上海市中学生负性情绪与失眠症状的相关研究

目的 探讨上海市中学生负性情绪与失眠症状的相关性,为进一步的心理健康教育和睡眠干预提供参考。方法 采用多阶段分层随机整群抽样方法,于2017年11月-2018年1月抽取上海市24所中学的学生进行调查,由学生填写抑郁-焦虑-压力自评量表精简版(DASS-21)和失眠严重程度指数量表(ISI),家长填写中学生个人及家庭社会环境问卷。 结果 有效样本1 986人,平均年龄(14.71±2.01)岁,男生1 019名(51.3%)。压力、焦虑、抑郁情绪的发生率分别为23.9%、51.0%和29.0%,失眠症状发生率为37.0%。在校正了人口学因素后,有压力、焦虑、抑郁等负性情绪的中学生失眠症状风险分别高于无相应负性情绪中学生(压力:OR=2.17,95%CI:1.60~2.95;焦虑:OR=2.97,95%CI:2.27~3.88;抑郁:OR=2.59,95%CI:1.94~3.47),且在初中生中更高。 结论 上海市中学生负性情绪与失眠症状风险增加相关,特别是在初中生中相关性更高,应当进行综合评估和干预     

更年期症状表现在口腔

潮热、心悸、易怒……人们很熟悉这些妇女更年期的典型症状，殊不知，妇女更年期症状还可以表现在口腔。口腔科医生近年注意到，一些50岁左右的女病人频频来求医，她们自诉舌头或口腔其他部位出现灼痛、麻木等感觉，但是医生检查时又没发现什么问题。     

隐形脊椎裂的影像学表现与临床症状的相关性

目的：探讨隐形脊椎裂的影像学表现与临床症状的相关性，以便追踪其治疗上的合理性。方法：通过对本院已实施手术的38例隐形脊椎裂患者进行影像学检查结果的分析，以及临床表现出的症候群进行对比归纳总结，评判两者的关联性。结果：X线片诊断脊椎裂分六型，各型从骨质结构上分别表现不同，与其对应的临床症状表现也各有特点；MSCT空间分辨率高，并通过后处理技术可获得高质量的脊柱骨骼的结构；MRI对隐形脊椎裂合并脊髓畸形、硬膜粘连、硬膜下囊肿脂肪瘤、脊髓栓系具有重要的诊断价值，三者检查不能互为替代，影像学的表现也决定着临床症状的轻重。结论：隐形脊椎裂的影像学表现与临床症状的多寡、轻重有一定的关联性，对于手术治疗有决定性的作用。     

青少年昼夜节律紊乱与抑郁症状

青少年期是一个独立性增加、经历新环境且进入社会角色出现的时期,这一时期会经历身体成分的变化、性腺发育和青春期进程,从而影响一系列行为,其中较为突出的行为改变是青少年明显呈现晚睡和晚起转变[1],昼夜节律开始出现延迟[2].青少年期亦是抑郁症状的高发时期[3],世界范围内青少年人群抑郁症状的患病率约为22%~60%[4].越来越多的研究显示,青少年昼夜节律紊乱与抑郁症状密切相关[5].笔者总结了昼夜节律紊乱的评价方法,综述昼夜节律紊乱与抑郁症状的关联及其可能机制,可为青少年昼夜节律紊乱与抑郁症状的关联研究提供参考依据.     

青少年抑郁症状的预防干预研究进展

抑郁在青少年中普遍存在,已成为21世纪影响青少年身心健康的主要危险因素。因此,研究青少年抑郁症状的影响因素、分析和探讨抑郁症状的有效干预方法已成为公共卫生领域的重要问题之一。本文在梳理青少年抑郁影响因素的基础上,结合国内外近几年来的研究成果,介绍几种常见的预防干预方法及其疗效,并进一步提出现有研究中存在的问题及未来研究的展望。     

浅析三叉神经痛的症状表现与临床治疗

在神经外科治疗中,我们经常能看到患三叉神经痛的患者比较多,由于三叉神经痛是神经外科中最常见的病种之一,所以,对于三叉神经痛这种病种我们要有一个很好的临床医学诊断和治疗方法。本文通过三叉神经痛的症状表现,能够准确的做出诊断,同时也提出了一些治疗方法。     

