综述

青少年群体述情障碍的研究进展

Advances in the study of alexithymia among adolescent populations

:30-38
 
       述情障碍(alexithymia)是一种主要表现为难以识别和描述情绪情感、社交依附和人际交往能力匮乏的人格特质与心理特征。近年来,述情障碍的发生在青少年群体中日益普遍,这不仅对青少年的身心健康造成威胁,还给家庭与社会带来沉重负担。因此,本研究通过系统回顾国内外相关文献,综述青少年述情障碍的评估工具、影响因素及干预方式,旨在为青少年述情障碍的早期识别与预防,以及干预措施的制定与应用提供参考依据。
    Alexithymia is a psychological trait characterized by difficulty in identifying and describing emotional feelings,as well as deficits in social attachment and interpersonal communication skills.In recent years,the prevalence of alexithymia among adolescents has become increasingly common,posing significant threats to their physical and mental health and imposing a heavy burden on families and society.This study conducts a systematic review of relevant literature from domestic and international databases to examine the influencing factors,assessment tools,and intervention strategies for adolescent alexithymia.The findings aim to provide a reference for early identification,prevention,and the development and application of targeted interventions for adolescent 
alexithymia.
专家述评

青少年非自杀性自伤行为研究进展

Advances in the study of non-suicidal self-injury in adolescents

:1473-1481
 
       非自杀性自伤行为(NSSI)是指个体在没有自杀意图的情况下,故意对自己身体进行伤害的行为。近年来,NSSI在全球范围内整体呈上升趋势,尤其在青少年群体中日益普遍,这与青少年的年龄特点、心理及生物学特征、社会压力等因素密切相关。有研究表明,NSSI是自杀行为的独立危险因素,不仅对青少年健康造成严重影响,也给家庭和社会带来了沉重的负担。因此,本文通过系统回顾NSSI相关文献,阐述其流行病学现况、影响因素和干预措施,旨在为早期识别高危人群、预防青少年NSSI行为的发生以及制定相应的干预策略提供科学依据。
       Non-suicidal self-injury(NSSI)is the behavior in which an individual intentionally inflicts harm on his or her own body without suicidal intent.In recent years,NSSI has been on the rise globally,especially among adolescents,which is closely related to the age characteristics,psychological and biological characteristics,and social pressure.Some studies have shown that NSSI is an independent risk factor for suicidal behavior,which not only poses a serious impact on the health of adolescents,but also imposes a heavy burden on families and society.Therefore,this article systematically reviews relevant literatures on NSSI,mainly elaborating the epidemiological status,influencing factors and interventions.We aim to provide a scientific basis for the early identification of high-risk populations,the prevention of NSSI in adolescents and the development of corresponding intervention strategies
论著

广州市越秀区青少年近视特点和危险因素分析

Analysis on the characteristics and risk factors of myopia among adolescents in Yuexiu District,Guangzhou

