北京东城区小学生身体活动视屏行为与抑郁症状的相关性

Association between physical activity,screen-based media use and depressive symptoms among children

目的研究儿童身体活动、视屏行为与抑郁症状的相关性,为有效预防儿童抑郁的发生提供科学依据。方法方便抽取北京市东城区12所小学的1 472名三~五年级学生,采用问卷调查法,比较不同性别儿童的身体活动、视屏时间、抑郁情况,采用Logistic回归分析身体活动、视屏行为与抑郁的关系。结果 1 472名学生在过去7 d中,身体活动不足的天数为（4.36±2.56）d,仅16.37%的儿童每天均达到推荐水平;视屏时间为（1.49±1.43）h/d,22.15%的儿童每天视屏时间过长;儿童抑郁量表的平均得分为（9.75±6.38）,抑郁症状率为31.05%（457/1 472）。男生每天身体活动不足率为79.73%（594/745）,低于女生的87.62%（637/727）（χ2=16.72,P〈0.01）;而男生视屏时间过长率为28.46%（212/745）、抑郁率37.99%（283/745）均高于女生的15.68%（114/727）,23.93%（174/727）（χ2值分别为34.83,33.94,P值均〈0.01）。单因素分析显示,有抑郁症状学生的身体活动不足率86.87%（397/457）高于无抑郁症状学生的82.17%（834/1 015）（χ2=5.09,P=0.024）;仅男生的抑郁与身体活动不足相关（χ2=7.27,P=0.007）。有抑郁症状学生的视屏时间过长率22.98%（105/457）高于无抑郁症状学生的9.36%（95/1 015）（χ2=49.76,P〈0.01）;男、女生的抑郁症状均与视屏时间过长相关（P值均〈0.01）。多因素分析显示,有抑郁症状男生的身体活动不足率、视屏时间过长率分别为无抑郁症状男生的1.74（95%CI：1.17~2.58）,2.48倍（95%CI：1.69~3.64）;有抑郁症状女生的视屏时间过长率为无抑郁症状女生的3.04倍（95%CI：1.80~5.12）。结论男生的抑郁症状与身体活动不足、视屏时间过长相关,女生的抑郁症状仅与视屏时间过长相关。

Objective To analyze the association between physical activity（ PA）,screen-based media use（ SBM） and depressive symptoms among children. Methods All the 1 472 subjects were recruited from grade 3- 5 in 12 primary schools in Dongcheng District of Beijing. Physical inactivity was defined as who can’ t meet recommended physical activity（ PA） guidelines of at least 1 h moderate to vigorous physical activity（ MVPA） per day. Screen abuse was defined as subjects who can’ t meet the recommendations for screen use not more than 2h per day. Subjects whose Children’ s Depression Inventory（ CDI） score higher than 12 were classified as having depressive symptoms. The detection rate of physical inactivity,screen abuse and depressive symptoms were compared between boys and girls. Chi-square test and logistic regression were used to analyze the relationship between PA,SBM and depressive symptoms among children. Results Data were available for 1 472 children including 745 boys and 727 girls. The average days which meet PA guidelines during the past 7 days was 4.36±2.56. Only 16.37%（ 241 / 1 472） children could meet the PA guidelines every day. The average time of SBM was 1.49± 1.43 h / d. The prevalence of screen abuse was 22.15%（ 314 / 1472）.The mean CDI score was 9.75±6.38,with 31.05%（ 457 / 1 472） participants were categorized as having depressive symptom. The prevalence of physical inactivity was higher among girls[87.62%（ 637 / 727） ] than boys[79. 73%（ 594 / 745） ],while higher proportions of boys were classified as screen abuse [28. 46%（ 212 / 745） ],depression symptom [37. 99%（ 283 / 745） ] than girls[15.68%（ 114/727）,23.93%（ 174/727） ]（ P〈0.01）. The prevalence of physical inactivity among children with depressive symptoms [86.87%（ 397 / 457） ] was higher than children without depressive symptom [82.17%（ 834 / 1015） ]（ P = 0.024）. The association between physical inactivity and depressive can only been seen in boys（ P = 0. 007）. The prevalence of screen abuse among children with depressive symptoms [22. 98%（ 105 / 457） ] was higher than children without depressive symptoms [9. 36%（ 95 /1 015） ]（ P〈0.01）. Screen abuse was associated with depressive symptoms in both boys and girls（ P〈0.01）. Compared with boys without depressive symptoms,the risk of physical inactivity [OR = 1.74（ 95%CI： 1.17-2.58） ]and screen abuse [OR = 2.48（ 95%CI： 1.69-3.64） ] among boys with depressive symptoms were higher. Among girls with depressive symptoms,the risk of screen abuse was higher [OR = 3.04（ 95%CI： 1.80-5.12） ]. Conclusion Physical inactivity and screen abuse is associated with depressive symptoms among boys,while only screen abuse is associated with depressive symptom among girls.