Anxiety, depresson status of adolescent females and prediction of related influencing factors in Hunan Province
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摘要:
目的 探讨青春期女性焦虑、抑郁现状及其影响因子，为促进青春期女性身心健康提供依据。 方法 采用一般资料问卷、月经情况问卷、广泛性焦虑量表（generalized anxiety disorder-7，GAD-7）、病人健康问卷抑郁量表（patient health questionnaire-9，PHQ-9），对多阶段分层随机抽取的湖南省10~19岁青春期女性进行调查。 结果 共调查2 575名青春期女性。研究对象焦虑症状检出率为9.6%，抑郁症状检出率为16.4%。多因素Logistic回归分析结果显示对于整体青春期女性，未在校读书、未遭受过身体/精神暴力、较长的睡眠时间、月经未来潮是焦虑症状出现的保护因素，较高的文化程度是焦虑症状出现的危险因素；未在校读书、未遭受过身体/精神暴力、月经未来潮是抑郁症状出现的保护因素，较高的文化程度是抑郁症状出现的危险因素（均有P < 0.05）。对于月经已来潮的青春期女性，未在校读书、未遭受过身体/精神暴力、较长的睡眠时间、近6个月未出现痛经是焦虑/抑郁症状出现的保护因素，较高的文化程度、近6个月月经不规律是焦虑/抑郁症状出现的危险因素（均有P < 0.05）。 结论 湖南省青春期女性存在一定程度的焦虑、抑郁情绪问题，建议有针对性地加强高危人群的健康干预。 Abstract:Objective To explore the prevalence and influencing factors of anxiety and depression among adolescent females. Methods Adolescent females aged 10-19 years in Hunan Province were investigated by general information questionnaire, menstrual status questionnaire, generalized anxiety scale (GAD-7) and patient health questionnaire depression scale (PHQ-9). Results A total of 2 575 adolescent females were included. The prevalence of anxiety was 9.6%, while the prevalence of depression was 16.4%. Multivariate Logistic analysis showed that among the overall adolescent females, not studying at school, no physical/mental violence, longer average sleep time, no menarche were protective factors for anxiety while higher education level was risk factor; not studying at school, no physical/mental violence, no menarche were protective factors for depression while higher education level was risk factor (all P < 0.05). Among the adolescent females with menarche, not studying at school, no physical/mental violence, longer average sleep time, no dysmenorrhea in the past six months were protective factors for anxiety/depression while higher education level and irregular menstrual cycle in the past six months were risk factors (all P < 0.05). Conclusions There is a certain degree of anxiety and depression among adolescent females in Hunan Province. It is suggested that more interventions should be strengthened for high-risk groups. -
Key words:
- Adolescent females /
- Anxiety /
- Depression
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表 1 湖南省青春期女性焦虑、抑郁症状的单因素分析[n(%)]
Table 1. Univariate analysis of anxiety and depressionin among adolescent females in Hunan Province[n(%)]
项目 例数 焦虑症状 抑郁症状 例数 χ2值 P值 例数 χ2值 P值 民族 0.910 0.340 10.935 0.001 汉族 2 536(98.5) 242(9.5) 409(16.1) 少数民族 39(1.5) 6(15.4) 14(35.9) 在校读书 6.083 0.014 5.379 0.020 是 2 467(95.8) 245(9.9) 414(16.8) 否 108(4.2) 3(2.8) 9(8.3) 文化程度 122.408 0.001 179.170 0.001 小学及以下 941(36.5) 38(4.0) 66(7.0) 初中 742(28.8) 46(6.2) 94(12.7) 高中或中职 686(26.6) 126(18.4) 203(29.6) 大专及以上 206(8.0) 38(18.4) 60(29.1) 是否有兄弟姐妹 4.134 0.042 11.388 0.001 是 1 666(64.7) 175(10.5) 304(18.2) 否 909(35.3) 73(8.0) 119(13.1) 是否吸烟 3.909 0.048 3.317 0.069 是 23(0.9) 