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Article(id=1321169779101119358, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169735128043598, articleNumber=null, orderNo=null, doi=10.11847/zgggws1145764, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1724342400000, receivedDateStr=2024-08-23, revisedDate=1733760000000, revisedDateStr=2024-12-10, acceptedDate=1743436800000, acceptedDateStr=2025-04-01, onlineDate=1792921021484, onlineDateStr=2026-10-25, pubDate=1752076800000, pubDateStr=2025-07-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921021484, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921021484, creator=13701087609, updateTime=1792921021484, updator=13701087609, issue=Issue{id=1321169735128043598, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='7', pageStart='769', pageEnd='896', issueExtLink='null', onlineDate='null', pubDate='1752076800000', pubDateStr='2025-07-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921011000, creator='13701087609', updateTime=1792921011000, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=817, endPage=822, ext={EN=ArticleExt(id=1321169779310834559, articleId=1321169779101119358, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Mental health literacy and its influencing factors among adults in Shandong province, 2023: a cross-sectional survey, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To assess mental health literacy and its determinants among adults in Shandong province and provide a basis for the development of targeted mental health services.

Methods

From November to December 2023, a combined online and on-site face-to-face survey was conducted among 10 533 residents aged 18 years and older recruited from 39 districts/counties/cities in Shandong province using stratified multistage random sampling. A general questionnaire, the National Mental Health Literacy Questionnaire (NMHLQ) developed by the Institute of Psychology, Chinese Academy of Sciences, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Insomnia Severity Index (ISI) were used in the study.

Results

Of 10 489 participants with valid responses, 12.51% were assessed as having adequate mental health literacy, with 15.47%, 99.05%, and 48.87% of participants having adequate mental health knowledge, mental health skills and awareness, and the ability to identify and manage common mental disorders, respectively. Chi-squared test results showed statistically significant differences in the proportion of adults with adequate mental health literacy across regions, gender, age, marital status, education, occupation, monthly household income, smoking, chronic disease status, anxiety, and depression Logistic regression analysis showed that female gender (odds ratio [OR] = 0.791, 95% confidence interval [95%CI]: 0.385 - 0.912), junior high school education (OR = 0.703, 95%CI: 0.576 - 0. 859), high school/vocational/technical education (OR = 0.743, 95%CI: 0.578 - 0.955), college degree or higher (OR = 0.594, 95%CI: 0.458 - 0.770), administrative/professional/technical occupation (OR = 0. 552, 95%CI: 0.442 - 0.689), other occupation (OR = 0.802, 95%CI: 0.663 - 0.968), monthly household income of 3 000 - 5 999 RMB yuan (OR = 0.630, 95%CI: 0.520 - 0.762), monthly household income of 6 000 - 9 999 RMB yuan (OR = 0.607, 95%CI: 0.494 - 0.746), and with fair/poor self-rated health (OR = 0.726, 95%CI: 0.612 - 0.860) were negatively associated with inadequate mental health literacy. Living in eastern Shandong province (OR = 1.190, 95%CI: 1.043 - 1.359), western Shandong province (OR = 1.483, 95%CI: 1.237 - 1.779), being married (OR = 1.363, 95%CI: 1.059 - 1.756), having other marital statuses (OR = 1.816, 95%CI: 1.112 - 2.964), having mild anxiety (OR = 1.408, 95%CI: 1.110 - 1.786), having moderate to severe anxiety (OR = 2.283, 95%CI: 1.183 - 4.408), having mild depression (OR = 1.443, 95%CI: 1.160 - 1.794), and having moderate to severe depression (OR = 1.819, 95%CI: 1.162 - 2.848) were positively associated with inadequate mental health literacy.

Conclusions

Mental health literacy among adult residents in Shandong province is at a relatively low level. Demographic characteristics such as place of residence, gender and marital status, and anxiety and depression status are influencing factors. Mental health services should focus on people with low levels of education, low income, and those with anxiety or depression.

, authors=Peipei KANG, Lingxi GU, Qi LI, Jing ZHANG, Yanhu WANG, Lili HU, authorsList=Peipei KANG, Lingxi GU, Qi LI, Jing ZHANG, Yanhu WANG, Lili HU, authorCompany=null, correspAuthors=Lili HU, authorNote=null, correspAuthorsNote=
HU Lili, E-mail：
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321169779973534594, articleId=1321169779101119358, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=2023年山东省居民心理健康素养现状及其影响因素, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

