上海市非毕业班中学生7978名焦虑障碍筛查及危险因素分析

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目的 评估上海市非毕业班中学生焦虑情绪状态并分析中学生焦虑障碍的影响因素.方法 选用自编基本人口学资料、长处与困难问卷、儿童焦虑性情绪障碍筛查量表对上海市24所中学的非毕业班学生进行调查.选取长处与困难问卷及儿童焦虑性情绪障碍筛查量表得分同时高于临界值的青少年进行简明儿童少年国际神经精神访谈的访谈评估.根据访谈结果,对符合DSM-Ⅳ中焦虑障碍诊断标准的学生焦虑障碍的相关因素进行分析.采用Logistic回归分析焦虑障碍的危险因素.结果 共7978名上海市非毕业班中学生参与调查.127例学生诊断为焦虑障碍,患病率为1.59%.其中,男生患病率为1.59%(63/3970),女生患病率为1.60%(64/4008),男女生之间的比较差异无统计学意义(x2=0.00,P=1.00).初中学生患病率为1.42%(59/4164),高中学生患病率为1.78%(68/3814),初中与高中生之间比较差异无统计学意义(x2=1.70,P=0.21).Logistic回归显示焦虑障碍的保护因素为性格中等(B=-0.72,P=0.00)、主动寻求帮助(B=-0.68,P=0.02; B=-0.87,P=0.00; B=-1.07,P=0.00)、自信心较高(B=-1.37,P=0.00; B=-2.21,P=-0.00)和自我价值水平中等(B=-0.60,P=0.01);而焦虑障碍的危险因素则为BMI指数较高(B=0.04,P=0.05)、受到过暴力虐待(B=0.88,P=0.00)、失去过朋友亲人(B=0.90,P=0.00).结论 上海市非毕业班中学生焦虑障碍患病率相对较低,焦虑障碍的主要危险因素为BMI指数较高、受到过暴力虐待、失去过朋友亲人.“,”Objective To evaluate the anxiety status of non-graduated students in Shanghai middle school.To find out the affecting factors of the anxiety disorders in middle school students.Methods The general situation questionnaire,Strength and Difficulty Questionnaire (SDQ),the Screen for Child Anxiety Related Emotional Disorders (SCARED),were used to select the students with anxiety disorders in Shanghai 24 middle schools.High-risk students with anxiety disorders were selected by virtue of having a SDQ total difficulties score and a SCARED total score higher than the delimitation value.The high-risk students with anxiety and depressive disorders were further assessed with the Mini International Neuropsychiatric Interview for Children and Adolescents(MINI KID) interview.According to the results of the MINI KID interview,we found the students with anxiety disorders,and analyzed the data to find out their features.Results 7 978 students were involved in this survey.127 students were diagnosed to be anxiety disorders.The prevalence of non-graduated students with anxiety disorders in Shanghai middle school was 1.59%.The prevalence of male students with anxiety disorders was 1.59% (63/3 970),the prevalence of female students with anxiety disorders was 1.60%(64/4008),there was no significant difference between male and female students(x2=0.00,P=1.00).The prevalence of junior high school students with anxiety disorders was 1.42% (59/4 164),the prevalence of senior high school students with anxiety disorders was 1.78%(68/3 814),there was no significant difference between junior high school students and senior high school students (x2=1.70,P=0.21).Logistic regression was done with the basic demographic data.It was found out that,the protective factors of anxiety disorder were gentle personality (B=-0.72,P=0.00),seeking for help (B=-0.68,P=0.02;B=-0.87,P=0.00; B=-1.07,P=0.00),high self-confidence (B=-1.37,P=0.00; B=-2.21,P=0.00) and moderate self-worth (B=-0.60,P=0.01),while the risk factors were obesity (B=0.04,P=0.05),had been abused (B=0.88,P=0.00),and had lost relatives and friends (B=0.90,P=0.00).Conclusions The prevalence of non-graduated students with anxiety disorders in Shanghai middle school may be relatively low and the risk factors of anxiety disorders including obesity,being abused,and lost of relatives and friends.
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