上海地区青少年精神障碍患者非自杀性自伤行为现状及影响因素研究

doi:10.12183/j.scjpm.2022.1323

摘要/Abstract

摘要： 目的调查上海市青少年精神障碍患者非自杀性自伤行为（NSSI）现状,并探讨其相关影响因素。方法以上海市精神卫生中心于2019年6月至2021年12月收治的青少年精神障碍患者为研究对象,参照《精神障碍诊断与统计手册》评定研究对象过去2年内非自杀性自伤行为发生情况,并采用自制调查问卷收集调查对象基本情况,采用Barratt冲动量表（BIS-11）对冲动状况进行评估,采用青少年生活事件量表（ASLEC）评估应激性生活事件发生的频率和强度。采用描述性分析方法对青少年精神障碍患者非自杀性自伤行为发生情况进行分析,并采用单、多因素分析方法对非自杀性自伤行为发生的影响因素进行分析。结果 1 683例青少年精神障碍患者中657例出现NSSI,发生率为39.03%。其中男262例,女395例,年龄13~20岁,平均年龄（14.63±; 3.09）岁,病程1~4年,平均病程（2.87±; 1.21）年; 268例为偶发NSSI,389例反复出现NSSI。下臂及腕部、手是发生NSSI患者的主要自伤部位（分别为40.03%、33.03%）。多因素Logistic回归分析结果显示抑郁程度越严重（OR=2.255）、遭受校园暴力（OR=2.289）、母亲教育程度为大专及以上（OR=2.428）、抑郁障碍（OR=1.855）、双向障碍（OR=2.212）、冲动总分偏高（OR=1.401）、人际关系得分高（OR=1.398）和学习压力得分高（OR=2.098）等均是导致青少年精神障碍患者发生NSSI的危险因素。结论 NSSI在青少年精神障碍患者中的发生率较高,重度抑郁、遭受校园暴力、母亲教育程度高、抑郁障碍、双向障碍、冲动总分偏高、人际关系差和学习压力大等的患者更易出现NSSI,应提高具有以上特征患者的关注度,并及时制定相应的干预策略,尽可能避免NSSI的发生。

关键词: 青少年, 精神障碍, 非自杀性自伤行为, 影响因素

Abstract: Objective To investigate the status of non‐suicidal self‐injury (NSSI) among adolescents with mental disorders in Shanghai, and explore its related influencing factors. Methods Adolescents with mental disorders admitted to Shanghai Mental Health Center from June 2019 to December 2021 were selected to evaluate the occurrence of NSSI in the past two years by referring to the Diagnostic and Statistical Manual of Mental Disorders. The basic information of the respondents was collected by using self‐made questionnaire, and the impulse status was evaluated by using the Barratt Impulse Scale (BIS-11). Adolescent Life Events Scale (ASLEC) was used to assess the frequency and intensity of stressful life events. The descriptive analysis method was used to analyze the occurrence of NSSI in adolescents with mental disorders, and univariate and multivariate analysis methods were used to analyze the influencing factors of NSSI. Results NSSI occurred in 657 of 1 683 adolescents with mental disorders, with an incidence rate of 39.03%. There were 262 males and 395 females, aged 13-20 years, with an average age of (14.63±3.09) years. The course of disease was 1-4 years, with an average course of disease of (2.87±1.21) years; 268 cases were sporadic NSSI, 389 cases were recurrent NSSI. The lower arm, wrist and hand were the main injury sites of NSSI patients (40.03% and 33.03% respectively). Multivariate Logistic regression analysis showed that the more serious the depression (OR=2.255), school violence (OR=2.289), mother's education level of junior college or above (OR=2.428), depressive disorder (OR=1.855), bidirectional disorder (OR=2.212), high impulsiveness total score (OR=1.401), poor interpersonal relationship (OR=1.398), and heavy pressure of study (OR=2.098) were all risk factors leading to NSSI in adolescents with mental disorders. Conclusions The incidence of NSSI is high in adolescents with mental disorders. Patients with severe depression, school violence, high education level of mothers, depressive disorder, bidirectional disorder, high impulsiveness total score, poor interpersonal relationship, and heavy pressure of study are more likely to have NSSI. Therefore, the attention of patients with the above characteristics should be raised and the corresponding intervention strategies should be formulated in time to avoid the occurrence of NSSI as much as possible.

Key words: Adolescent, Mental disorders, Non‐suicidal self‐injury, Influencing factor

中图分类号:

R179

奚晓丹, 陆晶晶, 林雪峰. 上海地区青少年精神障碍患者非自杀性自伤行为现状及影响因素研究[J]. 华南预防医学, 2022, 48(11): 1323-1327.

XI Xiao‐dan, LU Jing‐jing, LIN Xue‐feng. Status and influencing factors of non‐suicidal self‐injury among adolescents with mental disorders in Shanghai[J]. South China Journal of Preventive Medicine, 2022, 48(11): 1323-1327.

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