医专学生SCL-90调查分析

采用症状自评量表（ＳＣＬ－９０），对大同医专８４６名学生进行问卷调查。结果表明，ＳＣＬ－９０各因子分及总分均向于国内常模，其中强迫、人际关系、抑郁及敌对因子≥３分者占５％以上。女生组人际关系、抑郁、恐怖因子分显著高于男生组，而男生组的敌对因子分高于女生组。提示应对医专生加强心理卫生教育。     

护士学校学生心理健康状况的调查研究

目的 调查研究护士学校学生(下文简称护校生)的心理健康状况。方法 采用问卷法,对170名护校生进行症状自评量表(SCL-90)、抑郁自评量表(SDS)、焦虑自评量表(SAS)的测壹,并对量表标准分大于60分的学生进行面谈。结果 在170名护校生中,SCL-90测壹．人际关系因子分大于3分者人数最多(30人)．占17．6％。其次是偏执、敌对、强迫。SDS标准分大于50分的有68名,占总人数的40％,25名SDS标准分大于60分的学生中,面谈有3名符合CCMD-3抑郁发作症状标准,无1名达到抑郁症病程标准和严重程度标准。SAS标准分大于50分的有31名,占总人数的18．2％。结论 护校生中存在的主要心理健康问题是人际关系问题。部分护校生存在押郁情绪,但真正构成抑郁症临床诊断的极少。护校生中焦虑较少,程度也轻。     

新型冠状病毒感染疫情期间酒店隔离中小学生焦虑抑郁状态

目的:探讨新型冠状病毒感染疫情期间酒店隔离的中小学生焦虑抑郁状态。方法:对内蒙古自治区赤峰市2022年9月-10月在酒店集中隔离的726名中小学生,采用儿童焦虑性情绪障碍筛查表(SCARED)、儿童抑郁障碍自评量表(DSRSC)进行测评,回收有效问卷624例,应答率为86%。SCARED≥23分、DSRSC≥15分为筛检阳性。结果:焦虑检出率为17.9%,抑郁为15.4%;初中生焦虑、抑郁检出率高于小学生(均P<0.05);女生广泛性焦虑、社交恐怖因子得分高于男生(均P<0.05);初中生分离性焦虑因子评分、抑郁评分高于小学生(均P<0.01)。结论:新型冠状病毒感染疫情期间酒店集中隔离的初中生较小学生更易出现焦虑、抑郁症状,女生较男生更易出现焦虑症状。     

常用抑郁量表筛查我国青少年抑郁的效度和划界分

目的:检验常用抑郁量表即流调用抑郁量表(CES-D)和贝克抑郁量表第2版中文版(BDI-II-C)筛查我国青少年抑郁的效度和划界分。方法:5565名中学生(年龄:14.17±1.66)完成CES-D和BDI-II-C测试,其中634人[即CES-D总分≥20分(n=322)和20分(n=312)]进一步完成了学龄期儿童情感障碍和精神分裂症问卷(K-SADS)诊断访谈。对完成访谈的青少年以美国精神障碍诊断与统计手册第4版(DSM-IV)为标准做出抑郁障碍诊断,以此为效标,计算并比较CES-D和BDI-II-C在各自常规和最优划界分下筛查青少年抑郁症和所有抑郁障碍的效度。结果:1CES-D以总分≥29和≥24分为最优划界分,分别筛查青少年抑郁症和所有抑郁障碍的敏感度为94%-97%,特异度为74%-79%,阳性预测值为21%-30%,接受者操作特征(ROC)曲线下面积(AUC)为0.88-0.91;BDI-II-C以总分≥28和≥15分为最优划界分,分别筛查青少年抑郁症和所有抑郁障碍的敏感度为91%-95%,特异度为80%-83%,阳性预测值为23%-35%,AUC为0.88-0.91。2CES-D在常规划界分下筛查青少年抑郁症(≥24分)和所有抑郁障碍(≥20分)的特异度(55%-70%)和阳性预测值(16%-20%)均小于最优划界分;BDI-II-C在常规划界分下筛查青少年抑郁症(≥29分)和所有抑郁障碍(≥14分)结果与最优划界分相似,除筛查所有抑郁障碍的敏感度(99%)优于最优划界分(95%);3CES-D筛查抑郁症和所有抑郁障碍的特异度均小于BDI-II-C。结论:两常用抑郁量表筛查我国青少年抑郁具有较好的效标效度,建议CES-D选用最优划界分,BDI-II-C选用常规划界分。     

