摘要
近年来,国内外大量心理健康状况的研究结果表明,大学生中存在着各种不同程度的心理疾病。强迫症是大学生所患心理疾病中痛苦程度较高的顽症,且呈现出逐渐升高的趋势。其症状典型、特异性高、病程较长、治疗困难,严重影响了大学生的学习和生活。目前,针对强迫症的研究主要集中在临床群体,而对于非临床大学生的研究为数不多。
本研究遵循“现况调查-实验检测-理论分析”的思路,以某综合性大学的2046名本科生为研究对象。在大量文献阅读的基础上,通过流行病学的现况调查,分析大学生强迫症的流行病学特征和临床特点,探索影响大学生强迫症的相关因素。利用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)方法检测Sapap3基因上的rs11264155 tag SNP位点,初步探索Sapap3基因多态性与大学生强迫症的关系。调查结果显示,强迫症在大学生群体中检出率较高,有明显的性别和年级差异,并受家庭环境、儿童时期父母的教养方式和社会支持程度等方面的影响。实验结果显示,Sapap3基因多态性与大学生强迫症及其临床症状之间无关联。
本研究为高校实施大学生心理健康教育提供了科学的理论依据,并为强迫症的易感基因研究奠定了基础。建议学校、家庭和社会建立三级支持系统,预防大学生强迫症的发生。
Obsessive Compulsive Disorder is a chronic mental illness of higher degree among undergraduates, and the incidence rate of OCD in undergraduates has continued rising trend, which has seriously affected the living and learning of undergraduates. At present, most research of OCD is mainly focused on the clinical community. However, specific studies on the non-clinical community of undergraduates are much less carried out. Therefore, this study has important theoretical and practical value. Objective
By means of epidemiological investigation and molecular genetics technology, analyze the prevalence characteristics and clinical features of OCD undergraduates, discusse the relevant factors and investigate the genetic association between Sapap3 gene polymorphism and OCD in undergraduates.
Methods
1. The epidemiology of OCD in undergraduates.
This research takes 2046 undergraduates in a comprehensive University in Jilin for study. By the use of World Health Organization Composite International Diagnostic (WHO-CIDI 3.0), interviewed undergraduates in face-to-face standardized. Under the computer diagnostic procedures provided by WHO, diagnosed OCD in undergraduates. By the statistical method ofχ2 test, analysis of variance, t-test analysis to analyse the characteristics of gender, age, source, clinical sympotoms, family environment, childhood and social nets. Through correlation analysis and regression statistical methods, explore risk factors of OCD undergraduates.
2. Sapap3 gene polymorphism test
In this research, 190 cases of OCD and 190 normal controls were selected in undergraduates with age、sex and subject in match. With the informed consent of subjects, collecting saliva of undergraduates, using Promega (Promega, United States) liquid extract DNA Purification Kit, extraction of genomic DNA. The polymerase chain reaction (PCR) and restrictive fragment length polymorphism (RFLP) were applied to detect the gene types of Sapap3 the rs11264155 in OCD undergraduates. Application of goodness-of-fitχ2 test, the calculation of the SNP sites genotype frequency distribution is consistent with the Hardy-Weinberg equilibrium; applicationχ2 test of the SNP sites and clinical types of OCD.
Results
1. The lifetime prevalence rate of OCD undergraduates is 13.67%, 12-month prevalence rate is 6.19%. 30-day prevalence rate is 2.12%; Male prevalence is significant higher than female (χ2=5.474, P=0.019); There were found differences in different grades(χ2=16.479,P=0.001), the performance of the freshman and sophomore higher than junior and senior.
2. The OCD in undergraduates mainly in the type of mixed-oriented (45.24%), followed by the Obsessive (35.71%) and Compulsive (19.05%). The highest frequency of OCD symptom is aggressive obsessions (63.49%), following by symmetry obsessions (42.46%) and sexual obsessions (38.89%). There were found sex differences exist in symmetry obsessions(χ2=8.442,P=0.004)、sexual obsession(sχ2=6.488,P=0.012)and ordering compulsions(χ2=6.719,P=0.010).
3. Through single factor analysis, there were found several influence factors: gender、grades、parents moods、father occupational status、mother strict controls、parents is low-density、social exchanges、family conflicts and so on . Through multi-factor analysis, there were found risk factors: gender、grades、mood of mother、father occupational status、relationship with parents、look after by partents and family conflicts.
4. Sapap3 gene rs11264155 sites, genotype frequencies of case group and control group was not significant(P=0.300)and allele frequencies of case group and control group was also not significan(tχ2=2.295,P=0.130). The genotype and allele distribution between two groups in OCD type and sympotoms were not significant.
Conclusions
OCD performance higher prevalence in undergraduates, and exist significant differences in sex and grades; The OCD undergraduates mainly in the type of mixed-oriented, and mainly in the sympotoms of aggressive、symmetry and sexual obsessions. The OCD undergraduates imfluenced by family backgrounds、Childhoods and Social net; Sapap3 gene rs11264155 sites were not found significant with OCD of undergraduates.
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