了解山东省居民心理健康素养水平及影响因素，为开展有针对性的心理健康服务工作提供科学依据。

方法

于2023年11—12月，采用分层多阶段随机抽样方法抽取山东省≥18岁常住居民10 533人为调查对象，采取线上加线下相结合的方式，通过一般情况调查问卷、国民心理健康素养问卷（NMHLQ）、抑郁筛查量表（PHQ-9）、广泛性焦虑障碍量表（GAD-7）、失眠严重程度指数量表（ISI）评估山东省居民心理健康素养达标情况及其影响因素。

结果

共回收有效问卷10 489份，山东省居民心理健康素养达标率为12.51%，其中判断题达标率为15.47%，自我评估题达标率为99.05%，案例题达标率为48.87%。χ2检验结果显示，不同地区、性别、年龄、婚姻状况、文化程度、职业、家庭月收入以及是否吸烟、患慢性病、焦虑、抑郁的居民心理健康素养达标率差异均有统计学意义。logistic回归分析结果显示，女性（OR=0.791，95%CI=0.385～0.912），文化程度为初中（OR=0.703，95%CI=0.576～0.859）、高中/职高/中专（OR=0.743，95%CI=0.578～0.955）、大专及以上（OR=0.594，95%CI=0.458～0.770），职业为行政管理/专业技术人员（OR=0.552，95%CI=0.442～0.689）、其他（OR=0.802，95%CI=0.663～0.968），家庭月收入为3 000～5 999元（OR=0.630，95%CI=0.520～0.762）、6 000～9 999元（OR=0.607，95%CI=0.494～0.746），健康状况自我评估为一般/较差（OR=0.726，95%CI=0.612～0.860）与心理健康素养不达标呈负相关联；居住在鲁东（OR=1.190，95%CI=1.043～1.359）、鲁西（OR=1.483，95%CI=1.237～1.779），婚姻状况为已婚（OR=1.363，95%CI=1.059～1.756）、其他（OR=1.816，95%CI=1.112～2.964），焦虑状态为轻度（OR=1.408，95%CI=1.110～1.786）、中重度（OR=2.283，95%CI=1.183～4.408），抑郁状态为轻度（OR=1.443，95%CI=1.160～1.794）、中重度（OR=1.819，95%CI=1.162～2.848）与心理健康素养不达标呈正相关联。

结论

山东省居民心理健康素养水平整体偏低，居住地、性别、婚姻状况等人口学特征以及焦虑、抑郁状态均为心理健康素养水平的影响因素；心理健康服务应重点关注低学历、低收入以及有焦虑、抑郁状态人群。

, authors=康佩佩, 谷灵犀, 李奇, 张婧, 王延祜, 胡丽丽*, *, authorsList=康佩佩, 谷灵犀, 李奇, 张婧, 王延祜, 胡丽丽, authorCompany=null, correspAuthors=胡丽丽, authorNote=

康佩佩（1987–），主治医师，硕士，研究方向：心理健康和精神卫生防治

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胡丽丽，E-mail：
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康佩佩（1987–），主治医师，硕士，研究方向：心理健康和精神卫生防治

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康佩佩（1987–），主治医师，硕士，研究方向：心理健康和精神卫生防治

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Mental health literacy and mental health status in adolescents: a population-based survey[J]. Child and Adolescent Psychiatry and Mental Health, 2014, 8(1): 26., articleTitle=null, refAbstract=null), Reference(id=1321169788341171153, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169779101119358, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=34, rfOrder=33, authorNames=null, journalName=null, refType=null, unstructuredReference=Huang X X, Wang X Q, Hu J, et al. Inadequate mental health literacy and insufficient physical activity potentially increase the risks of anxiety and depressive symptoms in Chinese college students[J]. Front Psychiatry, 2021, 12: 753695., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321169780254552963, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169779101119358, xref=null, ext=[AuthorCompanyExt(id=1321169780262941572, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169779101119358, companyId=1321169780254552963, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Shandong Mental Health Center, Jinan 250014, China), AuthorCompanyExt(id=1321169780271330181, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169779101119358, companyId=1321169780254552963, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山东省精神卫生中心，济南 250014)])], figs=[ArticleFig(id=1321169783903597484, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169779101119358, language=EN, label=Tab.1, caption=

Number of respondents, number, and proportion of individuals with sufficient mental health literacy among 104 899 adults in Shandong province in 2023, stratified by demographics, monthly household income, alcohol consumption, smoking, self-rated health, chronic diseases, symptoms of anxiety and depression, and insomnia

