我国儿童青少年抑郁症状的人口学及生活方式相关影响因素研究

Demographic characteristics and lifestyle related factors of depressive symptoms in Chinese children and adolescents

目的研究我国儿童青少年抑郁症状的人口学特征及相关生活方式因素。方法采用横断面研究设计方案,以分层随机抽样,于2022年7-11月对我国四大经济区10个省(区、市)22693名小学四年级至初中三年级儿童青少年进行调查,以流调中心抑郁量表(the Center for Epidemiologic Studies Depression Scale,CES-D)和自编问卷对抑郁症状及相关影响因素进行信息采集和统计分析。结果(1)我国儿童青少年抑郁症状的总发生率为17.9%,其中轻度抑郁症状占12.8%,重度抑郁症状占5.1%。(2)人口学特征上:抑郁症状的女性发生率(19.6%vs 16.2%,χ^(2)=44.445,P<0.001)与抑郁症状得分[(5.53±5.53)分vs(5.10±5.13)分,t=-6.083,P<0.001]显著高于男性。教育阶段、父母受教育程度、父母职业、家庭经济状况、城乡地区、居住区域等变量的抑郁症状发生率及得分均存在显著差异(P<0.001)。(3)生活方式上:睡眠未达标组抑郁症状发生率(20.0%vs 13.1%,χ^(2)=169.680,P<0.001)与抑郁症状得分[(5.73±5.46)vs(4.37±4.85)分,t=18.560,P<0.001]显著高于达标组。摄入含糖饮料(sugar-sweetened beverages,SSBs)频率、运动频率、学习日上网时长与抑郁症状发生率及得分均显著相关(P<0.001)。(4)回归分析显示:女性、初中生、母亲为军人、居住西部地区、偶尔或经常摄入SSBs、学习日每天上网是抑郁症状的正性相关因素(P<0.001);而母亲文化程度初中及以上、主观家庭经济水平中等及以上、睡眠达标、偶尔或经常运动是抑郁症状的负性相关因素(P<0.001)。结论我国儿童青少年抑郁症状的发生可能受性别、年龄、母亲文化程度、母亲职业、家庭经济状况及居住地等人口学特征的影响;不达标的睡眠、频繁摄入SSBs、缺乏运动、上网时间长等不良生活方式与抑郁症状的发生密切相关。

ObjectiveTo explore the demographic characteristics and lifestyle factors associated with depressive symptoms among Chinese children and adolescents.MethodsA cross-sectional study was conducted on 22693 children and adolescents who were subjected with stratified random sampling from the fourth grade of primary school to the third grade of junior high school in 10 provinces across 4 major economic regions in China during July to November 2022.All participants were assessed with the Center for Epidemiologic Studies Depression Scale(CES-D)and a self-developed questionnaire to collect the factors associated with depressive symptoms and analyze statistically.Results①The overall prevalence of depressive symptoms was 17.9%in Chinese children and adolescents,with mild depressive symptoms accounting for 12.8%and severe symptoms for 5.1%.②Demographic analysis revealed that the female had significantly higher prevalence of depressive symptoms(19.6%vs 16.2%,χ^(2)=44.445,P<0.001)and higher depressive symptom score(5.53±5.53 vs 5.10±5.13,t=-6.083,P<0.001)than the male.Significant differences were observed in the participants at different educational stages,and those with different parental education levels,parental occupations,family economic status,urban and rural areas,and residential areas,respectively(P<0.001).③Lifestyle analysis indicated that the prevalence of depressive symptoms(20.0%vs 13.1%,χ^(2)=169.680,P<0.001)and the depressive symptom score(5.73±5.46 vs 4.37±4.85,t=18.560,P<0.001)were obviously higher in the participants without adequate sleep duration than those with.The frequency of sugar-sweetened beverages(SSBs)consumption,exercise frequency,and daily internet usage on school days were significantly correlated with the prevalence and scores of depressive symptoms(P<0.001).④Regression analysis identified that female,junior high school status,maternal military occupation,residence in the Western area,occasional or frequent SSBs consumption,and daily internet usage on school days were negative factors for depressive symptoms(P<0.001);Whereas maternal education level of junior high school or over,family economic status of moderate or higher,adequate sleep duration,and regular exercise were positive factors(P<0.001).ConclusionThe prevalence of depressive symptoms among Chinese children and adolescents may be influenced by demographic characteristics,such as gender,age,maternal education level,maternal occupation,family economic status,and region of residence.Unhealthy lifestyle behaviors,such as inadequate sleep,frequent SSBs consumption,lack of exercise,and prolonged daily internet usage are closely related to the occurrence of depressive symptoms.