医学生行为方式暴露模式与抑郁焦虑症状的关联

Association between behavior patterns and depressive and anxiety symptoms in medical students

目的探索医学生行为方式的异质性,分析不同暴露模式对抑郁、焦虑症状的影响。方法采用方便抽样的方法,于2022年10—11月整群选取安徽省两所专科学校大一新生为研究对象开展基线调查,于2023年10—11月进行随访调查,与基线调查匹配后有效人数为4764名。调查一般社会人口统计学信息、吸烟、饮酒、睡眠时长、非学习目的视屏时间、体力活动的情况,并运用9项患者健康问卷、广泛性焦虑量表评定抑郁、焦虑症状。采用潜在类别分析模型探索医学生行为方式的异质性,建立logistic回归模型分析医学生行为方式暴露模式与抑郁、焦虑症状之间的关联。结果医学生抑郁、焦虑症状检出率分别为32.9%和35.6%。医学生行为方式潜在类别分为物质依赖组(14.5%)、睡眠体力活动不足组(6.2%)和低风险组(79.3%)。logistic回归分析显示,与低风险组相比,物质依赖组(OR=2.017,95%CI:1.678~2.424)和与睡眠体力活动不足组(OR=1.489,95%CI:1.164~1.906)与抑郁症状风险升高相关,睡眠体力活动不足组(OR=2.165,95%CI:1.805~2.598)与焦虑症状风险升高相关。结论医学生行为方式的暴露模式表现为物质依赖组、睡眠体力活动不足组和低风险组,各类别与抑郁、焦虑症状关联不同,因此在学科心理健康教育活动中应针对医学生不同行为暴露模式制定个体化干预方案。

Objective To explore the heterogeneity of medical students'behavior patterns,and analyze the effects of different exposure patterns on depression and anxiety symptoms.Methods Using convenient sampling method,a baseline survey was conducted among the whole group of freshmen from two junior colleges in Anhui Province from October to November 2022.A follow-up survey was conducted from October to November 2023.After matching with the baseline survey,the valid number was 4764.General sociodemographic information,smoking,alcohol consumption,sleep duration,non-learning video time,and physical activity were investigated.The depression and anxiety symptoms were assessed using the 9-item patient health questionnaire and Generalized Anxiety Scale.The latent category analysis model was used to explore the heterogeneity of medical students'behavior patterns.Logistic regression model was established to analyze the association between medical students'behavior pattern exposure patterns and symptoms of depression and anxiety.Results The rates of depression and anxiety were 32.9%and 35.6%,respectively.The latent categories of medical students'behavior patterns were divided into substance dependence group(14.5%),sleep physical inactivity group(6.2%)and low risk group(79.3%).Logistic regression analysis showed that compared with the low-risk group,the substance dependence group(OR=2.017,95%CI:1.678~2.424)and sleep physical inactivity group were(OR=1.489,95%CI:1.164~1.906)associated with an increased risk of depression symptoms.The substance dependence group(OR=2.165,95%CI:1.805~2.598)was associated with an increased risk of anxiety symptoms.Conclusion The behavior pattern of medical students divided into substance dependence group,sleep physical inactivity group and low risk group.Each latent category has different correlation with depression and anxiety symptoms.Therefore,individualized intervention programs should be formulated according to different behavioral patterns of medical students in disciplinary mental health education activities.