高憂鬱情緒青少年之憂鬱疾患及自殺傾向：跨一年追蹤之研究

Depressive Disorder and Suicidality among Adolescents with High Depressive Mood: A Two-year Follow-up Study

研究目的：本研究主要在探討高憂鬱情緒青少年之憂鬱疾患與自殺傾向，並在追蹤一年後，瞭解上述之改變情形。研究方法：本研究以花蓮地區四所高中職校學生共5,259人為對象，先以台灣人憂鬱問卷（TDQ）作為第一階段篩選工具，再由精神科醫師以結構性診斷問卷MINI為基礎進行診斷性會談。研究結果：一、本研究發現不同性別與年級在憂鬱量表分數之分佈比例不甚相同，女生以及三年級學生在TDQ上21至28分以及29分以上者所佔比例高於男生及一、二年級。二、高憂鬱情緒青少年符合憂鬱疾患之情形分別為35.6%（第一年）及24%（第二年）；高憂鬱情緒自殺傾向盛行率第一年發現為38.9%，第二年為20.9%；一年後追蹤，發現上述均呈現比例下降的情形。三、高憂鬱情緒青少年其憂鬱疾患具有跨時間連續性及影響性。研究結論：以本研究二階段篩檢的方法，篩檢出來的青少年符合憂鬱症診斷以及具有高自殺傾向的比例高，值得做為學校輔導與心理衛生之參考依據。

Purpose: This study explored depressive disorder, suicidality, predicting relations of depressive disorder and suicidal tendency, and their changes after one year among Taiwan’s adolescents with high depressive mood. Methods: In the first stage, the Taiwanese Depression Questionnaire (TDQ) was used to screen 5,259 students from four senior high and vocational schools in Hualien, Taiwan. Interviews were subsequently conducted by psychiatrists to determine a diagnosis using the Mini International Neuropsychiatric Interview (MINI). Results: Three main results were identified. First, females had a higher percentage of scores in the 21-28 range and above 29 on the TDQ than males. Likewise 12th graders had a higher percentage of scores than that of 10th or 11th graders in these ranges. Second, 35.6% and 24% of students with high depressive mood were diagnosed as having depressive disorder in the first and second year, respectively. Suicidal tendency was 38.9% and 20.9% in the first and second year. After one year, the percentages decreased. Third, depressive disorders had considerable continuity and predictive power over time. Conclusions: Using a two-stage design is highly recommended to identify students with depressive disorder and suicidal tendency.