目的探讨青少年青春发动时相提前与心理行为问题的关联及性别差异。方法2014年11月采用整群抽样方法,对北京市和沈阳市各2所小学在校2—3年级女生、3—4年级男生和各2所中学在校7~8年级男女生进行问卷调查,问卷内容包括一般情况、体力活动、户外活动时间、视频时间、青春发育量表(PDS)和长处与困难问卷(SDQ),对青春发动时相提前及心理行为问题检出率进行描述统计分析,运用单因素和多项logistic回归分析比较青春发动时相提前对心理行为问题的影响。结果共纳入3253名学生,其中518人青春发动时相提前;情绪因子、品行因子、多动/注意缺陷、同伴交往因子、亲社会行为和客观困难异常检出人数(率)分别为269(8.3%)、297(9.1%)、211(6.5%)、534(16.4%)、299(9.2%)和448(13.8%)。多项logistic回归分析显示,青春发动时相提前是女生品行异常(OR=2.260,95%CI:1.322—3.863)和多动/注意缺陷(OR=1.980,95%CI:1.111-3.527)的危险因素,青春发动时相提前是男生客观困难异常的危险因素(OR=1.449,95%CI:1.018~2.063)。结论青春发动时相提前会增加女生品行异常和多动/注意缺陷的风险,青春发动时相提前的男生客观困难异常风险增加,青少年心理行为干预应考虑性别特点。
Objective To understand the gender specific association between early puberty and behavioral and emotional characteristics in children. Methods The questionnaire survey was conducted among the girls in grade 2-3, boys in grade 3-4 and both girls and boys in grade 7-8 selected through cluster sampling in 2 middle schools and 2 primary schools in Beijing and Shenyang respectively in November 2014. The questionnaire contents included general information, physical activity and video time, pubertal development scale (PDS) and strength and difficulties questionnaire (SDQ). Descriptive statistics were used to describe the prevalence of early puberty and the detection rate of abnormal behavioral problems. The effects of early puberty on behavioral and emotional problems were estimated with nnivariate and multivariate logistic regression analyses. The odds ratios and their 95% confidence intervals were calculated. Results A total of 3 253 complete questionnaires were collected, the prevalence of early puberty was 15.9% (518). The detection rate (number) of abnormal emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems,pro-social behaviors and total difficulties were 8.3 % (269), 9.1% (297), 6.5 % (211), 16.4% (534), 9.2% (299) and 13.8%(448) respectively. Multivariate logistic regression analysis showed that early puberty was the risk factor for conduct problems (OR=2.260, 95%CI: 1.322-3.863) and hyperactivity/inattention (OR= 1.980, 95%CI: 1.111-3.527) in the girls, and early puberty was risk factor for total difficulties in boys (95%CI: 1.018-2.063). Conclusions Early puberty might increase the risk of conduct problems and hyperactivity/inattention in girls and increase the risk of total difficulties in boys. It is important to conduct gender specific psychological intervention among adolescents for improving their physical and mental health.