简阳市单亲家庭青少年抑郁症状现状及预警模型构建和验证

任小兵; 徐洪霞; 钟若诗; 段昕; 于静

doi:10.16835/j.cnki.1000-9817.2024231

简阳市单亲家庭青少年抑郁症状现状及预警模型构建和验证

doi: 10.16835/j.cnki.1000-9817.2024231

1.
四川省简阳市人民医院健康管理中心, 641401
2.
简阳中学

基金项目:

四川省科技计划项目 2019YJ0487

详细信息

作者简介:
任小兵(1972-)，男，四川西充人，大学本科，副主任医师，主要从事公共卫生、健康管理工作

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 B844.2 G78 N945.12
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- 被引次数: 0
出版历程
- 收稿日期: 2024-03-06
- 修回日期: 2024-06-20
- 网络出版日期: 2024-08-31
- 刊出日期: 2024-08-25

Adolescent depressive symptoms in single-parent families in Jianyang City and construction and verification of the early warning model

1.
Health Management Center, the People's Hospital of Jianyang City, Jianyang (641401), Sichuan Province, China

摘要

摘要: 目的分析简阳市单亲家庭青少年抑郁症状发生现状，并构建和验证预警模型，为制订促进青少年心理健康发展规划提供科学依据。方法采用分层整群随机抽样方法，于2022年3月—2023年10月从简阳市25所中学选取12 125名初、高中生进行匿名自填式问卷调查，共获得有效单亲家庭青少年1 142名作为调查对象，按照8∶2随机分为训练集(914名)和验证集(228名)，采用中文版贝克抑郁量表(BDI)评估简阳市单亲家庭青少年抑郁症状情况。分析单亲家庭青少年抑郁症状的相关因素，建立预测模型并进行模型的验证及效能评估。结果训练集158名(17.29%)青少年检出抑郁症状，验证集43名(18.86%)青少年检出有抑郁症状。多因素Logistic回归分析显示，学习压力(OR=4.31，95%CI=1.67~11.13)、心理弹性量表(CDRISC)评分(OR=0.29，95%CI=0.12~0.71)、家庭亲密度与适应性量表(FACESⅡ)评分(OR=0.19，95%CI=0.06~0.63)均是单亲家庭青少年抑郁症状发生的相关因素(P值均＜0.05)。以上述相关因素作为预测变量建立列线图预测模型，验证结果显示，C-index为0.80(95%CI=0.75~0.80)，预测单亲家庭青少年抑郁症状发生的校正曲线趋近于理想曲线(χ²=0.26，P>0.05)。训练集受试者工作特征(ROC)曲线结果显示，列线图模型预测单亲家庭青少年抑郁症状的灵敏度为80.38%，特异度为80.03%，ROC曲线下面积(AUC)为0.84(95%CI=0.76~0.92)；验证集ROC曲线结果显示，列线图模型预测单亲家庭青少年抑郁症状的灵敏度为79.07%，特异度为82.16%，AUC为0.83(95%CI=0.76~0.91)。结论简阳市单亲家庭青少年抑郁症状发生风险高，学习压力、心理弹性、家庭功能均是简阳市单亲家庭青少年抑郁症状发生的相关因素，基于此构建的预警模型效能良好。
- 单亲家庭 /
- 抑郁 /
- 精神卫生 /
- 回归分析 /
- 青少年
Abstract: Objective To analyze the current situation of adolescent depressive symptoms in single-parent families in Jianyang City, and to construct and verify the early warning model, so as to provide a scientific basis for the government to formulate a plan of promoting the development of adolescent mental health. Methods A stratified cluster random sampling method was used to select 12 125 middle and high school students from 25 middle schools in Jianyang City from March 2022 to October 2023 for an anonymous self-filling questionnaire survey, and a total of 1 142 adolescents from valid single-parent families were obtained as the survey objects. They were randomly divided into the training set (914 participants) and the verification set (228 participants) according to the ratio of 8∶2. The Chinese version of Beck depression Inventory (BDI) was used to evaluate depressive symptoms among adolescents from single-parent families in Jianyang City. The factors related of depressive symptoms in adolescents from single-parent families were analyzed, and a prediction model was established to verify the model and evaluate its effectiveness. Results There were 158 adolescents (17.29%) in the training set and 43 adolescents (18.86%) in the verification set with depressive symptoms. Multivariate Logistic regression analysis showed that learning stress (OR=4.31, 95%CI=1.67-11.13), Connor-Davidson Resilience Scale (CDRISC) score (OR=0.29, 95%CI=0.12-0.71) and Family Adaptability and Cohesion Scale (FACESⅡ) scores (OR=0.19, 95%CI=0.06-0.63) were all related factors the occurrence of depressive symptoms in adolescents from single-parent families (P < 0.05). The results showed that the C-index was 0.80 (95%CI=0.75-0.80), and the correction curve for predicting the occurrence of depressive symptoms in single-parent families was close to the ideal curve (χ²=0.26, P>0.05). Receiver operating characteristic (ROC) curve results of the training set showed that the sensitivity and specificity of the nomogram model in predicting depressive symptoms in adolescents from single-parent families were 80.38% and 80.03% respectively, ROC area under the curve (AUC) was 0.84 (95%CI=0.76-0.92). The ROC curve results of the verification set showed that the sensitivity, specificity and AUC of histogram model to predict depressive symptoms in adolescents from single-parent families were 79.07%, 82.16% and 0.83 (95%CI=0.76-0.91). Conclusions Learning stress, mental resilience and family function are all factors that affect the occurrence of depressive symptoms in adolescents from single parent families in Jianyang City. Based on this, the early warning model can predict depressive symptoms in Jianyang City.
- Single-parent family /
- Depression /
- Mental health /
- Regression analysis /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 单亲家庭青少年抑郁症状发生的预测列线图模型验证曲线

