COVID-19疫情期间人群压力应对行为与焦虑、抑郁的关系

Association of stress-coping behaviors with depression and anxiety during the outbreak of COVID-19

目的探讨压力应对行为倾向与焦虑、抑郁的关系,为今后开展健康教育和心理干预提供证据及建议。方法以年龄>15岁男性为研究对象,采用分阶段整群抽样的方法,获得有效问卷4027份。压力应对行为采用自我报告的题目测量。焦虑自评量表和患者问卷抑郁量表用于测量心理健康状况。用多元Logistic回归模型检验变量间关系。用边际预测分析检验焦虑、抑郁对压力应对行为倾向的预测幅度。所有的分析均控制了城市间群组效应。结果多元Logistic回归模型结果显示,与"不采纳"组相比,较高抑郁程度(偶尔采纳OR=1.25,95%CI:1.21~1.28;有时采纳OR=1.29,95%CI:1.22~1.37;经常采纳OR=1.24,95%CI:1.18~1.31)和较高焦虑程度(偶尔采纳OR=1.09,95%CI:1.07~1.10;有时采纳OR=1.15,95%CI:1.11~1.18;经常采纳OR=1.17,95%CI:1.14~1.20)与消极压力应对行为采纳倾向呈正相关。边际预测分析结果显示,抑郁对"偶尔采纳"者和"有时采纳"者行为采纳概率的边际回报持续增高,而焦虑则对"经常采纳"者有更明显的边际回报增高的趋势。结论突发性公共卫生事件中应重视人群的不良心理状态及不适应对行为问题。

Objective To explore the relationship in stress-coping behaviors,anxiety and depression and provide evidence anxiety and depression,this study provides population-based evidences for future health education work and psychological intervention.Methods All subjects enrolled were males who aged over 15 years old.The multi-stage cluster sampling method was adopted and 4,027 valid questionnaires were recruited.Stress-coping behaviors were measured by a self-reported question.The self-rating anxiety scale and the patient heath questionnaire-9 depression scale were used to measure anxiety and depression respectively.Multivariate logistic regression model was used to test the relationship between variables.Marginal prediction analysis was conducted to test predicted margins of stress-coping behaviors by the depression and anxiety.All analyses were conducted based on controlling the clustering effect in cities.Results The results of multivariate logistic regression model showed that compared with non-adoption group,higher depression(occasional adoption OR=1.25,95%CI:1.21-1.28;sometime adoption OR=1.29,95%CI:1.22-1.37;usual adoption OR=1.24,95%CI:1.18-1.31)and higher anxiety(occasional adoption OR=1.09,95%CI:1.07-1.10;sometime adoption OR=1.15,95%CI:1.11-1.18;usual adoption OR=1.17,95%CI:1.14-1.20)were positively associated with passive stress-coping behaviors.The marginal prediction analysis showed that participants responding to sometime adoption were associated with stronger marginal returns of depression score,while those responding to usual adoption were associated with stronger marginal returns of anxiety scores.Conclusions Population’s adverse psychological state and stress-coping behaviors will require attention to public health emergencies.