家庭功能与儿童青春早期焦虑抑郁共患的关联及预测价值OA
Association and predictive value of family functioning with comorbid anxiety and depression in early adolescence
目的 探索家庭功能与儿童青春早期焦虑抑郁症状共患之间的关联,为制定儿童心理健康促进策略提供科学依据.方法 采用分层整群抽样法,抽取浙江省慈溪市 4 所小学四至六年级 986 名学生为调查对象,通过问卷收集基本信息、家庭功能、焦虑、抑郁等资料.采用多因素 Logistic 回归模型评估家庭功能与焦虑抑郁共患的关联,利用受试者工作特征曲线(ROC 曲线)和校准曲线评估家庭功能对焦虑抑郁共患风险的预测价值.结果 男生516 人(52.3%),女生 470 人(47.7%),焦虑抑郁共患 44 人(4.5%).Logistic 回归模型显示,调整个人和学校环境因素后,家庭功能(OR=1.038,95%CI:1.021～1.055)与儿童青春早期焦虑抑郁共患显著相关.家庭功能预测焦虑抑郁共患风险具有良好的区分度(AUC:0.826,95%CI:0.766～0.886)和校准度(Hosmer-Lemeshow 检验,χ2=9.689,P=0.288,Brier 分数 0.042),灵敏度为 0.795,特异度为 0.749.从家庭功能不同维度看,沟通(OR=1.142,95%CI:1.025～1.272)和行为控制(OR=1.123,95%CI:1.004～1.257)维度与儿童青春早期焦虑抑郁共患显著相关.结论 家庭功能与儿童青春早期焦虑抑郁共患相关,并且对该风险具有较好的预测价值.建议构建家庭功能监测体系,着重提升父母的沟通和行为控制技能,从而降低儿童焦虑抑郁共患的风险,实现一级预防.
Objective To explore the relationship between family function and comorbid anxiety and depression symptoms in early adolescence,and to provide a scientific basis for developing child mental health promotion strategies.Methods A stratified cluster sampling method was used to recruit 986 students from grades 4 to 6 of four primary schools in Cixi City,Zhejiang Province.Data on demographic characteristics,family functioning,anxiety,and depression were collected through questionnaires.Multiple Logistic regression was employed to assess the association between family functioning and comorbid anxiety and depression.Receiver Operating Characteristic(ROC)curves and calibration curves were used to evaluate the predictive value of family functioning for the risk of comorbidity.Results There were 516 male students(52.3%)and 470 female students(47.7%),with 44 participants(4.5%)presented with comorbid anxiety and depression.The Logistic regression model showed that,after adjusting for individual and school environmental factors,family functioning was significantly associated with the comorbidity of anxiety and depression in early adolescence(OR=1.038,95%CI:1.021-1.055).Family functioning demonstrated good discriminative ability(AUC:0.826,95%CI:0.766-0.886)and calibration(Hosmer-Lemeshow test:χ2=9.689,P=0.288,Brier=0.042)in predicting the risk of comorbidity,with a sensitivity of 0.795 and a specificity of 0.749.Regarding specific dimensions of family functioning,communication(OR=1.142,95%CI:1.025-1.272)and behavioral control(OR=1.123,95%CI:1.004-1.257)were significantly associated with comorbid anxiety and depression.Conclusions Family functioning is significantly associated with comorbidity of anxiety and depression in early adolescence,and exhibits good predictive value for this risk.It is recommended to establish a family functioning monitoring system,with emphasis on improving parents'communication and behavioral control skills,to reduce the risk of comorbid anxiety and depression and achieve primary prevention.
龚亮亮;戎志东
慈溪市疾病预防控制中心 健康教育科,浙江 慈溪 315300||浙江大学 公共卫生学院,浙江 杭州 311121慈溪市疾病预防控制中心 健康教育科,浙江 慈溪 315300
医药卫生
青春早期焦虑抑郁家庭功能
early adolescenceanxietydepressionfamily functioning
《健康研究》 2026 (2)
168-174,7
慈溪市公益性专项(CN2024034)
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