江西省中小学生视屏时间及行为类型与焦虑抑郁的关联

陈婷; 罗雅凌; 户华雄; 宋孝光; 陈福辉; 范奕; 方晓艳; 朱慧

doi:10.16835/j.cnki.1000-9817.2024077

江西省中小学生视屏时间及行为类型与焦虑抑郁的关联

doi: 10.16835/j.cnki.1000-9817.2024077

1.
江西省疾病预防控制中心公共卫生研究所，南昌 330029
2.
九江市濂溪区疾病预防控制中心办公室

基金项目:

江西省卫生健康委科技计划资助项目 202310075

详细信息

作者简介:
陈婷(1983-)，女，江西高安人，硕士，副主任医师，主要从事学校卫生方面工作

通讯作者:
户华雄，E-mail：281592739@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G444 R179 TN711 G478
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- 被引次数: 0
出版历程
- 收稿日期: 2023-10-19
- 修回日期: 2023-12-11
- 网络出版日期: 2024-03-29
- 刊出日期: 2024-03-25

Correlation between screen time, screen behavior type and anxiety, depression among children and adolescents in Jiangxi Province

1.
Institute of Public Health, Jiangxi Province Center for Disease Control and Prevention, Nanchang (330029), Jiangxi Province, China

摘要

摘要: 目的分析江西省中小学生视屏时间、行为类型与焦虑和抑郁现状及其相关性，为制定有效干预措施提供依据。方法 2020年9—12月，采用分层随机抽样法对江西省11个设区市8 851名中小学生进行问卷调查，分别采用状态-特质焦虑量表(STAI)和流调中心儿童抑郁量表(CES-DC)进行焦虑和抑郁状况调查。单因素分析采用χ²检验、t检验、方差分析，多因素分析采用广义线性模型。结果中小学生上学日和周末每天总视屏时间>2 h的比例分别为4.7%和20.4%。每天总视屏时间[小学：(1.88±0.68)分，初中：(1.96±0.71)分，高中：(2.03±0.80)分]、玩电子游戏时间的加权得分[小学：(1.51±0.64)分，初中：(1.62±0.69)分，高中：(1.68±0.75)分]随着学段增加均呈上升趋势(F值分别为31.48，42.13)，男生(1.97±0.74，1.66±0.72)均高于女生(1.93±0.72，1.53±0.66)(t值分别为2.48，9.07)(P值均＜0.05)。中小学生状态焦虑、特质焦虑平均得分为(42.20±9.05，40.65±9.85)分，随着学段的增长均呈上升趋势(F值分别为168.12，241.98)，女生均高于男生(t值分别为6.63，8.48)(P值均＜0.01)。抑郁平均得分为(11.99±11.00)分，小学生低于初中生和高中生，女生高于男生(F/t值分别为136.42，6.85，P值均＜0.01)。上学日，随着每天总视屏时间和玩电子游戏时间的增加，中小学生出现状态焦虑、特质焦虑和抑郁的风险均增加(OR=6.70~818.98，P值均＜0.01)。在周末，中小学生每天总视屏时间>1~2 h可降低状态焦虑的发生风险(OR=0.30)，每天玩电子游戏>2 h出现特质焦虑的风险是无视屏行为的2.50倍(OR=2.50)，每天总视屏时间>2 h出现抑郁的风险是无视屏行为的3.15倍(OR=3.15)；每天玩电子游戏时间>0~1，>1~2，>2 h出现抑郁的风险分别是无视屏行为的2.14，2.50，4.90倍(OR值分别为2.14，2.50，4.90)(P值均＜0.05)。结论江西省中小学生视屏行为与焦虑、抑郁的风险正性相关，但周末每天总视屏时间>1~2 h与状态焦虑呈负相关。应尽量控制中小学生视屏时间，以降低焦虑和抑郁的发生风险。
- 注视，眼 /
- 时间 /
- 行为 /
- 焦虑 /
- 抑郁 /
- 学生
Abstract: Objective To analyze the status and correlation between screen time, screen behavior type, and anxiety, depression among children and adolescents in Jiangxi Province, so as to provide a basis for effective intervention measures. Methods Using the method of stratified random sampling, 8 851 primary and secondary school students in 11 districts of Jiangxi Province were investigated by questionnaire during September to December in 2020. Anxiety and depression status were investigated using the State Trait Anxiety Inventory (STAI) and the Center for Epidemiological Studies Depression Scale for Children(CES-DC), respectively. Single factor analysis using χ²-test, t-test, analysis of variance, and multivariate analysis using generalized linear models. Results On school days and weekends, 4.7% and 20.4% of primary and secondary school students in Jiangxi Province had a total screen time of over 2 hours per day, respectively. The weighted scores of the total screen time (primary school students: 1.88±0.68, junior middle school students: 1.96±0.71, high school students: 