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目的了解医学生的心理健康状况及其人口学特征,探讨其与儿童期不良经历之间的关系,为进一步研究并开展有效的预防和治疗心理状况问题提供依据。方法采用症状自评量表(symptom checklist-90,SCL-90)和儿童期不良经历(adverse childhood experiences,ACEs)量表,使用分层整群抽样的方法,对475名医学生进行问卷调查。结果医学生心理状况异常检出率为35.58%。不同人口学特征的大学生心理状况异常检出率差异均无统计学意义(均有P>0.05)。单因素分析结果显示儿童期出现躯体虐待、情感虐待和性虐待经历的大学生,成年后发生心理状况异常的风险分别是无此经历大学生的2.42(95%CI:1.38～4.23)、2.65(95%CI:1.79～3.92)和1.66(95%CI:1.07～2.58)倍。儿童期有家庭暴力、家中有物质滥用者经历的大学生,成年后发生心理状况异常的风险是无此经历大学生的1.97(95%CI:1.31～2.96)、1.69(95%CI:1.13～2.54)倍。多因素结果分析显示:年龄每增加1岁,其发生心理状况异常的风险性就降低0.15(95%CI:0.01～0.27)倍;出现1种或多种ACEs经历的医学生分别是无ACEs经历医学生的1.89～6.97倍。结论儿童期各种不良经历是成年后各种心理问题的重要危险因素,儿童期不良经历对于成年期心理健康状况的影响是不容忽视的。
Objective To understand the mental health of medical students and their demographic characteristics, to explore the relationship between them and their poor experiences in childhood, and to provide evidences for further research and effective prevention and treatment of psychological conditions. Methods Four hundred and seventy-five medical students were surveyed by symptom checklist-90 (SCL-90) and adverse childhood experiences (ACEs) scale using stratified cluster sampling method. Results The abnormal detection rate of medical students was 35.58%. There was no significant difference in the abnormal detection rates of college students with different demographic characteristics (all P> 0.05). The results of univariate analysis showed that college students who experienced somatic, emotional and sexual abuse during their childhood were 2.42 (95% CI: 1.38-4.23) and 2.65 (95% CI: 1.79-3.92) and 1.66 (95% CI: 1.07-2.58) fold. 1.97 (95% CI: 1.31-2.96), 1.69 (95% CI: 1.13-2.54) were college students who experienced domestic violence in their childhood and experienced substance abusers at home. Times Multivariate analysis of the results showed that: for each 1-year increase in age, the risk of abnormal psychological status decreased by 0.15 (95% CI: 0.01-0.77); those with one or more ACEs experienced no ACEs Medical students 1.89 ~ 6.97 times. Conclusion All kinds of bad experiences in childhood are important risk factors of various psychological problems in adulthood. The impact of poor childhood experiences on mental health status in adulthood should not be neglected.