Depression and Anxiety among Parents of Children with Cystic Fibrosis Related to the Children’s Health Related Quality of Life

The aim was to examine depression and anxiety among parents of children with Cystic Fibrosis and the association between the parents’ symptoms and the child’s quality of life as rated by the parents. Parents completed HADS (Hospital Anxiety and Depression Scale), and CES-D (Center of Epidemiologic Studies Depression Scale), and assessed the children’s quality of life with CFQ-R (Cystic Fibrosis Questionnaire-Revised). Anxiety amongst the parents was higher than the general population (m = 6.55, SD = 3.54, p < 0.001). The level of depression does not differ from that of the general population. Mothers showed more anxiety symptoms than fathers (p < 0.001). Gender differences were not significant for depression symptoms. There is a strong association between the fathers’ self-rated depression and their rating of their child’s health. Both children and parents should be paid attention to in order to identify mental ill-health and take measures in good time.

Clarifying the relationship and analyzing the influential factors of bronchial asthma in children with attention-deficit hyperactivity disorder

BACKGROUND Bronchial asthma is closely related to the occurrence of attention-deficit hyperactivity disorder(ADHD)in children,which can easily have adverse effects on children’s learning and social interactions.Studies have shown that childhood asthma can increase the risk of ADHD and the core symptoms of ADHD.Compared with children with ADHD alone,children with asthma and ADHD are more likely to show high levels of hyperactivity,hyperactive-impulsive and other externalizing behaviors and anxiety in clinical practice and have more symptoms of somatization and emotional internalization.AIM To explore the relationship between ADHD in children and bronchial asthma and to analyze its influencing factors.METHODS This retrospective cohort study was conducted at Dongying People's Hospital from September 2018 to August 2023.Children diagnosed with ADHD at this hospital were selected as the ADHD group,while healthy children without ADHD who underwent physical examinations during the same period served as the control group.Clinical and parental data were collected for all participating children,and multivariate logistic regression analysis was employed to identify risk factors for comorbid asthma in children with ADHD.RESULTSSignificant differences were detected between the ADHD group and the control group in terms of family history ofasthma and allergic diseases, maternal complications during pregnancy, maternal use of asthma and allergymedications during pregnancy, maternal anxiety and depression during pregnancy, and parental relationshipstatus (P < 0.05). Out of the 183 children in the ADHD group, 25 had comorbid asthma, resulting in a comorbidityrate of 13.66% (25/183), compared to the comorbidity rate of 2.91% (16/549) among the 549 children in the controlgroup. The difference in the asthma comorbidity rate between the two groups was statistically significant (P <0.05). The results of the multivariate logistic regression analysis indicated that family history of asthma and allergicdiseases, maternal complications during pregnancy, maternal use of asthma and allergy medications duringpregnancy, maternal anxiety and depression during pregnancy, and parental relationship status are independentrisk factors increasing the risk of comorbid asthma in children with ADHD (P < 0.05).CONCLUSIONChildren with ADHD were more likely to have comorbid asthma than healthy control children were. A familyhistory of asthma, adverse maternal factors during pregnancy, and parental relationship status were identified asrisk factors influencing the comorbidity of asthma in children with ADHD. Clinically, targeted interventions basedon these factors can be implemented to reduce the risk of comorbid asthma. This information is relevant for resultssections of abstracts in scientific articles.

Effectiveness of psychosocial intervention for internalizing behavior problems among children of parents with alcohol dependence:Randomized controlled trial

