Abstract: Objective　To compare the differences of mental health status of middle school students with different types of custodial care in poor districts and counties of Chongqing and to provide references for further intervention measures.Methods　From September to October in 2011,with multi-stage random cluster sampling method,one county was randomly selected from 11 poor districts and counties in Chongqing,then three township middle schools were randomly selected from this district or county and finally students graded one of junior middle school and senior middle school of four to six classes were randomly selected from the above each middle school.By collective survey method,questionnaires were unified issued by trained investigators.The contents were divided into two parts:general demographic information questionnaire and middle school student mental health scale（MSSMHS）.A total of 2 401 questionnaires were distributed,2 171 were valid questionnaires with an effective response rate of 90.4%.Results　Among 2 171 middle school students,there were 1 072 females（49.4%） and 1 099 males（50.6%）;1 114 junior high school students graded one（51.3%）,and 1 057 senior high school students graded one（48.7%）;468 with custodial care of single parent（21.6%）,756 with cross-generation custody（34.8%）,101 with custodial care of the former generation（4.7%）,215 with peer custody（9.9%）,and 631 with custodial care of parents（29.0%）.The scores of obsessive-compulsive symptoms,hostility,interpersonal sensitivity and tensions,depression,anxiety,learning stress,maladjustment,emotional imbalance and psychological imbalance dimensions of middle school students with different types of custodial care were significantly different（P<0.05）,while there was no significant difference in the scores of paranoid dimension（P>0.05）.There were significant differences in obsessive-compulsive symptoms,paranoia,hostility,interpersonal sensitivity and tensions,depression,anxiety,learning stress,emotional imbalance and psychological imbalance dimensions among middle school students of different genders（P<0.05）,but there was no significant difference in the score of maladjustment dimension（P>0.05）.There were significant differences in obsessive-compulsive symptoms,paranoia,hostility,interpersonal sensitivity and tensions,depression,anxiety,learning stress,maladjustment,emotional imbalance and psychological imbalance dimensions of middle school students at different grades（P<0.05）.There were no significant differences in scores of obsessive-compulsive and learning stress dimensions among female middle school students with different types of custodial care（P>0.05）,while the scores of paranoia,hostility,interpersonal sensitivity and tensions,depression,anxiety,maladjustment,emotional imbalance and psychological imbalance dimensions were significantly different（P<0.05）;there were no significant differences in obsessive-compulsive symptoms,paranoia,hostility,interpersonal sensitivity and tensions,depression,anxiety,learning tensions,maladjustment,emotional imbalance and psychological imbalance scores among male middle school students with different types of custodial care（P>0.05）.There were no significant differences in scores of obsessive-compulsive symptoms,paranoia,anxiety,learning stress and emotional imbalances among junior high school students graded one with different types of custodial care（P>0.05）,but hostility,interpersonal sensitivity and tensions,depression,maladjustment and psychological imbalance dimensions were significantly different（P<0.05）;there were no significant differences in scores of obsessive-compulsive symptoms,paranoid,hostility,interpersonal sensitivity and tensions,learning stress and psychological imbalance dimensions among senior high school students graded one with different types of custodial care（P>0.05）,while the scores of depression,anxiety,maladjustment and emotional imbalance dimensions were significantly different（P<0.05）.Conclusion　There are many psychological problems in middle school students featured by female,senior class,custodial care of the former generation and peer custody in poor districts and counties of Chongqing.It is necessary for the government,the school and the guardian to make a concerted effort to reduce the mental health problems of middle school students.

Key words: Students, Custodial care, Mental health, Chongqing

摘要： 目的　比较重庆市贫困区县不同监护类型中学生心理健康状况的差异，为进一步的干预措施提供参考依据。方法　于2011年9—10月，采用多阶段随机整群抽样法，首先从重庆市11个贫困区县中随机抽取1个区县，然后在该区县随机抽取3个乡镇中学，最后在每个中学随机抽取初一、高一各4～6个班的中学生。采用集体调查的方法，由经过培训的调查员现场统一发放问卷，内容分为自编一般人口学信息调查问卷和中学生心理健康评定量表（MSSMHS）两部分，共发放问卷2 401份，回收有效问卷2 171份，有效回收率为90.4%。结果　2 171例中学生中，女1 072例（49.4%），男1 099例（50.6%）；初一学生1 114例（51.3%），高一学生1 057例（48.7%）；单亲监护468例（21.6%），隔代监护756例（34.8%），上代监护101例（4.7%），同辈监护215例（9.9%），父母亲监护631例（29.0%）。不同监护类型中学生强迫症状、敌对、人际关系敏感与紧张、抑郁、焦虑、学习压力、适应不良、情绪不平衡、心理不平衡维度得分间差异有统计学意义（P<0.05），而偏执维度得分间差异无统计学意义（P>0.05）。不同性别中学生强迫症状、偏执、敌对、人际关系敏感与紧张、抑郁、焦虑、学习压力、情绪不平衡、心理不平衡维度得分间差异有统计学意义（P<0.05），而适应不良维度得分间差异无统计学意义（P>0.05）。不同年级中学生强迫症状、偏执、敌对、人际关系敏感与紧张、抑郁、焦虑、学习压力、适应不良、情绪不平衡、心理不平衡维度得分间差异均有统计学意义（P<0.05）。不同监护类型女中学生强迫症状、学习压力维度得分间差异无统计学意义（P>0.05），而偏执、敌对、人际关系敏感与紧张、抑郁、焦虑、适应不良、情绪不平衡、心理不平衡维度得分间差异有统计学意义（P<0.05）；不同监护类型男中学生强迫症状、偏执、敌对、人际关系敏感与紧张、抑郁、焦虑、学习压力、适应不良、情绪不平衡、心理不平衡维度得分间差异均无统计学意义（P>0.05）。不同监护类型初一学生强迫症状、偏执、焦虑、学习压力、情绪不平衡维度得分间差异无统计学意义（P>0.05），而敌对、人际关系敏感与紧张、抑郁、适应不良、心理不平衡维度得分间差异有统计学意义（P<0.05）；不同监护类型高一学生强迫症状、偏执、敌对、人际关系敏感与紧张、学习压力、心理不平衡维度得分间差异无统计学意义（P>0.05），而抑郁、焦虑、适应不良、情绪不平衡维度得分间差异有统计学意义（P<0.05）。结论　重庆市贫困区县中女、高年级、上代监护、同辈监护中学生存在的心理问题较多，需要政府、学校、监护人的共同努力，以减少中学生的心理健康问题。

关键词: 学生, 监护, 心理健康, 重庆