2.03±0.80) and time spent for playing video games (primary school students: 1.51±0.64, junior middle school students: 1.62±0.69, high school students: 1.68±0.75) daily showed an upward trend with the increase of educational stage (F=31.48, 42.13), and with significantly higher in boys (1.97±0.74, 1.66±0.72) than girls (1.93±0.72, 1.53±0.66)(t=2.48, 9.07)(P < 0.05). The average scores of state anxiety and trait anxiety were (42.20±9.05) and (40.65±9.85), which showed an upward trend with the increase of educational stage (F=168.12, 241.98), and were higher in girls than boys (t=6.63, 8.48)(P < 0.01). The average score of depression was (11.99±11.00), which was lower in elementary school students than middle school students and high school students (F=136.42), with significantly higher in girls (t=6.85)(P < 0.01). On school days, with the increase of total screen time and time spent for playing video games daily, the risk of state anxiety, trait anxiety, and depression among primary and secondary school students significantly increased (OR=6.70-818.98, P < 0.01). On weekends, among primary and secondary school students, the total screen time of >1-2 hours daily reduced the risk of state anxiety (OR=0.30). The risk of developing trait anxiety among students playing video games for more than 2 hours daily was 2.50 times higher than those without screen behavior (OR=2.50). The risk of developing depression with a total screen time of more than 2 hours daily was 3.15 times higher those whithout screen behavior (OR=3.15). The risk of developing depression among students playing video games >0-1, >1-2, >2 h daily was 2.14, 2.50, 4.90 times that of those without screen behaviors (OR=2.14, 2.50, 4.90), and showed an upward trend with the increase of educational stage (P < 0.05). Conclusions Screen behaviors of primary and middle school students in Jiangxi Province are positively associated with the risk of anxiety and depression, but the total daily video time of >1-2 h on weekends was negatively associated with state anxiety. It is necessary to control the screen time as much as possible and reduce the risk of anxiety and depression.
- Fixation, ocular /
- Time /
- Behavior /
- Anxiety /
- Depression /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 中小学生上学日和周末不同视屏行为时间构成比较

Table 1. Comparison of different video behaviors time of primary and secondary school students between school days and weekends

时间	人数	每天视屏时间				每天玩电子游戏时间
时间	人数	0 h	>0~1 h	>1~2 h	>2 h	0 h	>0~1 h	>1~2 h	>2 h
上学日	8 851	3 605(40.7)	4 229(47.8)	605(6.8)	412(4.7)	5 758(65.1)	2 483(28.1)	367(4.1)	243(2.7)
周末	8 851	1 346(15.2)	4 059(45.9)	1 640(18.5)	1 806(20.4)	3 328(37.6)	3 428(38.7)	1 113(12.6)	982(11.1)
χ²值		2 955.90				3 761.07
P值		＜0.01				＜0.01
注： ()内数字为构成比/%。

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表 2 不同视屏时间中小学生焦虑、抑郁得分比较

Table 2. Comparison of anxiety and depression scores of primary and middle school students in different video time