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变量分类调查人数达标人数达标率/%χ2值P值
地区鲁中3 79052613.8822.220.000
鲁东4 67859212.65
鲁西2 0211949.60
性别男性4 43749711.2012.010.001
女性6 05281513.47
年龄/岁18～291 25122618.07118.870.000
30～443 20549715.51
45～59371341211.10
≥602 3201777.63
婚姻状况未婚99518818.8948.460.000
已婚91421 09912.02
其他352257.10
文化程度小学及以下2 6141877.15165.630.000
初中3 35438811.57
高中/职高/中专1 47017812.11
大专及以上3 05155918.32
职业农民5 2194759.10201.610.000
工人1 38216111.65
行政管理/专业技术人员1 63936122.03
退休3804010.53
其他1 86927514.71
家庭月收入/元0～2 9992 6411957.3891.300.000
3000～59993 00141213.73
6000～99993 46238515.64
≥10 0002 38532013.42
饮酒否8 8401 12012.671.340.247
是1 64919211.64
吸烟否8 9811 15012.805.020.025
是1 50816210.74
健康状况自我评估好5 41468212.600.780.679
较好2 69732512.05
一般/较差2 37830512.83
慢性病无7 51599513.2412.970.000
有2 97431710.66
焦虑症状无8 7111 14813.1822.750.000
轻度1 5631509.60
中重度215146.51
抑郁症状无8 2941 09413.1919.080.000
轻度1 71618010.49
中重度479387.93
失眠症状无9 3981 19712.744.570.102
轻度9209910.76
中重度171169.36
), ArticleFig(id=1321169783987483565, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169779101119358, language=CN, label=表1, caption=

不同人口学特征居民心理健康素养达标情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类调查人数达标人数达标率/%χ2值P值
地区鲁中3 79052613.8822.220.000
鲁东4 67859212.65
鲁西2 0211949.60
性别男性4 43749711.2012.010.001
女性6 05281513.47
年龄/岁18～291 25122618.07118.870.000
30～443 20549715.51
45～59371341211.10
≥602 3201777.63
婚姻状况未婚99518818.8948.460.000
已婚91421 09912.02
其他352257.10
文化程度小学及以下2 6141877.15165.630.000
初中3 35438811.57
高中/职高/中专1 47017812.11
大专及以上3 05155918.32
职业农民5 2194759.10201.610.000
工人1 38216111.65
行政管理/专业技术人员1 63936122.03
退休3804010.53
其他1 86927514.71
家庭月收入/元0～2 9992 6411957.3891.300.000
3000～59993 00141213.73
6000～99993 46238515.64
≥10 0002 38532013.42
饮酒否8 8401 12012.671.340.247
是1 64919211.64
吸烟否8 9811 15012.805.020.025
是1 50816210.74
健康状况自我评估好5 41468212.600.780.679
较好2 69732512.05
一般/较差2 37830512.83
慢性病无7 51599513.2412.970.000
有2 97431710.66
焦虑症状无8 7111 14813.1822.750.000
轻度1 5631509.60
中重度215146.51
抑郁症状无8 2941 09413.1919.080.000
轻度1 71618010.49
中重度479387.93
失眠症状无9 3981 19712.744.570.102
轻度9209910.76
中重度171169.36
), ArticleFig(id=1321169784067175342, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169779101119358, language=EN, label=Tab.2, caption=

Multivariate logistic regression analysis of the associations between mental health literacy and region of residence, gender, marital status, education, occupation, monthly household income, self-rated health, anxiety symptom, depression symptom, among adults in Shandong province

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变量比较组参照组β值 $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
地区鲁东鲁中0.1740.0686.6520.0101.1901.043～1.359
鲁西0.3940.09318.0480.0001.4831.237～1.779
性别女性男性–0.2350.07310.3340.0010.7910.685～0.912
婚姻状况已婚未婚0.3100.1295.7710.0161.3631.059～1.756
其他0.5960.2505.6870.0171.8161.112～2.964
文化程度初中小学及以下–0.3520.10211.9470.0010.7030.576～0.859
高中/职高/中专–0.2970.1285.3720.0200.7430.578～0.955
大专及以上–0.5210.13215.4350.0000.5940.458～0.770
职业工人农民0.1100.1150.9200.3371.1160.891～1.398
行政管理/专业技术人员–0.5950.11327.5030.0000.5520.442～0.689
退休–0.0050.1900.0010.9770.9950.686～1.442
其他–0.2210.0975.2530.0220.8020.663～0.968
家庭月收入/元3 000～5 9990～2 999–0.4630.09722.5360.0000.6300.520～0.762
6 000～9 999–0.4990.10522.4440.0000.6070.494～0.746
≥10 000–0.1600.1122.0170.1560.8530.685～1.062
健康状况自我评估较好好–0.0400.0750.2870.5920.9600.828～1.113
一般/较差–0.3210.08713.7180.0000.7260.612～0.860
焦虑症状轻度无0.3420.12110.8400.0051.4081.110～1.786
中重度0.8260.3366.8380.0142.2831.183～4.408
抑郁症状轻度无0.3660.1110.9790.0011.4431.160～1.794
中重度0.5980.2290.5300.0091.8191.162～2.848
), ArticleFig(id=1321169784159450031, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169779101119358, language=CN, label=表2, caption=

