中学生昼夜节律情绪调节与抑郁症状的相关性

Correlation between circadian rhythm,emotion regulation and depressive symptoms among adolescents

目的 了解中学生抑郁情绪的现状以及与昼夜节律、情绪调节的关联,为改善青少年抑郁情绪的心理健康宣教提供科学依据。方法 采用方便抽样法,抽取四川成都、阆中和乐山6所中学2 398名初、高中学生为被试,采用抑郁量表(CES-D)、清晨型与夜晚型量表简版和情绪调节量表进行调查,运用SPSS 21.0进行数据处理和分析。结果 青少年抑郁症状检出率为37.9%(909名),女生、农村、15~18岁年龄组青少年的抑郁症状检出率高于男生、城镇、12~14岁年龄组(χ^(2)值分别为25.15,15.45,187.24,P值均<0.01)。不同昼夜节律青少年抑郁症状检出率差异有统计学意义(χ^(2)=55.19,P<0.01),绝对夜晚型节律偏好青少年抑郁检出率(57.1%)最高。不同睡眠时长青少年抑郁症状检出率差异有统计学意义(χ^(2)=141.99,P<0.01),睡眠时长<6 h/d抑郁检出率(69.4%)最高。抑郁组较无抑郁组更多使用表达抑制策略,而无抑郁组较抑郁组更多使用认知重评策略。多因素Logistic回归分析结果显示,女生、15~18岁组、表达抑制、睡眠时长<6 h/d、睡眠时长6~8 h/d与青少年出现抑郁症状呈正相关(OR值分别为1.60,2.29,1.13,5.17,2.88),而睡眠时型中间型、清晨型和认知重评与抑郁症状呈负相关(OR值分别为0.53,0.55,0.90)(P值均<0.05)。结论 青少年睡眠节律延迟、睡眠不足以及压抑情绪与抑郁症状呈正相关,应积极倡导青少年养成良好的睡眠习惯,采用合理的情绪调节方式,以减少青少年的抑郁状况。

Objective To investigate association between adolescent depressive symptoms with circadian rhythm and emotion regulation strategies,and to provide the basis for mental health education for depression.Methods CES-D,Morning and Evening Questionnaire-5(MEQ-5) and Emotion Regulation scale(ERS) were administered to 2 398 students from 6 middle schools in Chengdu,Langzhong and Leshan of Sichuan Province.SPSS 21.0 was used to data processing and anlysis.Results About 37.9%(909/2 398) of adolescents reported depressive symptoms.Prevalence of depressive symptom was higher in female students(χ~2=25.15,P<0.01),rural adolescents(χ~2=15.45,P<0.01),adolescents aged 15-18 compared to aged 12-14(χ~2=187.24,P<0.01).There was significant difference in rate of depressive symptoms among adolescents with different circadian rhythms(χ~2=55.19,P<0.01),with definite evening rhythm preference was the highest(57.1%).Prevalence of depressive symptoms significantly varied by sleep duration(χ~2=141.99,P<0.01),and were highest in adolescents with sleep duration <6 h(69.4%).The scores of suppression dimension in depressed adolescents were significantly higher than that of non-depressive group,while the scores of reappraisal dimension were significantly higher in non-depressive group than that of depressive group.Multivariate Logistic regression analysis showed that gender(OR=1.60),age(OR=2.29),suppression(OR=1.13),sleep duration <6 h(OR=5.17),sleep duration 6-8 h(OR=2.88) were positively associated with depressive symptoms in adolescents.Moderate type(OR=0.53),morning type(OR=0.55) and cognitive reappraisal(OR=0.90) were associated with lower rate of depressive symptoms(P<0.05).Conclusion Sleep rhythm delay,lack of sleep and emotion suppression in adolescents are associated with higher risk for depression.Regular sleep habits and reasonable emotion regulation might help to prevent adolescent depression.