青少年抑郁症状的相关家庭因素研究

目的 调查青少年抑郁症状发生情况,分析其相关家庭因素。方法 于2019年11月选择西安市初级中学和高级中学各2所,采用分层整群抽样的方法抽取650名学生作为调查对象,采用一般情况调查问卷、流调中心用抑郁症状自评量表、儿童期创伤问卷和父母教养方式问卷进行调查。采用多元线性回归分析探究影响青少年抑郁症状水平的相关家庭因素。结果 本组青少年抑郁症状评分为16.00(9.00,20.00)分,抑郁症状阳性筛查率为19.7%。多元线性回归分析结果显示:性别、父母婚姻状态、情感虐待、躯体虐待、父亲过度保护、母亲过度保护、父亲情感温暖、母亲情感温暖(β=-0.028、0.030、0.103、0.267、0.467、0.047、-0.279、-0.272,P＜0.001)是青少年抑郁症状的主要影响因素,共解释总变异的92.3%。结论 青少年抑郁症状阳性筛查率处于较低水平,性别、父母婚姻状态、情感虐待、躯体虐待、父/母亲过度保护、父/母亲情感温暖是青少年抑郁症状的主要家庭因素。     

失眠服安定请根据症状选用

为岁的祝先生和妻子最近一段时间为一件事情很纠结,这就是他和妻子都患有失眠,所不同的是：他是入睡困难,躺到床上辗转反侧,直到夜深,怎么也睡不着;妻子倒是晚饭后没多久就早早睡了,可到了凌晨就醒了,再也睡不着。搞得他俩分床乃至分房睡觉,还是互相影响。他们想服用安眠药,听说安定这类药就很适合,这天祝先生来到内科门诊咨询我：他们能够服用安定吗？     

浦东新区学校传染病症状监测信息系统的建立与初步分析

目的对上海世博会期间浦东新区学校传染病症状监测信息系统的建立与运作情况进行分析评价,探讨该系统在学校传染病疫情预防控制中发挥的作用。方法开发"学生症状监测信息系统",从2010年5月1日起,学校通过信息系统网络报告发热伴呼吸道、胃肠道腹泻和发热伴出疹等3个症状群因病缺课数据以及异常情况事件。结果 478家中小学校及托幼机构加入该监测信息系统,2010年184天世博会活动期间,450家学校及托幼机构坚持每天及时上报症状监测信息;57家(11.9%)学校及托幼机构报告基于暴发疫情早期的异常情况事件409起,共发现11起学校/托幼机构传染病集聚性事件,平均每起事件报告病例3.5例。结论 "学校症状监测信息系统"在本地区成功建立并正常运作,对中小学校及托幼机构传染病预防控制及疫情早期预警防控起到了积极的作用。     

中国儿童青少年抑郁症状性别差异的流行病学调查

目的 了解中国儿童青少年抑郁症状的流行特征和性别差异。方法 采取整群抽样,在全国9个协作地区选取9．0～18．9岁汉族城乡各年龄组儿童青少年男女生各50人,每个地区最低样本量为2000人。采用儿童抑郁量表(CDI)评定小学四年级至高中三年级青少年的抑郁症 状,评估第二性征(男女童阴毛、女童乳房和男童外生殖器)发育指标。结果 中国青少年抑郁症状总检出率为14．81％,男女生抑郁症状检出率分别为15．35％和14．43％。农村地区儿童青少年抑郁症状检出率(16．41％)高于城市(13．23％)。lO、11岁组男生抑郁症状检出率均高于同龄女生(χ²=11．625,P＜0．005;χ^{2＜0．005),17岁组女生抑郁症状检出率(21．5％)高于同龄男生(17．26％)(χ2＜0．005)。仅在Tanner发育Ⅱ期,男生抑郁检出率(18．4％)高于女生 (15．8％),差异有统计学意义(χ2＜0．005)。结论 在特殊年龄段和特定发育阶段,中国儿童青少年抑郁症状检出率存在性别差异,但还需要进一步纵向研究以证实。}     

Intergenerational relationships and depressive symptoms among older adults in urban China: The roles of loneliness and insomnia symptoms

The prevalence of depressive symptoms in older Chinese adults has increased recently. Intergenerational relationships play an important role in the mental health conditions of older adults, especially in Chinese culture. Therefore, this study aims to unravel the complex connection between intergenerational relationships and depression, and to explore the potential mediating roles of loneliness and nighttime insomnia symptoms within that connection. A cross‐sectional household survey was conducted in China with 2038 participants aged 65 years or above. Variables were measured using the Center for Epidemiologic Studies Short Depression Scale, the Intergenerational Relationship Quality Scale for Aging Chinese Parents (IRQS‐AP), three nighttime insomnia symptoms extracted from the Insomnia Severity Index and the De Jong Gierveld Six‐Item Loneliness Scale. The IRQS‐AP includes four subdimensions: consensual‐normative solidarity, structural‐associational solidarity, affectual closeness and intergenerational conflicts. Path analyses were performed in Mplus to investigate regression coefficients and mediating effects. Results showed that three general intergenerational relationships (consensual‐normative solidarity, affectual closeness and intergenerational conflicts) were significantly correlated with all mental health outcomes, including their symptoms of loneliness, insomnia and depression. A serial mediation model suggested that loneliness mediated the connection between those constructs of intergenerational relationships and depression, with an independent path to insomnia symptoms via loneliness. The proposed mediators fully mediated the effects of affectual closeness on depression. Nighttime insomnia symptoms alone mediated only the relationship between intergenerational conflicts and depression independently from paths involving depression. Removal of sleep item from CES‐D did not affect the results of paths. Our findings highlight the importance of intergenerational relationships for mental health, especially for the mediating effects of loneliness and nighttime insomnia symptoms on the relationship between intergenerational relationships and depression. Effective mental health services for older adults can address their feelings of loneliness and sleep problems, especially for those who have a poor relationship with their adult children.     

