上海市嘉定区2015—2023年中学生非自杀性自伤流行特征及趋势

朱琰泓; 张琴; 刘欣欣; 张颜菲; 井光壮; 郭曼玉; 薛俊磊; 彭谦; 马飞飞; 于宏杰; 史慧静; 彭慧

doi:10.16835/j.cnki.1000-9817.2025263

上海市嘉定区2015—2023年中学生非自杀性自伤流行特征及趋势

doi: 10.16835/j.cnki.1000-9817.2025263

1.
上海市嘉定区疾病预防控制中心学校卫生与眼病防治科，201800
2.
复旦大学公共卫生学院妇幼与儿少卫生教研室

基金项目:

复旦—嘉定公共卫生高质量发展重点学科(儿少卫生与妇幼保健学) GWGZLXK-2023-04

详细信息

作者简介:
朱琰泓(1992-)，女，上海嘉定人，大学本科，主管医师，主要从事学校卫生工作

通讯作者:
史慧静，E-mail: hjshi@fudan.edu.cn

彭慧，E-mail: penny200210108@sina.com

中图分类号: R179 C913.5 G444
计量
- 文章访问数: 3
- HTML全文浏览量: 3
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2025-04-08
- 修回日期: 2025-07-19
- 网络出版日期: 2025-10-10
- 刊出日期: 2025-09-25

Epidemiological characteristics and trends of non-suicidal self-injury among middle school students in Jiading District of Shanghai from 2015 to 2023

1.
School Health and Ophthalmic Disease Prevention, Jiading District Center for Disease Control and Prevention Department, Shanghai 201800, China

摘要

摘要: 目的分析上海市嘉定区2015—2023年中学生非自杀性自伤(NSSI)行为的流行特征和变化趋势，为学生NNSI防控工作的开展提供依据。方法采用分层整群随机抽样方法，2015—2023年在上海市嘉定区每2年开展一次，共计5次“上海市青少年健康危险行为调查”，从中学学段(初中、高中)共选取5 231名中学生进行问卷调查。组间比较采用χ²检验或χ²趋势检验，采用JointPoint 5.0软件对变化趋势进行分析，用年度变化百分率(APC)进行评价。采用二分类Logistic回归模型分析中学生NSSI行为的相关因素。结果 2023年嘉定区中学生NSSI报告率为14.2%，初中生报告率(17.1%)高于高中生(11.1%)，女生(19.2%)高于男生(10.0%)(χ²值分别为10.04，23.21，P值均＜0.01)。2015—2023年中学生NSSI报告率呈增长趋势，由2015年的8.6%上升至2023年的14.2%(χ_趋势²=22.25)，APC为6.64%(t=3.49)，其中女生NSSI报告率APC为9.79%(t=3.20)(P值均＜0.05)。在发生NSSI行为的中学生中，≥6次占比由2015年的10.8%上升至2023年的19.2%(χ_趋势²=6.57，P＜0.05)。多因素Logistic回归分析结果显示，女生、初中生、失眠、有抑郁情绪及饮酒学生发生NSSI的风险相比男生、高中生、不失眠、无抑郁情绪及不饮酒的学生高(OR值分别为1.71，1.96，3.44，4.76，1.77，P值均＜0.05)。结论嘉定区2015—2023年中学生NSSI报告率逐年上升，且反复NSSI的比例呈上升趋势。应及早针对中学生、特别是初中生和女生采取干预措施，控制NSSI的发生和发展。
- 自我伤害行为 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the epidemiological characteristics and changing trends of non-suicidal self-injury (NSSI) behaviors among middle school students in Jiading District of Shanghai, from 2015 to 2023, so as to provide a basis for the development of NSSI prevention and control measures among students. Methods Using a stratified cluster random sampling method, a total of five times for Shanghai Adolescent Health Risk Behavior Surveys were conducted for every two years in Jiading District of Shanghai from 2015 to 2023. A total of 5 231 middle school students from junior high schools and senior high schools were selected for questionnaire surveys. Intergroup comparisons were performed using the χ² test or the χ² trend test, and the JointPoint 5.0 software was used to analyze the changing trends, with the annual percent change (APC) used for evaluation. A binary Logistic regression model was employed to analyze the related factors of NSSI behavior among middle school students. Results In 2023, the reported NSSI rate among middle school students in Jiading District was 14.2%. The rate was significantly higher among junior high school students (17.1%) than that among senior high school students (11.1%), and higher among females (19.2%) than that among males (10.0%) (χ²=10.04, 23.21, both P < 0.01). From 2015 to 2023, the overall reported NSSI rate showed an increasing trend, rising from 8.6% in 2015 to 14.2% in 2023 (χ_trend²=22.25), with an APC of 6.64% (t=3.49), and the APC for girls was 9.79% (t=3.20) (all P < 0.05). Among students reporting NSSI, the proportion experiencing ≥6 episodes increased from 10.8% in 2015 to 19.2% in 2023 (χ_trend²=6.57, P < 0.05). Multivariate Logistic regression analysis indicated that girls, junior high school students, those with insomnia, depressive emotion and drinkers had higher risks of NSSI, compared to boys, senior high school students, those without insomnia, non-depressive emotion students and non-drinkers (OR=1.71, 1.96, 3.44, 4.76, 1.77, all P < 0.05). Conclusions The reported rate of NSSI among middle school students in Jiading District of Shanghai, increased annually from 2015 to 2023, and the proportion of repeated NSSI also showed an upward trend. Early intervention measures targeting middle school students, especially junior high school students and females, should be implemented to prevent and control its occurrence and development.
- Self-injurious behavior /
- Mental health /
- Regression analysis /
- Students

