The Efficacy and Safety of Yokukansankachimpihange for Treating Behavioral and Psychological Symptoms of Dementia in Patients with Alzheimer’s Disease: An Open-Label Pilot Study

Previous clinical trials have demonstrated the efficacy of yokukansan, a traditional Japanese medicine, for the treatment of behavioral and psychological symptoms of dementia (BPSD). However, less evidence is available for the treatment of BPSD with yokukansankachimpihange (YKSCH), which consists of yokukansan and two additional herbal ingredients. The present study was conducted to investigate the efficacy and safety of YKSCH for treating BPSD in patients with Alzheimer’s disease (AD). We enrolled outpatients with mild-to-moderate AD who exhibited BPSD and obtained a Neuropsychiatric Inventory (NPI) score of >3 including subscale scores for “agitation”, “anxiety”, “irritability”, and “sleep and night-time behavior change”. A daily YKSCH dose of 7.5 g was administered for 12 weeks with concomitant administration of anti-dementia medication. BPSD was evaluated using the NPI at baseline and every 4 weeks during the intervention. We also examined apathy using the Japanese translation of the Apathy Scale, the short version of the Japanese version of the Zarit Caregiver Burden Interview, and the Modified Crichton Rating Scale for Predicting Activities of Daily Living. Cognitive dysfunction was evaluated using the Mini Mental State Examination and the AD Assessment Scale-Cognitive (Japanese version). Five participants were enrolled. The NPI total score tended to decrease between the baseline and 8-week evaluations during the YKSCH intervention (Wilcoxon signed rank test, P = 0.063). In terms of the NPI subscale scores, “apathy”, “agitation”, “delusions”, and “sleep and night-time behavior change” decreased after the intervention in those who exhibited each symptom at baseline. There were no significant differences in the other scores examined. No serious adverse events were observed. YKSCH could ameliorate BPSD in patients with mild-to-moderate AD with agitation, anxiety, irritability, and sleep and night-time behavior change, and it was well-tolerated.

Role of antipsychotics for treating behavioral and psychological symptoms of dementia

Over the past three decades, concerns about the high prevalence of antipsychotic use in the nursing homes(NHs) for the management of behavioral and psychological symptoms of dementia continue to be emphasized and intervened by many. However, despite the numerous side effects and the recent blackbox warning by the United States Food and Drug Administration about the increased risks for stroke and sudden death associated with the use of antipsychotics in dementia, the prevalence of antipsychotic use in NHs remains high. While the use of antipsychotics appeared to have modest efficacy in reducing symptoms of aggression and psychosis in dementia, there is insufficient evidence to routinely recommend the use of alternative psychopharmacological treatments for these symptoms. Hence, clinicians have to balance the safety warnings against the need to treat these symptoms in order to prevent harm to the resident that may result from his/her dangerous behaviors. Although the use of antipsychotics may be warranted in some cases, organizational, resource and training support should be provided to encourage and equip NH staff to participate in interventions so as to minimize inappropriate use of these medicines in NHs. This review will discuss the place in therapy, the trend and appropriateness of antipsychotic use in NHs, as well as the effectiveness of current and future strategies for reducing antipsychotic use in the NHs.

Gabapentin for the treatment of behavioral and psychological symptoms of dementia

Objective: To examine the efficacy of gabapentin for the treatment of behavioral and psychological symptoms of dementia (BPSD). Design: A retrospective chart review. Settings: Tertiary care geriatric psychiatry inpatient unit. Participants: 230 patients with BPSD. Measurements: The socio-demographic information, type of behaviors, co-morbid psychiatric and medical diagnoses, daily doses of medications and side-effects were recorded. Results: Of the 230 patients, 22 were treated with gabapentin. Twenty of these patients were on a combination of gabapentin and an antipsychotic medication while two patients were treated with gabapentin monotherapy. Eighteen of the 20 patients in the combination group tolerated the treatments with little or no side effects as did the two patients in the monotherapy group. Conclusions: Gabapentin may be a safe option for the treatment of BPSD in combination with antipsychotic medications. Gabapentin may also be effective as monotherapy in certain patients with BPSD.

