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Self-reported Psychosomatic Pathological Status among Adolescent Students: a School-based Cohort Study

Author: HuangLei
Tutor: TaoFangBiao;HaoJiaHu
School: Anhui Medical University,
Course: Child and adolescent health and maternal and child health science
Keywords: Sub-health status Stability Reactivity Psychopathology symptom Illness-induced school absenteeism
CLC: B844.2
Type: Master's thesis
Year: 2011
Downloads: 21
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Abstract


Objectives The purpose of this study was to investigate the stability of psychosomatic pathological status and the correlation between basic psychological symptoms and follow-up self-reported self-injurious behaviors, suicidal psychology/ behaviors and illness-induced school absenteeism in adolescents and to examine the reactivity and predictive value of Multidimensional Sub-health Questionnaire of Adolescents (MSQA).Methods The subjects were consisted of grades 10 and 11 students from a provincial model high school of Zongyang, Anhui Province. At baseline (December 2009, T0), 1637 available questionnaires were collected in total. Finally, 732 participated in baseline assessment (T0) and 4 times follow-up surveys (March 2010, T1; June 2010, T2; September 2010, T3; December 2010, T4). Except for March 2010 (T1), the remained surveys measured psychological syndromes using the Multidimensional Sub-health Questionnaire of Adolescents (MSQA). Meanwhile, sociodemographic characteristics and lifestyle factors such as age, gender and physical activity per week were obtained. Self-harm behaviors, suicidal psychology/ behaviors and illness-induced school absenteeism were surveyed all of the follow-up studies. Pearsonχ2 test was performed to compare the prevalence of psychosomatic pathology status and new-onset pathology status among different time points and to evaluate the basic differences of T0 sociodemographic and lifestyle characteristics between psychosomatic pathological status and non-pathological status. Multivariate Logistic regression model analysis was performed to find out influencing factors for new-onset pathological status. Pearsonχ2 test was conducted again to figure out the differences of prevalence of self-harm behaviors, suicidal psychology/ behaviors and illness-induced school absenteeism among different time points and to evaluate the trend of these rates based on the baseline self-reported psychosomatic symptoms.Results Compared with nonresponders, responders who were in grade 10, living in rural/ suburban area accounted for a larger proportion and reported lower incidence of drinking.The prevalence of physical/ psychological pathology status for T0, T2, T3 and T4 were 18.4%/17.9%, 16.1%/15.8%, 10.9%/6.4%, 16.4%/10.7%, respectively. The incidences of new-onset physical/ psychological pathology status for T2, T3 and T4 were 8.2%/6.4%, 5.6%/2.7%, 8.7%/5.1%. In total, the 1-year persistent prevalence of physical pathology and psychopathology status were 2.5% and 2.0%, respectively. The prevalence of physical pathological status was significantly higher than that of psychopathology status in T3 and T4 (P<0.01). Prevalence of psychosomatic pathology status and new-onset psychopathological status in T3 were lowest among all of time points (P<0.05). The proportion of girls who reported physical pathology status was larger than that of boys in T4 (P<0.05). Depression, anxiety, deliberate self-harm behavior and previous physical pathology status predicted higher level of new-onset psychosomatic pathology status. Urban registered residence and poor weight-loss mentality were the risk factors of psychosomatic pathology status and new-onset psychosomatic pathology status. County, urban residence and previous psychological pathology status were risk factors of physical and on-set physical pathology status, respectively. Additionally, large and small intensity physical activity was the protective factor.The 1 year self-reported rates of self-harm behaviors,≥4 kinds of self-harm behaviors, suicidal ideation, suicide plan, suicide attempts and illness-induced school absenteeism were 47.7%, 14.6%, 10.5%, 4.9%, 1.2% and 0.16%, respectively. Through comparisons of different time points groups, it was seen that for T1 self-reported rates of≥4 kinds of self-harm behaviors, suicidal ideation and illness-induced school absenteeism were the highest (P<0.05). The self-reported rate of total self-injurious behaviors of T2 was the highest. The prevalence of illness-induced school absenteeism of T3 was the lowest. The gender characteristics were the following: suicidal ideation (T1, T2, and T4) and suicide plan (T1) of girls were significantly higher than that of boys; illness-induced school absenteeism (T1 and T2) of boys was significantly higher than of girls. The grade characteristics were the following: for grades 10, total self-harm behaviors (T1 and T2),≥4 kinds of self-harm behaviors (T1), suicidal ideation (T3) and suicide plan (T2) were significantly higher than that of grades 11; And illness-induced school absenteeism of grades 11 was significantly higher than of grades 10. All of above differences have reached the statistical significance (P<0.05). For the majority of time points, the reported rates of self-harm behaviors, suicidal psychology and behaviors and illness-induced school absenteeism increased along with the increase of baseline (T0) psychological symptom; the corresponding 1-year reported rates also showed the same trend (P<0.05).Conclusions The stability of psychosomatic pathology status is substantial. The tendency that incidences of psychosomatic pathological status and new-onset psychopathology status in T3 decreased after summer vacation implies that the stability of psychosomatic pathology status is affected by academic pressure. It also suggests the good reactivity of MSQA we used in the study. Self-harm and suicidal psychological and behaviors are common among adolescents. Moreover, health risk behaviors increased along with the increase of numbers of T0 physiological symptoms. Thus, further intervention study on adolescents’psychopathological status is needed.MeSH Adolescent/ Health Status/ Risk Factors/ Questionnaires/ Follow-Up Studies/ Suicide/ Self-Injurious Behavior

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