Hjern Anders, Alfven Gösta, Ostberg Viveca
Department of Children's and Women's Health, Uppsala University, Sweden.
Acta Paediatr. 2008 Jan;97(1):112-7. doi: 10.1111/j.1651-2227.2007.00585.x. Epub 2007 Dec 11.
The proportion of Scandinavian school children reporting psychosomatic pain and psychological complaints have increased in recent decades. In this study we investigated these symptoms in relation to potential stressors in the school environment.
A cross-sectional study was conducted based on child interviews linked to nationally representative household surveys in Sweden during 2002-2003 covering a sample of 2588 children aged 10-18 years. The main outcome variable of psychosomatic pain signified suffering from headache as well as recurrent abdominal pain on a weekly basis.
School stressors, such as harassment by peers, schoolwork pressure and being treated poorly by teachers, were associated with psychosomatic pain as well as psychological complaints such as sadness, irritability, feeling unsafe and nervous. Harassment was identified as a particularly important determinant with adjusted odds ratios (ORs) ranging from 3.1 to 8.6 for psychosomatic pain. All psychological complaints were associated with psychosomatic pain with adjusted ORs ranging from 2.2 to 3.7, and mediated most of the association of harassment to psychosomatic pain.
School stressors are strongly associated with psychosomatic pain and psychological complaints in school children. Psychological complaints seem to function as mediators in the association of school stressors to psychosomatic pain symptoms to a great extent.
近几十年来,报告存在心身疼痛和心理问题的斯堪的纳维亚学龄儿童比例有所增加。在本研究中,我们调查了这些症状与学校环境中潜在压力源的关系。
基于2002年至2003年瑞典具有全国代表性的家庭调查中与儿童访谈相关的数据进行了一项横断面研究,样本包括2588名10至18岁的儿童。心身疼痛的主要结局变量表示每周患有头痛以及反复出现腹痛。
学校压力源,如同伴骚扰、学业压力以及受到教师的不良对待,与心身疼痛以及诸如悲伤、易怒、感觉不安全和紧张等心理问题相关。骚扰被确定为一个特别重要的决定因素,心身疼痛的调整比值比(OR)范围为3.1至8.6。所有心理问题均与心身疼痛相关,调整后的OR范围为2.2至3.7,并且在很大程度上介导了骚扰与心身疼痛之间的关联。
学校压力源与学龄儿童的心身疼痛和心理问题密切相关。心理问题似乎在很大程度上在心身疼痛症状与学校压力源之间的关联中起到中介作用。