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云南省农村留守儿童和青少年的抑郁症:患病率及其与自伤行为的关联

Depressive disorders in Chinese left-behind children and adolescents from Yunnan province: prevalence and association with self-harm behaviors.

作者信息

Ran Hailiang, Chang Wei, Xu Chuanzhi, Che Yusan, Fang Die, Chen Lin, Wang Sifan, Liang Xuemeng, Sun Hao, Peng Junwei, Li Qiongxian, Shi Yuanyu, Lu Jin, Xiao Yuanyuan

机构信息

Division of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, 1168 Chunrong West Road, Kunming, Yunnan, China.

Psychiatry Department, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China.

出版信息

Arch Public Health. 2024 Sep 18;82(1):161. doi: 10.1186/s13690-024-01393-3.

Abstract

BACKGROUND

The prevalence of clinically diagnosed depressive disorders (DD) in Chinese left-behind children (LBC) remains unknown. We aim to estimate the prevalence of DD, discuss the associations between DD and self-harm (SH) behaviors in a large representative sample of Chinese LBCs chosen from Yunnan province.

METHODS

A total of 5462 LBCs were selected from the most recent datasets of the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a mega population-based two-phase cross-sectional survey. Weighted prevalence rates and designed Logistic regression were adopted to estimate the prevalence of DD and the association between DD and SH.

RESULTS

The weighted prevalence of lifetime and current DD were 4.22% (95% CI: 3.13-6.00%) and 3.84% (95% CI: 2.85-5.00%) in Chinese LBCs. Higher lifetime and current DD prevalence rates were observed in girls and those reported adverse parental marital status and SH behaviors. The absence of DD was associated with significantly decreased odds of SH behavior (OR = 0.06), repetitive SH (OR = 0.09), using multiple SH methods (OR = 0.09), and severe SH (OR = 0.15). Subsequently performed stratified analyses identified prominent effect modification by sex and age, as a stronger association between DD and SH was found in girls (OR = 0.02 versus OR = 0.07 in boys) and younger adolescents (OR = 0.08 versus OR = 0.22 in older adolescents).

CONCLUSION

The prevalence of DD was high in Chinese LBCs. DD was associated with prominently increased risk of SH behaviors in LBCs. Attention and intervention are needed in this vulnerable population.

摘要

背景

中国留守儿童中临床诊断抑郁症(DD)的患病率尚不清楚。我们旨在估计DD的患病率,并在从云南省选取的具有代表性的大量中国留守儿童样本中探讨DD与自我伤害(SH)行为之间的关联。

方法

从云南儿童与青少年心理健康调查(MHSCAY)的最新数据集(一项基于大规模人群的两阶段横断面调查)中选取了5462名留守儿童。采用加权患病率和设计的逻辑回归来估计DD的患病率以及DD与SH之间的关联。

结果

中国留守儿童中终生和当前DD的加权患病率分别为4.22%(95%置信区间:3.13 - 6.00%)和3.84%(95%置信区间:2.85 - 5.00%)。在女孩以及报告有不良父母婚姻状况和SH行为的儿童中,观察到更高的终生和当前DD患病率。未患DD与SH行为(比值比[OR]=0.06)、重复性SH(OR = 0.09)、使用多种SH方法(OR = 0.09)和严重SH(OR = 0.15)的几率显著降低相关。随后进行的分层分析确定了性别和年龄的显著效应修正,因为在女孩(OR = 0.02,男孩为OR = 0.07)和青少年早期(OR = 0.08,青少年晚期为OR = 0.22)中发现DD与SH之间的关联更强。

结论

中国留守儿童中DD的患病率较高。DD与留守儿童中SH行为的风险显著增加相关。这一弱势群体需要得到关注和干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01fd/11409802/6afc548017da/13690_2024_1393_Fig1_HTML.jpg

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