5(21.7) 7(30.4) 否 2 552(99.1) 243(9.5) 416(16.3) 是否饮酒 22.360 0.001 55.023 0.001 是 92(3.6) 22(23.9)41(44.6) 否 2 483(96.4) 226(9.1) 382(15.4) 是否遭受过身体/精神暴力 57.335 0.001 69.374 0.001 是 167(6.5) 44(26.3) 66(39.5) 否 2 408(93.5) 204(8.5) 357(14.8) 日平均睡眠时间(h) 79.490 0.001 63.526 0.001 ＜7 104(4.0) 36(34.6) 46(44.2) 7~ 2137(83.0) 190(8.9) 336(15.7) ≥9 334(13.0) 22(6.6) 41(12.3) 是否月经初潮 69.037 0.001 138.822 0.001 是 1 525(59.2) 208(13.6) 357(23.4) 否 1 050(40.8) 40(3.8) 66(6.3) 月经初潮年龄 7.778 0.034 8.496 0.014 偏早组 268(17.6) 37(13.8) 65(24.3) 居中组 1 024(67.1) 127(12.4) 221(21.6) 偏晚组 233(15.3) 44(18.9) 71(30.5) 月经是否规律 11.832 0.001 19.953 0.000 是 1 137(74.6) 135(11.9) 234(20.6) 否 388(25.4) 73(18.8) 123(31.7) 是否痛经 36.152 0.001 51.183 0.001 是 619(40.6) 124(20.0) 203(32.8) 否 906(59.4) 84(9.3) 154(17.0) 
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表 2 湖南省青春期女性焦虑、抑郁症状的多因素Logistic回归分析
Table 2. Multivariate Logistic regression analysis of influencing factors of anxiety and depression among adolescent females in Hunan Province
因素 β Wald值 OR(95% CI)值 P值 焦虑 未在校读书 -1.739 8.343 0.176(0.054~0.572) 0.004 文化程度 0.471 23.293 1.601(1.322~1.938) ＜0.001 未遭受过身体/精神暴力 -1.023 24.696 0.360(0.240~0.538) ＜0.001 日平均睡眠时间 -0.546 8.578 0.579(0.402~0.835) 0.003 月经未来潮 -0.497 4.449 0.608(0.383~0.965) 0.035 抑郁 未在校读书 -1.757 8.568 0.173(0.053~0.560) 0.003 文化程度 0.498 26.639 1.645(1.362~1.988) ＜0.001 未遭受过身体/精神暴力 -1.053 26.577 0.349(0.234~0.521) ＜0.001 月经未来潮 -0.561 5.703 0.571(0.360~0.904) 0.017
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表 3 湖南省青春期月经已来潮女性焦虑、抑郁症状的多因素Logistic回归分析
Table 3. Multivariate Logistic regression analysis of influencing factors of anxiety and depression among adolescent females with menarche in Hunan Province
因素 β Wald值 OR(95% CI)值 P值 焦虑 未在校读书 -1.562 6.715 0.210(0.064~0.684) 0.010 文化程度 0.474 20.289 1.606(1.307~1.975) ＜0.001 未遭受过身体/精神暴力 -1.017 21.581 0.362(0.235~0.555) ＜0.001 日平均睡眠时间 -0.600 8.493 0.549(0.366~0.822) 0.004 月经不规律 0.410 5.467 1.507(1.069~2.126) 0.019 近6个月未出现痛经 -0.681 17.945 0.506(0.369~0.693) ＜0.001 抑郁 未在校读书 -1.296 11.219 0.274(0.128~0.584) 0.001 文化程度 0.438 25.664 1.549(1.308~1.835) ＜0.001 未遭受过身体/精神暴力 -0.767 13.747 0.465(0.310~0.697) ＜0.001 日平均睡眠时间 -0.350 3.951 0.705(0.499~0.995) 0.047 月经不规律 0.499 11.688 1.648(1.237~2.193) 0.001 近6个月未出现痛经 -0.644 24.104 0.525(0.460~0.679) ＜0.001
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[1] Kieling C, Baker-Henningham H, Belfer M, et al. Child and adolescent mental health worldwide: evidence for action[J]. Lancet, 2011, 378(9801): 1515-1525. DOI: 10.1016/S0140-6736(11)60827-1. [2] 杨静薇, 王宏, 何芳, 等. 重庆某区青春期女生月经来潮及其对生活质量的影响[J]. 