家庭醫學科門診青少年憂鬱症狀危險因子分析

The Risk Factor of Adolescent Depressive Symptoms in a Family Medicine Clinic

憂鬱症是21世紀最重要的公共衛生議題之一。青少年憂鬱症因為高盛行率、高共病率及高發生率且預後差，若能提早發現，加入適當介入，對於青少年及成人階段的生活狀態與健康安全皆有正面的效應。本研究擬探討台北縣某區域教學醫院青少年預防保健門診之青少年憂鬱症狀與身體狀態及健康行為之間的關係。本研究採用自行設計之青少年身心健康諮詢問卷，內容主要包括憂鬱篩檢（流行病學研究中心憂鬱量表，CES-D）、健康與行為問題以及家庭功能(Family APGAR)。研究對象共得到145位。其中女性77人(53%)，男性68人(47%)；CES-D的平均得分女性為18.3，男性為18.9。以男生超過23分、女生超過26分，將個案分為高低憂鬱風險組進行卡方檢定，並以多元迴歸模型尋找影響青少年憂鬱症狀的危險因子。結果發現青少年門診個案的憂鬱症狀與家庭功能、身體健康狀況、生活適應、性取向等方面具有相關性。臨床工作者在門診時應特別注意當個案並非以憂鬱或其相關診斷的症狀為主訴時，求診青少年之身體症狀或生活相關事件，以減低憂鬱相關症狀之診斷偏低，並能更全面評估青少年身心健康。

Depression is a major public health issue in the 21(superscript st) century. Adolescent depression has a high prevalence, high co-morbidity, and poor prognosis without treatment. Early detection and intervention of adolescent depression has a positive effect in adolescents and adulthood. This research investigated the relationship among symptoms of depression in adolescents, physical condition, and health behavior in a adolescent preventive health care clinic in a district hospital in Taipei county. A cross-sectional survey was conducted, which included a depression screening questionnaire (CES-D), health and behavior problems, and assessment of family function (i.e., the family APGAR). There were 145 participants; the mean CES-D for females and males was 18.3 and 18.9, respectively. Multiple regression was conducted to examine the risk factors for depression symptoms. It has been found that family function, physical condition, life adjustment, and sexual orientation are related to depression symptoms. The clinical workers need to pay attention to adolescent client's physical and life events when their main problems are not a depressed mood. A more complete evaluation for an adolescent's health would include the detection of depression.