BACKGROUND Parental drinking has a direct bearing on children.Behavioral problems such as anxiety and depression are common problems among children whose parents drink heavily.Psychosocial interventions have shown promising results for anxiety and depression among children;however,few studies have been conducted in the context of children of parents with alcohol dependence in India.AIM To evaluate the efficacy of psychosocial intervention for internalizing behavioral problems among children of parents with alcohol dependence.METHODS A randomized controlled trial with a 2×4 factorial design was adopted with longitudinal measurement of outcomes for 6 mo.Two-hundred and eleven children who met the eligibility criteria(at least one parent with alcohol dependence)at government high schools in Bangalore,India,were randomized to the experimental(n=97)or control group(n=98).The psychosocial intervention was administered to the experimental group in eight sessions(biweekly)over 4 wk after baseline assessment.The intervention focused on identifying and modifying negative thoughts,replacing thinking errors with realistic alternatives,modification of maladaptive behavior,developing adaptive coping skills and building self-esteem.The data was collected pre-intervention and at 1,3 and 6 mo after the intervention.Data were analyzed using SPSS 28.0 version.RESULTS Mean age of the children was 14.68±0.58 years,60.5%were male,56%were studying in 9th standard,70.75%were from nuclear families,and mean family monthly income was 9588.1±3135.2 INR.Mean duration of parental alcohol dependence was 7.52±2.94 years and the father was the alcohol-consuming parent.The findings showed that there were significant psychosocial intervention effects in terms of decreasing anxiety and depression scores,and increasing selfesteem level among experimental group subjects over the 6-mo interval,when compared with the control group(P<0.001).CONCLUSION The present study demonstrated that the psychosocial intervention was effective in reducing anxiety and depression,and increasing self-esteem among children of parents with alcohol dependence.The study recommends the need for ongoing psychosocial intervention for these children.

Review of the effects of SARS-CoV2 infection and COVID-19 on common pediatric psychiatric illnesses

Severe acute respiratory syndrome coronavirus-2 is a novel coronavirus strain that causes pneumonia and acute respiratory distress syndrome along with other morbidities,collectively known as coronavirus disease 2019(COVID-19)disease.There has been widespread discussion about the psychological impact of COVID-19 particularly on children and adolescents.There have been overarching negative effects with regards to decreased physical activity,more screen time,increasingly unhealthy diets,and irregularities in sleep/wake schedules.This,coupled with disruptions in ongoing mental health treatment and associated support structures,has caused unprecedented declines in the emotional and psychosocial wellbeing of children and adolescents.This review aims to systematically review the literature to provide a general overview of the ways in which COVID-19 has affected common psychiatric illnesses in children and adolescents.The included articles in all subsections concluded that symptoms of these common childhood psychiatric disorders have generally been exacerbated by the COVID-19 pandemic.This review indicates that quarantine and the consequent isolation have had multiple significant and consistent negative implications on the mental health of children and adolescents.Our study indicates that there should be increased vigilance among providers and families to mitigate the negative psychological effects that the COVID-19 pandemic has on children with common childhood psychiatric disorders.

Stressful life events and psychosocial correlates of pediatric inflammatory bowel disease activity

AIM To investigate the association of psychiatric and psychosocial correlates with inflammatory bowel disease(IBD) activity in children and adolescents.METHODS A total of 85 pediatric IBD patients(in remission or active state of the disease) and their parents completed a series of questionnaires and semi-structured interviews measuring life events,depression,anxiety,family dysfunction,and parent mental health.Differences between the remission and the IBD active group and the association of any significant variable with the disease activity state were examined.RESULTS Parents of children being in active state of the disease reported more life events(P = 0.005) and stressful life events(P = 0.048) during the past year and more mental health symptoms(P < 0.001),while the childrenthemselves reported higher levels of anxiety symptoms(P = 0.017) compared to the remission group.In the logistic regression multivariate analysis,the only predictor which had a significant positive effect on the probability of the patients being in active state was parent mental health symptoms(OR = 4.8;95%CI:1.2-25.8).CONCLUSION Life events,child anxiety and parent mental health symptoms may be important correlates of pediatric IBD activity and targets of thorough assessment and treatment.

人工智能在儿童青少年焦虑和抑郁中应用的Scoping综述

目的系统综述人工智能在儿童青少年焦虑和抑郁中的应用。方法检索2014年1月至2024年1月PubMed、Web of Science、中国知网和万方数据库中人工智能与儿童青少年焦虑和抑郁相关文献,进行Scoping综述。结果最终纳入10篇文献,来自美国、中国、澳大利亚和法国,主要来源于心理学、公共卫生、临床医学、神经科学、康复等领域的期刊,涉及6项横断面研究、3项纵向研究和1项访谈研究,包括10880例参与者,年龄3~18岁。数据类型主要包括问卷/量表、访谈数据和脑成像数据。从数据中提取与焦虑、抑郁相关的特征,使用人工智能技术建立模型,以识别或预测儿童青少年焦虑和抑郁。结论人工智能在识别或预测儿童和青少年焦虑和抑郁方面具有潜在的价值和应用前景。

