A Clinical Study of the Relationship between School Refusal and Depression

这项研究的对象是由一位作者在1989年至1997年间直接调查的旷课病例，对这些病例可以使用CDI，一种抑郁症的自评量表。从这些病例中选择符合学业拒绝或抑郁障碍标准的受试者。拒学44例（男生29例，女生15例），抑郁症12例（男生5例，女生7例），共56例（男生34例，女生22例）。拒绝入学病例的平均CDI评分为20.9（±±）。抑郁症患者的CDI得分为27.3(]SY.+-[)6.92，正常对照组的CDI得分为19.9(]SY.+-[)7.50，抑郁症患者的CDI得分明显高于拒学组和正常对照组。根据Tsujii的研究，CDI由“人际不适应感”、“核心抑郁”和“自我厌恶”三个下属量表组成。拒学个案与正常对照组在三个次级量表上的差异均不显著。抑郁症患者与其他两组在“人际适应不良感”和“核心抑郁”方面存在显著差异。我们的结论是，这些结果支持我们的信念，即拒学病例和抑郁症病例都抱怨学校缺勤，应该在临床上加以区分，尽管这两种病例在临床上表现相同。

The subject of this study were cases exhibiting school inattendance directly examined by one of the authors between 1989 and 1997, on whom the CDI,a self-rating scale on depression could be employed. From among these cases, subjects fulfillling the criteria of school refusa or depressive disorders were selected. The number of school refusal cases is 44 (29boys, 15girls), and the number of depressive disorder cases is 12(5boys, 7girls), total 56(34boys, 22girls). Mean CDI scores for school refusal cases was 20.9(]SY.+-。[) 7.07, that for depressive disorder cases was 27.3(]SY.+-。[)6.92, and that for normal controls was 19.9(]SY.+-。[)7.50, showing significantly higher CDI scores for depressive disorder cases in comparison to school refusal cases and normal controls. According to a study by Tsujii, the CDI is constructed of the 3 subordinate scales of "feelings of interpersonal maladaptation", "core depression", and "self revulsion". The difference between school refusal cases and normaol controls in terms of the three subordinate scales was not significant. There were significant differences in terms of "feeling of interpersonal maladaptation"and"core depression"between depressive disorder cases and two other groups. We conclude these results support our belief that school refusal cases and depressive disorder cases that both complain of school inattendance should be differenciated clinically, though both cases appear same clinically.