中国学校卫生, 2018, 39(4): 519-521, 525. DOI: 10.16835/j.cnki.1000-9817.2018.04.011.Yang JW, Wang H, He F, et al. Effect of menarche on quality of life among adolescent girls in Chongqing[J]. Chin J Sch Health, 2018, 39(4): 519-521, 525. DOI: 10.16835/j.cnki.1000-9817.2018.04.011. [3] Lien L, Dalgard F, Heyerdahl S, et al. The relationship between age of menarche and mental distress in Norwegian adolescent girls and girls from different immigrant groups in Norway: Results from an urban city cross-sectional survey[J]. Soc Sci Med, 2006, 63(2): 285-295. DOI: 10.1016/j.socscimed.2006.01.003. [4] Cao M, Zhu Y, He B, et al. Association between sleep duration and obesity is age-and gender-dependent in Chinese urban children aged 6-18 years: a cross-sectional study[J]. BMC Public Health, 2015, 15: 1029. DOI: 10.1186/s12889-015-2359-0. [5] 徐娜, 张永爱, 李菲, 等. 月经初潮年龄对经前期综合征症状及应对方式的影响[J]. 护理研究, 2016, 30(1B): 220-222. DOI: 10.3969/j.issn.1009-6493.2016.02.037.Xu N, Zhang YA, Li F, et al. Influence of menarche age on symptoms and coping styles of patients with premenstrual syndrome[J]. Chinese Nursing Research, 2016, 30(1B): 220-222. DOI: 10.3969/j.issn.1009-6493.2016.02.037. [6] Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7[J]. Arch Intern Med, 2006, 166(10): 1092-1097. DOI: 10.1001/archinte.166.10.1092. [7] 何筱衍, 李春波, 钱洁, 等. 广泛性焦虑量表在综合性医院的信度和效度研究[J]. 上海精神医学, 2010, 22(4): 200-203. DOI: 10.3969/j.issn.1002-0829.2010.04.002.He XY, Li CB, Qian J, et al. Reliability and validity of a generalized anxiety disorder scale in general hospital outpatients[J]. Shanghai Archives of Psychiatry, 2010, 22(4): 200-203. DOI: 10.3969/j.issn.1002-0829.2010.04.002. [8] Zuithoff NP, Vergouwe Y, King M, et al. The patient health questionnaire-9 for detection of major depressive disorder in primary care: consequences of current thresholds in a crosssectional study[J]. BMC Fam Pract, 2010, 11: 98. DOI: 10.1186/1471-2296-11-98. [9] 胡星辰, 张迎黎, 梁炜, 等. 病人健康问卷抑郁量表(PHQ-9)在青少年中应用的信效度检验[J]. 四川精神卫生, 2014, 27(4): 357-360. DOI: 10.3969/j.issn.1007-3256.2014.04.021.Hu XC, Zhang YL, Liang W, et al. Reliability and validity of the patient health questionnaire-9 in Chinese adolescents[J]. Sichuan Mental Health, 2014, 27(4): 357-360. DOI: 10.3969/j.issn.1007-3256.2014.04.021. [10] 张海军, 蔺萃, 董晓蕾. 潍坊市青春期学生焦虑抑郁现状及其相关因素分析[J]. 中国神经精神疾病杂志, 2017, 43(5): 289-293. DOI: 10.3969/j.issn.1002-0152.2017.05.007.Zhang HJ, Lin C, Dong XL, Study on status and influencing factors of anxiety and depression of adolescent students in Weifang city[J]. Chin J Nerv Ment Dis, 2017, 43(5): 289-293. DOI: 10.3969/j.issn.1002-0152.2017.05.007. [11] 马爽, 陈晶琦, 于卜一, 等. 女性青少年童年期同伴暴力受害及其与青少年健康相关危险行为的关联[J]. 中国儿童保健杂志, 2017, 25(12): 1251-1254. DOI: 10.11852/zgetbjzz2017-25-12-18.Ma S, Chen JQ, Yu BY, et al. Childhood peer violence victimization and its association with health related risky behaviors in female adolescents[J]. Chin J Child Health Care, 2017, 25(12): 1251-1254. DOI: 10.11852/zgetbjzz2017-25-12-18. [12] O'Donnell DA, Roberts WC, Schwab-Stone ME. Community violence exposure and post-traumatic stress reactions among Gambian youth: the moderating role of positive school climate[J]. Soc Psychiatry Psychiatr Epidemiol, 2011, 46(1): 59-67. DOI: 10.1007/s00127-009-0162-x. [13] Yi S, Poudel