混合性焦虑抑郁障碍服务质量情感主题识别研究

[目的/意义]为识别在线医疗社区中混合性焦虑抑郁障碍患者评论医疗服务质量情感及主题,提出一种基于CNN-BiLSTM和LDA模型的服务质量情感主题识别模型。[方法/过程]首先,构建CNN-BiLSTM模型提取患者评论内外关键特征得到情感倾向分布;其次,运用LDA主题模型提取患者正负向评论主题,结合《医院评价标准(征求意见稿)》得到医疗服务质量主题,从分布和情感词对正负向服务质量进行挖掘。[结果/结论]CNN-BiLSTM的F1值为94.43%,均优于其他对比模型;结合LDA主题模型和相关文献得到5维医疗服务质量主题及分布;根据主题情感词及分布得到负向评论产生的主要原因,为识别和改善医疗服务质量提供有效决策支持。

基于跨理论模型的护理管理对吻合器痔上黏膜环切术后混合痔患者疼痛、心理和康复质量的影响

目的 探讨基于跨理论模型的护理管理对混合痔患者采用吻合器痔上黏膜环切术(PPH)后疼痛、心理及康复质量的影响。方法 前瞻性纳入2019年1月至2022年12月安徽省亳州市人民医院采用PPH进行治疗的混合痔患者120例。采用随机数字法将其分为对照组和观察组,各60例。对照组采用常规专科护理,观察组应用基于跨理论模型的护理管理。比较两组术后12、24 h和48 h视觉模拟评分法(VAS)评分,比较两组术前,术后3、7 d的焦虑自评量表(SAS)和抑郁自评表(SDS),康复质量(术后首次排尿时间和持续时间、首次排便时间和持续时间、肛门创缘水肿和便血评分及便秘发生率)。结果 整体分析发现:两组VAS评分组间、时间点比较差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:两组术后24、48 h的VAS评分低于术后12 h,术后48 h的VAS评分低于术后24 h,差异有统计学意义(P<0.05);组间比较,观察组术后12、24、48 h的VAS评分均低于对照组,差异有统计学意义(P<0.05)。整体分析发现:两组SAS、SDS评分组间、时间点及交互作用比较,差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:术后3、7 d的SAS、SDS评分低于术前,术后7 d的SAS、SDS评分低于术后3 d,差异有统计学意义(P<0.05);组间比较,观察组术后3、7 d的SAS、SDS评分均低于对照组,差异有统计学意义(P<0.05)。观察组首次排尿时间和持续时间、首次排便时间和持续时间短于对照组,水肿和便血评分低于对照组,便秘发生率低于对照组,差异有统计学意义(P<0.05)。结论 基于跨理论模型的护理管理能够进一步减轻混合痔患者PPH术后的疼痛体验,降低焦虑和抑郁风险,改善康复质量,是一种新型优质护理模式,值得推广应用。

谓葆颗粒联合培菲康治疗小儿功能性腹痛临床疗效及对焦虑抑郁情绪的影响

目的探讨功能性腹痛患儿应用谓葆颗粒联合培菲康治疗的疗效及对患儿焦虑抑郁情绪影响。方法共计纳入102例功能性腹痛患儿(2019年3月—2023年9月入住湖北省妇幼保健院儿童消化内科),以随机数字表法分为观察组、对照组,每组51例。对照组患儿采取培菲康治疗,观察组患儿采取谓葆颗粒联合培菲康治疗。2组患儿治疗前后的结果,包括:疗效、腹痛及食欲不振、面色苍白等症状消失时间、儿童焦虑性情绪障碍筛查量表(SCARED)、儿童抑郁障碍自评量表(DSRSC)评分、不良反应。结果对照组与观察组患儿总有效率分别为84.31%、96.08%,观察组有效率高于对照组(P<0.05);观察组患儿腹痛及食欲不振、面色苍白等症状消失时间分别为(7.86±1.96)d、(4.95±0.38)d、(3.89±0.47)d,均短于对照组患儿[(10.45±1.15)d、(5.72±0.62)d、(5.10±0.38)d,P<0.05];治疗后观察组患儿SCARED及DSRSC评分分别为(10.15±1.52)分、(9.45±1.07)分,均低于对照组患儿[(17.49±2.95)分、(14.23±1.87)分,P<0.05];对照组与观察组患儿不良反应发生率分别为3.92%、1.96%,差异无统计学意义(P>0.05)。结论谓葆颗粒联合培菲康治疗小儿功能性腹痛临床疗效良好,患儿恢复快,还可较好改善患儿不良情绪,不良反应发生率较低,安全可靠。

