title: Psychological symptoms and nonfatal unintentional injuries among Chinese adolescents: a prospective study.
abstract: OBJECTIVE
  To describe patterns of nonfatal unintentional injuries and investigate the association of psychological symptoms with injury risk among adolescents in Guangxi, China.
  
  
  METHODS
  Adolescents were selected from middle and high school students in Baise City, Guangxi, China. Psychological symptoms at baseline were measured using SCL-90-R and nonfatal unintentional injuries that occurred among participants were recorded using a standardized injury surveillance questionnaire. Annual injury rates per 100 adolescents by adolescents' demographic and family characteristics were calculated. Student's t-test and the Chi-square test were used to test differences in mean raw scores of SCL-90-R subscales and injury rates. Relative risks and odds ratios of injury with 95% confidence intervals were calculated in univariate analyses and multivariate logistic models.
  
  
  RESULTS
  A total of 1474 middle and high school students finished the study. Of them, 442 reported nonfatal unintentional injuries during the study period, resulting in an annual injury rate of 30.3 per 100 adolescents. Boys had a significantly higher injury rate than girls (32.6% vs. 27.4%). Injury rate decreased as the adolescents' age increased. Compared with adolescents who were not injured, the injured adolescents had higher average raw scores of all subscales of SCL-90-R, with an exception of the subscale for hostility. All SCL-90-R subscales factors, except those for hostility and phobia, were associated with injury risk. After confounding effects of age, gender, and ethnicity were controlled using logistic regression models, SCL-90-R subscales for somatization (OR = 2.00, 95% CI 1.52-2.63), obsessive-compulsiveness (OR = 2.10, 95% CI 1.71-2.58), interpersonal-sensitivity (OR = 1.66, 95% CI 1.34-2.06), depression (OR = 2.00, 95% CI 1.59-2.51), anxiety (OR = 2.08, 95% CI 1.62-2.66), and psychoticism (OR = 1.60, 95% CI 1.26-2.03) were significantly associated with an elevated injury risk.
  
  
  CONCLUSIONS
  Psychological symptoms are associated with an elevated risk of nonfatal unintentional injury among middle and high school students. Mental health services, such as psychological counseling, may help reduce the risk of nonfatal unintentional injuries among Chinese adolescents.
authors.affiliation: Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, College of Medicine and Public Health, The Ohio State University, Columbus, Ohio, USA.
authors.forename: G
authors.initials: G
authors.lastname: Chen
authors.forename: G A
authors.initials: GA
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Deng
authors.forename: D
authors.initials: D
authors.lastname: Chen
authors.forename: K
authors.initials: K
authors.lastname: Kelleher
authors.forename: H
authors.initials: H
authors.lastname: Xiang
mesh_terms: D000059:Accidents; D000293:Adolescent; D000294:Adolescent Behavior; D002681:China / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*