Zhang Yingzhe, Coid Jeremy, Liu Xiang, Zhang Yamin, Sun Huan, Li Xiaojing, Tang Wanjie, Wang Qiang, Deng Wei, Zhao Liansheng, Ma Xiaohong, Meng Yajing, Li Mingli, Wang Huiyao, Chen Ting, Lv Qiuyue, Guo Wanjun, Li Tao
Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.
West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
Front Psychiatry. 2022 Apr 8;13:538200. doi: 10.3389/fpsyt.2022.538200. eCollection 2022.
University students experience high levels of stress, and the prevalence of depression is higher than in the general population. The reason is not clear. More effective interventions and better prevention are needed.
We did annual cross-sectional surveys of Chinese undergraduates 2014-2018 (mean age 18.7 [SD 2.1], = 39,573). We measured adaptation to university life using the Adolescent Self-rating Life Events Checklist (ASLEC) and common mental disorders using standardized self-report instruments. Regression analyses identified associations between childhood maltreatment, current family problems, stress in adaptation to undergraduate life, and psychiatric morbidity. Mediation analyses further tested relationships between these factors.
Childhood maltreatment, current family problems, stress in adaptation, and psychiatric morbidity were all significantly associated with each other. The strongest association between childhood experiences and psychiatric morbidity was for sexual abuse and depression (OR = 3.39, 95%CI: 2.38-4.83, < 0.001) and between stress from adaptation and somatic disorder (OR = 4.54, 95%CI: 3.62-5.68, < 0.001). Associations between childhood maltreatment and stress from university life were partly mediated by psychiatric morbidity. Associations between family problems and psychiatric morbidity were mediated by stress from university life.
Stress from adaptation to university life and pressures from academic study exert stronger effects on psychiatric morbidity among students than childhood traumatic experiences and current family problems, although these factors are closely interrelated. Mental health services for students should focus on adaptation to university life and pressures from academic study as well as external factors of childhood trauma and family problems.
大学生承受着高水平的压力，且抑郁症的患病率高于普通人群。原因尚不清楚。需要更有效的干预措施和更好的预防方法。
我们在2014 - 2018年对中国本科生进行了年度横断面调查（平均年龄18.7岁[标准差2.1]，n = 39573）。我们使用青少年自评生活事件量表（ASLEC）测量对大学生活的适应情况，并使用标准化的自我报告工具测量常见精神障碍。回归分析确定了童年期虐待、当前家庭问题、适应大学生活的压力与精神疾病发病率之间的关联。中介分析进一步检验了这些因素之间的关系。
童年期虐待、当前家庭问题、适应压力和精神疾病发病率均显著相关。童年经历与精神疾病发病率之间最强的关联是性虐待与抑郁症（比值比 = 3.39，95%置信区间：2.38 - 4.83，P < 0.001）以及适应压力与躯体疾病（比值比 = 4.54，95%置信区间：3.62 - 5.68，P < 0.001）。童年期虐待与大学生活压力之间的关联部分由精神疾病发病率介导。家庭问题与精神疾病发病率之间的关联由大学生活压力介导。
尽管这些因素密切相关，但适应大学生活的压力和学业压力对学生精神疾病发病率的影响比童年创伤经历和当前家庭问题更强。针对学生的心理健康服务应关注适应大学生活、学业压力以及童年创伤和家庭问题等外部因素。
