口学特征及健康危险行为的调查问卷进行调查。非条件Logistic回归分析抑郁症状的影响因素及因素的相乘交互作用,并采用Andersson等编制Excel软件计算其相加交互作用。结果纳入1381名受艾滋病影响的凉山州青少年,其中,孤儿510人(36.93%),抑郁症状检出率(28.04%)高于非孤儿(21.47%)(P值<0.05)。logistic回归结果表明,孤儿(OR=1.459,95%CI:1.101~1.932)、女性(OR=1.711,95%CI:1.275~2.294)、总是不被喜欢(OR=6.272,95%CI:2.245~17.521)、饮酒(OR=1.482,95%CI:1.030~2.133)、与他人发生冲突(OR=1.456,95%CI:1.074~1.974)及自伤(OR=1.931,95%CI:1.451~2.571)的受艾滋病影响的青少年更易存在抑郁症状,自评很健康(OR=0.314,95%CI:0.119~0.824)则越不易抑郁。饮酒与自我伤害(RERI=1.576,AP=0.442,SI=2.590)对抑郁症状存在相加交互作用。结论孤儿抑郁发生率高,总是不被喜欢为抑郁最严重的影响因素,同时存在饮酒与自我伤害的行为会增加患抑郁症状风险,须重点关注此类受艾滋病影响青少年。

Objective To examine the prevalence and related influencing factors of depressive symptoms among adolescents affected by AIDS in Liangshan prefecture of Sichuan province,and to explore the interaction of related influencing factors.Methods In September 2018,one school in each of the four counties in Liangshan prefecture with high HIV prevalence was selected as the investigation site.Cross-sectional survey were conducted by using questionnaires grouped by the Patient Health Questionnaire 2-item for screening Depression(PHQ-2),self-made general situation and health risk behaviors.Unconditional logistic regression model was used to explore the multiplicative interaction between the influencing factors on depressive symptoms and the Andersson’Excel software was used to calculate the additive interaction.Results Including 1381 adolescents affected by AIDS in Liangshan prefecture,510 of them were orphans(36.93%).The detection rate of depressive symptoms(28.04%)was higher than that of non-orphans(21.47%)(P<0.05).The results of Logistic regression model showed that,adolescents affected by AIDS such as Orphans(OR=1.459,95%CI:1.101~1.932),female(OR=1.711,95%CI:1.275~2.294),always being disliked by others(OR=6.272,95%CI:2.245~17.521),alcohol consumption(OR=1.482,95%CI:1.030~2.133),conflict with others(OR=1.456,95%CI:1.074~1.974)and self-injury(OR=1.931,95%CI:1.451~2.571)were more likely to have depressive symptoms.While self-rated very healthy was protective factor for depressive symptoms(OR=0.314,95%CI:0.119~0.824).There was a additive interaction between alcohol consumption and self-injury(RERI=1.576,AP=0.442,SI=2.590)on depressive symptoms.Conclusion The prevalence of depressive symptoms of orphans is high,and always being disliked by others is the most serious factor for depressive symptoms.Adolescents affected by AIDS who have both alcohol consumption and self-injury will increase the prevalence of depressive symptoms,so it is necessary to pay special attention to such adolescents affected by AIDS.