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医学生中自闭症谱系障碍和注意力缺陷多动障碍特质与抑郁及共情的关联

Association of Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder Traits with Depression and Empathy Among Medical Students.

作者信息

Watanabe Takafumi, Kondo Masaki, Sakai Mie, Takabatake So, Furukawa Toshiaki A, Akechi Tatsuo

机构信息

Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan.

Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan.

出版信息

Adv Med Educ Pract. 2021 Oct 28;12:1259-1265. doi: 10.2147/AMEP.S334155. eCollection 2021.

Abstract

PURPOSE

This study aimed to investigate the associations of the traits of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) with depression and empathy among medical students.

PATIENTS AND METHODS

A cross-sectional survey was conducted with 202 fifth-year students at a Japanese medical school for 10 months during their clinical clerkship. The survey included sociodemographic questions and validated tools to measure depressive symptoms (Hospital Anxiety and Depression Scale [HADS]), medical students' empathy for patients (Jefferson Scale of Empathy-Student version [JSE]), ADHD traits (ADHD Self-Report Scale Screener [ASRS Screener]), and ASD traits (Autism-Spectrum Quotient Japanese version-21 [AQ-J-21]).

RESULTS

A total of 151 students (response rate: 74.7%) participated in the survey. Of these, 41 (27.2%) reported a total score of ≥ 20 on the HADS and were categorized as depressed. Depressed students reported significantly lower and higher rates of having a part-time job and a history of enrolment in other faculties, respectively, than non-depressed students. According to the cutoff criteria of the ASRS Screener and AQ-J-21, 31 (20.5%) and 42 (27.8%) students reported ADHD and ASD traits, respectively. Multivariate regression analysis, controlling for age and sex, reported that higher age, ASRS Screener scores, and AQ-J-21 scores were significant predictors of higher HADS total scores. Additionally, higher AQ-J-21 scores significantly predicted lower JSE scores.

CONCLUSION

The degree of ADHD and ASD traits was significantly associated with depression. Moreover, the degree of ASD traits was significantly associated with lower empathy for their patients. It is important to consider that about 20-30% of medical students have these neurodevelopmental traits and to develop intervention strategies for improving depression and empathy.

摘要

目的

本研究旨在调查医学生自闭症谱系障碍(ASD)和注意力缺陷多动障碍(ADHD)的特征与抑郁和同理心之间的关联。

患者与方法

对日本一所医学院的202名五年级学生进行了为期10个月的横断面调查,调查时间为他们临床实习期间。调查内容包括社会人口学问题以及用于测量抑郁症状的有效工具(医院焦虑抑郁量表[HADS])、医学生对患者的同理心(杰斐逊同理心量表学生版[JSE])、ADHD特征(ADHD自我报告量表筛查版[ASRS筛查版])和ASD特征(自闭症谱系商数日语版-21[Aq-J-21])。

结果

共有151名学生(回复率:74.7%)参与了调查。其中,41名(27.2%)学生在HADS上的总分≥20分,被归类为抑郁。与非抑郁学生相比,抑郁学生报告有兼职工作的比例显著较低,而有其他院系入学经历的比例显著较高。根据ASRS筛查版和Aq-J-21的截断标准,分别有31名(20.5%)和42名(27.8%)学生报告有ADHD和ASD特征。在控制年龄和性别的多变量回归分析中,较高的年龄、ASRS筛查版得分和Aq-J-21得分是HADS总分较高的显著预测因素。此外,较高的Aq-J-21得分显著预测较低的JSE得分。

结论

ADHD和ASD特征的程度与抑郁显著相关。此外,ASD特征的程度与对患者的较低同理心显著相关。重要的是要考虑到约20%-30%的医学生具有这些神经发育特征,并制定改善抑郁和同理心的干预策略。

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