Sampling investigation into the problems related to mental health in 1 498 adolescents in some cities and rural areas in Hubei province / 中国组织工程研究

ABSTRACT

BACKGROUND: The incidence of mental problems in adolescents is increasingly higher and has gradually become an important factor affecting their health and growth.OBJECTIVE: To probe into the mental health status and its influencing factors in adolescents in some cities and rural areas in Hubei Province.DESIGN: Clustering stratified random sampling, cross-sectional survey.SETTING: Department of Maternal, Child and Adolescent Health, Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: According to the selected investigation spots of National Surveillance of Constitution and Health of Students, we selected representative urban areas (Wuhan City and Huangshi City) and rural areas (Yun County, Xiantao City, and Xiaogan City) in Hubei Province as sample spots. Totally 1 498 adolescents, aged 16-18 years, were surveyed by clustering stratified random sampling. There were 605 adolescents in urban group and 893 in rural group.METHODS: The self-made survey scale was used to investigate general conditions, such as age, parents' occupation and educational level, family type, social atmosphere, school type and atmosphere, and interpersonal relationship. Symptom Checklist-90 (SCL-90) was used to determine the adolescents' mentalhealth status; 9 subscales (somatization, obsessivecompulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychosis) were set as the observation indexes. SCL-90 is an inventory which is rated on a 5-point scale. Factor score of SCL-90 ≥ 3 or total score ≥ 160 was considered mental disorders. The family educational pattern was investigated through Egma Minnen av Bardndosnaupporstran(EMBU) by questionnaires. It contained positive rearing pattern and negative rearing pattern. Positive rearing pattern (namely, affectional warmth and understanding) contributes to mental health, while negative rearing pattern (e.g. punishment, firm control, excessive interference, partialism or rejection, denial and excessive protection) is adverse to mental health. The family environment was investigated with Family Environment Scale(FES). Four subscales (intimacy, conflict, intellectual-cultural orientation, and positive-recreational orientation) with high reliability and validity were set as indexes. All participants were given unified instructions and required to fill in anonymous questionnaires. The questionnaires were then collected by the teacher in charge of the class.Some indexes of adolescents in the urban and rural areas were observed including the score of SCL-90 and its relation with general conditions,parental rearing pattern and family environment quality. The total scores of symptom checklist 90 were set as dependent variables for stepwise regression analysis of related factors.MAIN OUTCOME MEASURES:①The incidence of mental health ,gender and regional difference of adolescents in some cities and rural areas in Hubei province; ②The score of SCL-90 and its comparison with national norm;③Correlation analysis of the total scores of SCL-90 with general condition and parents' educational type.RESULTS: ① The general incidence of mental disorders was 18.13 ％ in the 1 498 adolescents in Hubei province. It was 18.20% in boys and 18.04% in girls with no significant difference (P ＞ 0.05). Regional differences The incidence in rural areas [23.74% (212/893)] was significantly higher than that in urban areas [16.69% (101/605), P ＜ 0.05]. Among all kinds of mental disorders, compulsion, interpersonal sensitivity, hostility,paranoid ideation, and depression were more common. ② Comparison with the national norm The factor scores of SCL-90 and family environmentalquality were significantly lower that those of the national norm.③ Single factor analysis: The total score of SCL-90 was obviously correlated with age, gender, parents' educational level and expectation, and school atmosphere (P ＞ 0.01). It was negatively correlated with positive rearing pattern (affectional warm, understanding) (P ＞ 0.01), but positively correlated with negative rearing pattern (punishment, firm control, excessive interference,partialism or rejection, and denial). It had significant positive correlation with conflict and significant negative correlation with intimacy, intellectualcultural orientation and positive-recreational orientation(P ＞ 0.01).④Multiple factor analysis: The mental health status of the students was closely related to age, gender, parents' educational level and expectation, interpersonal sensitivity as well as school atmosphere, parental rearing pattern,and quality of family environment.CONCLUSION: The incidence of mental problems in adolescents in some urban and rural areas in Hubei Province is relatively high. Score factors of SCL-90 are all higher than those of the national norm and the mental health level is poor. This has obvious correlation with family factors including age, gender, parents' educational level and expectation, and school atmosphere. Moreover, the quality of family environment and parental rearing pattern are the major factors affecting their mental health.