HTML全文

表 1 上海市嘉定区中学生2015—2023年NSSI行为报告率及变化趋势

Table 1. Trend of reporting rates of NSSI behavior among middle school students in Jiading District, Shanghai from 2015 to 2023

组别	选项	2015		2017		2019		2021		2023		APC(95%CI)/%	t值
组别	选项	人数	NSSI人数	人数	NSSI人数	人数	NSSI人数	人数	NSSI人数	人数	NSSI人数	APC(95%CI)/%	t值
性别	男	443	38(8.6)	409	37(9.0)	618	61(9.9)	666	75(11.3)	730	73(10.0)	2.44(-1.88~6.95)	1.78
	女	309	27(8.7)	427	44(10.3)	419	73(17.4)	584	111(19.0)	626	120(19.2)	9.79(0.06~20.46)	3.20^*
学段	初中	276	28(10.1)	596	53(8.9)	628	96(15.3)	699	114(16.3)	700	120(17.1)	8.32(-0.94~18.43)	2.85
	高中	476	37(7.8)	240	28(11.7)	409	38(9.3)	551	72(13.1)	656	73(11.1)	4.22(-4.49~13.73)	1.51
合计		752	65(8.6)	836	81(9.7)	1 037	134(12.9)	1 250	186(14.9)	1 356	193(14.2)	6.64(0.57~13.08)	3.49^*
注： ()内数字为报告率/%；^*P < 0.05。

下载: 导出CSV

表 2 上海市嘉定区2015—2023年不同性别中学生NSSI行为频次报告率

Table 2. Reporting rates of NSSI behavior frequencies among middle school students by sex in Jiading District, Shanghai from 2015 to 2023

年份	男生				女生				合计
年份	人数	1次	2~5次	≥6次	人数	1次	2~5次	≥6次	人数	1次	2~5次	≥6次
2015	443	19(4.3)	13(2.9)	6(1.4)	309	15(4.9)	11(3.6)	1(0.3)	752	34(4.5)	24(3.2)	7(0.9)
2017	409	25(6.1)	10(2.4)	2(0.5)	427	26(6.1)	12(2.8)	6(1.4)	836	51(6.1)	22(2.6)	8(1.0)
2019	618	33(5.3)	21(3.4)	7(1.1)	419	30(7.2)	33(7.9)	10(2.4)	1 037	63(6.1)	54(5.2)	17(1.6)
2021	666	42(6.3)	24(3.6)	9(1.4)	584	46(7.9)	36(6.2)	29(5.0)	1 250	88(7.0)	60(4.8)	38(3.0)
2023	730	40(5.5)	21(2.9)	12(1.6)	626	51(8.1)	44(7.0)	25(4.0)	1 356	91(6.7)	65(4.8)	37(2.7)
注： ()内数字为报告率/%。