Investigating the Effectiveness of Dialectical Behavior Therapy in Clinical Symptoms, Anger Control and Emotional Regulation of Bully Children

The present study aims to investigate the effectiveness of dialectical behavior therapy in clinical symptoms, anger control and emotional regulation of bully children. This research is a pretest-posttest quasi-experimental study design with a nonequivalent control group. The research sample comprises 24 bully children who were purposefully selected from among the students who had responded positively to the researcher’s call. The participants were randomly assigned into two experimental and control groups. Group therapy intervention was conducted on the experimental group during ten sessions. The tools applied in this study consisted of Cognitive Emotion Regulation Questionnaire by Garnefski et al., State-Trait Anger Expression Inventory by Spielberger and Bullying Scale by Illinois, Espelage and Holt and the subjects answered to their questions in the stage of pretest and posttest. In this research, the data was analyzed based on the analysis of covariance test and with the aid of SPSS software. The findings demonstrated that dialectical behavior therapy has a significant impact on clinical symptoms, anger control and its components and emotional regulation and its components (P < 0.01).

Improving the Appropriateness of Antipsychotic Prescribing for Behavioral and Psychological Symptoms of Dementia (BPSD): A Pilot Study of the Psychotropic Use Monitoring (PUM) Program

In nursing homes, antipsychotic prescribing decisions (APDs) for managing behavioral and psychological symptoms of dementia (BPSD) depend on the nursing staff’s feedback. Inappropriate APDs can result in the lack of timeliness, objectivity and important clinical information when nursing staff’s feedback on residents’ behavior and pharmacotherapy outcomes. Currently, there are no reported interventions for improving psychiatrists’ APDs through nursing staff’s monitoring and feedback processes. This one-group pre-and-post pilot study aimed to evaluate the feasibility and impact of implementing a newly-developed Psychotropic Use Monitoring (PUM) program for improving the appropriateness of APDs in a 50-bed dementia ward of a nursing home. The PUM intervention involved 16 pharmacist-trained nursing staff, who monitored and reported residents’ BPSD changes and psychotropic side effects for 24 weeks, while carrying out their routine care duties. A face-to-face interview was then administered to determine the nursing staff’s perceptions of PUM. Data of 51 residents were collected from hardcopy individual patient records to evaluate the changes in APDs and the number of resident falls before and after implementing PUM. The nursing staff reported increases in their knowledge, awareness, confidence, and actual frequency of monitoring for side effects, as well as their ability in differentiating and managing BPSD (p < 0.05). After PUM, there was a significant increase in the number of APDs due to side effect-related reasons (4 versus 16) (p < 0.031). Although not significant, the number of APDs with no documented reasons (5 versus 9) and the number of resident falls (7 versus 15) appeared to be lesser after PUM. This study demonstrated the nursing staff’s positive participation in PUM intervention, specifically in monitoring and feedback of side effects. Furthermore, a potential exists for PUM to encourage more judicious APDs, which may be useful in settings with heavy patient load, limited human resources and dependence on foreign nursing staff from differing cultural backgrounds.

Rehabilitative Outcomes after Hip Fracture in a Special Care Unit for Persons with Dementia and Behavioral and Psychotic Symptoms

Aim: Hip fracture implies severe problems to older people;special concerns regard persons with dementia, due either to cognitive impairment, or to behavioral and psychic symptoms. This study illustrates rehabilitative outcomes of these patients discharged by a special care unit ruled by “GentleCare” principles. Method: 54 patients [89% females, aged 82.3 years (range 66 - 94)] followed a post-surgery rehabilitative program carried out by a physiotherapist and an occupational therapist, supported by a psychologist. The multidimensional assessment consisted of cognition evaluation (Mini Mental State Examination, Clinical Dementia Rating, Global Deterioration Scale), functional evaluation (Barthel Index, Tinetti Gait and Balance, Bedford Alzheimer Nursing Severity scale), behavioral evaluation (UCLA Neuropsychiatric Inventory) and comorbidity evaluation (Cumulative Illness Rating Scale). Results: All parameters improved, including the 5 most frequent behavioral and psychic symptoms that usually preclude admission in ordinary rehabilitation units. 24% of improvement in Barthel Index total score was explained by agitation and apathy at discharge, in a multiple linear regression model: better functional levels corresponded to smoother behavioral problems. Most patients improved;70.5% of them were discharged to home. Conclusion: A prosthetic approach enables valuable results in the rehabilitation of severely demented patients with hip fracture also in presence of behavioral symptoms.