4～6年级小学生儿童虐待经历与抑郁情绪、睡眠质量的关系

目的:探讨儿童虐待经历与小学生抑郁情绪、睡眠质量的关系。方法:分层抽取重庆市主城3区的9所小学校(重点、普通及农民工小学各3所)的1523名在校4～6年级小学生。运用儿童受虐量表评定小学生的受虐待状况,量表总分中负的分值代表虐待;儿童抑郁自评量表(DSRSC)评定小学生的抑郁情绪,总分≥15分表示有抑郁症状;匹兹堡睡眠质量指数(PSQI)评定小学生的睡眠状况,量表总分>7分表示有睡眠质量问题。共收回有效问卷1417份。结果:小学生虐待、抑郁情绪、睡眠质量问题检出率分别为41.7%、23.2%、26.2%。受虐者的PSQI总分、入睡时间、睡眠时间、睡眠效率、日间功能障碍得分均较非受虐者高(均P<0.05);抑郁者的PSQI总分、入睡时间、睡眠效率得分较无抑郁者高(均P<0.05)。相关分析显示,PSQI总分和抑郁总分与躯体虐待、言语虐待的总分呈负相关(r=-0.06～-0.72,P<0.05);PSQI总分、入睡时间、睡眠效率得分与抑郁总分呈正相关(r=0.13～0.14,P<0.01)。结论:小学生受虐待、抑郁情绪、睡眠质量问题的检出率均较高,且受虐程度特别是躯体虐待、言语虐待程度越严重其情绪和睡眠质量也越差,值得学校和家长高度关注。     

玉树震后半年灾区小学生的创伤后应激障碍及抑郁症状评估

目的:了解玉树震后半年时灾区小学生的创伤后应激障碍(PTSD)和抑郁症状。方法:玉树灾区某小学845名4-6年级的小学生完成了加州大学创伤后应激障碍反应指数修改版(UCLA PTSD Reaction Index)和流调中心儿童抑郁量表(CES-DC)。结果:①PTSD的筛查阳性率为12.5%,闯入症状表现最明显(67.3%)。②抑郁症状阳性率达61.7%,主要表现为积极情绪缺乏。③女生的PTSD检出率高于男生;5年级学生的抑郁阳性率高于4年级和6年级;曾目睹亲人死亡的学生PTSD检出率和抑郁阳性率都高于未曾目睹亲人死亡的学生。结论:玉树地震后灾区小学生创伤后应激障碍和抑郁检出率都较高,应特别关注女生、5年级学生和曾目睹亲人死亡的学生。     

医院焦虑抑郁量表与Beck抑郁问卷在综合医院门诊病人中评定抑郁的比较

目的:比较医院焦虑抑郁量表(HADS)和Beck抑郁问卷(BDI)在综合医院门诊病人中的评定结果 ,探讨量表间评定的一致性和量表划界分。方法:在广州15家综合医院焦虑抑郁调查样本中现场抽取229例HADS总分≧8的可疑焦虑抑郁患者,采用Beck抑郁问卷、17项汉密顿抑郁量表等进行再次评定。结果:HADS、HAD-D、BDI内部一致性良好,Cronbach琢系数分别为0.866、0.853、0.878。相关分析结果显示,HADS总分、HAD-D因子分与BDI总分、HAMD总分显著正相关,相关系数为0.415-0.853。量表的一致性分析显示,HAD-D≥9作为抑郁划界分与HAMD≥14、HAMD≥17的抑郁评定一致性Kappa值分别为0.420、0.373;BDI≥17与HAMD≥14、HAMD≥17的一致性Kap鄄pa值分别为0.535、0.508;HAD-D≥9与BDI≥17的一致性Kappa值为0.368。结论 :HADS和BDI作为两个最常用的抑郁自评量表,均具有良好的内部一致性,但HAD-D与BDI、HAMD间的评定一致性很低;BDI与HAMD间的评定一致性较好,但应用中BDI的划界分需要谨慎界定。     

