Cao Hui, Tao Fang-Biao, Huang Lei, Wan Yu-Hui, Sun Ying, Su Pu-Yu, Hao Jia-Hu
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University & Anhui Provincial Key Laboratory of Population Health, Hefei 230032, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2012 Mar;46(3):202-8.
To investigate the prevalence of common psychosomatic symptoms among Chinese adolescents and the influence on 6 months later suicide and self-injurious behavior.
Based on the cluster sampling method, the participants who were recruited from 8 cities from 3 areas in China, including Eastern areas (Beijing, Shaoxing and Guangzhou), Middle areas (Ezhou, Harbin and Taiyuan) and Western areas (Guiyang and Chongqing), were administered by multidimensional sub-health questionnaire of adolescents (MSQA) in March 2008. Demographics, life style, psychosomatic symptoms, suicide and self-injurious behavior were also assessed. A total of 17 622 questionnaires were valid at baseline. Six months later, 14 407 questionnaires were eligible for two waves investigation. Analysis of Pearson chi-square and logistic model regression analysis were employed to compare the incidence of psychosomatic symptoms, suicide and self-injurious behaviors among different areas and to explore the possible risk factors of those symptoms and behaviors.
At baseline, rates of total common physiological and psychological symptoms were 24.1% (4255/17622) and 30.9% (5447/17622), respectively, with the highest being eating and drinking too much (6.4%, 1130/17622) and hardly feel ease to learn at home (11.8%, 2087/17 622). In males, the rate of common psychological symptoms (30.7%, 2637/8599) was higher than physiological symptoms (24.0%, 2061/8599) (P < 0.05); in females, the rate of common psychological symptoms (31.1%, 2810/9023) was higher than physiological symptoms (24.3%, 2194/9023) (P<0.05). The rate of the common psychosomatic symptoms in senior high school students (46.8%, 2905/6208) were significantly higher than those in middle high school students (37.3%, 2337/6262) and college students (33.2%, 1711/5152) (all P values <0.05). Students from Western areas had the highest incidences of the common physiological and psychological symptoms (30.2%, 1471/4871; 40.6%, 1979/4871), higher than students from Middle areas (22.4%, 1443/6453; 27.0%, 1743/6453) and Eastern areas (21.3%, 1341/6298; 27.4%, 1725/6298) (all P values <0. 05). Results from multiple logistic regression showed that physical symptoms > or = 2 at baseline were shared risk factors for suicidal ideation (RR = 1.44, 95% CI:1.16 - 1.79), attempted suicide (RR = 1.79, 95% CI: 1.22 - 2.61) and self-injurious behaviors (RR = 1.39, 95% CI: 1.17 - 1.66) 6 months later. Psychopathological symptoms > or = 4 at baseline was the shared risk factors for suicide ideation (RR = 1.74, 95% CI: 1.39 -2.17), attempted suicide (RR = 2.08, 95%CI: 1.39 - 3.11) and self-injurious (RR = 1.90, 95%CI: 1.59 - 2.28) 6 months later.
It is common in Chinese adolescents who have multiple psychosomatic symptoms simultaneously. What's important is that those common psychosomatic symptoms are shared risk factors of later suicidal and self-injurious behaviors.
调查中国青少年常见的心身症状患病率及其对6个月后自杀及自我伤害行为的影响。
采用整群抽样方法,于2008年3月对来自中国3个地区8个城市的青少年进行调查,这3个地区包括东部地区(北京、绍兴和广州)、中部地区(鄂州、哈尔滨和太原)和西部地区(贵阳和重庆)。采用青少年多维亚健康问卷(MSQA)进行调查,并评估人口统计学特征、生活方式、心身症状、自杀及自我伤害行为。基线时共有17622份问卷有效。6个月后,有14407份问卷符合两波次调查要求。采用Pearson卡方分析和逻辑模型回归分析,比较不同地区心身症状、自杀及自我伤害行为的发生率,并探讨这些症状和行为的可能危险因素。
基线时,常见生理和心理症状的总发生率分别为24.1%(4255/17622)和30.9%(5447/17622),其中发生率最高的是饮食过量(6.4%,1130/17622)和在家学习时难以放松(11.8%,2087/17622)。男性中,常见心理症状的发生率(30.7%,2637/8599)高于生理症状(24.0%,2061/8599)(P<0.05);女性中,常见心理症状的发生率(31.1%,2810/9023)高于生理症状(24.3%,2194/9023)(P<0.05)。高中生常见心身症状的发生率(46.8%,2905/6208)显著高于初中生(37.3%,2337/6262)和大学生(33.2%,1711/5152)(所有P值<0.05)。西部地区学生常见生理和心理症状的发生率最高(30.2%,1471/4871;40.6%,1979/4871),高于中部地区学生(22.4%,1443/6453;27.0%,1743/6453)和东部地区学生(21.3%,1341/6298;27.4%,1725/6298)(所有P值<0.05)。多因素逻辑回归结果显示,基线时身体症状≥2项是6个月后自杀意念(RR=1.44,95%CI:1.16-1.79)、自杀未遂(RR=1.79,95%CI:1.22-2.61)和自我伤害行为(RR=1.39,95%CI:1.17-1.66)的共同危险因素。基线时精神病理症状≥4项是6个月后自杀意念(RR=1.74,95%CI:1.39-2.17)、自杀未遂(RR=2.08,95%CI:1.39-3.11)和自我伤害行为(RR=1.90,95%CI:1.59-2.28)的共同危险因素。
中国青少年同时存在多种心身症状的情况较为常见。重要的是,这些常见的心身症状是后期自杀及自我伤害行为的共同危险因素。