童年期不良经历和积极经历与中学生抑郁焦虑症状的关联

Correlation of adverse and positive childhood experiences and depression and anxiety symptoms among middle school students

目的分析童年期不良经历(ACEs)与童年期积极经历(PCEs)和中学生抑郁、焦虑症状的关联及性别差异,为促进中学生心理健康提供参考依据。方法采用分层随机整群抽样方法,于2021年10月—2022年10月选取南昌市、沈阳市、太原市、郑州市共6656名中学生为研究对象,采用童年期不良经历问卷(ACEs-IQ)、童年期积极经历量表(BCEs)、患者健康问卷(PHQ-9)和广泛性焦虑障碍量表(GAD-7)进行问卷调查。采用χ^(2)检验比较不同组别中学生抑郁、焦虑症状的报告率,建立Logistic回归模型分析ACEs和PCEs对中学生抑郁、焦虑症状的影响及其性别差异。结果中学生抑郁症状报告率为20.1%,焦虑症状报告率为13.9%。ACEs与中学生抑郁和焦虑症状均呈正相关(抑郁症状:OR=1.20,95%CI=1.18~1.22;焦虑症状:OR=1.18,95%CI=1.16~1.20),PCEs与中学生抑郁、焦虑症状均呈负相关(抑郁症状:OR=0.84,95%CI=0.83~0.86;焦虑症状:OR=0.85,95%CI=0.83~0.87)(P值均<0.05);在总人群(抑郁症状:OR=0.99,95%CI=0.98~0.99;焦虑症状:OR=0.99,95%CI=0.99~1.00)与女生中(抑郁症状:OR=0.98,95%CI=0.97~0.99;焦虑症状:OR=0.99,95%CI=0.98~1.00),ACEs与PCEs交互项与抑郁、焦虑症状均呈负相关(P值均<0.05)。结论ACEs显著影响中学生的抑郁、焦虑症状,而PCEs有助于减轻ACEs对中学生抑郁、焦虑症状的影响;女生比男生更易受到早期经历的影响。应关注性别差异,制定全面的心理健康保护策略,促进中学生心理健康发展。

Objective To analyze the correlation and gender differences between adverse childhood experiences(ACEs)and positive childhood experiences(PCEs)and depression and anxiety symptoms among middle school students,so as to provide a reference for promoting the mental health of middle school students.Methods With a stratified random cluster sampling method,a total of 6656 middle school students in 4 cities,including Nanchang,Shenyang,Taiyuan,and Zhengzhou,were selected as research subjects from October 2021 to October 2022.The Adverse Childhood Experiences International Questionnaire(ACEs-IQ),Benevolent Childhood Experiences Scale(BCEs),Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorders-7(GAD-7)scale were used to conduct questionnaire surveys.The Chisquare test was used to compare the reporting rates of depression and anxiety symptoms among middle school students in different groups,and a Logistic regression model was established to analyze the effects of ACEs and PCEs on depression and anxiety symptoms among middle school students and their gender differences.Results The reporting rate of depressive symptoms among middle school students was 20.1%,and the reporting rate of anxiety symptoms was 13.9%.ACEs were positively correlated with depression and anxiety symptoms among middle school students(depression symptoms:OR=1.20,95%CI=1.18-1.22,anxiety symptoms:OR=1.18,95%CI=1.16-1.20),while PCEs were negatively correlated with depression and anxiety symptoms among middle school students(depression symptoms:OR=0.84,95%CI=0.83-0.86,anxiety symptoms:OR=0.85,95%CI=0.83-0.87)(P<0.05).In the general population(depression symptoms:OR=0.99,95%CI=0.98-0.99,anxiety symptoms:OR=0.99,95%CI=0.99-1.00)and among girls(depression symptoms:OR=0.98,95%CI=0.97-0.99,anxiety symptoms:OR=0.99,95%CI=0.98-1.00),the interaction term between ACEs and PCEs were negatively correlated with depression and anxiety symptoms(P<0.05).Conclusions ACEs significantly affect the depression and anxiety symptoms of middle school students,while PCEs can help reduce the impact of ACEs on the depression and anxiety symptoms of middle school students,girls are more susceptible to the impact of early experiences than boys.It should focus on gender differences,formulate comprehensive mental health protection strategies,to promote the mental health development of middle school students.