LI Fengjuan, Xu Fengming, LIU Jingjing, WANG Xu, WANG Yanxin, GUO Dacheng, ZHANG Shufang, WANG Liru
Objective To investigate the prevalence of addictive substance use, depressive symptoms, anxiety symptoms, and their comorbidity among middle school students in Henan Province, to explore the associations of addictive substance use with depressive and anxiety symptoms so as to provide a basis for promoting the students’ mental health. Methods A total of 163,544 middle school students were selected through stratified random cluster sampling across 158 counties and districts in Henan Province from September to November 2024. χ2 test and logistic regression were employed to analyze the associations of addictive substance use with depressive and anxiety symptoms, and their comorbidity. Results The addictive substance use rate among the 163,544 middle school students in Henan Province in 2024 was 24.24%, with the highest detection rate for middle school students who had ever consumed alcohol, reaching 17.26%. The detection rates for depressive symptoms, anxiety symptoms and comorbidity of depressive and anxiety symptoms were 24.09%, 7.41% and 6.74% respectively. The detection rates of depressive symptoms, anxiety symptoms and their comorbidity among middle school students who had ever tried smoking (47.07%, 17.71%,16.72%), were current smokers (48.02%, 20.12%, 19.19%), had ever drunk alcohol (43.17%, 15.16%, 14.26%), had used inhalable solvents (41.31%, 18.99%, 18.38%), had used cough syrup (38.54%, 14.23%, 13.40%), had used sedative-hypnotic drugs (60.66%, 33.14%, 32.30%), and had used other addictive substances (47.95%, 20.36%, 19.01%) were all higher than those of non-users (P<0.05). The feature importance ranking of variables from logistic regression indicated that sedative-hypnotic drug use (OR=3.95, 95%CI: 3.53-4.42), having ever consumed alcohol (OR=2.42, 95%CI: 2.31-2.53), and other addictive substance use (OR=1.58, 95%CI: 1.45-1.72) were the top three risk factors for the comorbidity of depressive-anxiety symptoms. Addictive substance use was associated with depressive symptoms (OR=3.05, 95%CI: 2.97-3.13), anxiety symptoms (OR=3.31, 95%CI: 3.18-3.44) and their comorbidity (OR=3.53, 95%CI: 3.38-3.67). Compared with the non-users, students with addictive substance use, including male students (OR=3.52, 95%CI: 3.31-3.74), female students (OR=3.87, 95%CI: 3.67-4.09), junior middle school students (OR=4.11, 95%CI: 3.88-4.36), regular high school students (OR=2.46, 95%CI: 2.33-2.61), vocational high school students (OR=2.24, 95%CI: 1.91-2.61), students from normal families (OR=3.28, 95%CI: 3.13-3.44), and students from non-normal families (OR=3.05, 95%CI: 2.84-3.26), showed increased risks of comorbid depression and anxiety (P<0.05). Conclusion Addictive substance use among the middle school students is closely related to depressive symptoms, anxiety symptoms, and their comorbidity. Multiple measures should be taken to reduce addictive substance use, thereby promoting mental health among the middle school students.