6~24岁超重/肥胖儿童青少年抑郁及焦虑症状检出率Meta分析

目的 评估6~24岁超重/肥胖儿童青少年抑郁及焦虑症状检出率。方法 系统检索中国知网、万方数据、重庆维普、中国生物医学文献数据库和PubMed,搜集有关超重/肥胖儿童青少年抑郁及焦虑症状检出率的文献,检索时限均由建库至2022年12月。由2位研究者独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Stata 14.0软件进行Meta分析。结果 超重/肥胖儿童青少年中,抑郁及焦虑症状的总体检出率分别为21%(95%CI:17%~25%,I2=95.8%)和20%(95%CI:13%~27%,I2=96.7%);超重/肥胖儿童青少年比非超重/肥胖儿童青少年更有可能有抑郁症状(OR=1.62,95%CI:1.25~2.10,P<0.05)和焦虑症状(OR=2.13,95%CI:1.11~4.10,P<0.05)。结论 抑郁及焦虑症状在超重/肥胖儿童青少年中较常见,超重/肥胖儿童青少年有较高的抑郁及焦虑风险。为了减少抑郁及焦虑风险,应定期进行有效筛查和干预。

综合医院儿童精神科联络会诊中躯体化症状障碍患儿焦虑症状、抑郁症状和自我意识的分析

目的探讨综合医院儿童精神科联络会诊中躯体化症状障碍(SSD)患儿的焦虑症状、抑郁症状和自我意识及其影响因素。方法选取83例SSD患儿作为研究对象,依据症状表现分为神经系统症状组(n=44)和消化系统症状组(n=39)。比较两组焦虑症状、抑郁症状和自我意识,应用多因素Logistic回归模型分析SSD患儿自我意识的影响因素。结果神经系统症状组的儿童焦虑性情绪障碍筛查量表总分、社交恐怖因子分和学校恐怖因子分均高于消化系统症状组,消化系统症状组儿童自我意识量表的焦虑因子分高于神经系统症状组(均P<0.05)。多因素Logistic回归模型分析结果显示,人际关系、独生子女、焦虑症状、抑郁症状均是SSD患儿自我意识的影响因素(均P<0.05)。结论综合医院儿童精神科联络会诊中不同症状表现的SSD患儿的焦虑症状和自我意识水平不同,患儿的自我意识跟人际关系、是否独生子女、焦虑症状和抑郁症状均有关,对SSD患儿的治疗应更多关注其情绪状态,提高其自我意识。

累积生态风险与留守儿童心理健康:应对方式的中介作用和积极心理资本的调节作用

目的:探讨累积生态风险对留守儿童心理健康的影响及内在作用机制。方法:采用累积生态风险量表、消极应对方式量表、积极心理资本量表及抑郁-焦虑-压力量表,对5所乡村中小学共905名留守儿童进行调查。结果:①累积生态风险正向预测留守儿童抑郁-焦虑-压力水平(β=0.15,P<0.001);②消极应对方式在累积生态风险对留守儿童抑郁-焦虑-压力的影响中起部分中介作用(β=0.59,95%CI=0.50~0.61),中介效应值是0.05;③积极心理资本在消极应对方式对留守儿童抑郁-焦虑-压力的影响中起调节作用(β=-0.06,P<0.05),即消极应对方式对高/低积极心理资本留守儿童的影响作用均显著,但相比积极心理资本水平高的个体,消极应对方式对低积极心理资本留守儿童抑郁-焦虑-压力的影响更大。结论:降低留守儿童消极应对方式、提高积极心理资本可有效预防抑郁-焦虑-压力发生。

家庭跟进式护理结合全人照护管理改善肺炎患儿情绪及睡眠质量的研究

目的:分析探讨家庭跟进式护理结合全人照护管理对肺炎患儿情绪及睡眠的影响,为提高患儿的心理健康与睡眠质量提供参考。方法:选取2022年5月至2023年5月厦门大学附属第一医院收治的肺炎患儿80例作为研究对象,按照随机数字表法分为对照组和观察组,每组40例。对照组给予常规护理干预,观察组给予家庭跟进式护理结合全人照护管理。采用匹兹堡睡眠质量指数(PSQI)比较2组患儿睡眠质量的差异,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)比较2组患儿焦虑、抑郁症状改善情况,采用健康调查简表(SF-36)比较2组患儿干预前后生命质量的变化。结果:干预后,观察组患儿的PSQI评分、SAS评分、SDS评分均显著低于对照组,观察组SF-36评分显著高于对照组,差异均有统计学意义(均P<0.05)。结论:家庭跟进式护理结合全人照护管理能够有效改善肺炎患儿的情绪状态与睡眠质量,提高其生命质量,值得在临床实践中推广应用。