下载: 导出CSV

表 3 上海市嘉定区2015—2023年不同性别中学生发生NSSI行为不同频次构成比分布

Table 3. Distribution of different composition ratios of NSSI behavior among middle school students by sex in Jiading District, Shanghai from 2015 to 2023

年份	男生			女生			合计
年份	1次	2~5次	≥6次	1次	2~5次	≥6次	1次	2~5次	≥6次
2015	19(50.0)	13(34.2)	6(15.8)	15(55.6)	11(40.7)	1(3.7)	34(52.3)	24(36.9)	7(10.8)
2017	25(67.6)	10(27.0)	2(5.4)	26(59.1)	12(27.3)	6(13.6)	51(63.0)	22(27.2)	8(9.9)
2019	33(54.1)	21(34.4)	7(11.5)	30(41.1)	33(45.2)	10(13.7)	63(47.0)	54(40.3)	17(12.7)
2021	42(56.0)	24(32.0)	9(12.0)	46(41.4)	36(32.4)	29(26.1)	88(47.3)	60(32.3)	38(20.4)
2023	40(54.8)	21(28.8)	12(16.4)	51(42.5)	44(36.7)	25(20.8)	91(47.2)	65(33.7)	37(19.2)
注： ()内数字为构成比/%。

下载: 导出CSV

表 4 上海市嘉定区2023年中学生NSSI行为相关因素Logistic回归分析(n=1 356)

Table 4. Logistic regression analysis of factors affecting NSSI behavior among middle school students in Jiading District, Shanghai in 2023(n=1 356)

自变量	选项	单因素		多因素
自变量	选项	OR值(95%CI)	P值	OR值(95%CI)	P值
学段	高中	1.00		1.00
	初中	1.65(1.21~2.26)	< 0.01	1.96(1.33~2.90)	< 0.01
性别	男	1.00		1.00
	女	2.13(1.56~2.92)	< 0.01	1.71(1.20~2.43)	< 0.01
父亲文化	初中	1.00		1.00
程度	高中	1.07(0.71~1.61)	0.74	1.10(0.60~1.70)	0.96
	大专/大学	0.86(0.58~1.26)	0.43	0.83(0.492~1.40)	0.48
	研究生及以上	1.68(0.85~3.32)	0.14	1.40(0.560~3.50)	0.47
母亲文化	初中	1.00		1.00
程度	高中	0.98(0.66~1.47)	0.93	1.10(0.66~1.82)	0.72
	大专/大学	0.97(0.67~1.41)	0.89	1.35(0.81~2.25)	0.25
	研究生及以上	1.94(0.83~4.50)	0.12	1.80(0.57~5.70)	0.32
家庭类型	核心家庭	1.00		1.00
	单亲	1.66(0.99~2.79)	0.06	1.63(0.90~2.96)	0.11
	重组	2.22(0.93~5.30)	0.07	1.97(0.73~5.18)	0.18
	隔代	1.92(1.01~3.64)	0.05	1.76(0.85~3.65)	0.13
独生子女	否	1.00		1.00
	是	1.03(0.75~1.42)	0.84	0.83(0.58~1.21)	0.34
孤独	否	1.00		1.00
	是	3.81(2.60~5.57)	< 0.01	1.54(0.99~2.40)	0.06
学习压力	否	1.00		1.00
	是	5.24(3.05~9.00)	< 0.01	1.72(0.92~3.24)	0.09
失眠	否	1.00		1.00
	是	6.52(4.25~10.02)	< 0.01	3.44(2.09~5.66)	< 0.01
抑郁情绪	否	1.00		1.00
	是	6.44(4.55~9.11)	< 0.01	4.76(3.24~6.97)	< 0.01
饮酒	否	1.00		1.00
	是	2.67(1.85~3.85)	< 0.01	1.77(1.16~2.71)	0.01
网络成瘾	否	1.00		1.00
	是	2.40(1.34~4.29)	< 0.01	0.68(0.35~1.35)	0.27

下载: 导出CSV

参考文献(23)

