中国9~18岁儿童青少年心理困扰流行现状

Prevalence of psychological distress among Chinese children and adolescents aged 9-18 years

目的描述2019年中国9~18岁儿童青少年心理困扰流行情况, 并分析其影响因素。方法使用2019年全国学生体质与健康调研数据, 纳入148 892名9~18岁汉族儿童青少年。使用凯斯勒心理困扰量表(K10)评分对心理困扰进行测量:≤19、20~、25~、≥30分别表示无、轻度、中度、重度心理困扰(中度和重度心理困扰合称高心理困扰)。使用方差分析、t检验和χ2检验比较不同特征儿童青少年K10评分和高心理困扰率的差异, 使用方差分析和趋势χ2检验分析趋势, 使用修正泊松回归模型分析高心理困扰的影响因素。结果 2019年中国9~18岁儿童青少年K10评分为21.5±9.2, 高心理困扰率为31.6%。9~、13~、16~18岁儿童青少年的高心理困扰率分别为22.3%、35.9%和38.8%, 随着年龄升高其K10评分和高心理困扰率均呈上升趋势(趋势检验均P<0.001)。年龄较高、女生、乡村、中低人均GDP水平地区、父/母亲文化程度较低儿童青少年高心理困扰率更高(均P<0.001)。多因素修正泊松回归模型分析显示, 13~15岁、16~18岁、女生、乡村和中低人均GDP水平地区的儿童青少年高心理困扰风险较高(均P<0.05), 其aOR值(95%CI)分别为1.55(1.52~1.58)、1.66(1.63~1.69)、1.07(1.05~1.09)、1.02(1.01~1.04)、1.10(1.07~1.12);中高人均GDP水平地区、父亲文化程度为高中/中专、大专及以上以及母亲文化程度为高中/中专、大专及以上的儿童青少年高心理困扰风险较低(均P<0.05), 其aOR值(95%CI)分别为0.96(0.94~0.98)、0.92(0.90~0.93)、0.84(0.82~0.86)、0.95(0.93~0.97)、0.86(0.83~0.88)。结论 2019年9~18岁中国儿童青少年的心理困扰率较高, 需引起重视。心理健康干预应重点关注高年龄段、女性、乡村、地区经济状况较差及父母文化程度较低的人群。

Objective To describe the prevalence of psychological distress and to analyze its influencing factors among Chinese children and adolescents aged 9-18 years in 2019.Methods Data was from the 2019 Chinese National Survey on Students'Constitution and Health,and 148892 children and adolescents were included.Psychological distress was measured using the Kessler Psychological Distress Scale(K10):scores≤19 were defined as no psychological distress,scores between 20-24 were defined as mild psychological distress,scores between 25-29 were defined as moderate psychological distress,and scores≥30 were defined as severe psychological distress(moderate to severe psychological distress were defined as high psychological distress).The ANOVA,t test,andχ2 test were used to compare the differences in K10 scores and high psychological distress rates among children and adolescents with different characteristics.The ANOVA and trendχ2 test were used to analyze the trends.Modified-Poisson regression models were used to determine influencing factors of high psychological distress.Results The K10 scores for Chinese children and adolescents aged 9-18 years in 2019 was 21.5±9.2,and their rate of high psychological distress was 31.6%.The rates of high psychological distress among children and adolescents aged 9-12,13-15,and 16-18 years were 22.3%,35.9%,and 38.8%.K10 scores and rates of high psychological distress showed an increasing trend as age increased(trends test all P<0.001).K10 scores and rates of high psychological distress were higher among children and adolescents who were older,female,rural,in areas with medium to low GDP per capita level,and with lower parental education(all P<0.001).Multifactorial modified-Poisson regression analysis showed that children and adolescents aged 13-15 years,16-18 years,female,rural,and in areas with low to moderate GDP per capita level were at higher risk of high psychological distress(all P<0.05),with aOR(95%CI)of 1.55(1.52-1.58),1.66(1.63-1.69),1.07(1.05-1.09),1.02(1.01-1.04),1.10(1.07-1.12).Children and adolescents in areas with medium to high GDP per capita level,whose father had a secondary or high school degree,whose father had a college degree or above,whose mother had a secondary or high school degree,and whose mother had a college degree or above were at lower risk of high psychological distress(all P<0.05),with aOR(95%CI)of 0.96(0.94-0.98),0.92(0.90-0.93),0.84(0.82-0.86),0.95(0.93-0.97),0.86(0.83-0.88).Conclusions The prevalence of psychological distress was high among Chinese children and adolescents aged 9-18 years in 2019,which is a vital problem.Mental health interventions need to be implemented among children and adolescents that were older,girls,rural,live in areas with lower economic levels,and whose parents have a lower education level.