:541-547
 
目的 探讨广州市越秀区青少年近视特点和危险因素,为降低青少年近视发病率提供参考依据。方法 本项目采用分层随机整群抽样的研究方法,抽取分布于广州市越秀区2 774名青少年作为研究对象,根据近视检查情况将其分为近视组(n=1 657)与非近视组(n=1 117),通过问卷调查的方式,分析青少年近视整体现况、流行病学特征以及影响青少年近视发生、发展的相关行为和因素。结果 2 774名青少年中,1 657名近视,检出率为59.73%;其中女生为872名,多于男生的785名;幼儿园、小学生、初中生、高中生近视人数分别为20名、446名、484名、707名,呈升高趋势。学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的影响因素(P<0.05)。广州市越秀区青少年近视程度均与学段、校外用眼环境、电子屏幕使用情况、户外活动及睡眠情况、近距离用眼情况呈正相关(P<0.05),与校内用眼环境、读写姿势、近视检查及矫治情况呈负相关(P<0.05)。对不同预后组间存在统计学差异的因素进行Logistic多因素分析后得到,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的相关影响因素(P<0.05)。结论 广州市越秀区青少年近视发生人群呈现高龄化,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是青少年近视的相关影响因素,建议加强组织学生到户外进行多种课间户外体育活动,同时鼓励家长在校外从自身做起,树立爱眼护眼好榜样,与学校共同保护孩子的视力。
Objective To explore the characteristics and risk factors of myopia among adolescents in Yuexiu District,Guangzhou,and to provide reference for reducing the incidence of myopia among adolescents.Methods This project adopted stratified random cluster sampling to select 2 774 adolescents distributed in Yuexu District,Guangzhou as the research objects,which were divided into myopia group(n=1 657)and non-myopia group(n=1 117)according to the myopic examination.Through questionnaire survey,the overall situation and epidemiological characteristics of myopia among adolescents in our district were comprehensively known,in order to explore the related behaviors and factors affecting the occurrence and development of myopia among adolescents in our district,explore reasonable intervention measures,and put forward scientific and effective myopia prevention and control technical means and strategies.Results Among 2 774 adolescents,1 657 were nearsighted(59.73%).Among them,872 were female and 785 were male.The number of myopia in kindergarten,primary school,middle school and high school students were 20,446,484 and 707 respectively,showing an increasing trend.School period,eyes use environment in school and outside school,reading and writing posture,situations of electronic screen use,close distance eye use,outdoor activities and sleep,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou(P<0.05).The myopia degree of adolescents in Yuexiu District of Guangzhou was positively correlated with school period,out-of-school eyes use environment,electronic screen use,outdoor activities and sleep conditions,and close distance eyes use(P<0.05),and negatively correlated with in-school eyes use environment,reading and writing posture,myopia examination and correction conditions(P<0.05).After Logistic multivariate analysis of the factors with statistical difference between different prognostic groups,school period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep conditions,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou(P<0.05).Conclusions In Yuexiu District,Guangzhou,the population with myopia is gradually moving to a younger age.School period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep condition,myopia examination and correction are the relevant influencing factors.It is recommended to strengthen the organization of students to go outdoors for a variety of outdoor sports activities between classes,while encouraging parents to set a good example of eye care outside the school and work with the school to protect their children’s eyesight.
论著

Nolla分期对青少年拔牙正畸患者下颌第三磨牙倾斜角的影响

The effect of Nolla staging on the inclination angle of mandibular third molars in adolescent orthodontic patients undergoing tooth extraction

:1193-1197
 
目的 探讨Nolla分期对青少年拔牙正畸患者下颌第三磨牙倾斜角的影响。方法 选择2018年10月—2022年10月收治的100例拔牙正畸青少年患者。100例患者均拔除了4颗前磨牙,共有100颗下颌第三磨牙,通过Nolla分期,可将100例患者分成四组,每组25例。Ⅰ组:牙冠正在形成,Ⅱ组:牙冠基本形成,Ⅲ组:牙根形成在1/2以下,Ⅳ组:牙根形成在1/2以上。在治疗前后,测量下颌第三磨牙倾斜角,对角度α的变化进行分析。结果 第三磨牙牙胚倾斜角、MP-SN、MP-FH在不同组间比较差异无统计学意义(F=0.256,P=0.857;F=0.033,P=0.992;F=0.028,P=0.994);治疗前组间下颌第三磨牙角度比较差异无统计学意义(P>0.05),治疗后不同组间下颌第三磨牙角比较差异有统计学意义(F=13.376,P<0.001),治疗前后Ⅰ组、Ⅱ组、Ⅳ组第三磨牙的角度无差异(t=0.757,P=0.453;t=0.224,P=0.824;t=0.852,P=0.399),Ⅲ组治疗后角度变化减少(t=3.697,P<0.001)。结论 青少年正畸拔牙后,下颌第三磨牙处于牙根形成阶段的一半以下可能会导致第三磨牙近中倾斜加重。当下颌第三磨牙处于牙冠形成阶段,牙冠形成超过一半时,第三磨牙角度变化较小。在治疗前应根据Nolla分期评估下颌第三磨牙的预后情况,并及时制定相应的干预策略。
Objective To explore the effect of Nolla staging on the inclination angle of mandibular third molars in adolescent orthodontic patients undergoing tooth extraction. Methods A total of 100 adolescent patients who underwent tooth extraction orthodontic treatment from October 2018 to October 2022 were included.All 100 patients had 4 premolars extracted,with a total of 100 mandibular third molars.According to Nolla staging,the 100 patients can be divided into 4 groups,with 25 cases in each group.Group I:The crown was forming,Group II:The crown was basically formed,Group III:The root formation was below 1/2,Group IV:The root formation was above 1/2.The inclination angle of the mandibular third molar was measured before and after treatment,and the angle α changes will be analyzed. Results There was no difference in the inclination angle,MP-SN,and MP-FH of the third molar tooth germ among different groups(F=0.256,P=0.857;F=0.033,P=0.992;F=0.028,P=0.994).There was no difference in the angle of mandibular third molar teeth between groups before treatment(P>0.05),the contrast of mandibular third molar angles between different groups after treatment was signifiant(F=13.376,P<0.001),while the angles in Group I,Group and Group Ⅳ were not slgnificantly different(t=0.757,P=0.453;t=0.224,P=0.824;t=0.852,P=0.399),and the angle change decreased after treatment in Group Ⅲ(t=3.697,P<0.001). Conclusions After orthodontic extraction in adolescents,if the mandibular third molar is less than half of the root formation stage,it may lead to increased mesial inclination of the third molar.However,when the mandibular third molar is in the stage of crown formation and the crown is more than half formed,the angle change of the third molar is relatively small.Therefore,in clinical practice,Nolla staging should be evaluated in the prognosis of mandibular third molars before treatment and develop corresponding intervention strategies in a timely manner.
论著