[1]	TSCHAN T, SCHMID M, IN-ALBON T. Parenting behavior in families of female adolescents with nonsuicidal self-injury in comparison to a clinical and a nonclinical control group[J]. Child Adolesc Psychiatry Ment Health, 2015, 9: 17. doi: 10.1186/s13034-015-0051-x
[2]	袁兆康, 文小桐. 中国青少年健康危险行为研究设计与流行现状[J]. 中国学校卫生, 2019, 40(4): 638-640. doi: 10.16835/j.cnki.1000-9817.2019.04.046 YUAN Z K, WEN X T. Research design and current situation of health-risk behaviors among Chinese adolescents[J]. Chin J Sch Health, 2019, 40(4): 638-640. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.04.046
[3]	LIM K S, WONG C H, MCINTYRE R S, et al. Global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents between 1989 and 2018: a Meta-analysis[J]. Int J Environ Res Public Health, 2019, 16(22): 4581. doi: 10.3390/ijerph16224581
[4]	连孟泽, 丁瑜, 刘小玲, 等. 青少年非自杀性自伤研究进展[J]. 职业与健康, 2023, 39(8): 1135-1141. LIAN M Z, DING Y, LIU X L, et al. Review of non-suicidal self-injury in adolescents[J]. Occup Health, 2023, 39(8): 1135-1141. (in Chinese)
[5]	韩阿珠, 徐耿, 苏普玉. 中国大陆中学生非自杀性自伤流行特征的Meta分析[J]. 中国学校卫生, 2017, 38(11): 1665-1670. doi: 10.16835/j.cnki.1000-9817.2017.11.019 HAN A Z, XU G, SU P Y. A Meta-analysis of characteristics of non-suicidal self-injury among middle school students in mainland China[J]. Chin J Sch Health, 2017, 38(11): 1665-1670. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2017.11.019
[6]	尹慧芳, 徐浩林, 刘肇瑞, 等. 青少年非自杀性自伤行为的理论模型研究[J]. 中国心理卫生杂志, 2022, 36(8): 707-713. YIN H F, XU H L, LIU Z R, et al. A review of theoretical models of non-suicidal self-injury (NSSI) in adolescents[J]. Chin Ment Health J, 2022, 36(8): 707-713. (in Chinese)
[7]	周鑫, 蒋琬婷. 青少年非自杀性自伤行为的研究现状[J]. 精神医学杂志, 2021, 34(4): 381-384. ZHOU X, JIANG W T. Research status of non-suicidal self-injury behaviors among adolescents[J]. J Psychiatry, 2021, 34(4): 381-384. (in Chinese)
[8]	POUDEL A, LAMICHHANE A, MAGAR K R, et al. Non suicidal self injury and suicidal behavior among adolescents: co-occurrence and associated risk factors[J]. BMC Psychiatry, 2022, 22(1): 96. doi: 10.1186/s12888-022-03763-z
[9]	袁家盛, 永忠甜, 王凯, 等. 社会生态学风险因素与中学生非自杀性自伤行为的关联[J]. 现代预防医学, 2024, 51(5): 848-853. YUAN J S, YONG Z T, WANG K, et al. The relationship between socio-ecological risk factors and non-suicidal self-injury behavior of middle school students[J]. Mod Prev Med, 2024, 51(5): 848-853. (in Chinese)
[10]	季成叶. 青少年健康危险行为监测: 学校卫生工作的重要前沿[J]. 中国学校卫生, 2009, 30(2): 99-105. JI C Y. Monitoring of adolescent health risk behaviors: an important frontier in school health work[J]. Chin J Sch Health, 2009, 30(2): 99-105. (in Chinese)
[11]	杨妍婷, 严琼, 张喆, 等. 上海市2004—2019年青少年健康危险行为特征和变化趋势[J]. 中国学校卫生, 2022, 43(8): 1148-1151. doi: 10.16835/j.cnki.1000-9817.2022.08.007 YANG Y T, YAN Q, ZHANG Z, et al. Characteristics and trend of adolescent health-risk behaviors in Shanghai from 2004 to 2019[J]. Chin J Sch Health, 2022, 43(8): 1148-1151. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.08.007
[12]	YOUNG K S. Internet addiction: the emergence of a new clinical disorder[J]. Gyber Psychol Behav, 1998, 1(3): 237-244. doi: 10.1089/cpb.1998.1.237