Figure 1. Verification curve of the predictive Nomogram model for adolescent depressive symptoms in single-parent families

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表 1 不同组别训练集单亲家庭青少年抑郁症状检出率比较

Table 1. Comparison of detection rates of depressive symptoms among adolescents from single-parent families in training sets of different groups

组别	选项	人数	抑郁症状人数	χ²值	P值	组别	选项	人数	抑郁症状人数	χ²值	P值
性别	男	473	89(18.82)	1.60	0.21	母亲职业	机关事业单位	196	29(14.80)	6.26	0.10
	女	441	69(15.65)				国有企业	197	26(13.20)
民族	汉族	874	148(16.93)	1.74	0.19		私营企业	263	48(18.25)
	其他	40	10(25.00)				自由职业	258	55(21.32)
家庭所在地	城镇	867	146(16.84)	2.36	0.13	精神病家族史	有	125	28(22.40)	2.65	0.10
	乡村	47	12(25.53)				无	789	130(16.48)
年级	初中	416	81(19.47)	2.55	0.11	近1个月睡眠质量	伴睡眠障碍	242	50(20.66)	2.62	0.11
	高中	498	77(15.46)				无睡眠障碍	672	108(16.07)
宗教信仰	有	16	5(31.25)	2.22	0.14	寄宿	是	507	95(18.74)	1.68	0.20
	无	898	153(17.04)				否	407	63(15.48)
独生子女	是	411	62(15.09)	2.53	0.11	学习情况	好	310	52(16.77)	4.23	0.12
	否	503	96(19.09)				一般	441	69(15.65)
家庭月收入/元	≥10 000	396	35(8.84)	34.88	＜0.01		差	163	37(22.70)
	＜10 000	518	123(23.75)			学习压力	大	261	60(22.99)	8.51	0.01
父亲文化程度	本科及以上	450	69(15.33)	2.37	0.12		一般	487	75(15.40)
	专科及以下	464	89(19.18)				无	166	23(13.86)
母亲文化程度	本科及以上	428	66(15.42)	1.96	0.16	与家人关系	和睦	291	57(19.59)	2.42	0.30
	专科及以下	486	92(18.93)				一般	464	79(17.03)
父亲职业	机关事业单位	209	31(14.83)	5.42	0.14		不和睦	159	22(13.84)
	国有企业	208	28(13.46)			与周围同伴关系	和睦	380	75(19.74)	3.49	0.18
	私营企业	251	50(19.92)				一般	438	71(16.21)
	自由职业	246	49(19.92)				不和睦	96	12(12.50)
＞6个月的留守经历	有	253	52(20.55)	2.61	0.11	被欺负时态度	忍气吞声	312	98(31.41)	67.16	＜0.01
	无	661	106(16.04)				奋力反击	453	41(9.05)
							告诉他人	149	19(12.75)
注：()内数字为检出率/%。

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