儿童期逆境与中学生抑郁和焦虑情绪的关系

Relationship between adverse childhood experiences and depression and anxiety among students in middle school

目的 了解儿童期逆境与中学生抑郁和焦虑情绪的关系,为中学生抑郁和焦虑情绪的预防及干预提供依据。方法 于2020年10-11月,采用方便抽样法选取湖北省的初中、普高、中职、职高共计12所学校4 861名中学生,调查人口学信息、儿童期逆境及抑郁焦虑状况,并采用χ2检验和多因素Logistic回归分析数据。结果 中学生的抑郁、焦虑情绪检出率分别为39.0%和52.3%;单因素分析显示,儿童期逆境总分及儿童虐待忽视、家庭功能障碍、家庭缺失、家庭外暴力维度与抑郁和焦虑情绪有关联(χ^(2)值分别为105.36,147.12,43.69,46.61,196.48;100.06,132.28,26.53,24.32,169.94,P值均<0.01);在调整年龄、是否独生子女、性别等控制变量后,Logistic回归分析结果显示,儿童虐待忽视、家庭功能障碍、家庭缺失和家庭外暴力与抑郁情绪均呈正相关(OR值分别为1.61,1.62,1.06,2.08,P值均<0.01);儿童虐待忽视、家庭功能障碍、家庭外暴力与焦虑情绪均呈正相关(OR值分别为1.66,1.50,1.98,P值均<0.05)。结论 中学生的抑郁与焦虑情绪和儿童期逆境有关联,其中在儿童期受到家庭外暴力和虐待忽视的中学生发生抑郁和焦虑情绪的风险更高。

Objective To investigate the relationship between adverse childhood experiences with depression and anxiety prevention and intervention among middle school students,so as to provide evidence for preventing and intervening in depression and anxiety among adolescents.Methods From October to November 2020,a total of 4861 middle school students from 12 schools in a province in central China,including junior high schools,senior high schools,secondary vocational schools,and vocational high school selected by using convenient sampling method.Demographic information,adverse childhood experiences,depression and anxiety symptoms were collected.The Chi-square test and multivariate Logistic regression analysis were used to analyze the data.Results The detection rates of depression and anxiety of students in middle school were 39.0%and 52.3%,respectively.Univariate analysis showed that the total scores of adverse childhood experiences and dimensions of childhood maltreatment and neglect,family dysfunction,parent absence,and violence outside the home were significantly associated with depressive and anxiety symptoms(χ^(2)=105.36,147.12,43.69,46.61,196.48;100.06,132.28,26.53,24.32,169.94,P<0.01).After controlling variables such as age,only child,sex and economic status of family,Logistic regression showed that childhood maltreatment and neglect,family dysfunction,family absence and violence outside the home were positively associated with depressive symptoms(OR=1.61,1.62,1.06,2.08,P<0.01)and anxiety symptoms(OR=1.66,1.50,1.98,P<0.05).Conclusion Depressive and anxiety symptoms among middle school students are associated with adverse childhood experiences,and those who experienced childhood maltreatment and neglect and violence outside the home are at higher risk.