儿童焦虑障碍症状与父母养育方式的关系

目的：探讨儿童焦虑障碍症状与父母养育方式的关系。方法：采用儿童焦虑性情绪障碍筛查表（SCARED）和父母养育方式评价量表（EMBU）对329名4～6年级小学生（男生175名。女生154名）进行调查。以SCARED筛查阳性（SCARED总分≥23分）的学生为焦虑组，其余为非焦虑组。结果：在329名小学生中。SCARED筛查阳性的有59例。占总人数的17．9％，其中男23人，女36人；焦虑组双亲的“惩罚严厉”、“过分干涉“、“拒绝否认”、“过度保护”因子得分均明显高于非焦虑组，差异具有统计学意义（P〈0．01），而“情感温暖、理解”和”偏爱被试”因子得分两组间尤显著性差异（P〉0．05）：父母“惩罚严厉”、“过分干涉”、“过度保护”、“拒绝否认”因子均与焦虑症状评分存在显著正相关（P〈0．01）：多元逐步同归分析显示．“惩罚严厉”、“拒绝否认”、“过度保护”三个因子进入了回归方程，是儿童焦虑情绪的预测因素。结论：在儿童中焦虑情绪存在较普遍，儿童焦虑障碍症状与其父母养育方式关系密切。     

初中生目睹特大火灾后的心理健康状况

目的:探讨目睹火灾对初中学生创伤后应激障碍(PTSD)、焦虑及抑郁症状的影响。方法:采用方便抽样方法抽取距某特大火灾现场200米某中学六年级及初一、初二3个年级全体387名学生为研究组,抽取另一区与研究学校性质、等级相匹配的某中学六年级及初一、初二3个年级全体480名学生为对照组,对全体被试施测埃森儿童青少年创伤问卷(ETI-KJ)中文版、儿童焦虑性情绪障碍筛查表(SCARED)、儿童抑郁障碍自评量表(DSRSC)。结果:研究组PTSD及疑似PTSD检出率高于对照组(均P0.05),SCARED量表广泛性焦虑及躯体化/惊恐因子分高于对照组(均P0.05),DSRSC量表总分低于对照组(P0.05)。两组焦虑(SCARED总分≥23分)、抑郁(DSRSC总分≥15分)症状检出率差异无统计学意义(P0.05)。女性(OR=1.90)、既往经历创伤(OR=5.67)及来自目睹火灾学校(OR=1.61)者更易出现PTSD症状。结论:目睹特大火灾的初中学生可能会出现创伤后应激障碍及广泛性焦虑、躯体化/惊恐等症状,在进行灾后心理支持及危机干预时需重视目睹学生的心理健康。     

大学生抑郁症状、问题解决能力与压力感知的关系分析

目的：探讨大学生抑郁症状、问题解决能力与压力感知的关系。方法：使用中文版知觉压力量表、流调用抑郁自评量表以及中文版问题解决评价问卷对275名一年级大学生进行了调查。结果：275名大学生中，52％存在健康危险性压力状况，55．3％存在抑郁症状。抑郁症状、压力感与问题解决能力评价总分及分量表之间存在显著相关(r=．262-．617)。路径分析提示，问题解决评价与抑郁症状和压力感知存在因果关系，特别是，问题解决评价分别可以预测抑郁症状与压力感知水平。结论：大学生目前抑郁症状与压力感知水平较高，个体问题解决评价是重要的相关影响因素。     

Unsuspected depressive mania in pre-pubertal Hispanic children referred for the treatment of 'depression' with history of social 'deviance'

BACKGROUND: Despite an emerging Literature on the mixed nature of pediatric mania, initial presentation with conduct problems continues to mislead mental health clinicians. The present report focuses on Hispanic pre-pubertal children referred for the treatment of depression in the context of conduct problems. METHODS: Eleven boys and two girls received a structured psychiatric assessment in a practice setting to make sense of the presenting clinical complexity. Diagnoses were assigned using the DSM-IV criteria. RESULTS: Ten of the boys and both girls met criteria for depressive mania. Their family histories were replete with affective disorder. Five (50%) of the boys and both of the girls (100%) with depressive mania had family histories of bipolar disorder. Six (60%) of the boys and neither of the girls with depressive mania had psychotic features. Those with depressive mania exhibited clear-cut circadian changes in symptomatology. Euphoria, oscillating with affective states indicative of psychic pain, was characteristically restricted to the evenings or nighttime. However, the drive to seek treatment had stemmed from social 'deviance'. CONCLUSION: Children with depressive mania are often unrecognized in clinical settings. Boys with conduct problems may be disproportionately represented among such children. These data support Akiskal's hypothesis that externalizing (conduct) problems in clinically referred children with depression are indicative of bipolar disorder.     

