贵州省中学生自杀意念流行现况及影响因素
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摘要
目的了解贵州省中学生自杀意念的流行现况及影响因素,为中学生心理行为干预提供依据。方法采用多阶段整群随机抽样方法,抽取贵州省14所中学4 903名学生,采用"中国青少年健康相关行为问卷"进行调查,用χ~2检验和多因素Logistic回归统计分析数据。结果贵州省中学生过去12个月里自杀意念报告率为14. 3%,其中男生为13. 2%,女生为15. 4%,女生高于男生(χ~2=5. 20,P<0. 05);初中生为13. 7%,高中生为15. 0%,汉族学生为14. 5%,少数民族学生为14. 1%,学段及民族间差异均无统计学意义(P值均>0. 05)。多因素Logistic回归分析显示,女生(OR=1. 49),母亲文化程度大专以上(OR=2. 26),过去30 d遭受心理暴力(OR=1. 30),过去12个月里参与打架(OR=1. 33)、经常感到孤独(OR=1. 86)、经常失眠(OR=1. 38)、故意自伤(OR=3. 58)、因伤心绝望停止平常活动(OR=1. 87)、离家出走意念(OR=3. 31)、网络成瘾(OR=1. 37)、经常步行违规(OR=2. 42)与自杀意念呈正相关(P值均<0. 05);经常因学习压力感到心情不愉快(OR=0. 73)与自杀意念呈负性相关(P<0. 05)。结论中学生自杀意念与校园暴力、不良内隐性心理体验及行为方式密切相关。社会各界应广泛重视,有针对性地制定措施进行防护。
Objective To analyze the prevalence and associated factors of suicide ideation among adolescent students in Guizhou Province, and to provide scientific evidence for developing strategy. Methods Multi-stage stratified cluster sampling method was used to recruit 4 903 adolescents from 14 middle schools in Guizhou Province. China Youth Health Risk Behaviors Questionnaire was used and data were analyzed by using univariate analysis and Logistic regression analysis. Results Totally 14.3%( 703/4 903) middle school students had suicide ideation during the past 12-month period, in which 13.2% were boys and 15.4% were girls, more girls were prone to suicide than boys( χ~2= 5.20, P<0.05); 13.7% junior students, 15.0% senior students,14.5% Han ethnic students and 14.1% minority students suicide ideation, and the differences between grades and ethnic groups were of no statistical significance( P>0.05). The multi-variates Logistic regression analysis showed that risk factors for suicidal ideation included being girl( OR = 1.49),higher maternal education( college and above: OR = 2.26), suffering psychological bullying over the past 30 days( OR = 1.30), taking part in fighting for the past 12 months( OR = 1.33), often feeling lonely( OR = 1.86), sleeplessness( OR = 1.38), deliberate self-injury( OR = 3.58),decreases of daily activities due to depression( OR = 1.87), ideation of running away( OR = 3.31), internet addiction( OR = 1.37), walk violating regulations( OR = 2.42), but occasional low mood from academic pressure( OR = 0.73) was a protective factor for suicidal ideation( P< 0.05). Conclusion Suicide ideation of middle school students is closely related to campus violence, adverse inner metal experience and unhealthy behavior pattern. All sectors of society should attach great importance and targeted measures to prevent suicide and protect the students.
Objective To analyze the prevalence and associated factors of suicide ideation among adolescent students in Guizhou Province, and to provide scientific evidence for developing strategy. Methods Multi-stage stratified cluster sampling method was used to recruit 4 903 adolescents from 14 middle schools in Guizhou Province. China Youth Health Risk Behaviors Questionnaire was used and data were analyzed by using univariate analysis and Logistic regression analysis. Results Totally 14.3%( 703/4 903) middle school students had suicide ideation during the past 12-month period, in which 13.2% were boys and 15.4% were girls, more girls were prone to suicide than boys( χ~2= 5.20, P<0.05); 13.7% junior students, 15.0% senior students,14.5% Han ethnic students and 14.1% minority students suicide ideation, and the differences between grades and ethnic groups were of no statistical significance( P>0.05). The multi-variates Logistic regression analysis showed that risk factors for suicidal ideation included being girl( OR = 1.49),higher maternal education( college and above: OR = 2.26), suffering psychological bullying over the past 30 days( OR = 1.30), taking part in fighting for the past 12 months( OR = 1.33), often feeling lonely( OR = 1.86), sleeplessness( OR = 1.38), deliberate self-injury( OR = 3.58),decreases of daily activities due to depression( OR = 1.87), ideation of running away( OR = 3.31), internet addiction( OR = 1.37), walk violating regulations( OR = 2.42), but occasional low mood from academic pressure( OR = 0.73) was a protective factor for suicidal ideation( P< 0.05). Conclusion Suicide ideation of middle school students is closely related to campus violence, adverse inner metal experience and unhealthy behavior pattern. All sectors of society should attach great importance and targeted measures to prevent suicide and protect the students.
引文
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[13]朱琦,夏庆华,喻彦,等.上海市长宁区初中生自杀意念流行现状及影响因素分析[J].中国学校卫生,2017,38(11):1637-1640.
[14]田琪,汪晓敏,章荣华,等.杭州市青少年自杀问题现况调查[J].中国心理卫生杂志,2012,26(3):230-234.
[15]汪耿夫,方玉,江流,等.安徽省中学生网络欺凌与自杀相关心理行为的关联研究[J].卫生研究,2015,44(6):896-903.