山东省居民心理健康素养多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量比较组参照组β值 $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
地区鲁东鲁中0.1740.0686.6520.0101.1901.043～1.359
鲁西0.3940.09318.0480.0001.4831.237～1.779
性别女性男性–0.2350.07310.3340.0010.7910.685～0.912
婚姻状况已婚未婚0.3100.1295.7710.0161.3631.059～1.756
其他0.5960.2505.6870.0171.8161.112～2.964
文化程度初中小学及以下–0.3520.10211.9470.0010.7030.576～0.859
高中/职高/中专–0.2970.1285.3720.0200.7430.578～0.955
大专及以上–0.5210.13215.4350.0000.5940.458～0.770
职业工人农民0.1100.1150.9200.3371.1160.891～1.398
行政管理/专业技术人员–0.5950.11327.5030.0000.5520.442～0.689
退休–0.0050.1900.0010.9770.9950.686～1.442
其他–0.2210.0975.2530.0220.8020.663～0.968
家庭月收入/元3 000～5 9990～2 999–0.4630.09722.5360.0000.6300.520～0.762
6 000～9 999–0.4990.10522.4440.0000.6070.494～0.746
≥10 000–0.1600.1122.0170.1560.8530.685～1.062
健康状况自我评估较好好–0.0400.0750.2870.5920.9600.828～1.113
一般/较差–0.3210.08713.7180.0000.7260.612～0.860
焦虑症状轻度无0.3420.12110.8400.0051.4081.110～1.786
中重度0.8260.3366.8380.0142.2831.183～4.408
抑郁症状轻度无0.3660.1110.9790.0011.4431.160～1.794
中重度0.5980.2290.5300.0091.8191.162～2.848
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2023年山东省居民心理健康素养现状及其影响因素
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康佩佩 , 谷灵犀 , 李奇 , 张婧 , 王延祜 , 胡丽丽 *, *
中国公共卫生 | 调查报告与分析 2025,41(7): 817-822
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中国公共卫生 |调查报告与分析 2025 , 41 (7) : 817 -822
2023年山东省居民心理健康素养现状及其影响因素
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康佩佩, 谷灵犀, 李奇, 张婧, 王延祜, 胡丽丽*, *
作者信息
  • 山东省精神卫生中心，济南 250014
通讯作者:
胡丽丽，E-mail：
作者简介:

康佩佩（1987–），主治医师，硕士，研究方向：心理健康和精神卫生防治

Mental health literacy and its influencing factors among adults in Shandong province, 2023: a cross-sectional survey
Peipei KANG, Lingxi GU, Qi LI, Jing ZHANG, Yanhu WANG, Lili HU
Affiliations
  • Shandong Mental Health Center, Jinan 250014, China
    • Corresponding Author:
    HU Lili, E-mail：
出版时间: 2025-07-10 doi: 10.11847/zgggws1145764
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摘要
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目的

了解山东省居民心理健康素养水平及影响因素，为开展有针对性的心理健康服务工作提供科学依据。

方法

于2023年11—12月，采用分层多阶段随机抽样方法抽取山东省≥18岁常住居民10 533人为调查对象，采取线上加线下相结合的方式，通过一般情况调查问卷、国民心理健康素养问卷（NMHLQ）、抑郁筛查量表（PHQ-9）、广泛性焦虑障碍量表（GAD-7）、失眠严重程度指数量表（ISI）评估山东省居民心理健康素养达标情况及其影响因素。

结果

共回收有效问卷10 489份，山东省居民心理健康素养达标率为12.51%，其中判断题达标率为15.47%，自我评估题达标率为99.05%，案例题达标率为48.87%。χ2检验结果显示，不同地区、性别、年龄、婚姻状况、文化程度、职业、家庭月收入以及是否吸烟、患慢性病、焦虑、抑郁的居民心理健康素养达标率差异均有统计学意义。logistic回归分析结果显示，女性（OR=0.791，95%CI=0.385～0.912），文化程度为初中（OR=0.703，95%CI=0.576～0.859）、高中/职高/中专（OR=0.743，95%CI=0.578～0.955）、大专及以上（OR=0.594，95%CI=0.458～0.770），职业为行政管理/专业技术人员（OR=0.552，95%CI=0.442～0.689）、其他（OR=0.802，95%CI=0.663～0.968），家庭月收入为3 000～5 999元（OR=0.630，95%CI=0.520～0.762）、6 000～9 999元（OR=0.607，95%CI=0.494～0.746），健康状况自我评估为一般/较差（OR=0.726，95%CI=0.612～0.860）与心理健康素养不达标呈负相关联；居住在鲁东（OR=1.190，95%CI=1.043～1.359）、鲁西（OR=1.483，95%CI=1.237～1.779），婚姻状况为已婚（OR=1.363，95%CI=1.059～1.756）、其他（OR=1.816，95%CI=1.112～2.964），焦虑状态为轻度（OR=1.408，95%CI=1.110～1.786）、中重度（OR=2.283，95%CI=1.183～4.408），抑郁状态为轻度（OR=1.443，95%CI=1.160～1.794）、中重度（OR=1.819，95%CI=1.162～2.848）与心理健康素养不达标呈正相关联。

