Karyotaki Eirini, Cuijpers Pim, Albor Yesica, Alonso Jordi, Auerbach Randy P, Bantjes Jason, Bruffaerts Ronny, Ebert David D, Hasking Penelope, Kiekens Glenn, Lee Sue, McLafferty Margaret, Mak Arthur, Mortier Philippe, Sampson Nancy A, Stein Dan J, Vilagut Gemma, Kessler Ronald C
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States.
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Front Psychol. 2020 Jul 30;11:1759. doi: 10.3389/fpsyg.2020.01759. eCollection 2020.
The college years are stressful for many students. Identifying the sources of stress and their relative importance in leading to clinically significant emotional problems may assist in the development of targeted stress management interventions. The current report examines the distribution and associations of perceived stress across major life areas with 12-month prevalence of common mental disorders in a cross-national sample of first-year college students. The 20,842 respondents were from 24 universities in 9 countries that participated in the World Health Organization World Mental Health International College Student Initiative. Logistic regression analysis examined associations of current perceived stress in six life areas (financial situation, health, love life, relationships with family, relationships at work/school, problems experienced by loved ones) with six types of 12-month mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Population attributable risk proportions (PARPs) were calculated to estimate the upper-bound potential effects of interventions focused on perceived stress in reducing prevalence of mental disorders. The majority of students (93.7%) reported at least some stress in at least one of the six areas. A significant dose-response association was found between extent of stress in each life area and increased odds of at least one of the six disorders. The multivariable models that included all stress measures were significant for all disorders ( = 20.6-70.6, < 0.001). Interpretation of PARPs as representing causal effects of stresses on disorders suggests that up to 46.9-80.0% of 12-month disorder prevalence might be eliminated if stress prevention interventions were developed to block the associations of stress with these disorders.
大学时光对许多学生来说压力重重。识别压力源及其在导致具有临床意义的情绪问题方面的相对重要性，可能有助于制定有针对性的压力管理干预措施。本报告考察了在一个跨国的大一学生样本中，主要生活领域中感知到的压力分布及其与常见精神障碍12个月患病率的关联。20842名受访者来自9个国家的24所大学，这些大学参与了世界卫生组织的世界心理健康国际大学生倡议。逻辑回归分析考察了六个生活领域（经济状况、健康、爱情生活、与家人的关系、工作/学校中的人际关系、亲人经历的问题）中当前感知到的压力与六种12个月内的精神障碍类型（重度抑郁症、双相情感障碍、广泛性焦虑障碍、惊恐障碍、酒精使用障碍、药物使用障碍）之间的关联。计算了人群归因风险比例（PARPs），以估计针对感知到的压力进行干预在降低精神障碍患病率方面的上限潜在效果。大多数学生（93.7%）报告在六个领域中的至少一个领域至少有一些压力。在每个生活领域的压力程度与六种障碍中至少一种障碍的患病几率增加之间，发现了显著的剂量反应关联。包含所有压力测量指标的多变量模型对所有障碍均具有显著性（ = 20.6 - 70.6， < 0.001）。将PARPs解释为压力对障碍的因果效应表明，如果制定压力预防干预措施来阻断压力与这些障碍之间的关联，那么12个月内的障碍患病率可能会消除高达46.9% - 80.0%。
