商丘市青少年自杀意念和抑郁的个体-家庭-学校三因素分析

Individual-family-school three factors analysis of suicidal ideation and depression among adolescents in Shangqiu City

目的 了解商丘市青少年自杀意念和抑郁症状的个体、家庭、学校因素,为促进青少年心理健康提供数据支撑。方法2021年5—6月,采用分层随机整群抽样方法对商丘市4所高中的1 607名学生进行心理健康调查。结果 28.31%的青少年报告有抑郁症状,21.90%有自杀意念。女生(OR=1.58,95%CI:1.21~2.07)、家庭功能不全(OR=2.21,95%CI:1.68~2.91)、经历童年虐待(OR=1.13,95%CI:1.09~1.18)增加青少年出现自杀意念的风险,而心理韧性(OR=0.97,95%CI:0.96~0.98)和学校联结水平(OR=0.93,95%CI:0.91~0.95)较高的青少年不易产生自杀意念;同样地,女生(OR=1.47,95%CI:1.13~1.92)、家庭功能不全(OR=2.11,95%CI:1.59~2.79)、经历童年虐待(OR=1.23,95%CI:1.18~1.29)的青少年更易产生抑郁症状,而心理韧性(OR=0.93,95%CI:0.92~0.95)和学校联结(OR=0.93,95%CI:0.91~0.95)可以降低青少年出现抑郁症状的风险。此外,高二学生抑郁发生率高于高一学生(OR=1.34,95%CI:1.03~1.74)。结论 商丘市青少年的心理健康受个体、家庭和学校因素的共同影响,为有效预防青少年的心理健康问题,应从青少年的整体成长环境出发,通过建立“个体-家庭-学校”的联动体系,强化各层次的保护性因素,降低危险性因素,为青少年健康成长提供支持性环境。

Objective To explore the effects of individual,family,school factors on suicidal ideation and depression among adolescents in Shangqiu City,and to provide targeted interventions for adolescents' mental health.Methods From May to June2021,a stratified random cluster sampling method was used to investigate the mental health of 1 607 adolescents from four high schools in Shangqiu City.Results 21.90% of adolescents reported suicidal ideation,and 28.31% had depressive symptoms.Girls(OR=1.58,95%CI:1.21-2.07),family dysfunction(OR=2.21,95%CI:1.68-2.91) and childhood abuse(OR=1.13,95%CI:1.09-1.18)could significantly predict suicidal ideation,while those with higher levels of psychological resilience(OR=0.97,95%CI:0.96-0.98)and school connectedness(OR=0.93,95%CI:0.91-0.95) were less likely to report suicidal ideation.Similarly,girls(OR=1.47,95%CI:1.13-1.92),family dysfunction(OR=2.11,95%CI:1.59-2.79) and childhood abuse(OR=1.23,95%CI:1.18-1.29) could significantly predict depression,while psychological resilience(OR=0.93,95%CI:0.92-0.95) and school connectedness(OR=0.93,95%CI:0.91-0.95) could prevent adolescents from developing depressive symptoms.Additionally,11th graders reported significantly higher prevalence of depression than 10th graders(OR=1.34,95%CI:1.03-1.74).Conclusion The psychological health of adolescents in Shangqiu City is influenced by individual,family,and school factors.To effectively prevent psychological health problems among adolescents,we should start from the overall growth environment of adolescents,establish a linkage system of "individual family school",strengthen protective factors in all levels,reduce risk factors,and provide a supportive environment for the healthy growth of adolescents.