14～16岁留守儿童心理状况及自杀倾向分析

目的 探讨父母外出打工对14～16岁留守儿童心理状况与自杀倾向(包括意念、计划和行为)的影响.方法 选取安徽省六安市3所中等专业学校14～16周岁在校学生852名,有效调查人数840名;采用抑郁自评量表(SDS)、焦虑自评量表(SAS)和特质对应方式问卷(TCSQ),进行抑郁、焦虑和应对方式的心理状况评定;参考美国疾病预防控制中心(CDC)青年危险行为监测系统(YRBSS)自杀行为定义设计调查问卷;采用描述流行病学方法分析父母外出打工对14～16岁留守儿童的心理状况与自杀意念、计划和行为的影响.结果 840名14～16周岁儿童中,父母均外出打工146名,仅父亲外出打工149名,仅母亲外出打工39名.父母外出打工与否儿童的抑郁和焦虑检出率差异无统计学意义;父亲外出打工儿童的积极应对评分为(28.221 5±5.513 92),父母均未外出打工儿童的积极应对评分为(28.915 0±5.857 61),与父母均外出打工儿童的积极应对评分(30.527 4±5.886 51)比较,差异均有统计学意义(P<0.01);840名儿童中,有过自杀意念者占37.0%;有过自杀计划者占12.5%;有过自杀行为者占6.3%;仅父亲外出打工儿童的自杀意念发生率为63.8%,仅母亲外出打工儿童的自杀意念发生率为64.1%,与父母均未外出儿童的自杀意念发生率(29.8%)比较,差异有统计学意义(均P<0.001);多因素非条件Logistic回归分析结果显示,年级(RR=0.714,95%CI=0.517～0.986,P=0.041)和民族(RR=2.441,95%CI=1.087～5.480,P=0.031)对14～16岁留守儿童自杀意念的影响差异有统计学意义.结论 父母外出打工对14～16岁留守儿童心理发育仍有一定影响,其中除自杀意念外,抑郁、焦虑检出率及自杀计划、自杀行为发生率等与同年龄组无父母外出儿童比较无明显差异.     

Examining emotional, physical, social, and spiritual health as determinants of self-rated health status

PURPOSE: To determine whether individuals' perceptions of their emotional, physical, social, and spiritual health constitute elements of their self-rated health status operationalized with a commonly employed single indicator. DESIGN: Secondary analysis of cross-sectional survey data. Structural equation modeling with LISREL was used. SETTING: The Yukon Health Promotion Survey, Yukon Territory, Canada, 1993. SUBJECTS: The population-based sample was made up of 742 women and 713 men between 15 and 90 years of age; 80.3% responded. MEASURES: Self-rated health status was operationalized with the "excellent, good, fair, poor" indicator derived from the question: "In general, compared to other people your age, would you say your health is...." Social, spiritual, emotional, and physical health status were also self-rated from excellent to poor. RESULTS: The model's fit of the data was acceptable. Only physical health status significantly contributed to the variance in self-rated health status (55.1% of the variance was explained). Emotional, social, and spiritual health were found to have no effect on individuals' ratings of their health status. CONCLUSIONS: Although recent conceptualizations have broadened in much of the theoretical and political discourse about health, especially in health promotion, the self-rated health status indicator measures only physical health status.     

社会支持在超重肥胖青少年心理健康与自杀意念间的中介作用

目的 探讨超重肥胖青少年心理健康、社会支持与自杀意念的关系,为促进超重肥胖青少年心理健康发展,降低自杀意念检出率提供指导。方法 2018年3-5月选取潍坊市4 250名青少年,采用自杀意念自评量表(SIOSS)、心理健康自评量表(K10)、社会支持量表(SSRS)进行调查。结果 青少年超重检出率为9.55%(406/4 250),肥胖检出率为6.94%(295/4 250);农村超重肥胖青少年心理健康得分显著高于城市青少年(P<0.001),城市超重肥胖青少年社会支持得分显著高于农村,超重肥胖青少年自杀意念得分农村显著高于城市(P<0.001);心理健康与自杀意念呈显著正相关(r=0.639,P<0.01),社会支持分别与心理健康、自杀意念呈显著负相关(r=-0.378和-0.449,P<0.01);心理健康与社会支持对超重肥胖青少年自杀意念有显著预测作用(β=0.278和-0.197,P<0.01;R²=0.459),且社会支持在心理健康与自杀意念之间起部分中介作用。结论 通过改善超重肥胖青少年的心理健康状况,提高其社会支持,从而降低超重肥胖青少年的自杀意念。     

