中学生心理健康素养和非自杀性自伤行为交互作用与自杀相关行为关联

Association of interaction between mental health literacy and non-suicidal self-injury with suicidal behaviors among middle school students:a crosssectional survey in three China cities

目的探讨中学生心理健康素养和非自杀性自伤行为的交互作用与自杀相关行为的关联。方法于2020年10月—2021年6月,采用多阶段整群抽样方法,抽取北京、广东省阳江市、河南省郑州市3个城市16853名在校中学生,使用《青少年心理健康素养量表》、《青少年非自杀性自伤行为评定问卷》等进行自填式问卷调查,建立多因素logistic回归模型分析心理健康素养和非自杀性自伤行为与自杀相关行为的关联。结果中学生自杀意念、自杀计划和自杀未遂检出率分别为31.3%、16.3%和7.5%,非自杀性自伤行为检出率为28.9%。多因素logistic回归分析结果显示,不具备心理健康素养和非自杀性自伤行为是中学生自杀意念、自杀计划、自杀未遂的危险因素。并且心理健康素养和非自杀性自伤行为对自杀相关行为存在相加交互作用和相乘交互作用。结论中学生自杀相关行为检出率较高,不具备心理健康素养和非自杀性自伤行为是自杀相关行为的危险因素,两者联合作用时可显著增加自杀相关行为的发生。

Objective To investigate the association of interaction between mental health literacy(MHL)and nonsuicidal self-injury(NSSI)with suicidal behaviors among middle school students in China.Methods With multistage cluster sampling,totally 17000 students were recruited from 39 middle schools in three China cities(Beijing,Zhengzhou of Henan province,and Yangjiang of Guangdong province)for self-administered anonymous survey during October 2020-June 2021.Two scales compiled by Chinese researchers(Adolescent Mental Health Literacy Assessment Questionnaire[AMHLAQ]and Adolescent Non-suicidal Self-injury Assessment Questionnaire[ANSAQ]and a self-designed questionnaire were adopted in the survey.Multivariate logistic regression model was used to explore the association of interaction between MHL and NNSI with suicidal behavior in the students.Results Among the 16853 students with valid responses,31.3%,16.3% and 7.5% reported ever having suicidal ideation,plan and attempt during past one year and the overall self-reported rate of NSSI was 28.9%.Multivariate logistic regression analyses revealed that inadequate MHL and NSSI are risk factors for suicidal ideation,plan and attempt.Furthermore,MHL and NSSI could exert an additive or multiplicative interactive effect on suicidal-related behaviors.Conclusion Among middle school students in China,suicidalrelated behaviors is relatively prevalent and inadequate MHL and NSSI are risk factors for suicidal ideation,suicidal plan and suicidal attempt;the interaction between the two risk factors could increase the risk of suicide-related behaviors.