中国5省在校中学生自杀行为流行状况及其与抑郁、焦虑关联  

Prevalence of and impact of depression and anxiety on suicidal behaviors among high school students:a cross-sectional survey in five provinces,China

作　　者：汪妍 彭畅 程君菡 荣发娟 胡婕 徐紫萱 关美琪 张楠 余毅震[1] WANG Yan;PENG Chang;CHENG Junhan;RONG Fajuan;HU Jie;XU Zixuan;GUAN Meiqi;ZHANG Nan;YU Yizhen(Department of Maternal and Child Health,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]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,武汉430030

出　　处：《中国公共卫生》2023年第10期1225-1231,共7页Chinese Journal of Public Health

基　　金：国家自然科学基金(81973066);国家自然科学基金(82173541)。

摘　　要：目的了解中国中学生自杀行为和抑郁、焦虑情绪的发生情况,分析抑郁、焦虑情绪与不同阶段自杀行为的关联性。方法于2021年4-12月,采用多阶段分层整群抽样方法,对江苏、广东、云南、甘肃、湖北5个省份共计20792名11~20岁在校中学生通过问卷调查其自杀行为(包括自杀意念、自杀计划和自杀未遂)、抑郁、焦虑情绪及个人基本情况。结果中学生中有自杀行为者占比为23.54%,其中自杀意念者、自杀计划者、自杀未遂者占比分别为10.41%、8.03%、5.10%。抑郁、焦虑情绪检出率分别为19.70%、13.97%。其中,农村女生抑郁、焦虑情绪检出率均最高,分别为27.86%、19.43%。城市女生自杀意念(OR=1.73,95%CI=1.52~1.97)、自杀计划(OR=1.79,95%CI=1.53~2.08)、自杀未遂(OR=1.69,95%CI=1.40~2.04)的风险均高于城市男生;农村女生自杀意念(OR=1.68,95%CI=1.47~1.92)、自杀计划(OR=1.67,95%CI=1.43~1.95)、自杀未遂(OR=1.47,95%CI=1.22~1.78)的风险也均高于城市男生。抑郁、焦虑情绪与不同阶段自杀行为的关联强度均不同。自杀未遂阶段与抑郁(OR=5.99,95%CI=5.00~7.16)、焦虑(OR=3.37,95%CI=2.82~4.03)情绪的关联强度更强。结论抑郁、焦虑情绪均是我国在校中学生不同阶段自杀行为的危险因素。在制定预防和干预青少年心理行为问题措施时,应注意性别和城乡差异。Objective To investigate the prevalence of suicidal behaviors,depressive emotion and anxious emotion and the associations of depressive/anxious emotion with suicidal behaviors among high school students in China.Methods An on-site self-administered questionnaire survey was conducted among 21207 students recruited with stratified multistage cluster sampling at 40 high schools in five representative provinces(Jiangsu,Guangdong,Yunnan,Gansu,and Hubei province)of China during April–December 2021.The Patient Health Questionnaire-9(PHQ-9),Generalized Anxiety Disorder-7(GAD-7),and a self-designed questionnaire were used to assess the participants′depressive and anxious emotion and to collect demographics and other relevant information of the participants.Results Of 20792 students(10319 males and 10473 females aged 11–20 years and averagely 15.16±1.87 years)with eligible responses,23.54%reported ever having suicidal behaviors during past one year,with 10.41%,8.03%,and5.10%reporting experience of suicidal ideation,plan,and attempt during past one year,respectively.For all the eligible respondents,the detection rate of depressive and anxious emotion were 19.70%and 13.97%and the highest proportion of having depressive and anxious emotion(27.86%and 19.43%)were detected among rural girl students.The results of multivariate logistic regression analysis showed that compared to urban boy students,both urban and rural girl students were at an increased risk of having suicidal behavior during past one year,with the odds ratio(OR)(95%confidence interval[95%CI])for urban and rural girl students in terms of suicidal ideation:1.73(1.52–1.97)and 1.68(1.47–1.92),suicidal plan:1.79(1.53–2.08)and 1.67(1.43–1.95),and suicidal attempt:1.69(1.40–2.04)and 1.47(1.22–1.78),respectively;the results also revealed significantly positive correlations of depressive and anxious emotion with suicidal behaviors among the students and the correlation of depressive emotion(OR=5.99,95%CI:5.00–7.16)and anxious emotion(OR=3.37,95%CI:2.8

关 键 词：抑郁 焦虑 自杀行为 在校中学生 

分 类 号：R179[医药卫生—妇幼卫生保健]