Hyperactive and aggressive pathways: Effects of demographic,family, and child characteristics on children's adaptive functioning

Examined ethnic and sex differences in depressive symptoms, along with hypothesized mediators of those differences (academic achievement, peer acceptance), for a sample of African American (n = 272) and Euro-American (n = 630) children in Grades 3 to 5. Group comparisons revealed a significant Ethnicity ×Sex interaction in depressive symptoms. African American boys reported more depressive symptoms than Euro-American boys, whereas African American and Euro-American girls reported comparable levels of depressive symptoms. Sex differences in depressive symptoms differed by ethnicity: Boys were more depressed than girls in the African American group whereas girls were more depressed than boys in the Euro-American group. The Ethnicity ×Sex interaction was mediated by academic achievement, but not peer acceptance. These findings have implications for understanding the mechanisms underlying depressive symptoms in preadolescence and for developing interventions to prevent depression.     

多动儿童焦虑抑郁自评与父母他评一致性研究

目的探讨注意缺陷多动障碍(ADHD)伴情绪问题儿童自我情绪评价与父母他评在临床诊断中的一致性。方法41例ADHD伴情绪问题儿童及父母分别完成儿童焦虑性情绪障碍筛查诊断量表(SCARD)、儿童抑郁障碍自评量表(DSRSC)。结果儿童焦虑性情绪障碍筛查诊断量表(SCARD)、儿童抑郁障碍自评量表(DSRSC),儿童自评与父母他评之间差异有显著性(P0.01),两者诊断一致性程度不高,存在差异性(Kappa0.4,P0.05)。结论重视ADHD儿童对自身情绪问题的表达,对早期发现ADHD儿童共病情绪障碍有一定价值。     

Are there sex differences in the predictive validity of DSM-IV ADHD among younger children?

We assessed the predictive validity of attention-deficit/hyperactivity disorder (ADHD) in 20 girls and 98 boys who met the Diagnostic and Statistical Manual for Mental Disorders (4th ed., American Psychiatric Association, 1994) criteria for ADHD at 4 to 6 years of age compared to 24 female and 102 male comparison children. Over the next 8 years, both girls and boys who met criteria for ADHD in Year 1 exhibited more ADHD symptoms and impairment than same-sex comparison children. Effect sizes were consistently large, indicating that the diagnosis of ADHD at 4 to 6 years of age has predictive validity for both sexes. Both girls and boys with ADHD in Year 1 also exhibited higher levels of symptoms of conduct disorder, major depression, and anxiety disorders in early adolescence than same-sex comparison children, controlling levels of the same symptoms in Year 1. This indicates both substantial homotypic and heterotypic continuity for ADHD in both sexes, but significant interactions with time indicated that childhood ADHD predicts more steeply rising symptoms of anxiety and depression during early adolescence in girls than in boys.     

Emergence of Depressive Symptoms from Kindergarten to Sixth Grade

This study documents the emergence of symptoms of anxiety and depression in a community sample of school-age children and describes the temporal progression of symptoms leading to depressive episodes. Caregivers of 468 seventh graders reported retrospectively the manifestation of 14 symptoms of depression and anxiety in their children from kindergarten through sixth grade. The sample was balanced by sex and reflected the racial and economic diversity of the urban school district. Childhood period prevalence was calculated for each symptom, and discrete time survival analyses compared likelihoods of early symptom emergence in children who did and did not meet diagnostic criteria for major depressive disorder (MDD) by ninth grade. Symptom prevalence ranged between 20% (excessive guilt) and 50% (concentration problems) during the elementary school years. The 4-year period prevalence of MDD was 8.9%, 95% confidence interval [6.5%, 12.1%]. Low energy, excessive worry, excessive guilt, anhedonia, social withdrawal, and sadness or depressed mood were each associated with a significantly higher likelihood of onset of MDD. Compared to girls, boys were more likely to exhibit sad mood, fatigue, and trouble concentrating. Children who later met criteria for MDD demonstrated a significantly higher likelihood of showing core features of depressive and anxiety disorders during their elementary school years. The findings underscore the importance of recognizing early signs and developing interventions to help children manage early symptoms and prevent later psychiatric illness.     

