Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China.
Research Center for Physical Fitness at High Altitude, Public Cultural Service Center, Chengguan District Culture and Tourism Bureau, Lhasa 850000, China.
Int J Environ Res Public Health. 2023 Jan 21;20(3):2013. doi: 10.3390/ijerph20032013.
Environmental factors of high altitude, especially hypobaric hypoxia, may directly and persistently affect human physical and mental health. Our study was designed to assess the psychological and social fitness in healthy adults permanently living at very high altitude, i.e., an average elevation of 3650 m.
In our observational study, 320 participants were included, among which 218 (68.1%) had resided in such a setting for more than 20 years. Participants underwent 138 assessments, including the Self-Rating Anxiety Scale (SAS), Symptom Check List 90 (SCL-90) and the Evaluation Scale of Human Adaptation Capability (ESHAC). SAS (20 items) and SCL-90 (90 items) were used to assess psychological fitness, and the ESHAC (28 items) was used to assess social fitness. Pearson analysis was used to assess correlations and Logistic regression analysis was performed to determine independent influencing factors.
The highest SAS score was 80 and the mean score was 43.26 ± 8.88, which was higher than the norm in China ( < 0.001). Sixty (18.8%) participants showed anxiety symptoms and 14 (4.4%) had moderate or severe anxiety. The average score of SCL-90 was 140.88 ± 44.77, and 96 (30.0%) participants showed SCL-90 scores ≥160. Compared with the norm, significant differences were shown in eight of the nine SCL-90 factor scores, i.e., somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The average score of ESHAC was 19.92 ± 4.54, and 114 (35.6%) participants did not reach the qualifying standard. Significant correlations were observed between the SAS score, SCL-90 total and factor scores, and ESHAC scores. The Logistic regression analysis showed that being born at very high altitude was an independent influencing factor (AOR = 2.619; 95% CI, 1.629-4.211; < 0.001) after controlling for other factors.
Permanently living at very high altitude can influence the psychological and social fitness of healthy adults.
高海拔地区的环境因素，尤其是低气压缺氧，可能会直接且持续地影响人类身心健康。我们的研究旨在评估长期居住在极高海拔地区（平均海拔 3650 米）的健康成年人的心理和社会适应能力。
在我们的观察性研究中，纳入了 320 名参与者，其中 218 名（68.1%）在这样的环境中居住超过 20 年。参与者接受了 138 项评估，包括自评焦虑量表（SAS）、症状自评量表 90（SCL-90）和人类适应能力评估量表（ESHAC）。SAS（20 项）和 SCL-90（90 项）用于评估心理健康，ESHAC（28 项）用于评估社会适应能力。采用 Pearson 分析评估相关性，采用 Logistic 回归分析确定独立影响因素。
SAS 的最高得分为 80 分，平均得分为 43.26 ± 8.88，高于中国常模（<0.001）。60 名（18.8%）参与者出现焦虑症状，14 名（4.4%）出现中度或重度焦虑。SCL-90 的平均得分为 140.88 ± 44.77，96 名（30.0%）参与者的 SCL-90 得分≥160。与常模相比，九项 SCL-90 因子得分中有八项存在显著差异，即躯体化、强迫症状、抑郁、焦虑、敌对、恐怖、偏执观念和精神病性。ESHAC 的平均得分为 19.92 ± 4.54，114 名（35.6%）参与者未达到合格标准。SAS 得分、SCL-90 总分和因子得分与 ESHAC 得分之间存在显著相关性。Logistic 回归分析显示，出生于极高海拔地区是独立的影响因素（AOR=2.619；95%CI，1.629-4.211；<0.001），在控制其他因素后仍具有统计学意义。
长期居住在极高海拔地区会影响健康成年人的心理和社会适应能力。
