Abstract：Objective To study the prevalence of depressive symptoms and its main risk factors among middle school students in Changsha City during the SARS-Cov-2 epidemic. Methods A cross-sectional questionnaire survey was conducted among 6,307 middle school students selected by stratified cluster random sampling. Results The mean score of the Center for Epidemiological Studies Depression Scale (CES-D) was (11.19±8.88). The number of students with depressive symptoms was 978, with the detection rate being 15.51% (95%CI:14.61-16.40). Multivariate logistic regression model analysis showed that female students, vocational high school, residential schools, single-parent or reorganized families, insufficient sleep time per day, sitting for long periods of time every day, lack of physical exercise, irregular breakfast behavior, suffering from domestic violence, suffering from school bullying, attempt at smoking, alcohol consumption, other substance addiction and Internet addiction behavior were all risk factors for depression in the middle school students (all P<0.05). Conclusion The middle school students’ depressive symptoms are correlated with schools, family environment, lifestyle, injury-related behaviors and addictive behavior; and hence, corresponding measures should be taken to enhance psychological interventions for students with depressive symptoms.
奉琪, 陈艳, 吴鑫. 长沙市中学生抑郁症状流行状况及其影响因素分析[J]. 实用预防医学, 2023, 30(8): 949-954.
FENG Qi, CHEN Yan, WU Xin. Prevalence of depressive symptoms and its influencing factors among middle school students in Changsha City. , 2023, 30(8): 949-954.
[1] GBD 2019 Mental Disorders Collaborators. Global,regional,and national burden of 12 mental disorders in 204 countries and territories,1990-2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet Psychiatry,2022,9(2):137-150. [2] Nanayakkara S,Misch D,Chang L,et al. Depression and exposure to suicide predict suicide attempt[J]. Depress Anxiety,2013,30(10):991-996. [3] WHO. Guidelines on mental health promotive and preventive interventions for adolescents[EB/OL]. (2021-09-28)[2022-08-31]. https://www.who.int/publications/i/item/guidelines-on-mental-health-promotive-and-preventive-interventions-for-adolescents. [4] COVID-19 Mental Disorders Collaborators. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic[J]. Lancet,2021,398(10312):1700-1712. [5] UNICEF. The State of the World's Children 2021—On My Mind: promoting,protecting and caring for children’s mental health[EB/OL]. (2021-11-10)[2022-08-31]. https://www.unicef.org/reports/state-worlds-children-2021. [6] Zhang Y,Bao X,Yan J,et al. Anxiety and depression in Chinese students during the COVID-19 pandemic: a meta-analysis[J]. Front Public Health,2021,9:697642. [7] Costello EJ,Erkanli A,Federman E,et al. Development of psychiatric comorbidity with substance abuse in adolescents: effects of timing and sex[J]. J Clin Child Psychol,1999,28(3):298-311. [8] Schlack R,Petermann F. Prevalence and gender patterns of mental health problems in German youth with experience of violence: the KiGGS study[J]. BMC Public Health,2013,13: 628. [9] Stice E, Ragan J, Randall P. Prospective relations between social support and depression: differential direction of effects for parent and peer support?[J]. J Abnorm Psychol,2004,113(1):155-159. [10] 勉丽娜,陈辉,韩霄,等. 北京市东城区中学生抑郁状况及影响因素调查研究[J]. 中国预防医学杂志,2019,20(8):724-728. [11] 赵雪,杨林胜,陈明春,等. 安徽省长丰县中小学生抑郁症状及其相关因素两年纵向研究[J]. 中华流行病学杂志,2014,35(5):505-509. [12] Radloff LS. The CES-D scale A self-report depression scale for research in the general population[J]. Appl Psych Meas,1977,1(3):385-401. [13] 张明园. 精神科评定量表手册[M]. 长沙: 湖南科学技术出版社,1998:27-31. [14] 季成叶. 中国青少年健康相关/危险行为调查综合报告2005[M]. 北京:北京大学医学出版社,2007:97-98. [15] 徐斐,王晨阳,李解权,等. 南京地区中学生抑郁障碍及其影响因素的流行病学研究[J]. 中华流行病学杂志,2006,27(4):324-327. [16] 陈咏梅,范明明. 开封市中学生抑郁状况及影响因素分析[J]. 中国学校卫生,2021,42(10):1520-1523. [17] 傅小兰,张侃,陈雪峰,等. 中国国民心理健康发展报告(2019—2020)[R].