结论

山东省居民心理健康素养水平整体偏低，居住地、性别、婚姻状况等人口学特征以及焦虑、抑郁状态均为心理健康素养水平的影响因素；心理健康服务应重点关注低学历、低收入以及有焦虑、抑郁状态人群。

心理健康素养  /  现况调查  /  影响因素  /  山东省
Objective

To assess mental health literacy and its determinants among adults in Shandong province and provide a basis for the development of targeted mental health services.

Methods

From November to December 2023, a combined online and on-site face-to-face survey was conducted among 10 533 residents aged 18 years and older recruited from 39 districts/counties/cities in Shandong province using stratified multistage random sampling. A general questionnaire, the National Mental Health Literacy Questionnaire (NMHLQ) developed by the Institute of Psychology, Chinese Academy of Sciences, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Insomnia Severity Index (ISI) were used in the study.

Results

Of 10 489 participants with valid responses, 12.51% were assessed as having adequate mental health literacy, with 15.47%, 99.05%, and 48.87% of participants having adequate mental health knowledge, mental health skills and awareness, and the ability to identify and manage common mental disorders, respectively. Chi-squared test results showed statistically significant differences in the proportion of adults with adequate mental health literacy across regions, gender, age, marital status, education, occupation, monthly household income, smoking, chronic disease status, anxiety, and depression Logistic regression analysis showed that female gender (odds ratio [OR] = 0.791, 95% confidence interval [95%CI]: 0.385 - 0.912), junior high school education (OR = 0.703, 95%CI: 0.576 - 0. 859), high school/vocational/technical education (OR = 0.743, 95%CI: 0.578 - 0.955), college degree or higher (OR = 0.594, 95%CI: 0.458 - 0.770), administrative/professional/technical occupation (OR = 0. 552, 95%CI: 0.442 - 0.689), other occupation (OR = 0.802, 95%CI: 0.663 - 0.968), monthly household income of 3 000 - 5 999 RMB yuan (OR = 0.630, 95%CI: 0.520 - 0.762), monthly household income of 6 000 - 9 999 RMB yuan (OR = 0.607, 95%CI: 0.494 - 0.746), and with fair/poor self-rated health (OR = 0.726, 95%CI: 0.612 - 0.860) were negatively associated with inadequate mental health literacy. Living in eastern Shandong province (OR = 1.190, 95%CI: 1.043 - 1.359), western Shandong province (OR = 1.483, 95%CI: 1.237 - 1.779), being married (OR = 1.363, 95%CI: 1.059 - 1.756), having other marital statuses (OR = 1.816, 95%CI: 1.112 - 2.964), having mild anxiety (OR = 1.408, 95%CI: 1.110 - 1.786), having moderate to severe anxiety (OR = 2.283, 95%CI: 1.183 - 4.408), having mild depression (OR = 1.443, 95%CI: 1.160 - 1.794), and having moderate to severe depression (OR = 1.819, 95%CI: 1.162 - 2.848) were positively associated with inadequate mental health literacy.

Conclusions

Mental health literacy among adult residents in Shandong province is at a relatively low level. Demographic characteristics such as place of residence, gender and marital status, and anxiety and depression status are influencing factors. Mental health services should focus on people with low levels of education, low income, and those with anxiety or depression.

