重庆市中学生睡眠时间型与抑郁症状的交叉滞后分析

A cross-lagged study of relationship between chronotype and depression symptoms among middle school students in Chongqing

目的:探讨重庆市中学生睡眠时间型与抑郁症状的发展变化及两者间相互影响。方法:选取1 208名中学生(初一613人,高一595人)进行3次追踪调查,每次间隔6个月。T1~T3时期分别代表基线、6月、12月时间点。采用清晨型与夜晚型量表-5条目(MEQ-5)和病人健康问卷抑郁量表(PHQ-9)分别测量睡眠时间型和抑郁症状。使用SPSS26.0和Mplus8.3进行分析。结果:T1时期MEQ-5得分低于T3时期得分,T2时期MEQ-5得分低于T1与T3时期得分(F=20.08,P<0.001),提示睡眠时间型在基线后先向夜晚型转变,后向清晨型发展,呈现波动关系。PHQ-9得分3次测量存在差异(χ^(2)/df=9.77/2,P<0.01),但两两比较提示无统计学意义(P>0.05)。交叉滞后模型显示,T_(i)MEQ-5得分负向预测T_(i+1)PHQ-9得分(β_(Ti-Ti+1)=0.12/-0.09,P<0.05)与TiPHQ-9得分负向预测T_(i+1)MEQ-5得分的交叉滞后通径有统计学意义(β_(Ti-Ti+1)=-0.07/-0.11,P<0.05)。结论:青少年睡眠时间型与抑郁症状存在一定变化,越倾向于夜晚型抑郁症状发生可能性更高,抑郁症状越严重后续向夜晚型转变的可能性更大。

Objective:To explore the development and interaction between chronotype and depressive symp-toms among middle school students in Chongqing.Methods:A total of 1208 middle school students(613 in grade 7,595 in grade 10)were surveyed for three follow-ups at 6-month intervals.Periods T1-T3 represented baseline,6 months later,and 12 months later,respectively.Chronotype and depressive symptoms were measured by the Morn-ing and Evening Questionnaire-5(MEQ-5)and the Patient Health Questionnaire-9(PHQ-9).Analyses were per-formed using SPSS 26.0 and Mplus 8.3.Results:The MEQ-5 scores were lower in T1 than in T3,and the scores were lower in T2 than in T1 and T3(F=20.08,P<0.001),suggesting a fluctuating trend of chronotype shifting to the Evening-type first after baseline and then to the Morning-type.The PHQ-9 scores exhibited a significant differ-ence among the three-time measurements(χ^(2)/df=9.77/2,P<0.01).But pairwise comparisons did not yield any statistically significant findings(P>0.05).The cross-lagged panel model showed that pathways of T,MEQ-5 scores negatively predicted T_(i+l)PHQ-9 scores(β_(Ti-Ti+1)=-0.12/-0.09,P<0.05)and T_(i)PHQ-9 scores nega-tively predicted T_(i+l)MEQ-5 scores(β_(Ti-Ti+1)=-0.07/-0.11,P<0.05).Conclusion:Chronotype and depressive symptoms show some changes in adolescents.The more inclined adolescents are to the Evening-type,the higher the likelihood of depressive symptoms occurring later.The more severe the depressive symptoms,the greater the likeli-hood of a subsequent shift to the Evening-type.