动机性访谈在反复喘息患儿照护者心理疏导及家庭照护中的应用

目的探讨动机性访谈在反复喘息患儿照护者的心理健康疏导及管控能力中的应用效果。方法选取2023年5月至2024年5月杭州市儿童医院接诊的反复喘息患儿照护者120名,采用随机数字表法分为对照组和观察组,每组60名。对照组患儿照护者采用常规方式进行知识培训和健康宣教,观察组在对照组基础上采用动机性访谈。比较两组干预前后患儿喘息控制水平与患儿照护者的焦虑、抑郁程度、家庭管理测量量表各维度评分及满意度。结果干预后观察组患儿喘息再发次数低于对照组,差异有统计学意义(P<0.05)。两组患儿照护者家庭管理量表评分干预前后比较,差异有统计学意义(P<0.05)。观察组患儿照护者满意度高于对照组,差异有统计学意义(P<0.05)。结论通过动机性访谈干预,可有效缓解反复喘息患儿的喘息次数,改善患儿家庭照护情况,降低患儿照护者的焦虑、抑郁情绪。

厦门市某精神专科医院儿童青少年患者的抑郁状况及影响因素分析

目的 探讨厦门市某精神专科医院儿童青少年患者的抑郁状况及其影响因素,为提升儿童青少年的心理健康状况提供思路与方法。方法 选取2019年7月至2023年9月就诊于厦门市仙岳医院的儿童青少年患者2 400例,进行回顾性研究,要求儿童青少年患者已在该院心理测评室同时完成儿童抑郁情绪障碍量表、儿童社交焦虑量表、儿童焦虑情绪障碍筛查量表和90项症状清单。结果 儿童青少年的抑郁情绪障碍检出率为85.33%(2 048/2 400)。其中,有抑郁症状的女生比例高于男生,有抑郁症状的初中生或高中生比例高于小学生,差异均有统计学意义(P<0.05)。焦虑症状[比值比(OR)=3.597,95%可信区间(95%CI)2.548~5.078]、社交焦虑症状(OR=2.819,95%CI 1.995~3.982)、强迫症状(OR=1.643,95%CI 1.083~2.494)、敌对(OR=1.670,95%CI 1.147~2.431)和饮食、睡眠问题(OR=4.375,95%CI 2.873~6.664)是儿童青少年患者出现抑郁症状的危险因素。结论 存在焦虑症状、社交焦虑症状、强迫症状、敌对和饮食、睡眠问题会增加儿童青少年抑郁的风险。

分析数字疼痛量化联合提肛运动对混合痔术后患者睡眠质量的改善作用

目的:观察对混合痔手术患者护理过程中开展数字疼痛量化护理联合提肛运动对于患者疼痛程度以及睡眠质量的改善作用。方法:选取2021年1月至2023年1月邵武市立医院收治的混合痔手术患者80例作为研究对象,按照随机数字表法分为对照组和观察组,每组40例。对照组给予常规护理干预,观察组给予数字疼痛量化护理联合提肛运动干预。采用数字模拟评分法(NRS)比较2组患者的疼痛感受,采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后的睡眠质量,针对患者在恢复期间肛管最大收缩压、肛管最大收缩长度以及肛管静压进行测量,以肛肠压力检测评估肛门功能,采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)比较2组患者干预前后焦虑、抑郁状态的改善效果。结果:干预后,观察组PSQI评分、HAMA评分、HAMD评分、NRS评分均显著低于对照组,观察组最大收缩压、肛管最大收缩长度以及肛管静压均显著高于对照组,差异均有统计学意义(均P<0.05)。结论:在对混合痔手术患者护理过程中开展数字疼痛量化护理联合提肛运动,可以降低患者术后的疼痛程度,提升患者的睡眠质量,改善患者肛门功能,缓解患者负面情绪,有助于患者恢复,值得临床推广应用。