Effectiveness of Family-Based Behavioral Treatment Based on Medication Behavior Barkley Compared with Drug Therapy in Reducing the Symptoms of Children with Attention Deficit Disorder-Hyperactivity

Children with attention deficit and hyper activity disorder have various problems such as low academic performance, social and communication problems, anxiety, depression, aggression, conduct disorder and delinquency, and also when they become adults, they have problems in social relationships that these problems can increase or decrease in dealing with family. Hence, this study was performed in order to examine the impact of family-based behavioral treatment compared with Barkley behavior therapy in reducing symptoms of children with attention deficit disorder—ADHD. To meet the aim, 20 of children with age range of 7 to 12 years old with attention deficit disorder—hyperactivity were selected in both experimental and control groups, and exposed to the treatment of behavioral family therapy groups and changes in behavior Barkley. Before and after the treatment, they were evaluated according to the scale of the Conner’s Parent Rating Scale-Revised Short Form (CPRS-R: S). Results of multivariate analysis of covariance indicated that there were significant differences between the experimental group who had received family-based behavioral treatments based on changes in behavior Barkley and a control group who had received drug treatment in variables, including conduct problems, learning problems, psychosomatic symptoms, and signs of impulsive hyperactivity, anxiety and hyperactivity (p < 0.01). These results could be guidance for counsel or sand therapists for children with attention deficit disorder—ADHD.

Menopause-Related Symptoms and Help Seeking Behavior among Women Attended at a Tertiary Care Hospital in Bangladesh

Background: Women have experienced different menopause-related symptoms. Objective: The purpose of the present study was to see the menopause-related symptoms and help seeking behavior among the women attended at a tertiary care hospital. Methodology: This cross-sectional study was conducted in the outpatient Department of Kushtia Medical College Hospital, Kushtia, Bangladesh from October 2015 to September 2016 for a period of one (01) year. Menopausal women who were attended in the outpatient Department of Hospital were included as study population. The eligible women had at least one year of amenorrhoea. Surgical menopause or due to severe illness, extreme weight loss endocrine disorders or radio therapy were excluded. Each subject completed a questionnaire that elicited their sociodemographic information, personal and family history and current medical problems. Result: A total number of 437 women were recruited for this study. The most prevalent menopausal symptom among the participants was generalized body ache 91.30%. Followed by low back pain 88.55%, muscle & joint pain 87.18%, tiredness 86.04%, hot flush 64.30%, urinary symptoms 43.93%, vaginal dryness 48.28%, insomnia 73.91%, irritability 23.56%. Most of the participants consulted at first with village doctors (63.15%) followed by general practitioners 20.82% due to their health problems. Some sought help from traditional healers like kobiraj 3.20%. Conclusion: In conclusion, body ache, low back pain, muscle and joint pain and tiredness are the most commonly reported menopause-related symptoms that are mostly consulted with village doctors.

Predictors of Comorbid Psychological Symptoms among Patients with Social Anxiety Disorder after Cognitive-Behavioral Therapy

Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.

Depressive Symptoms and Food Intake among Weight-Preoccupied Women: Do Eating Behaviors and Attitudes or BMI Mediate This Association?

Associations between depressive symptoms, dysfunctional eating behaviors and attitudes, higher food intake and body mass index (BMI) have been previously observed. However, few studies have assessed these variables in the same study. The first objective is to compare, in a natural setting environment, the profile of women reporting lower or higher levels of depressive symptoms in terms of food intake, eating behaviors and attitudes, and BMI. The second objective is to test mediational models for which the link between depressive symptoms and food intake would be mediated by eating behaviors and attitudes or BMI. Weight-preoccupied women were recruited (n = 323), and their level of depressive symptoms was assessed using the Beck Depression Inventory. The median score was used to create two groups (lower ≤ 13;higher > 13). A web-based food-frequency questionnaire, the Three-Factor Eating Questionnaire, and the Intuitive Eating Scale were completed. BMI was calculated from reported body weight and height. Compared to women with a lower level of depressive symptoms, those with a higher level of depressive symptoms reported a higher energy intake (p = 0.02), and a higher consumption of savoury foods (p = 0.02). These women also had higher scores of disinhibition (p p = 0.0002), ate less intuitively (p p = 0.005). Association between depressive symptoms and energy intake was mediated by disinhibition, susceptibility to hunger and eating for physical rather than emotional reasons, while the role of BMI was less clear. Regarding another component of food intake, association between depressive symptoms and consumption of savoury foods was mediated by disinhibition and eating for physical rather than emotional reasons. In summary, it seems essential to be aware of the presence of depressive symptoms and to pay attention to eating behaviors and attitudes in interventions among weight-preoccupied women.