武汉市大学新生自杀意念和日常压力及积极心理健康的关联

  目的  了解武汉市大学新生的自杀意念现状及影响因素, 探讨日常压力、积极心理健康对其自杀意念的影响, 从积极心理的视角为提高大学新生心理健康水平、减少大学新生的自杀率提出对策。  方法  于2020年12月采用方便抽样方法, 抽取武汉市3所大学共2 592名大学新生进行问卷调查。调查内容包括一般人口学信息、自杀意念、积极心理健康、日常压力源等。采用t检验、Logistic回归分析等方法探究大学新生的自杀意念现状及其影响因素。  结果  大学新生过去1年自杀意念报告率为27.5%。与无自杀意念大学新生相比, 有自杀意念的大学新生日常压力总分及不同领域日常压力得分均较高(t=-13.00~-4.68), 积极心理健康得分较低(t=17.14), 差异均有统计学意义(P值均 < 0.01)。Logistic回归分析显示, 女生(OR=1.72, 95% CI=1.44~2.05)、母亲受教育程度为高中以上(OR=1.27, 95% CI=1.05~1.53)、日常压力总分(OR=1.11, 95% CI=1.09~1.13)与自杀意念的发生呈正相关(P值均 < 0.01)。积极心理健康(OR=0.88, 95% CI=0.87~0.90)与自杀意念的发生呈负相关(P < 0.01), 积极心理健康对日常压力与自杀意念的关系具有一定调节作用。  结论  大学新生自杀意念的形成与日常压力、积极心理健康有密切关系, 需要关注大学新生日常压力事件, 提高其积极心理健康水平, 降低大学新生自杀意念的发生。     

Employment status, social ties, and caregivers' mental health

The purpose of this study of mid-life and older women was to assess the relation between informal care provision and depressive symptoms, taking into account concurrent demands on women's time (including multiple caregiving roles and employment outside the home) as well as participants' access to potentially supportive social ties. This cross-sectional study included women ages 46-71, free from major disease, who provided complete health and social information in the 1992 Nurses' Health Study follow-up survey (n = 61,383). In logistic regression models predicting depressive symptoms, we examined the interaction between employment outside the home and informal care provision for a disabled or ill spouse or parent. We also investigated level of social ties, measured with the Berkman-Syme Social Network Index, as a potential modifier of the association between informal care provision and depressive symptoms. In all analyses, higher weekly time commitment to informal care for a spouse or parent was associated with increased risk of depressive symptoms. This relationship persisted whether women were not employed outside the home, were employed full-time, or were employed part-time. Higher weekly time commitment to informal care provision was associated with increased risk of depressive symptoms whether women were socially integrated or socially isolated. However, both informal care provision and social ties were potent independent correlates of depressive symptoms. Therefore, women who reported high spousal care time commitment and few social ties experienced a dramatic elevation in depressive symptoms, compared to women with no spousal care responsibilities and many social ties (OR for depressive symptoms=11.8; 95% CI 4.8, 28.9). We observed the same pattern among socially isolated women who cared for their parent(s) many hours per week, but the association was not as strong (OR for depressive symptoms=6.5; 95% CI 3.4, 12.7). In this cross-sectional study, employment status did not seem to confer additional mental health risk or benefit to informal caregivers, while access to extensive social ties was associated with more favorable caregiver health outcomes.     