癫痫患儿家长焦虑、抑郁现状调查及其影响因素分析

目的:了解癫痫患儿家长的焦虑、抑郁现状并分析其影响因素。方法:采用一般情况问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)对2011年5-10月在某儿童医院神经内科就诊或住院的癫痫患儿父亲或母亲共104名进行问卷调查。结果:癫痫患儿家长SAS总得分为(49.41±6.99)分;SDS总得分为(59.68±8.47)分;家长学历和服药疗程知识是家长焦虑的影响因素,家长学历是家长抑郁的影响因素。结论:癫痫患儿家长存在焦虑和抑郁的心理问题,家长学历和服药疗程知识是其焦虑或抑郁的影响因素,可以通过加强对家长进行健康教育、改善患儿治疗效果来改善癫痫患儿家长的心理状况。

流动儿童压力应对方式与抑郁感、社交焦虑的关系:一项追踪研究

为了探讨流动儿童压力应对方式与抑郁感、社交焦虑的变化特点及其动态关系,本研究通过整群抽样法从5所北京市公立学校和1所打工子弟学校选取1164名流动儿童,采用问卷调查的形式对其进行为期一年的追踪测查,追踪时回收有效数据680份。对前、后测均参加调查的680名被试的数据进行分析,结果发现:(1)经过一年的城市适应,流动儿童整体的积极应对增多,消极应对减少,抑郁感下降,但社交焦虑水平无明显变化;(2)流动儿童个体在压力应对、抑郁感、社交焦虑的发展上均表现出两极分化的现象,年龄越小、来京时间越短、低年级及女生流动儿童群体的发展趋势更为良好;(3)流动儿童压力应对方式与抑郁感、社交焦虑间存在相互作用的动态关系,前测压力应对方式、抑郁感、社交焦虑均能显著预测后测相应变量的水平,前后测压力应对方式对抑郁感、社交焦虑均有即时预测作用,而前测抑郁感和社交焦虑对后测压力应对方式有不同的延时性影响。

儿童混合性焦虑抑郁障碍微量生物电脑导入刺激治疗结果

目的分析儿童混合性焦虑抑郁障碍微量生物电脑导入刺激（Cranial electrotherapy stimulation简称CES）治疗结果。方法将经宗氏抑郁自评量表（SDS）和宗氏焦虑自评量表（SAS）评分均大于40分,符合ICD-10混合性焦虑抑郁障碍的特点的门诊8-16岁初诊儿童30例作为实验组,予CES治疗;将南京市中小学老师推荐的,以同样方法筛选的30例儿童作为对照组,予象征性地CES治疗,2组儿童均接受3个疗程的规范化治疗,3个疗程结束时复查SAS和SDS量表,比较3组疗效、副反应,同时比较治疗前后脑电地形图变化。结果SDS总分：治疗前实验组49.60±7.03,对照组47.23±5.86。SAS：治疗后实验组34.08±7.79,对照组46.83±10.35。SAS总分：治疗前实验组48.27±7.01,对照组46.03±6.24;治疗后实验组29.67±6.03,对照1组39.17±12.73。方差分析显示实验组有明显效果。实验组枕区α1、α2有明显改变。结论CES治疗儿童混合性焦虑抑郁障碍安全有效,脑电地形图枕区α频带功率值有变化。

困境儿童孤独与社交焦虑对抑郁的影响——自尊的中介作用

为探讨困境儿童孤独、社交焦虑、抑郁和自尊的现状、特点、关系以及自尊在其中的中介作用,进而为困境儿童心理帮扶及救助提供依据。本研究使用儿童抑郁障碍自评量表、儿童孤独量表、儿童社交焦虑量表和自尊量表对重庆市17个区县1733名困境儿童进行调查。结果发现:(1)抑郁、社交焦虑和自尊存在性别差异,抑郁、孤独、社交焦虑和自尊存在年龄差异;(2)孤独和社交焦虑与抑郁呈显著正相关并显著预测抑郁,自尊与抑郁呈显著负相关并显著预测抑郁。(3)困境儿童的自尊在孤独和抑郁之间,社交焦虑和抑郁之间起中介作用。结果表明:困境儿童的孤独、社交焦虑既可直接影响其抑郁水平,也可通过自尊的中介作用间接影响其抑郁水平。