青春期多囊卵巢综合征患者AMH与25(OH)D3的关联性研究

Study on the relationship between anti-Müllerian hormone and 25(OH)D3 in adolescent patients with polycystic ovary syndrome

:79-82
 
目的 探讨青春期多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)与25(OH)D3水平的相关性。方法 本研究选择在2019年1月—2020年12月在我院妇科门诊就诊的PCOS青春期女性79名,另选择同期体检的非PCOS健康对照85名。对所有受试者测量身高、体质量,计算体质量指数(BMI)。由诊治医生检查研究对象是否有痤疮、多毛以及月经情况。抽取静脉血检测黄体生成素、卵泡刺激素、总睾酮、硫酸脱氢表雄酮、抗苗勒管激素和 25(OH)D3,将 25(OH)D3分为不足[25(OH)D3<30 ng/mL]和缺乏[25(OH)D3<20 ng/mL]2组,对数据进行比较分析。结果 与健康对照组比较,PCOS组更容易发生月经稀发/闭经,其痤疮发生率较高(P值均<0.05)。体质量指数、AMH值、总睾酮和硫酸脱氢表雄酮的体内检出水平在PCOS组较高,而25(OH)D3在PCOS组较低(P值均<0.05)。PCOS组的AMH与BMI和总睾酮呈正相关关系,与25(OH)D3呈负相关关系(P值均<0.05)。25(OH)D3缺乏组的AMH水平高于25(OH)D3不足组,对照组和PCOS组的25(OH)D3缺乏组的AMH水平均高于25(OH)D3不足组,两两比较其差异有统计学意义(P值均<0.05)。健康对照组的25(OH)D3缺乏率为67.1%(57/85),而PCOS组的25(OH)D3缺乏率为96.2%(76/79),2组比较其差异有统计学意义(χ2=22.68,P<0.001)。结论 青春期多囊卵巢综合征患者体内 25(OH)D3水平与AMH 水平显著相关。AMH 和25(OH)D3可用于评估青春期PCOS发病风险的替代指标。
Objective To explore the correlation between serum anti-Müllerian hormone (AMH) and 25(OH)D3 levels in adolescent patients with polycystic ovary syndrome (PCOS). Methods Seventy-nine adolescent girls with PCOS and 85 non-PCOS healthy controls who walked in the gynecological clinic of our hospital from January 2019 to December 2020 were selected. Height, weight were measured and body mass index (BMI) was calculated.Hirsutism, acne and menstruation were evaluated by doctors on all subjects. Venous blood was drawn to detect levels of luteinizing hormone, follicle stimulating hormone, total testosterone, dehydroepiandrosterone sulfate, AMH and 25(OH)D3, 25(OH)D3 was further divided into insufficient [25(OH)D3<30 ng/mL] and deficient [25(OH)D3<20 ng/mL]level, then all data were compared and analyzed between two groups. Results Compared with the healthy control group, the PCOS group was more prone to have oligomenorrhea or amenorrhea, the incidence of acne was higher in PCOS group than in control group (all P values<0.05). BMI, the levels of AMH, total testosterone and dehydroepiandrosterone sulfate were significantly higher in the PCOS group compared to the control group, while 25(OH)D3 was the opposite (all P values <0.05). AMH in the PCOS group was positively correlated with BMI and level of total testosterone, and negatively correlated with 25(OH)D3 (all P values<0.05). The AMH level in the 25(OH)D3 deficiency group was higher than that in the 25(OH)D3 insufficient group, the AMH levels of the 25(OH)D3 deficient group and control group were higher than that in the 25(OH)D3 insufficient group,the differences were statistically significant (P<0.05). The 25(OH)D3 deficiency rate in the healthy control group was 67.1% (57/85), while the 25(OH)D3 deficiency rate in the PCOS group was 96.2% (76/79). The difference between the two groups was statistically significant (χ2=22.68, P<0.001). Conclusions Serum 25(OH)D3 level was an independent factor significantly associated with AMH level in adolescents with PCOS. AMH and 25(OH)D3 levels may be used as surrogate markers of PCOS risk in adolescents.
论著