多感官刺激联合多领域认知训练对阿尔茨海默病患者精神行为症状的影响

目的探讨多感官刺激联合多领域认知训练对阿尔茨海默病患者(Alzheimer’s disease,AD)精神行为症状的影响。方法便利抽样选取2023年2-4月某医院神经内科病房收治的AD患者共94例,对照组予常规护理,试验组在此基础上实施多感官刺激联合多领域认知训练。干预前后采用神经精神量表(neu-ropsychiatric inventory,NPI)、科恩-曼斯菲尔德激越行为量表(Cohen-Mansfield agitation inventory,CMAI)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)和汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评价两组患者的精神行为、情绪变化。结果试验组患者在接受干预后的NPI、CMAI、HAMA和HAMD评分明显低于对照组(均P<0.05)。结论对AD患者实施多感官刺激联合多领域认知训练,可有效降低其激越行为的发生率,改善焦虑和抑郁等负面情绪。

老年期痴呆的BPSD非药物治疗及其与ApoE基因多态性相关性的临床研究

目的分析老年期痴呆的行为精神症状(behavioral and psychological symptom of dementia,BPSD)的非药物治疗效果及其与载脂蛋白E(apolipoprotein E,ApoE)基因多态性的关系。方法选取2016年1月至2022年12月江西省人民医院收治的90例老年期痴呆患者为研究对象,根据随机数字表法将其分为常规组、对照组和观察组,每组各30例。常规组患者给予盐酸美金刚片治疗,对照组患者在常规组基础上加以音乐疗法,观察组患者在常规组基础上加以重复经颅磁刺激治疗,三组均连续治疗12周。比较三组患者的BPSD严重程度、痴呆严重程度、认知功能、日常生活能力、ApoE基因多态性。结果治疗前,三组患者的神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)、简明精神状态检查量表(mini-mental state examination,MMSE)、日常生活能力评定量表(activity of daily living scale,ADL)评分比较差异均无统计学意义(P>0.05);治疗后,三组患者的NPI、CDR评分均显著低于本组治疗前,MMSE、ADL评分均显著高于本组治疗前(P<0.05);观察组和对照组患者的NPI、CDR评分均显著低于常规组,MMSE、ADL评分均显著高于常规组(P<0.05)。ApoE共有ε2、ε3、ε4三种等位基因,其中ε3表达频率最高,共55例,其次为ε4和ε2;三组患者的ApoE不同基因检出率比较差异无统计学意义(P>0.05)。ApoEε4型患者的NPI评分显著高于ApoEε3型与ApoEε2型(P<0.05)。结论非药物治疗老年期痴呆患者效果显著,可减轻BPSD和痴呆表现,提高患者的认知功能和日常生活能力,ApoEε4型基因与老年期痴呆患者的BPSD存在紧密联系。

