青少年學生憂鬱症狀多系統因素的關聯性

Associations among Multi-systematic Factors and Depressive Symptoms in Adolescent Students

目的：青少年憂鬱是源自系統性因素（ 個人、家庭、和學校），但對於憂鬱症狀和系統 性危險因素之相關性卻鮮為人知，本文研究目的在調查以學校樣本為基礎，探討青少年憂 鬱症狀與個人、家庭和學校危險因素的關聯性。方法：針對學校群體採橫斷式隨機研究設 計，使用「機率與大小成比例抽樣法」，透過受訓訪員以面對面方式進行資料收集，共篩檢 1,009 位受試者（回應率99.11%，有效問卷1,000 份）。研究工具為貝克憂鬱量表 (BDI-II)、 人格特質 (MPI)、家庭功能 (family APGAR) 量表，和學校背景相關的資料。結果：青少年憂 鬱症狀的盛行率為25.8%（ 平均年齡14.75 ± 0.90 歲）。以多元邏輯式迴歸進行分析，並調 整性別變項和物質使用史的作用下 (-2 log likelihood = 710.48, d.f. = 9, p < 0.001)，研究對象的 神經質得分高者 (OR = 1.21, p < 0.05)、外向性得分低者 (OR = 0.83, p < 0.05)、家庭功能較差 者 (OR = 0.89, p < 0.05) 有較高的憂鬱症狀。結論：本研究發現青少年憂鬱症狀和多系統(個人、家庭和學校) 的危險因素具有關聯性。我們建議預防計畫宜整體性介入，並針對每個層 面的危險因素加以處置之。

Objective: The risks of depression among adolescents are from multi-systematic (personal, family/parental, and school) factors. But there are little known about the correlation between those risk factors of depressive symptoms and multisystematic characteristics. The objective of the study was to investigate the association between depressive symptoms and their personal, family/parental, and school risk factors in school-based adolescents. Methods: The authors conducted a cross-sectional randomized study on adolescent school population with probability proportional sampling to choose sample sizes in each school district. Data were collected face-to-face through training visits to subjects. After having screened 1,009 subjects with response rate of 99.11%, the authors received 1,000 copies of valid questionnaire (including Beck Depression Inventory-II, Maudsley Personality Inventory, and the adaptability, partnership, growth, affection, and resolve [APGAR] index as well as the in formation of their school background. Results: The prevalence of adolescents (14.75 ± 0.90 years) with depressive symptoms was 25.8%. Their risk factors for having depressive symptoms in logistic regression were those who had higher score in neuroticism (OR = 1.21, p < 0.05), who had lower score in extroversion (OR = 0.83, p < 0.05), and who had poorer family function (OR = 0.89, p < 0.05) after adjusting the effects of sex and history of substance use (-2 log likelihood = 710.48, d.f. = 9, p < 0.001). Conclusion: Our study data showed an association between depressive symptoms and multi-systematic risk factors. Based on the study findings, the authors recommend that the comprehensive program should include multiple intervention components, and that each of those components needs to be addressed for risk factors in different domains.