农村青少年童年期虐待与自杀行为的关联  

Association between childhood maltreatment and suicide among rural adolescents

作　　者：张艳梅 余毅震[2] 唐杰 康纯 荣发娟 杨海军 杨旻 魏沙 ZHANG Yanmei;YU Yizhen;TANG Jie;KANG Chun;RONG Fajuan;YANG Haijun;YANG Min;WEI Sha(Department of Preventive Medicine,College of Basic Medicine,Hubei University of Chinese Medicine,Wuhan(430065),China;不详)

机构地区：[1]湖北中医药大学基础医学院,武汉430065 [2]华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系 [3]广州医科大学公共卫生学院预防医学系

出　　处：《中国学校卫生》2021年第11期1650-1654,共5页Chinese Journal of School Health

基　　金：国家自然科学基金项目(NSFC-81903349);湖北中医药大学青苗计划项目(2020ZZX025)。

摘　　要：目的探讨童年期虐待与青少年自杀行为的关联,为制定自杀预防策略提供科学依据。方法采用多阶段分层整群随机抽样方法,从安徽、广东、云南、黑龙江和湖北农村地区共纳入16 271名中学生。采用结构化问卷收集研究对象一般情况、童年期忽视、虐待情况以及调查前1年内的自杀意念、自杀计划、自杀未遂情况,运用多因素Logistic回归模型分析童年期忽视、虐待与自杀意念、自杀计划和自杀未遂的关联。结果农村青少年自杀意念、自杀计划和自杀未遂的发生人数分别为2 453(15.1%)、1 164(7.2%)和572(3.5%)人,童年期忽视、中度和重度躯体虐待的发生人数分别为10 756(66.1%),4 311(26.5%)和703(4.3%)人。单因素分析显示,童年期忽视、虐待与自杀意念、自杀计划、自杀未遂相关均有统计学意义(P值均<0.05)。在控制年龄、性别、独生子女、父母文化程度、经济收入、情绪管理和社会支持因素后,童年期忽视、虐待与自杀意念、自杀计划、自杀未遂差异均有统计学意义(OR=1.62~5.14,P值均<0.05),其中重度躯体虐待的OR值(95%CI)分别为3.00(2.49~3.62),3.52(2.81~4.40),5.14(3.87~6.83)。结论童年期忽视和虐待可能会增加农村青少年自杀行为发生风险,应积极采取有效措施减少童年期忽视虐待,预防自杀。Objective This study explored the relationship between childhood maltreatment and adolescent suicide provides a scientific basis for suicide prevention strategies. Methods A total of 16 271 middle and high school students from rural areas in Anhui, Guangdong, Yunnan, Heilongjiang and Hubei provinces were enrolled through multi-stage stratified cluster random sampling. Structured questionnaires were used to collect information on participants’ general information, childhood neglect, abuse, suicide ideation, suicide plans and suicide attempts in the 12 months prior to the survey. Multivariate Logistic regression models were used to analyze the associations of childhood neglect and childhood maltreatment with suicide ideation, suicide plans and suicide attempts. Results The number of suicide ideations, suicide plans and suicide attempts among rural adolescents were 2 453(15.1%), 1 164(7.2%) and 572(3.5%), respectively. The number of cases of childhood neglect, moderate physical abuse and severe physical abuse were 10 756(66.1%), 4 311(26.5%) and 703(4.3%), respectively. Univariate analysis showed that childhood neglect and abuse were significantly associated with suicide ideation, suicide plans and suicide attempts(P<0.05). After controlling for age, gender, only children, parental education level, income, emotional management and social support, childhood neglect and abuse remained significantly correlated with suicide ideation, suicide plans and suicide attempts(OR=1.62-5.14,P<0.05);the OR(OR 95%CI) for severe physical abuse were 3.00(2.49-3.62), 3.52(2.81-4.40),5.14(3.87-6.83) respectively. Conclusion Childhood neglect and abuse may increase the risk of suicide among adolescents in rural China, and effective measures should be taken to reduce childhood neglect and abuse and prevent suicide.

关 键 词：虐待儿童 自杀 精神卫生 回归分析 青少年 农村人口 

分 类 号：G479[文化科学—教育学] B844.2[文化科学—教育技术学]