青少年抑郁情绪与心理弹性、家庭环境因素的关联

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摘要目的探讨青少年抑郁情绪与家庭环境因素、心理弹性之间的关系。方法采用整群抽样法，选取2014年12月~2016年7月河南省新乡市3230名初高中生进行一般社会资料问卷、Kutcher青少年抑郁量表（11项）、家庭环境量表中文版（FES-CV）、中文版心理弹性量表（CD-RISC）评估。测评后，比较不同性别、年龄等的抑郁情绪差异；比较有抑郁情绪组与无抑郁情绪组CD-RISC评分、心理弹性的差异；对差异有统计学意义的因子进一步采用二分类Logistic回归分析研究心理弹性、家庭环境因素与青少年抑郁的关联。结果有效问卷为2960份，有抑郁情绪者659名（22.7%），其中男221名（20.0%），女483名（24.3%）；母亲外出工作的家庭中有107名青少年（28.3%）有抑郁情绪，明显高于父亲外出的家庭（24.2%）。有抑郁情绪组与无抑郁情绪组的心理弹性（Z = -12.032）、忍受消极情感（Z = -9.677）、面对困难的能力（Z = -12.860）、接受变化（Z = -11.025）和控制方面（Z = -11.514）比较，差异均有统计学意义（P ＜ 0.05），且有抑郁情绪组明显低于无抑郁情绪组（P ＜ 0.05）。心理弹性（OR：0.967，95%CI：0.961~0.973）、控制力（OR：0.671，95%CI：0.604~0.745）、接受变化能力（OR：0.725，95%CI：0.659~0.796）、面对困难的能力（OR：0.720，95%CI：0.667~0.778）、忍受消极情绪（OR：0.804，95%CI：0.734~0.880）分值低，会增加抑郁症的危险。控制年龄和性别因素后，情感表达（OR：0.928，95%CI：0.869~0.990）、组织性（OR：0.886，95%CI：0.833~0.942）、娱乐性（OR：0.932，95%CI：0.887~0.980）、亲密度（OR：0.839，95%CI：0.788~0.839）越低，抑郁情绪明显；独立性（OR：1.075， 95%CI：1.010~1.114）和控制性分值（OR：1.143，95%CI：1.081~1.208）越高，抑郁情绪越明显。结论青少年抑郁情绪与心理弹性如忍受消极情绪和接受变化低有明显关联。情感表达低，家庭亲密度低是青少年抑郁的风险因素。控制性增高增加了抑郁情绪风险。

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	从恩朝蔡亦蕴陈海莹吴彦

关键词 ：青少年抑郁症, 消极观念, 家庭亲密度, 心理弹性

Abstract：Objective To explore the relationship between adolescent depressive and family environment factors and mental resilience. Methods A cluster sampling method was used to select 3230 junior high school students from Xinxiang City, He′nan Province from December 2014 to July 2016 for general social data questionnaire, Kutcher Adolescent Depression Scale (11 items), and Family Environment Scale Chinese version (FES-CV), Chinese version of the Mental Resilience Scale (CD-RISC) assessment. After the evaluation, the differences in depression and emotions of different genders and ages were compared. The differences of CD-RISC scores and psychological elasticity between the depression group and the non-depression group were compared. Factors with statistically significant differerces were further analyzed by binary Logistic regression to study the relationship between resilient family environment factors and adolescent depression. Results There were 2 960 valid questionnaires, 659 (22.7%) with depression, including 221 males (20.0%) and 483 females (24.3%). 107 adolescents (28.3%) with mothers working out had depression, which was significantly higher than those with fathers (24.2%). There were significant differences in resilience (Z = 12.032), tolerance of negative emotions (Z = 9.677), ability to face difficulties (Z = 12.860), acceptance of changes (Z = 11.025) and control (Z = 11.514) between the depressive group and the non-depressive group (P < 0.05), and the depressive group was significantly lower than the non-depressive group (P < 0.05). Low scores of resilience (OR: 0.967, 95%CI: 0.961-0.973), control (OR: 0.671, 95%CI: 0.604-0.745), acceptance of change (OR: 0.725, 95%CI: 0.659-0.796), ability to face difficulties (OR: 0.720, 95%CI: 0.667-0.778), tolerance of negative emotions (OR: 0.804, 95%CI: 0.734-0.880) increase the risk of depression. After controlling for age and gender factors, the lower the emotional expression (OR: 0.928, 95%CI: 0.869-0.990), organization (OR: 0.886, 95%CI: 0.833-0.942), and entertainment (OR: 0.932, 95%CI: 0.887-0.980), intimacy (OR: 0.839, 95%CI: 0.788-0.839), the depression was more obvious; the higher the scores of independence (OR: 1.075, 95%CI: 1.010-1.114) and control (OR: 1.143, 95%CI: 1.081-1.208), the more obvious depression. Conclusion There is a significant correlation between adolescent depression and resilience, such as low tolerance of negative emotions and low acceptance changes. Low emotional expression and family intimacy are risk factors for depression in adolescents. Controlled increases increase increases the risk of depression.

Key words： Adolescents&prime depression Suicidal ideation Family intimacy Psychological resilience

基金资助:上海市精神卫生中心院级课题（2014-YJ-01）。

通讯作者: 吴彦（1967-），男，硕士，主任医师；研究方向：心境障碍。

作者简介: 从恩朝（1980-），女，博士；研究方向：心境障碍。

引用本文:

从恩朝蔡亦蕴陈海莹吴彦. 青少年抑郁情绪与心理弹性、家庭环境因素的关联[J]. 中国医药导报, 2019, 16(17): 31-34.
CONG Enzhao CAI Yiyun CHEN Haiying WU Yan. Association between adolescents′ depressive mood with resilience and family environment factors. 中国医药导报, 2019, 16(17): 31-34.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I17/31

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