mental health literacy  /  cross-sectional survey  /  influencing factor analysis  /  Shandong province
康佩佩, 谷灵犀, 李奇, 张婧, 王延祜, 胡丽丽. 2023年山东省居民心理健康素养现状及其影响因素. 中国公共卫生, 2025 , 41 (7) : 817 -822 . DOI: 10.11847/zgggws1145764
Peipei KANG, Lingxi GU, Qi LI, Jing ZHANG, Yanhu WANG, Lili HU. Mental health literacy and its influencing factors among adults in Shandong province, 2023: a cross-sectional survey[J]. Chinese Journal of Public Health, 2025 , 41 (7) : 817 -822 . DOI: 10.11847/zgggws1145764
正文
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随着生活节奏的加快、社会竞争的加剧以及各种生活压力的增加，心理健康问题逐渐成为影响公共健康的重要因素之一[1–2]。国家层面的健康中国战略以及地方各级政府的健康行动计划中，心理健康被列为重要组成部分，要求建立健全心理健康服务体系，加强心理健康教育和干预，减缓心理相关疾病的上升趋势[3]。提升全民心理健康素养、提高相关知识的知晓率是当前我国精神卫生工作的重要任务[4]。本研究采用国民心理健康素养问卷于2023年对山东省10 489名居民心理健康素养现状进行调查，了解心理健康状况及变化趋势，分析相关影响因素，为卫生行政部门制定心理健康服务相关政策提供数据支撑和依据。
1　对象与方法
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1.1　对象
于2023年11—12月，采用分层多阶段随机抽样方法，从山东省16市抽取39个县 （市、区）、58个街 （镇）、167个居 （村）委员会，每个居 （村）委员会抽取60户，每户抽取1人作为调查对象。纳入标准：年龄≥18岁，当地常住居民（连续居住>6个月），能够理解问卷、配合调查并签署知情同意书者。排除标准：经过调查员反复解释后，被调查者（或家属）拒绝调查；在不同时间经过至少3次回访，均未找到调查对象。本研究共纳入调查对象10533人，发放调查问卷10 533份，收回有效问卷10 489份，有效率99.58%。本研究通过山东省精神卫生中心伦理委员会审查[批准文号：2019伦审第（R11）号]，所有调查对象均自愿参加并知情同意。
1.2　方法
1.2.1　调查方法
省级统一制定调查方案和实施计划，设立省市县三级技术指导和质量控制组，省级统一进行调查方案培训，为调查工作提供分级培训和技术指导，开展质量控制和评价反馈。调查人员由各调查点（社区卫生服务中心或卫生院）熟悉心理健康和精神卫生工作的精防人员、全科医生、公共卫生医生、护士等组成，培训合格后按照标准方案进行调查。采用线上调查和线下入户调查相结合的方式，线上调查借助山东省居民心理健康素养测评系统进行，调查员生成问卷二维码，可以熟练使用手机的调查对象用手机扫码进行自评。对于年龄较大的老年人等不能熟练使用手机的对象采用线下调查。调查员入户并通过面对面询问方式填写线上问卷或纸质问卷，并将纸质问卷及时录入测评系统。
1.2.2　调查工具及判断标准
本研究的调查工具包括一般情况调查问卷、国民心理健康素养问卷、抑郁筛查量表（9-item Patient Health Questionnaire, PHQ-9）、广泛性焦虑障碍量表（7-item Generalized Anxiety Disorder Scale, GAD-7）、失眠严重程度指数量表（Insomnia Severity Index, ISI）。（1）一般情况问卷主要内容包括性别、年龄、文化程度、职业、婚姻状况、家庭月收入，吸烟、饮酒情况，健康状况自我评估、是否有慢性病（自报）等。其中，吸烟指吸烟≥1支/日且持续≥6个月，饮酒指饮酒≥1次/周且持续≥6个月[5]。（2）国民心理健康素养调查问卷为2019年由中国科学院心理研究所编制[6]，第一部分为知识判断题，主要测评心理健康知识水平，共20题，每题5分，分值范围为0～100分；第二部分为自我评估题，主要测试心理健康意识，分值范围为8～32分；第三部分为案例题，主要为心理疾病的应对，包括识别技能、求助的态度和病耻感，分值范围为0～40分。心理健康素养达标是指心理健康素养的3部分得分同时满足以下3个条件：①第一部分知识判断题总分≥80；②第二部分自我评估题总分≥24分；③第三部分案例题总分≥28分。该问卷具有较好的信度和效度[6–7]。（3）抑郁筛查量表（PHQ-9）[8–9]包含9个条目，每个条目得分为0～3分，总分为0～27分，PHQ- 9总分0～4分为无抑郁症状，5～9分为轻度抑郁，≥10分为中重度抑郁。该量表操作简单，经国内外验证有较好的信度和效度[10–11]。（4）广泛性焦虑障碍量表（GAD-7）[12–13]包含7个条目，每个条目得分为0～3分，总分为0～21分，GAD-7总分0～4分为无焦虑症状，5～9分为轻度焦虑，≥10分为中重度焦虑。该量表适用于不同人群，具有良好的信度和效度[14]。（5）失眠严重程度指数量表（ISI）[15–16]包含7个条目，每个条目得分为0～4分，总分为0～28分，ISI总分0～7分为无失眠症状；8～14分为轻度失眠；≥15分为中重度失眠。研究显示该量表具有较好的信度和效度[17–18]。