中国5省初中生视屏时间和饮食行为与抑郁症状的关联

目的·了解中国5省初中生视屏时间和饮食行为与抑郁症状的关联。方法·采用分层随机整群抽样方法,对中国东部地区的浙江、广东,中部地区的江西,西部地区的四川、贵州共5省1067名初中生进行问卷调查,包括一般人口学特征、健康行为情况、饮食行为情况、抑郁情况。采用单因素分析比较不同人口学特征的初中生的抑郁症状报告率、每日视屏时间和饮食行为,采用Logistic回归分析每日视屏时间和饮食行为与抑郁症状的关联,并分析前两者的交互作用。结果·中国5省初中生抑郁症状报告率为12.9%,西部地区、非独生子女、每周零花钱超过100元、有过吸烟行为、有过饮酒行为、每日视屏时间≥2 h、有不健康饮食行为的初中生抑郁症状报告率较高,差异均有统计学意义(均P<0.05)。15.2%初中生每日视屏时间≥2 h;调整混杂因素后,与每日视屏时间<2 h组相比,≥2 h组抑郁症状报告率更高(OR=1.89,95%CI 1.22~2.95)。29.5%的初中生有不健康饮食行为;调整混杂因素后,与健康饮食行为组相比,不健康饮食行为组抑郁症状报告率更高(OR=2.16,95%CI 1.47~3.19)。6.4%的初中生每日视屏时间≥2 h且有不健康饮食行为;调整混杂因素后,这部分学生比每日视屏时间<2 h且饮食行为健康学生抑郁症状报告率更高(OR=4.26,95%CI 2.24~7.56)。调整混杂因素后,每日视屏时间与饮食行为的交互作用分析结果显示,两者存在相加交互作用,超额相对危险度(relative excess risk due to interaction,RERI)为1.21(95%CI 1.02~1.51),交互作用归因比(attributable proportion due to interaction,AP)为0.19(95%CI 0.13~0.31),交互作用指数(synergy index,S)为1.35(95%CI 1.12~1.69)。结论·视屏时间过长且有不健康饮食行为的中国初中生更容易出现抑郁症状,且两者对抑郁症状有相加交互作用。

生慧益智汤联合盐酸多奈哌齐对轻中度阿尔茨海默病患者精神行为症状的影响

目的基于“神志病”视角,探究生慧益智汤联合盐酸多奈哌齐对轻中度阿尔茨海默病(Alzheimer,s disease,AD)患者精神行为症状(behavioral and psychological symptoms of dementia,BPSD)的临床疗效。方法选取符合纳入标准的AD患者70例,随机分为治疗组和对照组,每组35例。对照组患者给予盐酸多奈哌齐,治疗组患者给予生慧益智汤联合盐酸多奈哌齐治疗,疗程6个月。治疗前后采用AD认知评定量表(Alzheimer's disease assessment scale-cognitive subscale,ADAS-cog)和神经精神症状问卷(neuropsychiatric inventory,NPI)评分,评估患者认知功能及精神行为异常表现,并观察治疗期间药物不良反应。结果治疗后2组患者ADAS-cog、NPI评分较治疗前均显著降低(P<0.05),治疗组明显低于对照组(P<0.05)。NPI在抑郁、焦虑、情感淡漠领域,2组患者治疗后评分均低于治疗前(P<0.05),且治疗组明显低于对照组(P<0.05);此外治疗组患者治疗后妄想、易激惹、睡眠/夜间行为异常评分低于治疗前(P<0.05),且评分低于对照组(P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论轻中度AD患者BPSD以抑郁、淡漠、易激惹、焦虑、睡眠/夜间行为异常、妄想为主,生慧益智汤联合多奈哌齐能整体改善认知功能、减轻上述BPSD症状。中西医结合疗效优于单用多奈哌齐,值得临床推广应用。

苍耳子油滴剂对变应性鼻炎小鼠行为学症状及血清IL-5水平的影响

目的观察中医验方苍耳子油滴剂对变应性鼻炎(AR)小鼠行为学症状和血清白细胞介素-5(IL-5)水平的影响。方法将SPF级BALB/c雄性小鼠32只,随机分为正常组、模型组、对照组、实验组,每组8只。除正常组外,其余三组采用卵清蛋白致敏法建立变应性鼻炎小鼠模型。造模成功后,实验组用苍耳子油滴剂滴鼻,对照组用盐酸西替利嗪滴剂滴鼻,其余两组用生理盐水滴鼻,疗程9 d。治疗结束后,对小鼠鼻部行为学症状进行评分,ELISA法检测血清炎症细胞因子IL-5水平。结果与模型组比较,对照组小鼠行为学评分略升高(P<0.05),实验组小鼠行为学评分降低(P<0.05),对照组、实验组小鼠血清IL-5水平均降低(P<0.01);与对照组比较,实验组小鼠行为学评分降低(P<0.05),血清IL-5水平亦降低(P>0.05)。结论苍耳子油滴剂可以改善变应性鼻炎小鼠的鼻部行为学症状,并降低其血清IL-5水平。

痴呆特别照料单元的现状和展望

在痴呆负担日益沉重的背景下,痴呆特别照料单元(Dementia Special Care Units,DSCU)作为旨在为阿尔茨海默病等痴呆症患者提供专病照料的有效手段逐渐受到重视。经过长期发展,DSCU在物理空间、人力资源建设、效果评价等方面已经形成成熟的建设策略,实践证明规范的DSCU可以帮助控制痴呆相关精神行为异常(Behavioral and psychological symptoms of dementia,BPSD),使痴呆患者获益。本文就DSCU的发展、建设、展望作一综述。

