山东省青少年阈下抑郁及精神病性体验与非自杀性自伤的关联

Association between subthreshold depression and psychoticlike experiences with nonsuicidal selfinjury among adolescents in Shandong Province

目的探讨山东省青少年阈下抑郁和精神病性体验(PLEs)及其交互作用与非自杀性自伤(NSSI)行为的关联,为青少年NSSI的预防和早期干预提供参考依据。方法于2023年3—4月,采用分层整群随机抽样的方法,在山东省沿海和内陆分别各抽取2座城市中6090名13~22岁大中学生施测。使用非自杀性自伤行为评定问卷、简式版社区心理体验评估问卷(CAPE-P8)、流调中心抑郁量表(CES-D)进行电子问卷调查,采用多因素Logistic回归分析青少年阈下抑郁和PLEs及其交互作用与NSSI的关联。结果青少年NSSI检出率为21.3%,单因素分析发现年龄在13~15岁青少年NSSI报告率最高(27.9%),有阈下抑郁和PLEs者NSSI报告率分别为49.9%,30.7%。多因素分析结果显示,存在阈下抑郁青少年发生NSSI的风险是无抑郁青少年的3.47倍[OR值(95%CI)=3.47(2.68~4.50)];有PLEs者发生NSSI的风险是未检出者的5.32倍[OR值(95%CI)=5.32(4.10~6.89)],阈下抑郁与PLEs同时存在时发生NSSI的风险是均未检出者的18.47倍[OR值(95%CI)=18.47(14.75~23.13)](P值均<0.01);超额危险度(RERI)、交互作用归因比(AP)和协同指数(S)分别为11.44,0.61,2.89,即阈下抑郁和PLEs对青少年NSSI的相加交互作用占比为61%。结论阈下抑郁和精神病性体验与青少年NSSI相关且存在相加交互作用。缓解青少年阈下抑郁并降低精神病性体验,对预防NSSI的发生具有积极作用。

Objective To investigate the association between subthreshold depression,psychoticlike experiences(PLEs),and their interactions with nonsuicidal selfinjury(NSSI)in adolescents from Shandong,so as to provide a reference for the prevention and early intervention of NSSI in adolescents.Methods A random cluster sampling method was used to select a total of 6090 adolescents aged 13-22 from two cities along the coast and inland of Shandong Province.Electronic surveys were administered using the SelfInjurious Behavior Questionnaire,Community Assessment of Psychic Experiencepositive 8 items(CAPE-P8),and the Center for Epidemiological Studies Depression Scale(CES-D).The relationship between subthreshold depression,PLEs,and their interaction with NSSI was analyzed using multivariate Logistic regression.Results The detection rate of NSSI among adolescents was 21.3%.The highest NSSI reporting rate(27.9%)was found in the age group of 13-15 years.The NSSI reporting rates for those detected with subthreshold depression and PLEs were 49.9%and 30.7%,respectively.Multivariate analysis indicated that individuals with subthreshold depression were 3.47 times more likely to engage in NSSI[OR(95%CI)=3.47(2.68-4.50)].Those identified with PLEs had 5.32 times higher risk of engaging in NSSI than those without such experiences[OR(95%CI)=5.32(4.10-6.89)].When both subthreshold depression and PLEs coexist,the risk of engaging in NSSI was 18.47 times higher than in individuals with neither condition[OR(95%CI)=18.47(14.75-23.13)](P<0.01).The relative excess risk due to interaction(RERI),attributable proportion(AP),and synergy index(S)were 11.44,0.61,and 2.89,respectively,indicating that the combined interaction of subthreshold depression and PLEs accounted for 61%of adolescent NSSI.Conclusions Subthreshold depression and psychoticlike experiences are associated NSSI in adolescents and exhibit an additive interaction.Alleviating subthreshold depression in adolescents and reducing psychotic experiences may play a positive role in preventing the occurrence of NSSI.