KC, Yasuoka J, et al. Exposure to violence in relation to depressive symptoms among male and female adolescent students in Cambodia[J]. Soc Psychiatry Psychiatr Epidemiol, 2013, 48(3): 397-405. DOI: 10.1007/s00127-012-0553-2. [14] Matamura M, Tochigi M, Usami S, et al. Associations between sleep habits and mental health status and suicidality in a longitudinal survey of monozygotic twin adolescents[J]. J Sleep Res, 2014, 23(3): 290-294. DOI: 10.1111/jsr.12127. [15] Wang S, Li B, Wu Y, et al. Relationship of sleep duration with sociodemographic characteristics, lifestyle, mental health, and chronic diseases in a large chinese adult population[J]. J Clin Sleep Med, 2017, 13(3): 377-384. DOI: 10.5664/jcsm.6484. [16] Leger D, Beck F, Richard JB, et al. Total sleep time severely drops during adolescence[J]. PLoS One, 2012, 7(10): e45204. DOI: 10.1371/journal.pone.0045204. [17] Mitchell JA, Rodriguez D, Schmitz KH, et al. Sleep duration and adolescent obesity[J]. Pediatrics, 2013, 131(5): e1428-e1434. DOI: 10.1542/peds.2012-2368. [18] Baum KT, Desai A, Field J, et al. Sleep restriction worsens mood and emotion regulation in adolescents[J]. J Child Psychol Psychiatry, 2014, 55(2): 180-190. DOI: 10.1111/jcpp.12125. [19] Segura-Jimenez V, Carbonell-Baeza A, Keating XD, et al. Association of sleep patterns with psychological positive health and health complaints in children and adolescents[J]. Qual Life Res, 2015, 24(4): 885-895. DOI: 10.1007/s11136-014-0827-0. [20] Tarokh L, Saletin JM, Carskadon MA. Sleep in adolescence: physiology, cognition and mental health[J]. Neurosci Biobehav Rev, 2016, 70: 182-188. DOI: 10.1016/j.neubiorev.2016.08.008. [21] 罗珊, 廉启国, 毛燕燕, 等. 中国中小学女生月经初潮年龄和月经模式调查分析[J]. 中华生殖与避孕杂志, 2017, 37(3): 208-212. DOI: 10.3760/cma.j.issn.2096-2916.2017.03.007.Luo S, Lian QG, Mao YY, et al. Age at menarche and menstrual cycle pattern among school adolescent girls in China[J]. Chin J Reprod Contracep, 2017, 37(3): 208-212. DOI: 10.3760/cma.j.issn.2096-2916.2017.03.007. [22] 罗华丽. 心理健康状况与青春期月经失调的相关性研究[J]. 中国医药科学, 2013, 3(6): 50-51. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX201306023.htmLuo HL, Investigation of correlation of mental health and adolescent menstruation disorders[J]. China Medicine and Pharmacy, 2013, 3(6): 50-51. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX201306023.htm [23] Sveinsdottir H. Menstruation, objectification and health-related quality of life: a questionnaire study[J]. J Clin Nurs, 2018, 27(3-4): e503-e513. DOI: 10.1111/jocn.14049. [24] Copeland W, Shanahan L, Miller S, et al. Outcomes of early pubertal timing in young women: a prospective population-based study[J]. Am J Psychiatry, 2010, 167(10): 1218-1225. DOI: 10.1176/appi.ajp.2010.09081190. [25] Beltz AM. Gendered mechanisms underlie the relation between pubertal timing and adult depressive symptoms[J]. J Adolesc Health, 2018, 62(6): 722-728. DOI: 10.1016/j.jadohealth.2017.12.019. -