视屏时间	选项	人数	状态焦虑			特质焦虑			抑郁
视屏时间	选项	人数	x±s	F值	P值	x±s	F值	P值	x±s	F值	P值
上学日每天总视屏时间/h	0	3 605	39.27±9.96	65.17	＜0.01	40.78±9.01	78.50	＜0.01	10.05±10.21	104.57	＜0.01
	>0~1	4 229	41.08±9.60			42.66±8.86			12.60±10.82
	>1~2	605	43.08±9.60			44.65±8.69			15.14±11.64
	>2	412	44.87±9.50			46.33±9.43			18.15±14.06
周末每天总视屏时间/h	0	1 346	40.01±10.20	21.04	＜0.01	41.09±9.00	39.44	＜0.01	10.24±10.85	40.53	＜0.01
	>0~1	4 059	40.33±9.67			41.75±8.82			11.57±10.73
	>1~2	1 640	40.20±9.57			42.04±8.89			11.93±10.78
	>2	1 806	42.28±10.07			44.18±9.47			14.30±11.54
上学日每天玩电子游戏时间/h	0	5 758	39.40±9.84	102.58	＜0.01	41.02±9.04	108.34	＜0.01	10.43±10.06	135.87	＜0.01
	>0~1	2 483	42.55±9.42			43.94±8.51			14.20±11.55
	>1~2	367	44.29±9.42			45.74±9.22			17.30±13.63
	>2	243	45.65±9.14			47.02±8.89			18.64±13.17
周末每天玩电子游戏时间/h	0	3 328	39.46±9.98	40.41	＜0.01	41.05±9.10	48.21	＜0.01	10.22±10.20	66.58	＜0.01
	>0~1	3 428	40.90±9.67			42.36±8.83			12.29±10.94
	>1~2	7 113	41.23±9.54			42.85±8.77			13.54±11.52
	>2	982	43.19±9.82			44.82±9.34			15.21±12.09

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表 3 中小学生视屏行为与焦虑、抑郁广义线性模型分析(n=8 851)

Table 3. Generalized linear model analysis of screen-based sedentary behaviors, anxiety, and depression in primary and secondary school students(n=8 851)

自变量	选项	状态焦虑		特质焦虑		抑郁
自变量	选项	B值	OR值(95%CI)	B值	OR值(95%CI)	B值	OR值(95%CI)
上学日每天总视屏时间/h	>0~1	2.01	7.45(4.74~11.69)^**	1.90	6.70(4.44~10.10)^**	2.48	11.92(7.19~19.76)^**
	>1~2	3.70	40.60(16.95~97.27)^**	3.29	26.91(12.14~59.61)^**	4.51	90.64(34.03~241.42)^**
	>2	4.61	100.74(35.93~282.46)^**	4.15	63.22(24.73~161.66)^**	6.71	818.98(257.75~2 602.18)^**
周末每天总视屏时间/h	>0~1	-0.47	0.63(0.34~1.16)	-0.10	0.91(0.52~1.59)	0.27	1.32(0.66~2.62)
	>1~2	-1.20	0.30(0.14~0.62)^**	-0.42	0.66(0.34~1.28)	-0.08	0.93(0.41~2.10)
	>2	-0.25	0.78(0.37~1.65)	0.64	1.89(0.96~3.74)	1.15	3.15(1.36~7.28)^*
上学日每天玩电子游戏时间/h	>0~1	2.87	17.57(10.70~28.84)^**	2.64	13.99(8.91~21.97)^**	3.18	24.11(13.83~42.04)^**
	>1~2	4.28	72.53(25.33~207.69)^**	4.02	55.67(21.34~145.19)^**	5.72	305.85(93.95~995.70)^**
	>2	4.84	126.77(33.90~474.12)^**	4.51	90.56(27.22~301.26)^**	6.65	771.39(175.61~3 388.54)^**
周末每天玩电子游戏时间/h	>0~1	0.32	1.38(0.85~2.25)	0.33	1.40(0.89~2.18)	0.76	2.14(1.24~3.71)^**
	>1~2	-0.22	0.80(0.40~1.61)	-0.04	0.96(0.51~1.82)	0.92	2.50(1.14~5.47)^**
	>2	0.73	2.08(0.96~4.51)	0.92	2.50(1.24~5.06)^*	1.59	4.90(2.06~11.68)^**
注： P＜0.05，*P＜0.01。

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