学生心理健康问题检出率比较:元分析的证据

A Comparison of the Rates of Prevalence of Students'Mental Health Problems:Evidence Based on Meta-analysis

为澄清我国学生心理健康问题检出率不一的争论,基于科学临床经验的分类方法,将心理健康问题分为内化问题与外化问题,并采用元分析方法纳入1043篇研究文献,囊括大中小学生2905979名,详细比较了2010—2020年我国大中小学生内外化问题检出率的共通点与差异。研究结果发现,我国学生心理健康问题总体检出率为18.9%,内化问题总体检出率为20.0%,外化问题总体检出率为11.7%,区域特点与年份不同是造成内外化问题检出率波动的共同因素。同时,研究系统考察了这十年间我国学生各类心理健康问题检出率的大小、分布特点、影响因素与发展趋势,其总体检出率由高到低依次是抑郁与睡眠问题(均为22.2%)、自伤行为(20.1%)、焦虑(18.1%)、自杀意念(13.6%)、自杀未遂(3.3%),学段、经济区域、检出工具和检出时间、年份等是影响上述总体检出率的关键原因。而人口统计学特征如性别、生源地和独生子女与否则没有显著影响。在此基础上,有的放矢地提出心理健康研究重在“深耕细作”、心理健康教育重在“对症下药”、心理健康服务重在“追根溯源”、心理健康政策制定重在“与时俱进”等相关教育对策和建议。

To classify the disputes over the different rates of prevalence of mental health problems from Chinese students,this study,based on scientific clinical experience,divides mental health problems into internalizing problems and externalizing problems,makes a meta-analysis of 1043 research articles covering 2,905,979 students from primary schools,junior high schools,senior high schools,and higher education institutions,and makes a detailed comparison of the similarities and differences in the rates of prevalence between internalizing and externalizing mental health problems from Chinese students from 2010 to 2020.The results show that the general prevalence of mental health problems from Chinese students,the prevalence of their internalizing problems,and the prevalence of their externalizing problems accounted for 18.9%,20.0%,and 11.7%,respectively,and that regional features and different years were the common factors leading to the fluctuating prevalence of internalizing and externalizing mental health problems.At the same time,based on a survey of different types of prevalence of mental health problems from Chinese students during the ten years,their characteristics,the factors affecting them,and the trends of their development,the authors find the following:Depression,sleep disorders,self-injury,anxiety,suicidal ideation,and attempted suicide accounted for 22.2%,22.2%,20.1%,18.1%,13.6%,and 3.3%,respectively;the factors affecting the aforesaid prevalence included educational stages,economic regions,detection tools and time,and the years;and demographic characteristics,such as gender,the place of origin,and one-child families failed to significantly affect the prevalence.In conclusion,the authors suggest the following:Mental health research should focus on"deep plowing"(deliberating the direction and problems of the research);mental health education should focus on"suiting the remedy to the specific case"(helping all students receive mental health education in line with their psychological features);mental health service should focus on"going back to the source"(exploring ways to solve individuals'mental health problems,and helping citizens,especially students,to correctly understand their relationship with society);and the mental health policy should focus on"keeping pace with the times"(improving mental health policies based on the development of the times).