北京:社会科学文献出版社,2021. [18] Demir T,Karacetin G,Demir DE,et al. Epidemiology of depression in an urban population of Turkish children and adolescents[J]. J Affect Disord,2011,134(1/3):168-176. [19] Sarkar S,Praharaj S. Depressive disorders in school children of suburban India: an epidemiological study[J]. Soc Psychiatry Psychiatr Epidemiol,2012,47(5):783-788. [20] Bitsko RH, Holbrook JR, Ghandour RM, et al. Epidemiology and impact of health care provider-diagnosed anxiety and depression among US children[J]. J Dev Behav Pediatr,2018,39(5):395-403. [21] 朱伟昂.长沙市中学生抑郁障碍实施综合干预探讨[J].医学信息,2009,22(6):975-977. [22] 马静,禹顺英,梁珊,等. 长沙市中学生抑郁伴/不伴焦虑的调查[J]. 中国临床心理学杂志,2013,21(5):708-712. [23] 刘福荣,宋晓琴,尚小平,等. 中学生抑郁症状检出率的meta分析[J]. 中国心理卫生杂志,2020,34(2):123-128. [24] 刘贤臣,唐茂芹. SDS和CES-D对大学生抑郁症状评定结果的比较[J]. 中国心理卫生杂志,1995,9(1):19-20. [25] 汪耿夫,王秀秀,方玉,等. 青少年传统欺凌,网络欺凌与抑郁症状的相关性研究[J]. 中华预防医学杂志,2015,49(8):722-727. [26] Zhou M,Bian B,Zhu W,et al. A half century of research on childhood and adolescent depression: science mapping the literature,1970 to 2019[J]. Int J Environ Res Public Health,2021,18(18):9524. [27] 苏林雁,高雪屏,金宇,等. 小学生焦虑抑郁共存的现状调查[J]. 中国心理卫生杂志,2006,20(1):1-4. [28] 高青,吴明,叶茜雯,等. 辽宁省中学生抑郁现况及影响因素分析[J]. 中国学校卫生,2020,41(9):1362-1364. [29] Salk RH,Hyde JS,Abramson LY. Gender differences in depression in representative national samples: meta-analyses of diagnoses and symptoms[J]. Psychol Bull,2017,143(8):783-822. [30] 汪小斌,汪俊华,陈雄. 贵州省中学生抑郁影响因素结构方程模型分析[J]. 中国学校卫生,2018,39(12):1818-1820. [31] 何健,孙经,李凤娟,等. 河南省住校中学生心理健康现况分析[J]. 中国公共卫生,2017,33(3):437-440. [32] Lifei W,Zheng Z. Depressive symptoms among children and adolescents in western China: an epidemiological survey of prevalence and correlates[J]. Psychiatry Res,2016,246:267-274. [33] Hoare E,Milton K,Foster C,et al. The associations between sedentary behaviour and mental health among adolescents: a systematic review[J]. Int J Behav Nutr Phys Act,2016,13(1):108. [34] Goldfield GS,Henderson K,Buchholz A,et al. Physical activity and psychological adjustment in adolescents[J]. J Phys Act Health,2011,8(2):157-163. [35] 邓欣,马明坤,黄柳倩. 广西壮族大学生锻炼与睡眠的交互作用及其对心理健康影响[J]. 中国学校卫生,2018,39(2):277-280. [36] 曹慧,钱青文,孙莹,等. 安徽省蚌埠市初中生体力活动现状及其与抑郁症状、学校生活满意度的关联研究[J]. 中华流行病学杂志,2012,33(2):154-159. [37] Yen KT, Cherng S. Secondary prevention of depressive prodrome in adolescents: before and after attending a jogging program on campus[J]. Int J Environ Res Public Health,2020,17(21):7705. [38] Ferrer-Cascales R,Sánchez-Sansegundo M,Ruiz-Robledillo N,et al. Eat or skip breakfast? The important role of breakfast quality for health-related quality of life, stress and depression in Spanish adolescents[J]. Int J Environ Res Public Health,2018,15(8):1781. [39] Bond L, Toumbourou JW, Thomas L, et al. Individual, family, school, and community risk and protective factors for depressive symptoms in adolescents: a comparison of risk profiles for substance use and depressive symptoms[J]. Prev Sci,2005,6(2):73-88. [40] 金凤,刁华,蒲杨,等. 重庆市中学生传统欺凌,网络欺凌与自杀相关心理行为关系[J]. 中国公共卫生,2022,38(1):39-46. [41] Brunstein Klomek A, Marrocco F, Kleinman M, et al. Bullying, depression, and suicidality in adolescents[J]. J Am Acad Child Adolesc Psychiatry,2007,46(1):40-49. [42] 赵一菊,王声湧. 治理校园欺凌刻不容缓[J]. 中华流行病学杂志,2017,38(3):277-279. [43] 刘小群,杨孟思,彭畅,等. 校园欺凌中不同角色中学生的焦虑抑郁情绪[J]. 中国心理卫生杂志,2021,35(6):475-481. [44] 贺万静,蔡云. 毕节市中学生抑郁症状与遭受校园欺凌分析[J]. 预防医学情报杂志,2021,37(4):539-544,552. [45] 王秀希,王雪,李清华. 中学生家庭暴力人际信任与心理健康问题的关系[J]. 中国学校卫生,2014,35(9):1401-1403. [46] Rodman AM, Jenness JL, Weissman DG, et al. Neurobiological markers of resilience to depression and anxiety following childhood maltreatment: the role of neural circuits supporting the cognitive control of emotion[J]. Biol Psychiatry,2019,86(6):464-473. [47] Ohannessian CM, Vannucci A, Lincoln CR, et al. Self-competence and depressive symptoms in middle-late adolescence: disentangling the direction of effect[J]. J Res Adolesc,2019,29(3):736-751. [48] 海波,沈蕙,杨海兵,等.苏州市中学生抑郁症状现况及影响因素调查[J].实用预防医学,2022,29(4):463-466. [49] 余小东,余金聪,吴清峰,等. 5 935名中等职业学校学生抑郁、焦虑和压力与成瘾物质使用行为的关系研究[J]. 中华预防医学杂志,2017,51(3):226-231. [50] 郎艳,贾福军,李恒芬,等. 网络成瘾初中生焦虑和抑郁及其共存的现状调查[J]. 中国行为医学科学,2008,17(6):504-505.
2023, Vol. 30 