Lifestyles and psychosomatic symptoms among elementary school students and junior high school students

Objectives  To examine the relationship between lifestyles and psychosomatic symptoms in children, we conducted a self-administered questionnaire survey of elementary school students and junior high school students in Japan. Methods  We designed an original questionnaire to investigate the lifestyles and psychosomatic symptoms of children. In 1997, responses to the questionnaires were elicited from public elementary school fourth grade students (then aged 9–10) and public junior high school seventh grade students (then aged 12–13). The survey was repeated annually for three years as the students advanced through school. Results  For both boys and girls, each cross-sectional analysis revealed a strong relationship between lifestyle behaviors and psychosomatic symptoms. Psychosomatic, symptoms scores varied according to daily hours of sleep, eating of breakfast, having strong likes and dislikes of food, bowel habits, and daily hours of television watching. Both boys and girls with “good” lifestyle, behaviors evaluated by the HPI (Health Practice Index) showed lower scores for psychosomatic symptoms. Conclusions  These findings show that the lifestyle behaviors of children are significantly associated with psychosomatic symptoms and suggest that poor lifestyle behaviors are likely to increase physical and psychological health risks.     

中学生抑郁症状的影响因素分析

目的 探讨中学生出现抑郁症状的影响因素,建立风险预测的列线图模型,为防控中学生抑郁提供理论依据。方法 采用分层整群抽样的方法,抽取大连市城市和农村中学生共3 470名,使用学生健康行为调查表及抑郁量表进行问卷调查;采用多因素logistic回归分析抑郁症状的影响因素,并建立列线图,预测中学生出现抑郁症状的风险。 结果 中学生的抑郁症状检出率为24.12%,肯定有抑郁症状的检出率为16.22%。遭受校园欺凌（OR = 2.748,95%CI:2.257～3.346）、被家长打骂（OR = 2.025,95%CI:1.679～2.433）、学段（职高:OR = 1.883,95%CI:1.286～2.758;高中:OR = 1.242,95%CI:1.001～1.541）、上网时间越长（≥3 h:OR = 1.773,95%CI:1.366～2.302;2～＜3 h:OR = 1.525,95%CI:1.190～1.954）、女生（OR = 1.352,95%CI:1.141～1.603）、农村地区（OR = 1.351,95%CI:1.126～1.622）均是中学生抑郁症状检出的危险因素;体育课时数多（2 节:OR = 0.685,95%CI:0.504～0.931;≥3 节:OR = 0.583,95%CI:0.425～0.799）、睡眠时间充足（OR = 0.676,95%CI:0.562～0.812）都是中学生抑郁症状检出的保护因素;基于以上影响因素建立的列线图模型具有较好的区分度（一致性指数C - index = 0.700,95%CI:0.680～0.721）和准确度（Hosmer - Lemeshow检验χ2 = 2.885,P = 0.941）。 结论 遭受校园欺凌、被家长打骂、职高或高中、上网时间越长、女生、来自农村地区、体育课时数少、睡眠时间不足的中学生更容易出现抑郁症状,可以利用列线图直观、有效地预测中学生出现抑郁症状的风险,从而有针对性地对高危群体及时采取干预措施。     

Multidimensional factors of determining trajectories in self-rated health and depressive symptoms among Korean children and adolescents

ABSTRACT

Understanding health disparities in the early stage of life is complicated by the complex interplay of psychosocial and environment factors. Despite these complexities, few studies have investigated multidimensional aspects of determining health trajectories of Korean children and adolescents. Thus, this study aims to investigate the impact of intrapersonal, interpersonal, and environmental factors on trajectories in self-rated health and depressive symptoms. Totally, 2378 Korean student samples were selected from the Korean Children and Young Panel Survey for data analysis. The findings indicated that higher levels of self-esteem, attachment to parents, and relationship with friends predicted better self-rated health and less depressive symptoms at baseline. Perception on community only predicted better self-rated health but not depressive symptoms at baseline. Among multidimensional factors, only self-esteem predicted the rate of changes in self-rated health and depressive symptoms. This study suggested that enhancing self-esteem and supportive environment should be provided throughout childhood and adolescence.     