Volume and social context of physical activity in association with mental health,anxiety and depression among youth

There is growing interest in physical activity (PA) to prevent mental disorders in youth. However, few studies examine the association between PA and mental health. Further, how PA volume and context relate to mental health and mental disorders remains unclear, especially among youth in transition to adulthood. This study examined the cross-sectional associations among PA volume and context, mental health, and symptoms of anxiety and depression in post-secondary students. A total of 1527 post-secondary students (97.4% were age 16–24 years) recruited in a CEGEP in Quebec, Canada completed a self-report questionnaire during class-time in October 2013. Multivariate linear regression was used to model the associations between PA volume and context and mental health, anxiety and depression controlling for sex, age and perceived socioeconomic status. Volume of moderate-to-vigorous leisure time PA (MVPA) was positively associated with mental health (β (95% CI) = 0.072 (0.045, 0.099)) and inversely associated with symptoms of anxiety (− 0.011 (− 0.020, − 0.001)) and depression (− 0.010 (− 0.017, − 0.003)). Volume including all PA intensities was associated with mental health (0.052 (0.028, 0.076)). After controlling for PA volume, active youth involved in team sports had better mental health than those who engaged in PA individually. PA volume and the social context of PA are independently associated with mental health among youth. MVPA is inversely associated with anxiety and depressive symptoms.     

有自杀意念的大学生应对方式在心理韧性与心理健康间的中介作用

目的 探讨有自杀意念的大学生应对方式在心理韧性与心理健康之间的中介作用,以期能够促进心理韧性发挥积极效果,为预防有自杀意念的大学生实施自杀行为提供参考。方法:采用分层随机抽样抽取山东省1170名大学生,采用特质应对方式问卷（TCSQ）、青少年心理韧性量表（RSCA）、一般健康问卷（CHQ-20）进行现场调查。结果:①有自杀意念的大学生检出率为12.70%（149名）;②有自杀意念的大学生心理韧性、积极应对的分数均比无自杀意念的大学生低（P＜0.05）,消极应对与心理健康的分数均比无自杀意念的大学生高（P＜0.01）;③有自杀意念的大学生心理韧性、积极应对分数与心理健康分数均为负相关（P＜0.01）,消极应对与心理健康分数为正相关（P＜0.01）;④PC和NC在心理韧性对心理健康的作用中都发挥了中介作用,中介效应值占总效应值的62.15%。结论 有自杀意念的大学生应对方式在心理韧性与心理健康间起到了部分中介效应。     

Relationships of self-reported physical health, sociability, and spiritual life with mental health: an investigation according to gender and life stage

OBJECTIVE: To investigate the relationships of self-reported physical health, social and spiritual satisfactions with subjective mental health according to gender and life stage. METHODS: Self-reported questionnaires with questions regarding subjective health status and lifestyles were sent to 1905 community residents aged 20 years or older selected by random sampling in Wakayama Prefecture, Japan. Subjective mental health, physical health, social and spiritual satisfactions as measures of subjective health status were assessed using a visual analogue scale. Multiple logistic regression analysis was used to evaluate the relationships between the subjective mental health and the other three components of the subjective health status with adjustment for life style factors related to the subjective mental health in the subjects without missing values of relevant factors (n=1,752). The subjects were divided into three life stages depending on their ages: young (20-39), middle (40-59), and old (60 or more). RESULTS: Overall, the poor statuses of the three components, namely, physical health, social and spiritual satisfactions, were significantly associated with poor mental health in both genders at any life stage. However, detailed analysis revealed some interesting characteristics. In young men, social dissatisfaction was strongly associated with poor mental health whereas spiritual dissatisfaction in addition to social dissatisfaction was strongly associated with poor mental health in young women. In the middle aged group, both social and spiritual dissatisfactions were strongly associated with poor mental health in both genders. On the other hand, poor physical health status was strongly associated with poor mental health in the old aged group. CONCLUSIONS: These results suggest the importance of the mental health interventions under consideration for each life stage and gender.     

