军人心理健康量表在新兵精神疾病筛查中的应用价值研究

目的 探讨军人心理健康量表在入伍新兵精神疾病筛查中的价值,并探究入伍后新兵精神疾病发病的高危因子,为新兵精神疾病筛查工作提供客观工具.方法 选择新兵共83 327名作为研究对象,采用军人心理健康量表进行筛查,同时结合线索调查,心理访谈,以及《中国精神病与分类诊断标准第3版》(CCMD-3)三级检诊明确临床诊断,将确诊患精神疾病的新兵共256例作为病例组,另从健康新兵中分层抽取256例作为对照组,比较军人心理健康量表和临床诊断检出率的一致性.采用判别分析方法,分析军人心理健康量表8个因子(X1-X8)对新兵精神疾病的筛查效果.结果 军人心理健康量表对新兵精神疾病复检的敏感度为87.89％,特异度为95.94％.判别函数为:对照组Y=-1.913+0.097 X1+0.176 X2-0.488 X3+0.519 X4-0.042 X5+0.456 X6+0.282 X7+0.156 X8.病例组Y=-6.099+0.324 X1+0.036 X2-0.672 X3+0.844 X4-0.275 X5+0.105 X6+0.537 X7+0.735 X8.总体判别符合率为89.5％,其中病例组符合率为7996,对照组符合率为100％,总误判率为10.5％.CMMHS中的强迫、焦虑、抑郁、躯体化及人际关系敏感等因子是健康新兵入伍后新发精神疾病的高危因了子.结论 军人心理健康量表对新兵精神疾病筛查诊断符合率较高,其检测结果与CCMD-3临床诊断结果无明显差异,其敏感度及特异度均较高,可作为中国军人精神疾病的筛查工具.

Application of Chinese Military Mental Health Scale in screening mental health of new recruits

Objective To explore the value of Chinese Military Mental Health Scale (CMMHS) in screening mental health and the risk factors associated with the pathogenesis of mental disorders to offer an objective tool for screening mental disorders among new recruits.Methods 83 327 new recruits were screened with CMMHS,mainly combined with trace survey, psychological interview and Chinese Classification and Diagnostic Criteria for Mental Disorders version 3(CCMD-3).256 soldiers were diagnosed as having mental disorders and designated to the patient group,and another group of 256 healthy soldiers selected by stratified sampling were designated as control group. The rate of consistency in detection rate of mental disorders between CMMHS and clinical diagnosis was determined.Eight factors(X1-X8) of CMMHS were analyzed using discriminant analysis to examine the effects of the aforesaid scale on mental disorders screening.Results Sensitivity and specificity of the said scale were 87.89% and 95.94% respectively.The function of discriminant analysis: in the control group,Y=-1.913+0.097X1+0.176X20.488X3+0.519X4-0.042X5+0.456X6+0.282X7+0.156X8,and in the patient group,Y=-6.099+0.324X1+0.036X2-0.672X3 +0.844X4-0.275X5+0.105X6+0.537X7+0.735X8. The total coincidence was 89.5% and the simple coincidence was 79% in patient group,and 100% in control group.The total misjudgement rate was 10.5%.The obsessive-compulsive factor,anxiety factor, depression factor,somatization factor and interpersonal sensitivity factor of CMMHS were the high-risk factors of developing mental disorders in new recruits.Conclusion There is no significant difference between CMMHS and CCMD-3 in terms of detection of mental disorders,and CMMHS can be used as an effective tool for screening mental disorders in new recruits due to its high sensitivity and specificity.