北京市6~16岁在校生抑郁障碍患病率调查

The prevalence of depressive disorders in school students aged 6-16 years in Beijing

目的:探究北京地区6~16岁在校生抑郁障碍的总体患病率、抑郁障碍患病率的年龄和性别效应及抑郁障碍患儿的情绪和行为特点。方法:采用多阶段分层随机抽样的方法,调查2012年1月至2014年12月北京市6~16岁在校中小学生的抑郁障碍患病率。第一阶段采用儿童行为调查表对高危儿童青少年进行初筛,第二阶段采用简明儿童少年国家神经精神访谈工具对初筛阳性的患儿进行进一步的诊断筛查,由2名精神科医师根据美国精神疾病诊断手册第4版中关于抑郁障碍的诊断标准进行诊断,确定最终诊断抑郁障碍的人数。该研究属于流行病学类的调查研究,采用前瞻性研究设计思路。同时采用χ^(2)检验对比其年龄及性别效应。结果:北京市6~16岁在校生抑郁障碍的患病率为2.29%(234/10215例)。其中男童的患病率为1.80%(106/5866例),女童的患病率为2.94%(128/4349例)。抑郁障碍的患病率存在年龄效应,随着年龄的增加,抑郁障碍的患病率增高。12岁是一个关键的转折点,15岁前后达到峰值。抑郁障碍患儿的情绪和行为问题主要表现在社交问题、退缩抑郁、焦虑抑郁、体诉及冲动行为等方面。结论:北京市6~16岁在校生的抑郁障碍患病率为2.29%。抑郁障碍发生在中小学生的各个年龄阶段,在小升初和中考前后两个阶段需要重点关注学生的抑郁情绪,尤其需要关注女童的情绪问题。在进行抑郁障碍的筛查和诊治过程中,抑郁情绪的非典型症状需要重点关注。

Objective To investigate the prevalence of depressive disorders among school students aged 6-16 years in Beijing,the effect of age and gender on the prevalence,and the behavioral and emotional profiles of identified students with depressive disorders.Methods The prevalence of depressive disorders in primary and secondary school students aged 6-16 years in Beijing from January 2012 to December 2014 was examined by a multistage stratified random sampling method.In the first stage,the Achenbach′s Child Behavior Checklist(CBCL)was used to identify high-risk children and adolescents.In the second stage,the high-risk group was further screened by Mini International Neuropsychiatric Interview for Children and Adolescents(MINI-KID),and then two psychiatrists made the final diagnosis according to the diagnostic criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM-Ⅳ).This study was a prospective epidemiological investigation.The effect of age and gender on the disease prevalence was analyzed by Chi-square test.Results About 2.29%(234/10215 cases)of the school students aged 6-16 years in Beijing had depressive disorders.The incidence of depressive disorders was 1.80%(106/5866 cases)in boys and 2.94%(128/4349 cases)in girls.There is an age effect on the prevalence of depression.As the age increases,the morbidity of depressive disorders increases.The age of 12 years was a critical turning point,and the peak incidence was reached at around the age of 15 years.The emotional and behavioral problems of patients with depressive disorders mainly include social problems,withdrawal depressed,anxiety and depressed,somatic complaints,and aggressive behavior.Conclusions The prevalence of depressive disorders among school students aged 6-16 years in Beijing is 2.29%.Depressive disorders occur in primary and middle school students of all ages.More attention should be paid to the mood of students before and after the entrance exams for junior high school and senior middle school,especially the girls′mood.In the process of screening,diagnosis and treatment of depressive disorders,the atypical symptoms of depression need to be paid more attention.