户外身体活动和失眠症状交互效应与大学生抑郁症状的关联

Association of interaction effects of outdoor physical activity and insomnia with depressive symptoms in college students

目的探讨户外身体活动及失眠症状与大学生抑郁症状的关联,为预防和改善大学生抑郁症状提供理论依据。方法2021年11—12月采取整群抽样法抽取湖北省、江西省和重庆市3个省(市)长江大学、赣南师范大学、赣州师范高等专科学校和重庆幼儿师范高等专科学校4所高校9349名大学生进行问卷调查。采用患者健康问卷(PHQ-9)、失眠严重程度指数量表(ISI)和户外身体活动调查问卷评估大学生的抑郁症状、失眠症状、户外身体活动情况。采用Logistic回归分析户外身体活动时间和失眠症状与抑郁症状之间的关联,使用广义线性模型分析大学生户外身体活动时间和失眠症状交互效应与抑郁症状的关联。结果大学生抑郁症状检出率为37.4%。不同专业、民族、学历、家庭居住地、家庭类型、家庭经济条件、学习负担、朋友数量、父亲文化程度、母亲文化程度与大学生抑郁症状检出率存在显著性差异(P值均<0.05)。Logistic回归分析显示,大学生户外身体活动(OR=0.51~0.69)及失眠症状(OR=6.15~21.30)与抑郁症状关联(P值均<0.01)。广义线性模型显示,失眠症状(B=0.57)、户外身体活动(B=-0.15)及其交互项(B=-0.02)均与大学生抑郁症关联(P值均<0.05)。结论户外身体活动时间不足和失眠可能增加大学生抑郁症状发生的风险,户外身体活动时间不足且有失眠症状的大学生抑郁症状发生的风险更高。

Objective The aim of the study was to investigate the association of outdoor physical activity and insomnia symptoms with depressive symptoms in college students,so as to provide a theoretical basis for preventing and improving depression of the college students.Methods A sample survey of 9349 college students from 4 colleges and universities in 3 provinces in Hubei,Jiangxi and Chongqing were conducted from November to December 2021.The Patient Health Questionnaire,Insomnia Severity Index and outdoor physical activity questionnaire were used to evaluate the depressive symptoms,insomnia symptoms and outdoor activities of college students,respectively.Theχ^(2)test was used to compare the difference of the positive rate of depressive symptoms in college students.Logistic regression analysis was used to analyze the association between outdoor physical activity,insomnia symptoms and depressive symptoms.Generalized linear model was used to analyze the association of interaction effect of outdoor activity and insomnia symptoms with depressive symptoms.Results The detection rate of depressive symptoms in college students was 37.4%.Significant differences in the detection rate of depressive symptoms were observed among college students with different majors,nationalities,educational backgrounds,family residence,family type,family economic conditions,study burden,number of friends,father's education level,mother's education level(P<0.05).Logistic regression analysis showed that outdoor physical activity(OR=0.51-0.69,P<0.01)and insomnia symptoms(OR=6.15-21.30,P<0.01)were associated with depressive symptoms(P<0.01).Generalized linear model showed that insomnia symptoms(B=0.57),outdoor physical activity(B=-0.15)and their interaction terms(B=-0.02)were associated with college students'depression(P<0.05).Conclusion This study suggests that insufficient time for outdoor physical activity and insomnia symptoms may increase the risk of depressive symptoms in college students.College students with insufficient time for outdoor physical activity and insomnia have a higher risk of developing depressive symptoms.