[16]TEMPIER R,GUéRIN E.Tobacco smoking and suicidal thoughts andattempts:relationships from a general population survey[J]. Clin Ep-idemiol Global Health,2015,3(3):137-143.
[17]常利涛,戴璟,闵杰青,等.中国人口较少民族中小学生自杀意念流行现况及危险因素研究[J].中华疾病控制杂志,2018,22(3):244-248.
[18]HONG L,GUO L,WU H,et al. Bullying,depression,and suicidalideation among adolescents in the Fujian province of china:a cross-sectional study[J]. Medicine,2016,95(5):e2530.
[19]BRUNSTEIN K A,BARZILAY S,APTER A,et al. Bi-directionallongitudinal associations between different types of bullying victimiza-tion,suicide ideation/attempts,and depression among a large sampleof European adolescents[J]. J Child Psychol Psychiatry,2018,DOI:10.1111/jcpp.12951.
[20]KIM Y J,MOON S S,KIM M J. Physical and psycho-social predic-tors of adolescents’suicide behaviors[J]. Child Adolesc Soc Work J,2011,28(6):421-438.
[21]ZUBRICK S R,HAFEKOST J,JOHNSON S E,et al. The continuityand duration of depression and its relationship to nonsuicidal self-harmand suicidal ideation and behavior in adolescents 12-17[J]. J AffectDisord,2017,220:49-56.
[22]NORTON P J,TEMPLE S R,PETTIT J W. Suicidal ideation andanxiety disorders:elevated risk or artifact of comorbid depression[J].J Behav Ther Exp Psychiatry,2008,39(4):515-525.
[2]GALFALVY H C,OQUENDO M A,MANN J J,et al. Suicidal idea-tion and behavior in institutions of higher learning:a latent class anal-ysis[J]. Acta Psychiatr Scand,2008,117(4):244-252.
[3]董永海,刘芸,刘磊,等.中国中学生自杀相关行为报告率的Meta分析[J].中国学校卫生,2014,35(4):532-536.
[4]李陈,王宏,李金,等.重庆地区青少年自杀意念及其相关因素分析[J].中国全科医学,2012,15(34):4003-4005.
[5]张媛,胡小兵,程欣,等.高中生自杀态度的特征及其与自杀意念[J].中国健康心理学杂志,2013,21(2):258-260.
[6]潘菁,王怡,曹承建,等.杭州市城乡中学生伤害发生现况及影响因素分析[J].中国社会医学杂志,2011,28(2):103-105.
[7]都芳,齐凯,鲁玮,等.大学生遭受校园暴力现状及影响因素分析[J].中国学校卫生,2018,39(6):857-859.
[8]郭丽.安阳市青少年网络成瘾现况及影响因素分析[J].现代预防医学,2016,43(5):827-831.
[9]高仙,卢立新,张世伟,等.北京西城区中学生减肥相关行为调查[J].中国公共卫生,2012,28(11):1417-1420.
[10]郭丽.安阳市青少年自杀行为及影响因素分析[J].中国公共卫生,2016,32(11):1520-1523.
[11]潘丝媛,李武权,黎明,等.广州市中学生网络成瘾与自杀相关行为的关系[J].中国学校卫生,2018,39(2):229-231.
[12]吴虹,邓剑雄,高雪,等.深圳市中学生自杀相关行为现况调查[J].中国公共卫生,2015,31(11):1373-1376.
[13]朱琦,夏庆华,喻彦,等.上海市长宁区初中生自杀意念流行现状及影响因素分析[J].中国学校卫生,2017,38(11):1637-1640.
[14]田琪,汪晓敏,章荣华,等.杭州市青少年自杀问题现况调查[J].中国心理卫生杂志,2012,26(3):230-234.
[15]汪耿夫,方玉,江流,等.安徽省中学生网络欺凌与自杀相关心理行为的关联研究[J].卫生研究,2015,44(6):896-903.
[16]TEMPIER R,GUéRIN E.Tobacco smoking and suicidal thoughts andattempts:relationships from a general population survey[J]. Clin Ep-idemiol Global Health,2015,3(3):137-143.
[17]常利涛,戴璟,闵杰青,等.中国人口较少民族中小学生自杀意念流行现况及危险因素研究[J].中华疾病控制杂志,2018,22(3):244-248.
[18]HONG L,GUO L,WU H,et al. Bullying,depression,and suicidalideation among adolescents in the Fujian province of china:a cross-sectional study[J]. Medicine,2016,95(5):e2530.
[19]BRUNSTEIN K A,BARZILAY S,APTER A,et al. Bi-directionallongitudinal associations between different types of bullying victimiza-tion,suicide ideation/attempts,and depression among a large sampleof European adolescents[J]. J Child Psychol Psychiatry,2018,DOI:10.1111/jcpp.12951.
[20]KIM Y J,MOON S S,KIM M J. Physical and psycho-social predic-tors of adolescents’suicide behaviors[J]. Child Adolesc Soc Work J,2011,28(6):421-438.
[21]ZUBRICK S R,HAFEKOST J,JOHNSON S E,et al. The continuityand duration of depression and its relationship to nonsuicidal self-harmand suicidal ideation and behavior in adolescents 12-17[J]. J AffectDisord,2017,220:49-56.
[22]NORTON P J,TEMPLE S R,PETTIT J W. Suicidal ideation andanxiety disorders:elevated risk or artifact of comorbid depression[J].J Behav Ther Exp Psychiatry,2008,39(4):515-525.