重复经颅磁刺激联合艾司西酞普兰治疗青少年首发抑郁症的临床疗效及影响

Clinical efficacy and influence of repetitive transcranial magnetic stimulation combined with escitalopram in first-episode depression in adolescents

:65-69
 
目的 探究青少年首发抑郁症患者治疗中联合应用艾司西酞普兰与重复经颅磁刺激(rTMS)的总疗效及应用价值。方法 选取东莞市第七人民医院2020年5月—2021年10月80例青少年首发抑郁症患者,参考“数字双盲法”,分为对照组和观察组(各40例)2组,对照组接受伪rTMS+艾司西酞普兰治疗,观察组接受rTMS+艾司西酞普兰治疗。评价指标:临床总疗效、抑郁评分(17项汉密尔顿抑郁量表,HAMD-17)、认知功能评分(威斯康星卡片分类测验,WCST)、生活质量(SF-36评分),不良反应发生率(副反应量表,TESS)。结果 观察组患者总有效率95.00%较对照组80.00%明显高(P<0.05);且2组不良反应率比较(P>0.05)。观察组治疗1周、2周、4周HAMD-17评分均较对照组低,同时治疗4周后WCST项目中完成分类评分较对照组更高(P<0.05)。观察组SF-36(角色、社会、躯体、认知)评分均较对照组高(P<0.05)。结论 青少年首发抑郁症患者,在艾司西酞普兰用药基础上联合rTMS,可获取更为显著的治疗效果,控制病情进展,减轻抑郁症状,同时对认知功能无影响,促进生活质量大幅度提高,且用药安全性有保障。
Objective To explore the total efficacy and application value of escitalopram combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of adolescent patients with first-episode depression.Methods A total of 80 adolescent patients with first-episode depression in Dongguan Seventh People's Hospital from May 2020 to October 2021 were selected.Referring to the “digital double-blind method”,they were divided into control group and observation group (40 cases each).The control group was treated with pseudo rTMS and escitalopram,and the observation group was treated with rTMS and escitalopram.Evaluation indexes: total clinical efficacy,depression score (17-item Hamilton Depression Scale,HAMD-17),cognitive function score (Wisconsin Card Sorting Test,WCST),quality of life (SF-36 score),adverse reaction rate (Treatment Emergent Symptom Scale,TESS).Results The total effective rate of 95.00% in the observation group was significantly higher than 80.00% in the control group (P<0.05); the incidence of adverse reactions was compared between the two groups (P>0.05).The HAMD-17 scores of the observation group at 1 week,2 weeks and 4 weeks were significantly lower than those of the control group.At the same time,the classification scores of WCST items after 4 weeks of treatment were higher in observation group (P<0.05).The SF-36 (role,society,body and cognition) scores in the observation group were higher than those in the control group (P<0.05).Conclusions Adolescent patients with first-episode depression treated with rTMS on the basis of escitalopram can obtain more significant therapeutic effect,control the progress of the disease,reduce depressive symptoms,have no effect on cognitive function,greatly improve the quality of life,and ensure the safety of medication.
论著