1.2.3　质量控制
参与调查的人员进行统一培训，培训内容包括调查方法解读、调查表及量表使用方法等，培训合格后方可进行调查。及时核查调查表及量表填写质量，避免缺项漏项、逻辑错误等问题。抽取5%左右的样本进行回访，核实填报真实性等。
1.3　统计分析
使用Stata 12.0进行统计分析，计数资料使用构成比（%）进行描述，组间差异性比较采用χ2检验，采用多因素logistic回归分析探讨居民心理健康素养的影响因素，所有显著性检验皆为双侧检验，检验水准α=0.05。
2　结　果
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2.1　不同特征居民心理健康素养达标率比较（表1）
本次调查收回有效问卷10 489份，其中，男性4 437人（42.28%），女性6 052人（57.72%）；地区分布以鲁东地区居多，为4 678人（44.60%）；对象年龄为18～97岁，以45～59岁人群居多，为3 713人（35.40%）；初中学历人数较多，为3 354人（31.97%）；婚姻状况以已婚为主，为9 142人（87.16%）；职业以农民为主，为5 219人（49.76%）；8 111人（77.33%）认为自我健康状况较好。χ2检验结果表明，不同地区、性别、年龄、婚姻状况、文化程度、职业、家庭月收入以及是否吸烟、患慢性病、焦虑、抑郁的居民心理健康素养达标率差异均有统计学意义。鲁中地区达标率高于鲁西和鲁东地区，女性高于男性；年龄越大达标率越低；未婚居民达标率高于已婚和其他居民；学历越高达标率越高；行政管理和专业技术人员达标率高于其他职业，家庭月收入6 000～9 999元居民达标率高于其他收入居民，不吸烟居民达标率高于吸烟居民，无慢性病居民达标率高于患慢性病居民，焦虑、抑郁症状越轻达标率越高。
2.2　心理健康素养达标情况
10 489名调查对象中有1 312人心理健康素养达标，达标率为12.51%。其中知识判断题总分1 623人达标，达标率15.47%；自我评估题总分10 389人达标，达标率99.05%；案例题总分5 126人达标，达标率48.84%。
2.3　心理健康素养影响因素logistic回归分析 （表2）
以心理健康素养是否达标作为因变量（达标=0，不达标=1），根据以往心理健康素养相关研究结果，考虑各指标的理论和现实意义，将地区、性别、年龄、婚姻状况、文化程度、职业、家庭月收入、饮酒、吸烟、健康状况自我评估、慢性病、焦虑症状、抑郁症状、失眠症状作为自变量，全部纳入模型进行多因素logistic回归分析。结果显示，女性，文化程度升高，职业为行政管理/专业技术人员、其他，家庭月收入为3 000～5 999元、6 000～9 999元，健康状况自我评估为一般/较差与心理健康素养不达标呈负相关联；居住在鲁东、鲁西地区，婚姻状况为已婚、其他，焦虑状态为轻度、中重度，抑郁状态为轻度、中重度与心理健康素养不达标呈正相关联。
3　讨　论
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本研究结果显示，2023年山东省居民心理健康素养达标率为12.51%，高于江苏省2021年的6.4%[19]、河南省2020—2021年的9.2%[20]及海南省2021年的5.3%[21]，表明山东省在心理健康素养科普宣教方面取得了一定效果，但依然低于健康中国行动设定的目标值。国际上一些发达国家如澳大利亚、英国等国家的居民心理健康素养普遍较高，这些国家通过长期实施心理健康教育项目和社会支持系统建设，已经取得了较好的成效[22–24]。相比之下，尽管山东省的数据有所提高，但与这些国家相比，仍存在较大差距，当前公众对常见精神障碍和心理行为问题的认知率总体偏低，缺乏对心理健康服务专业性、有效性的认识[25]。
国内外研究均强调了普及心理健康知识的重要性，认为这是提高居民心理健康素养的关键途径之一。无论是国内还是国外的研究均表明，需要进一步加强心理健康教育，以提升公众的心理健康意识和应对能力。健康中国行动之心理健康促进行动明确提出要普及心理健康知识，提升居民心理健康素养水平。山东省的居民心理健康素养水平较之前的研究有所提高，这可能与多方面因素有关，包括社会对心理健康重视程度的提升、心理健康教育的普及以及心理健康服务的逐步完善。虽然不同地区或国家的具体数值存在差异，但总体来看，随着时间的推移，各国各地区的心理健康素养水平都有不同程度的提升，反映了全球范围内对心理健康问题关注的增加以及相应政策措施的有效性。