新疆高校大学生社会支持与自杀意念相关分析

目的了解新疆高校大学生自杀意念发生的情况及社会支持对自杀意念的影响,为大学生群体自杀预防、危机干预提供科学依据。方法分层整群随机抽取新疆维吾尔族自治区范围内7所高校的各个年级大学生2 763名进行问卷调查。结果新疆高校大学生自杀意念报告率为21.6%;女生的社会支持总分、客观支持和支持利用度得分高于男生;非独生子女的社会支持总分、主观支持得分高于独生子女;非单亲大学生的社会支持总分和客观支持得分高于单亲;汉族大学生客观支持得分显著高于民族大学生得分;无自杀意念组大学生的客观支持、主观支持、支持利用、支持总分均高于有自杀意念组的分数。结论提高社会支持可以降低大学生的自杀意念报告率。     

Problematising depression: young people,mental health and suicidal behaviours

The published literature provides strong evidence for connections between mental health issues, such as depression, and suicidal behaviours. However, in spite of this, no investigations to date have explored young people's perceptions of the interconnections between depression, and suicidal behaviours. This article presents discussive analyses of discussions of the contributions of depression to their suicidal behaviours of young people in New Zealand. Two dominant discourses of depression emerged: a medicalised discourse, and a moral discourse. The medicalised discourse was accessible to the majority of participants, and constructed depression as a disease. This discourse prioritised the voices of health professionals and suggested that depression was difficult to resist. The moral discourse was an alternative to the medicalised discourse, and constructed young people who experienced depression and suicidal behaviours as failures. Both discourses were informed by a mechanistic cause-and-effect relationship between depression and suicidal behaviours: attempting suicide was seen as an inevitable outcome of experiencing depression, and suicidal behaviours were inevitably undertaken by young people who were depressed. Resistance to either of these dominant discourses was problematic, and was best articulated during discussions of the stigma associated with mental ill-health and depression.     

Depression,sleeping pattern,and suicidal ideation among medical students in Bangladesh: a cross-sectional pilot study

Journal of Public Health - Depression is a major morbidity and the most common mental disorder among the medical students in medical schools globally. Undergraduate students suffer stress more due...     

Cultural change and mental health in Greenland: the association of childhood conditions, language, and urbanization with mental health and suicidal thoughts among the Inuit of Greenland

In Greenland, the rapid sociocultural change of the last 50 years has been paralleled by an epidemiological transition characterized by a reduction in infectious diseases, an increase in cancer and cardiovascular diseases, and an increased prevalence of mental health problems. During 1993-94 and 1997-98, two health interview surveys were conducted among Inuit in Greenland and Inuit migrants in Denmark. The response rates were 71 and 55%. Information on mental health was obtained from 1388 and 1769 adults. As indicators of mental health, the prevalence of potential psychiatric cases according to the General Health Questionnaire (GHQ-12) and the prevalence of suicidal thoughts were studied in relation to childhood residence and father's occupation, current residence, and language. The statistical methods included logistic regression and graphical independence models. The results indicated a U-shaped association in Greenland of GHQ-cases with age and a high prevalence of suicidal thoughts among young people; a low prevalence of GHQ-cases among those who were bilingual or spoke only Danish; and a high prevalence of suicidal thoughts among migrants who grew up in Denmark and among residents of the capital of Greenland. In Greenland, women were more often GHQ-cases and had suicidal thoughts more often than men. The association between language and GHQ-cases is presumed to operate through socioeconomic factors. It is necessary to modify the common notion that rapid societal development is in itself a cause of poor mental health: as a result of successful integration into the modern Greenlandic society, some population groups have better mental health compared to other groups.     

The association between subjective social status and mental health among Asian immigrants: investigating the influence of age at immigration

This paper examines how age at immigration influences the association between adult subjective social status and mental health outcomes. The age when people immigrate shapes the capacity and efficiency at which they learn and use a new language, the opportunities to meet and socialize with a wide range of people, and respond to healthy or stressful environments. We hypothesize that adult subjective social status will be more predictive of health outcomes among immigrants who arrive in the US in mid- to late-adulthood compared with immigrants who arrive earlier. To investigate this hypothesis, data on immigrants are drawn from the US first national survey of mental health among Asian Americans (N=1451). Logistic regression is used to estimate the relationships between adult subjective social status and mood dysfunction, a composite of anxiety and affective disorder symptoms. As predicted, age at immigration moderated the relationship between adult subjective social status and mood dysfunction. Adult subjective social status was related to health among immigrants arriving when they were 25 years and older, but there was no association between subjective social status and mental health among immigrants arriving before the age of 25 years.     

