重点高中学生强迫症状流行特征及其与抑郁和焦虑的关系  

Prevalence of obsessive-compulsive symptoms and its relationship with depression and anxiety symptoms among students of key high schools

作　　者：杨巧红[1] 王君[1] 刘乃鹏[2] 刘晓宇[2] 张洪波[1] 

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,合肥230032 [2]安徽医科大学公共卫生学院流行病与卫生统计学系

出　　处：《中国学校卫生》2016年第11期1607-1610,共4页Chinese Journal of School Health

基　　金：国家自然科学基金项目(81402698);安徽高校省级自然科学重点项目(KJ2011A156)

摘　　要：目的了解重点高中生强迫症状流行特征及其与抑郁、焦虑症状的关系,为在重点高中生中开展心理健康促进提供依据。方法采用分层整群抽样的方法对安徽省南部、中部、北部6所重点高中学校1 943名学生进行问卷调查,以耶鲁布朗强迫量表（Y-BOCS）、焦虑自评量表（SAS）和流调用抑郁自评量表（CES-D）进行心理健康评定。结果以Y-BOCS≥16分界定为有强迫症状,共检出有强迫症状者337人,检出率为17.3%。强迫症状学生中,既有强迫思维又有强迫行为者占66.2%,以强迫思维为主和以强迫行为为主者分别占19.0%和14.8%;强迫思维中居前2位的症状为怕伤害和怕污染,强迫行为居前2位的症状为检查和清洗。在有强迫症状的学生中,同时合并抑郁和焦虑症状者占17.5%,仅合并抑郁症状占45.1%,仅合并焦虑症状占2.7%。学习成绩中等及以下的学生强迫症状检出率分别高于学习成绩中等以上者（4.5%）,差异有统计学意义（χ~2=10.011,P〈0.05）。有抑郁症状和有焦虑症状的学生发生强迫症状的危险性分别增加到约3倍和2倍（OR=3.11,95%CI=2.40~4.03;OR=2.07,95%CI=1.45~2.94）。结论强迫症状与抑郁和焦虑症状相互作用严重危害学生的心理健康,因此,学校和家长需要提高对青少年强迫症状的认识,促进强迫症状早期发现和及时干预。Objective To investigate the prevalence of obsessive-compulsive symptoms（ OCS） and to examine its relationship with depression and anxiety symptoms, and to provide references for development of psychological health of students in key high schools. Methods A total of 943 students were selected from 6 key high schools in south,central and north of Anhui province by stratified clustering sampling method. A questionnaire was used to survey implemented, including social demographic characteristics, Yale-Brown obsessive compulsive scale（ Y-BOCS）, Self-Rating Anxiety Scale（ SAS）, Center for Epidemiological Survey and Depression Scale（ CES-D）. Results Of participants, 337（ 17.3%） students had OCS with a score of Y-BOCS≥16. Students who had symptoms of both obsessive thoughts and compulsive behavior accounted for 66. 2%, those who had predominant symptoms of obsessive thoughts and compulsive behaviors accounted for 19. 0% and 14. 8% respectively. The top two symptoms of obsessive thoughts were the terror of being harmed and contaminated, and the symptoms of checking and cleaning ranked top two among compulsive behaviors symptoms accordingly. Of students with OCS, 17.5% had both depression and anxiety symptoms, 45.1% had depression and 2.7% had anxiety. The rates of OCS among students with poor academic records were significant higher than that among students with excellent academic records（ P〈0.05）. The risk of OCS among students who had depression and anxiety symptoms increased to about 3 times（ OR = 3.11,95%CI = 2.40-4.03） and 2 times（ OR = 2.07,95%CI = 1.45-2.94） respectively. Conclusion The OCS interacted with depression and anxiety symptoms seriously compromised the students＇ psychological well-being. The OCS should be recognized, detected early and should be promptly intervened in school and family.

关 键 词：强迫 抑郁 焦虑 精神卫生 学生 

分 类 号：R395.6[哲学宗教—心理学] R749.72[医药卫生—医学心理学]