我国城市学龄儿童青少年伤害现状及特征

目的 分析我国近10年城市学龄儿童青少年伤害发生的现状及特征, 为有效预防提供依据。方法 采用Meta分析方法, 根据文献检索策略及纳入、排除标准, 检索中国相关生物医学数据库, 并结合文献追溯, 收集2002年1月-2012年12月过去10年间公开发表有关我国城市学龄儿童青少年伤害现状的研究文献。应用Stata 11.0软件进行系统分析。结果 最终符合纳入标准的文献有33篇, 涉及总样本量146 757人, 男女比例为1.02∶1。Meta分析显示, 我国城市学龄儿童青少年伤害人数发生率为29%(95%CI:24.5%~34.3%), 人次发生率为53.2%(95%CI:41.7%~67.9%)。跌落伤为首位原因, 而交通伤害则倾向于在同一个体身上重复发生。男生伤害人数发生率(35.1%)高于女生(27.6%), 中学生伤害人数发生率(31.2%)略高于小学生(30.1%)(P>0.05)。结论 我国城市学龄儿童青少年伤害现状严峻, 建议完善符合我国国情的伤害预防监测和干预机制。     

Internet addiction and psychiatric symptoms among Korean adolescents

BACKGROUND: The aims of this study were to identify the independent factors associated with intermittent addiction and addiction to the Internet and to examine the psychiatric symptoms in Korean adolescents when the demographic and Internet-related factors were controlled. METHODS: Male and female students (N = 912) in the 7th-12th grades were recruited from 2 junior high schools and 2 academic senior high schools located in Seoul, South Korea. Data were collected from November to December 2004 using the Internet-Related Addiction Scale and the Symptom Checklist-90-Revision. A total of 851 subjects were analyzed after excluding the subjects who provided incomplete data. RESULTS: Approximately 30% (n = 258) and 4.3% (n = 37) of subjects showed intermittent Internet addiction and Internet addiction, respectively. Multivariate logistic regression analysis showed that junior high school students and students having a longer period of Internet use were significantly associated with intermittent addiction. In addition, male gender, chatting, and longer Internet use per day were significantly associated with Internet addiction. When the demographic and Internet-related factors were controlled, obsessive-compulsive and depressive symptoms were found to be independently associated factors for intermittent addiction and addiction to the Internet, respectively. CONCLUSIONS: Staff working in junior or senior high schools should pay closer attention to those students who have the risk factors for intermittent addiction and addiction to the Internet. Early preventive intervention programs are needed that consider the individual severity level of Internet addiction.     

Association between duration of daily visual display terminal work and insomnia among local government clerks in Japan

BACKGROUND: Visual display terminal (VDT) work has become very common among office workers in developed countries; however, studies investigating the association between the duration of daily VDT work and insomnia are limited. METHODS: The aim of this study was to clarify the association between the duration of daily VDT work and sleep disturbances. We investigated 2,417 clerks (men, 2,030; women, 387) at local government offices. Sleep disturbances were evaluated using the Athens Insomnia Scale (AIS). RESULTS: VDT work of 6 hr or more per day was significantly associated with insomnia (odds ratio = 1.62, 95% confidence interval: 1.16-2.27) and, in particular, caused problems with "total sleep duration" and "sleepiness during the day" among sleep-related symptoms, even after adjusting for possible confounding factors. CONCLUSIONS: Our study suggested that VDT work of 6 hr or longer per day was related to insomnia.     

云南农村初中生抑郁症状及其相关因素研究

目的探讨农村初中生抑郁症状状况及其相关因素的关系。方法采用流调中心用抑郁量表(CES-D)、青少年生活事件量表(ASLEC)、中学生应对方式量表、社会支持评定量表(SSRS)和自编问卷对云南省2293名农村初中生进行调查。结果抑郁症状检出率为22.2%,其中男生20.9%,女生23.7%,男女生差异无统计学意义(χ2=2.696,P﹥0.05);初一18.8%,初二26.3,初三21.7%,各年级间差异有统计学意义(χ2=12.740,P﹤0.05);汉族23.7%,彝族21.9%,白族15.5%,哈尼族30.1%,其他民族22.7%,各民族间差异有统计学意义(χ2=20.974,P﹤0.001)。农村初中生抑郁症状与生活事件、应对方式、社会支持各因子均有显著的相关关系。结论农村初中生抑郁症状普遍存在,且抑郁症状与生活事件、应对方式、社会支持关系密切,受多种因素的影响。