慢性病管理模式下护理对老年慢性支气管炎患者遵医行为和症状恢复的影响

目的探讨慢性病管理模式下护理对老年慢性支气管炎患者遵医行为和症状恢复的影响。方法选择2021年1月至2023年5月辽阳市中心医院收治的86例老年慢性支气管炎患者为研究对象,采用随机数字表法分为对照组和观察组,各43例。对照组采用常规方法护理干预,观察组在对照组基础上给予慢性病管理模式下护理,比较两组干预效果。结果干预前,两组患者自我效能水平、生活质量对比差异无统计学意义(P>0.05)。干预后,与对照组相比,观察组患者的自我效能评分、生活质量、遵医率、护理满意度更高(均P<0.05);观察组患者的症状消退时间更短(P<0.05)。结论慢性病管理模式下护理对老年慢性支气管炎患者应用效果十分显著,具有很高的优势,可在未来临床中运用和推广。

社区老年2型糖尿病患者糖尿病痛苦和抑郁症状对自我管理行为的影响

目的:了解社区老年2型糖尿病(Type 2 Diabetes Mellitus,T2DM)患者糖尿病痛苦(Diabetes Distress,DD)、抑郁症状(Depression Symptom,DS)和自我管理行为现状,探讨DD和DS对老年2型糖尿病患者自我管理行为的影响,为制定有效的干预策略提供参考依据。方法:采用方便抽样的方法对南京市8家社区卫生服务中心注册的588名老年T2DM患者进行问卷调查,问卷内容包括一般资料问卷,糖尿病痛苦量表、九条目患者健康问卷和自我管理行为量表。结果:①社区老年T2DM患者DD和DS的患病率分别为28.4%和39.1%,糖尿病自我管理行为处于中等水平。②DD(r=-0.43,P<0.01)和DS(r=-0.28,P<0.01)均与糖尿病自我管理行为呈显著负相关。③在校正可能的混杂因素后,多元线性回归结果显示较高的DD得分(B=-0.594,P<0.01)和DS得分(B=-0.799,P<0.01)均能单独预测患者的自我管理行为。当DD和DS同时纳入回归模型时,DS(B=-0.224,P=0.071)对自我管理行为的影响不再显著,而DD(B=-0.529,P<0.01)依旧显著,可以解释自我管理行为总变异的20.8%。结论:社区医疗保健专业人员需对老年T2DM患者的DD和DS进行常规评估,实施侧重于降低DD水平的干预策略可能对于改善患者的自我管理行为具有重要意义。

职校学生24小时活动与抑郁症状关系的横断面研究

目的使用等时替代模型,探索有、无抑郁症状的职校学生10 min/天身体活动(physical activity,PA)、久坐行为(sedentary behavior,SB)和睡眠(sleep,SLP)之间等时替代与抑郁症状量表得分的关联。方法采用方便整群抽样方法,选取上海市和江苏省的14所职校,调查对象为1~3年级学生,于2021年12月—2022年1月开展问卷调查。根据流调中心抑郁量表(Centre for Epidemiologic Studies Depression Scale,CES-D)得分将学生分为有抑郁症状组和无抑郁症状组。结果共收回问卷40339份,其中能够清楚记得过去1周身体活动时间的问卷10086份,数据清洗后获得有效问卷8149份,包括无抑郁症状组5496人(67.44%),有抑郁症状组2653人(32.56%)。调查对象平均年龄(16.70±1.19)岁。无抑郁症状组的中强度身体活动(moderate physical activity,MPA)替代其他所有研究的行为均与CES-D得分呈负相关,高强度身体活动(vigorous physical activity,VPA)替代MPA和SB均与CES-D得分呈正相关;有抑郁症状组的MPA替代步行、SB和SLP均与CES-D得分呈负相关。MPA替代步行、SB和SLP与CES-D得分的负关联,在有抑郁症状组中的强度大于无抑郁症状组。结论职校学生抑郁症状检出率较高,学生MPA替代步行、SB和SLP与CES-D得分呈负相关,有抑郁症状组中的关联大于无抑郁症状组。