广州市青少年自杀行为的危险因素分析

Analysis on the risk factors of suicide among adolescents in Guangzhou

:28-29
 
目的 分析影响广州青少年自杀行为的因素。方法 选取100例自杀行为青少年为观察组,选100例健康青少年为对照组,对比两组青少年家庭结构、家庭教育方式、自身人格特征等指标。多因素Logistic回归分析其自杀行为危险因素。结果 观察组青少年抑郁量表、焦虑量表、攻击性人格及冲动性人格量表分值均高于对照组高;单亲家庭或父母常年在外、家庭教育方式不当、学校无健康心理教育课、抑郁或焦虑、冲动或攻击性人格、负面事件、消极应对是青少年自杀行为独立危险因素,P均<0.05。结论 家长及学校应正确引导青少年处事方式,积极面对生活,打消自杀意念。
Objective To analyze the factors influencing the suicide behavior of adolescents in Guangzhou. Methods The 100 cases of adolescent suicide behavior were selected as the observation group, 100 healthy adolescents were selected as control group, compared with two groups of adolescent family structure, family education, personality traits and other indicators. Multivariate logistic regression analysis of risk factors was taken for suicidal behavior. Results In the observation group adolescent depression scale, anxiety scale, attack impulse personality and personality amount scores were higher than those in the control group, single parent family or parents staying outside, improper family education, school health psychological education, depression or anxiety, impulsivity, or aggressive personality, negative events, negative coping were independent risk factors for adolescent suicide, P<0.05. Conclusion Parents and schools should have guide to adolescents, toface life positively, and give up thought of suicide.
论著

可及与连贯的病人服务改善青春期多囊卵巢综合症患者长期治疗依从性

Access to care and continuity of care improve the compliance of adolescent patients with polycystic ovary syndrome in long-term treatment

:33-35
 
目的 对86例青春期多囊卵巢综合症(polycystic ovary syndrome,PCOS)患者进行随访,探讨患者长期治疗的依从性。方法 选择2009年11月—2012年6月在我院门诊首次诊断为青春期PCOS患者进行前瞻性队列研究。按随诊方法不同分为常规随访组和可及与连贯病人服务(ACC)组,前瞻随访6个月。分别在初次就诊时、3个月及6个月后对比两组的身体质量指数(Body Mass Index, BMI)、复诊率和遵医嘱服药率。结果 共86名患者入组,其中常规随访组43人,ACC组43人。两组基线资料基本一致。随访3月时,两组的BMI、复诊率和遵医嘱服药率的差异无统计学意义(P>0.05)。随诊6月时,ACC组的复诊率和服药依从性均优于常规随访组分别为(97.7% 比 81.4%,97.7% 比 76.7%,P<0.05),BMI比常规随访组下降(22.33±7.31 比 24.59±7.8 kg/m2,t<0.05)。结论 可及与连贯的病人服务可以改善青春期PCOS患者BMI及长期随诊的复诊率和服药依从性。
Objective To investigate the compliance of adolescent patients with polycystic ovary syndrome (PCOS) in long-term treatment by access to care and continuity of care(ACC) on 86 cases. Methods A prospective cohort study was taken for 6 months on adolescent patients diagnosed as PCOS for the first time in out-patient department from November 2009 to June 2012. These patients were selected and divided into ACC group and regular follow-up group according to the different modes of follow-up visit. The relevant data including body mass index (BMI), clinic visit rate and rate of medication adherence were compared in the first visit and 3rd, 6th month in the follow-up visit. Results 86 patients were enrolled with 43 in ACC group and 43 in regular follow-up group. The baseline information was similar between the two groups. There were no statistically significant difference between groups in BMI, clinic visit rate and rate of medication adherence after 3 months (P>0.05). However, after 6 months, BMI, clinic visit rate and rate of medication adherence were significantly improved in the ACC group compared to the regular follow-up group (22.33±7.31 vs 24.59±7.8 kg/m2, 97.7% vs 81.4%, 97.7% vs 76.7%, P<0.05, respectively). Conclusion ACC could improve BMI, clinic visit rate and medication adherence of adolescent patients with polycystic ovary syndrome in long-term treatment.
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