Predictors of mental and physical health: Individual and neighborhood levels of education, social well-being, and ethnicity

This study examines how education benefits health through social well-being in Hawaii where the centrality of community life is underscored. The 2007 Hawaii Health Survey with linked zip-code information was used to investigate the effects of education at both individual and neighborhood levels using mixed-effects models. Geographic Information System was applied to map the geographical distributions of education, social well-being, and health. It was found that individual-level education benefits mental health and its effects are largely mediated by respondents' employment status and their social well-being (social integration, social contribution, social actualization, and social coherence). Both individual and neighborhood-level education promotes physical health and their effects are partially mediated by economic well-being and two indicators of social well-being (social integration and social coherence). Results of this study suggest the independent effects of two levels of education on physical health and the importance of education and social well-being to both mental and physical health in the State of Hawaii.     

大学生自我和谐、心理健康与自杀意念关系

目的了解大学生自杀意念特点,探讨大学生自我和谐、心理健康与自杀意念的关系,为自杀预防与干预提供依据。方法采取分层整群抽样方法,运用自我和谐量表(SCCS)、症状自评量表(SCL-90)调查6所高校768名在校学生自我和谐、心理健康及自杀意念情况。结果13.2%的大学生有自杀意念,男生自杀意念为14.0%,高于女生的12.6%;理科学生为16.2%,高于文科学生的10.4%,差异均有统计学意义(P<0.05);有自杀意念组大学生自我和谐及心理健康水平(100.11±9.26),(211.30±52.40)低于无自杀意念组大学生(90.34±12.14),(143.28±34.59),差异有统计学意义(P<0.001);多元逐步回归分析显示,躯体化、抑郁、自我与经验不和谐、自我灵活性、强迫症状和恐怖因子对自杀意念有明显预测作用。结论通过提高心理健康水平和自我和谐可以降低大学生自杀意念。     

临床医生社会支持与心理健康关系

目的 探讨社会支持、心理控制源对临床医生心理健康的影响.方法 采用症状自评量表(SCL-90)、社会支持评定量表(SSRS)和内控性、有势力他人及机遇量表(IPC)对276名临床医生进行问卷调查.结果 临床医生的心理健康状况总体良好,优于全国青年常模;临床医生的心理健康各因子与心理控制源中的有势力他人因子呈正相关(P≤0.05);心理健康中的人际敏感因子、抑郁因子和精神病性因子与心理控制源和社会支持的各因子相关明显.回归分析表明,有势力他人与主观支持因子对临床医生心理健康具有明显预测作用.结论 临床医生的心理健康状况良好;心理控制源中的有势力他人因子和社会支持对其心理健康状况具有一定的预测作用.     

Reconsidering the role of social disadvantage in physical and mental health: stressful life events, health behaviors, race, and depression

Prevalence of depression is associated inversely with some indicators of socioeconomic position, and the stress of social disadvantage is hypothesized to mediate this relation. Relative to whites, blacks have a higher burden of most physical health conditions but, unexpectedly, a lower burden of depression. This study evaluated an etiologic model that integrates mental and physical health to account for this counterintuitive patterning. The Baltimore Epidemiologic Catchment Area Study (Maryland, 1993-2004) was used to evaluate the interaction between stress and poor health behaviors (smoking, alcohol use, poor diet, and obesity) and risk of depression 12 years later for 341 blacks and 601 whites. At baseline, blacks engaged in more poor health behaviors and had a lower prevalence of depression compared with whites (5.9% vs. 9.2%). The interaction between health behaviors and stress was nonsignificant for whites (odds ratio (OR = 1.04, 95% confidence interval: 0.98, 1.11); for blacks, the interaction term was significant and negative (β: -0.18, P < 0.014). For blacks, the association between median stress and depression was stronger for those who engaged in zero (OR = 1.34) relative to 1 (OR = 1.12) and ≥2 (OR = 0.94) poor health behaviors. Findings are consistent with the proposed model of mental and physical health disparities.