[13]	沈艳辉, 江初, 沈源, 等. 北京海淀区中学生自我伤害和自杀相关行为现状及影响因素分析[J]. 中国公共卫生, 2020, 36(6): 951-955. SHEN Y H, JIANG C, SHEN Y, et al. Behaviors and influencing factors of self-harm and suicide among high school students in Haidian district of Beijing: a retrospective analysis[J]. Chin J Public Health, 2020, 36(6): 951-955. (in Chinese)
[14]	赵文欣, 田萌, 陈思远, 等. 贵州中学生非自杀性自伤相关因素的网络分析[J]. 中国学校卫生, 2025, 46(1): 92-95. doi: 10.16835/j.cnki.1000-9817.2025022 ZHAO W X, TIAN M, CHEN S Y, et al. Network analysis of factors related to non-suicidal self-injury among middle school students in Guizhou Province[J]. Chin J Sch Health, 2025, 46(1): 92-95. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2025022
[15]	COMACCHIO C, LASALVIA A, RUGGERI M. Current evidence of childhood traumatic experiences in psychosis-focus on gender differences[J]. Psychiatry Res, 2019, 281(8): 112507.
[16]	徐慧琼, 万宇辉, 许韶君. 青少年非自杀性自伤行为与自杀行为关联的理论模型研究进展[J]. 中国学校卫生, 2019, 40(2): 314-317. doi: 10.16835/j.cnki.1000-9817.2019.02.045 XU H Q, WAN Y H, XU S J. Research progress on the theoretical model of the association between non-suicidal self-injury behaviors and suicidal behaviors among adolescents[J]. Chin J Sch Health, 2019, 40(2): 314-317. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.02.045
[17]	ESSAU C A, LEWINSOHN P M, SEELEY J R, et al. Gender differences in the developmental course of depression[J]. J Affect Disord, 2010, 127(1-3): 185-190. doi: 10.1016/j.jad.2010.05.016
[18]	刘洋, 张伟波, 葛聪聪, 等. 2015年上海市初中生焦虑抑郁情绪现状调查[J]. 中国健康教育, 2018, 34(4): 299-303. LIU Y, ZHANG W B, GE C C, et al. A survey on anxiety and depression among junior high school students, in Shanghai, 2015[J]. Chin J Health Educ, 2018, 34(4): 299-303. (in Chinese)
[19]	杨春, 张瑞. 抑郁障碍青少年自伤行为影响因素分析[J]. 中国学校卫生, 2021, 42(6): 879-882. doi: 10.16835/j.cnki.1000-9817.2021.06.019 YANG C, ZHANG R. Associated factors of non-suicidal self-injury behavior in adolescents with depression disorder[J]. Chin J Sch Health, 2021, 42(6): 879-882. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.06.019
[20]	肖青青, 夏倩, 黄雪花. 青少年非自杀性自伤危险因素的Meta分析[J]. 临床精神医学杂志, 2021, 31(2): 105-109. XIAO Q Q, XIA Q, HUANG X H. Meta analysis of the risk factors of non-suicidal self-injury in adolescents[J]. J Clin Psychiatry, 2021, 31(2): 105-109. (in Chinese)
[21]	袁勇, 干敏雷, 尹小俭, 等. 青少年非自杀性自伤行为与抑郁症状的相关性[J]. 中国学校卫生, 2023, 44(5): 659-663. doi: 10.16835/j.cnki.1000-9817.2023.05.005 YUAN Y, GAN M L, YIN X J, et al. Correlation analysis between non-suicidal self-injury behavior and depressive symptoms in adolescent[J]. Chin J Sch Health, 2023, 44(5): 659-663. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.05.005
[22]	罗媛, 任鹏宇, 马臣萃, 等. "双减"政策下中学生学习倦怠、睡眠质量对非自杀性自伤行为的影响[J]. 中国健康教育, 2024, 40(1): 51-55. LUO Y, REN P Y, MA C C, et al. The impact of learning burnout and sleep quality on non-suicidal self-injury behaviors among middle school students under the Double Reduction policy[J]. Chin J Health Educ, 2024, 40(1): 51-55. (in Chinese)
[23]	归冰, 何影, 卢葳, 等. 青少年饮酒与自伤行为关系[J]. 中国学校卫生, 2021, 42(7): 1052-1055. doi: 10.16835/j.cnki.1000-9817.2021.07.021 GUI B, HE Y, LU W, et al. Association of drinking behavior and self-injury behavior in adolescents[J]. Chin J Sch Health, 2021, 42(7): 1052-1055. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.07.021