Ethnic and sex differences in children's depressive symptoms.

This study examined ethnic and sex differences in children's depressive symptoms, along with hypothesized mediators of those differences (academic achievement, peer acceptance), in a follow-up of African American (n = 179) and Euro-American (n = 462) children in Grades 3 to 5. African American boys reported more depressive symptoms than African American girls, and Euro-American boys and girls. Also, depressive symptoms of African American boys increased over time whereas depressive symptoms of the other groups decreased or remained stable. Academic and social competence deficits were associated with elevated levels of depressive symptoms across the school year, although only academic achievement scores emerged as a unique predictor of increases in depressive symptoms over time. Neither academic nor social competence mediated the SexA xA ethnicity interaction in changes in children's depressive symptoms.     

学龄儿童的抑郁

３２２名１０～１２岁小学五、六年级学生填写了Ｂｕｌｅｖｕｅ抑郁量表（ＢＩＤ）。抑郁症状的出现率３．４％～１１．５％，有自杀观念者５．９％。自杀观念与总分、心境恶劣、自卑和自杀、攻击性行为和社会交往４个因子的相关程度最高。３２２人中１０人（３．１％）为抑郁症检出者，临床表现与成人抑郁症相似，其中８人有自杀观念。结果提示抑郁情绪、自杀观念、抑郁症在学龄儿童中的出现率较高，应加强预防和治疗。     

Violence and risk of PTSD,major depression,substance abuse/dependence,and comorbidity: results from the National Survey of Adolescents

With a national household probability sample of 4,023 telephone-interviewed adolescents ages 12-17, this study provides prevalence, comorbidity, and risk-factor data for posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance abuse/dependence (SA/D). Roughly 16% of boys and 19% of girls met criteria for at least 1 diagnosis. Six-month PTSD prevalence was 3.7% for boys and 6.3% for girls, 6-month MDE prevalence was 7.4% for boys and 13.9% for girls, and 12-month SA/D prevalence was 8.2% for boys and 6.2% for girls. PTSD was more likely to be comorbid than were MDE and SA/D. Results generally support the hypothesis that exposure to interpersonal violence (i.e., physical assault, sexual assault, or witnessed violence) increases the risk of these disorders and of diagnostic comorbidity.     

Insomnia and hypersomnia associated with depressive phenomenology and comorbidity in childhood depression

STUDY OBJECTIVES: To examine sleep disturbance (insomnia and hypersomnia) and associated clinical profiles among depressed children and adolescents in terms of illness history, depressive severity, depressive phenomenology, and psychiatric comorbid disorders. DESIGN: Clinical profiles from standardized clinical evaluations were compared. SETTING: Twenty-three mental health facilities in Hungary between April 2000 and December 2004. PATIENTS AND MEASUREMENTS: Five hundred fifty-three children with a current episode of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depressive disorder: 55% were boys, mean age was 11.7 years (SD = 2.0, range = 7.3-14.9), and 94% were Caucasian. Sleep and depressive symptoms were assessed with the Interview Schedule for Children and Adolescents-Diagnostic Version. INTERVENTIONS: N/A. RESULTS: Of the total sample, 72.7% had sleep disturbance: 53.5% had insomnia alone, 9.0% had hypersomnia alone, and 10.1% had both disturbances. Depressed girls were more likely to have sleep disturbance than boys (77.0% vs 69.2%, p < .05), but age had no significant effects. Compared with children without sleep disturbance, sleep-disturbed children were more severely depressed and had more depressive symptoms and comorbid anxiety disorders. Across sleep-disturbed children, those with both insomnia and hypersomnia had a longer history of illness, were more severely depressed, and were more likely to have anhedonia, weight loss, psychomotor retardation, and fatigue than were those with either insomnia or hypersomnia. CONCLUSION: Clinical profiles differ between depressed children without and with sleep disturbance, with those presenting insomnia plus hypersomnia being most severely depressed. Differentiating depressed children with different sleep disturbances may have important implications for research efforts on the etiology and therapeutics of child depression.