本次调查发现，居民心理健康素养水平与地区、性别、婚姻状况、文化程度、职业、家庭月收入、健康状况自我评估状况有关，这与已有研究结果基本一致[26–28]。鲁中地区的心理健康素养达标率高于鲁东和鲁西地区，这可能与鲁中地区医疗资源相对丰富有关，可以为居民提供更好的心理健康支持和服务。女性心理健康素养水平高于男性，这与2022年全国调查结果一致[29]，可能与女性在情感表达、社会支持等方面的优势有关，同时，女性相对更关注自身的心理健康，并积极参与心理健康教育和干预活动；但与绵阳市的调查结果相反[30]，这可能与存在抽样误差有关，需要进一步研究探讨性别对心理健康素养水平的影响。年龄越大，心理健康素养达标率越低，这可能与老年人对心理健康知识的接受度较低、对心理健康服务的利用度较低有关[31]。随着年龄的增长，老年人可能面临更多的生理和心理挑战，如退休、疾病、孤独等，这些因素都可能影响他们的心理健康素养水平，建议针对老年人的心理特点实施针对性的心理关爱项目，提供更多心理支持。文化程度越高，心理健康素养达标率越高，提示受教育水平在心理健康素养的提升中起着重要作用，教育不仅可以提高个体的知识水平，还可以增强其对心理健康问题的认识和应对能力[32]，提示在未来做好心理健康知识科普宣传的重要性。行政管理和专业技术人员的心理健康素养达标率高于其他职业，与绵阳市的结果类似[30]，这可能与这些职业的工作性质、工作环境以及职业发展机会有关，这些职业通常具有较高的社会地位和经济收入，可以获得更好的心理健康支持，相对来说其他职业获得心理健康相关知识的途径较少，缺乏关注自身心理健康的意识。随着家庭月收入越高，心理健康素养水平逐渐提升，家庭收入6 000～9 999元的居民心理健康素养达标率最高，这可能与他们经济状况相对较好，有更多的资源和机会来关注和改善自身的心理健康有关；但是家庭月收入超过10 000元的居民心理健康素养水平出现下降趋势，一方面可能与他们面临的工作压力更大有关，另一方面不能排除调查对象出于各方面考虑对家庭收入的填写不准确，导致调查结果存在偏差。健康状况自我评估为一般或较差的居民心理健康素养达标率较高，这可能与这些居民对自身健康状况的关注和重视有关，更倾向于寻求心理健康服务和支持，从而改善自身的健康状况。
此外，本次调查结果显示心理健康素养水平与焦虑症状和抑郁症状有关，与已有研究结果相符[33–34]。随着焦虑症状逐渐加重，心理健康素养达标率逐渐降低，这可能与焦虑症状对认知功能和情绪调节能力的影响有关，焦虑可能导致个体难以集中注意力、做出理性判断，进而影响心理健康知识的学习和应用。抑郁症状越严重，心理健康素养水平越低，抑郁症状常表现为情绪低落、兴趣减退等，会影响对心理健康知识学习和实践的积极性，抑郁症患者可能更难以识别和应对心理问题，这在一定程度上限制了心理健康素养的提升。
本研究样本量较大，抽样方法较科学，根据人口密度和城乡分布抽取调查对象，具有较好的代表性，调查工具选择适用性好，调查结果在一定程度上能代表山东省居民的心理健康素养水平。但是本研究也存在一定局限性，一是尽管采用了多阶段随机抽样，但不能排除抽样误差对结果的影响；二是本研究的调查信息大部分由调查对象自我报告，回忆和理解偏差可能会影响结果的准确性；三是横断面调查不能确认变量与心理健康素养之间的因果关系，限制研究结果的解释和应用。
综上所述，山东省居民心理健康素养仍处于较低的水平，且在不同人口学特征的人群中差异较大，居住在鲁西地区、男性、老年、农民、低学历、低收入、自评健康不好、存在焦虑和抑郁状态的人群心理健康素养水平较低，应重点关注这部分人群，建议从强化政策支持、提高心理健康服务可及性、关注重点人群（儿童青少年、老年人、孕产妇、高压职业人群等特定群体）心理健康、加强心理健康教育等方面入手，有针对地探索提高心理健康素养的健康教育和健康促进活动，进一步提升居民的心理健康素养水平，促进全面身心健康。鉴于本研究的局限性，未来需要进一步完善心理健康素养的长期监测机制，定期评估居民的心理健康素养水平，为政策制定和资源分配提供科学依据。

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doi: 10.11847/zgggws1145764
  • 接收时间：2024-08-23
  • 首发时间：2026-10-25
  • 出版时间：2025-07-10
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  • 收稿日期：2024-08-23
  • 修回日期：2024-12-10
  • 录用日期：2025-04-01
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    山东省精神卫生中心，济南 250014

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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