浙江省2018—2021年中学生抑郁症状及影响因素分析

Analysis of depressive symptoms and influencing factors among middle and high school students from 2018 to 2021 in Zhejiang Province

目的了解浙江省中学生抑郁症状的流行特征及影响因素,为实施相应的干预措施提供科学依据。方法基于2018—2021年学生常见病和健康影响因素监测与干预项目中中学生健康状况及影响因素部分,采用多阶段分层整群随机抽样方法,在浙江省11个市纳入所调查的所有初中、普通高中(简称普高)、职业高中(简称职高),共计73309名中学生,2018—2021年分别为6008,21917,23712,21672名。采用χ^(2)检验和Logistic回归模型对中学生抑郁症状的影响因素进行分析。结果2018—2021年中学生抑郁症状检出率为14.8%,女生(17.1%)高于男生(12.7%),高中阶段(普高17.1%,职高17.6%)高于初中阶段(12.5%)(χ^(2)值分别为278.77,327.22,P值均<0.05)。单因素分析显示,不同年份(2018:16.7%,2019:17.9%,2020:13.1%,2021:13.0%)、住校(是:16.3%,否:13.5%)、体质量指数分类(非超重肥胖:14.8%,超重:14.2%,肥胖:15.7%)、每周运动天数(0~2 d:17.1%,3~5 d:12.5%,6~7 d:13.1%)及有无校园欺凌(有:35.5%,无:10.7%)的中学生抑郁症状检出率差异均有统计学意义(χ^(2)值分别为293.40,118.35,7.83,287.24,4978.84,P值均<0.05)。多因素Logistic回归分析显示,女生、普高、职高、肥胖、遭受校园欺凌与抑郁均呈正相关(OR值分别为1.65,1.70,1.60,1.12,5.21),每周运动3~5和6~7 d与抑郁均呈负相关(OR值分别为0.77,0.81)(P值均<0.01)。结论浙江省中学生抑郁症状问题突出。应加强中学生的心理健康教育,从家庭、学校、社会等方面给予关注,以减少中学生抑郁症状的发生。

Objective To investigate the prevalence and associated factors of depressive symptoms among middle and high school students in Zhejiang Province,so as to provide scientific basis for the implementation of depressive intervention.Methods Based on the health status and associated factors of middle and high school students in the project"Monitoring of Common Diseases and Health Influencing Factors of Students"during 2018 to 2021,a total of 73309 students including middle school,ordinary high school and vocational high school surveyed in 11 cities of Zhejiang Province were selected by multi-stage stratified cluster random sampling method.From 2018 to 2021,there were 6008,21917,23712 and 21672 students,respectively.The Chi-square test and Logistic regression model were used to analyze the influencing factors of depressive symptoms in middle and high school students.Results From 2018 to 2021,depressive symptoms detection rate of middle school students was 14.8%,with higher rate in girls(17.1%)than in boys(12.7%),higher rate in high school(17.1% in ordinary high school,17.6% in vocational high school)than middle school(12.5%)(χ^(2)=278.77,327.22,P<0.05).Univariate analysis showed that there were statistically significant differences in depressive symptoms detection rate among middle school students with different years(2018:16.7%,2019:17.9%,2020:13.1%,2021:13.0%),residence(yes:16.3%,no:13.5%),body mass index classification(not overweight or obesity:14.8%,overweight:14.2%,Obesity:15.7%),weekly exercise days(0-2 d:17.1%,3-5 d:12.5%,6-7 d:13.1%)and bullying(yes:35.5%,no:10.7%)(χ^(2)=293.40,118.35,7.83,287.24,4978.84,P<0.05).Multivariate Logistic regression analysis showed that female students,ordinary high schools,vocational high schools,obesity,school bullying were positively correlated with depression(OR=1.65,1.70,1.60,1.12,5.21),exercise 3 to 5 days per week,exercise 6 to 7 days per week were negatively correlated with depression(OR=0.77,0.81,P<0.01).Conclusions Depressive symptoms among middle and high school students in Zhejiang Province are prominent.Strengthening mental health education for students and providing attention and support from families,schools,and society are essential steps to reduce the occurrence of depressive symptoms among these students.