大学生手机依赖与焦虑抑郁共病症状的关联

曲杨; 伍晓艳; 陶舒曼; 杨娅娟; 邹立巍; 谢阳; 李婷婷; 张丹; 翟爽; 陶芳标

doi:10.16835/j.cnki.1000-9817.2021.12.020

大学生手机依赖与焦虑抑郁共病症状的关联

doi: 10.16835/j.cnki.1000-9817.2021.12.020

曲杨¹,
伍晓艳^{1, 2, ,},
陶舒曼³,
杨娅娟⁴,
邹立巍¹,
谢阳¹,
李婷婷¹,
张丹¹,
翟爽¹,
陶芳标^{1, 2}

1.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系，合肥 230032
2.
出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室
3.
安徽医科大学第二附属医院肾脏内科
4.
安徽医科大学护理学院

基金项目:

国家自然科学基金 82173542

国家自然科学基金 81773455

国家自然科学基金 81803257

安徽省教育厅2020年度高校优秀人才支持计划重点项目 gxyqZD2020011

详细信息

作者简介:
曲杨(1997-)，女，山东烟台人，在读硕士，主要研究方向为青少年心理健康

通讯作者:
伍晓艳，E-mail：xywu85@126.com

中图分类号: G444 G647.8 B844.2
计量
- 文章访问数: 1016
- HTML全文浏览量: 402
- PDF下载量: 148
- 被引次数: 0
出版历程
- 收稿日期: 2021-04-28
- 修回日期: 2021-06-17
- 网络出版日期: 2021-12-23
- 刊出日期: 2021-12-25

Association between cell phone dependence and anxiety-depression co-morbid symptoms among college students

1.
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei (230032), China

摘要

摘要: 目的描述大学生手机依赖和焦虑抑郁共病症状的流行现况及关联，为促进大学生心理健康发展提供参考依据。方法于2019年4—5月在安徽省合肥市和江西省上饶市2所高校中随机整群抽样1 135名在校大学生进行基线调查，2019年11月对抽样人群进行随访调查，与基线调查匹配后有效人数为1 110人。使用青少年手机使用依赖自评问卷评估大学生手机依赖情况，使用抑郁-焦虑-压力自评量表评估抑郁、焦虑、焦虑抑郁共病症状，使用自编大学生健康相关行为及心理健康问卷报告睡眠时长。结果基线与随访调查中大学生手机依赖检出率分别为24.5%和27.7%，基线调查中焦虑症状、抑郁症状、焦虑抑郁共病症状的检出率分别为28.7%，21.3%和18.4%。二元Logistic回归模型结果显示，手机依赖与大学生基线(OR=5.79，95%CI=4.06~8.24)和随访调查(OR=2.62，95%CI=1.86~3.69)焦虑抑郁共病症状风险均呈正关联(P值均＜0.01)。调节效应分析结果显示，睡眠时长在手机依赖与焦虑抑郁共病症状关联间起调节作用，交互项具有统计学意义(β_基线=0.08，β_随访=0.04，P值均＜0.01)。结论大学生手机依赖可增加抑郁焦虑共病症状的发生风险，睡眠时长可缓解手机依赖对大学生抑郁焦虑共病症状的预测作用。
- 便携式电话 /
- 行为, 成瘾 /
- 焦虑 /
- 抑郁 /
- 回归分析 /
- 学生
Abstract: Objective To describe the prevalence of cell phone dependence and anxiety-depression co-morbidity among college students, and to explore the association between cell phone dependence and anxiety-depression co-morbidity among college students, in order to provide a reference basis for promoting the development of college students' mental health. Methods Using a prospective study design, baseline survey was conducted in April-May 2019 among a random whole-group sample of 1 135 individuals in two universities in Hefei, Anhui Province and Shangrao, Jiangxi Province, and a follow-up survey was conducted in November 2019 among the sampled population, with a valid number of 1 110 individuals after matching with the baseline survey. The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) was used to assess college students' cell phone dependence, and the Depression-Anxiety-Stress Self-Rating Scale (DASS-21) to assess depression, anxiety, and anxiety-depression co-morbidity symptoms, and the self-administered Health-Related Behavior and Mental Health Questionnaire for College Students to report sleep duration. Results The detection rates of cell phone dependence among college students at baseline and follow-up surveys were 24.5% and 27.7%, respectively, and the detection rates of anxiety symptoms, depressive symptoms, and anxiety-depression co-morbidities were 28.7%, 21.3%, and 18.4%, respectively. The results of the binary Logistic regression model showed that cell phone dependence was positively associated with the risk of anxiety-depression co-morbid symptoms among college students at baseline (OR=5.79, 95%CI=4.06-8.24) and after six months of follow-up (OR=2.62, 95%CI=1.86-3.69) (P < 0.01). The results of the moderating effect analysis showed that sleep duration moderated the association between cell phone dependence and anxiety-depression co-morbidities, and the interaction term was statistically significant (β=0.08, 0.04, P < 0.01). Conclusion Cell phone dependence in college students increases the risk of depressive and anxiety co-morbid symptoms, and sleep mitigates effect of cell phone dependence on depressive and anxiety co-morbid symptoms in college students.
- Cellular phone /
- Behavior, addictive /
- Anxiety /
- Depression /
- Regression analysis /
- Students

HTML全文

表 1 基线中不同人口统计学特征大学生在焦虑、抑郁及焦虑抑郁共病症状检出率比较

Table 1. Analysis of anxiety, depression, and anxiety-depression co-morbidity detection rates across demographic characteristics at baseline

人口统计学指标	选项	人数	焦虑症状		抑郁症状		焦虑抑郁共病症状
人口统计学指标	选项	人数	检出人数	χ²值	检出人数	χ²值	检出人数	χ²值
性别	男	419	139(33.2)	6.47^*	114(27.2)	14.22^**	102(24.3)	16.17^**
	女	691	180(26.0)		122(17.7)		102(14.8)
家庭居住地	农村	623	180(28.9)	0.12	134(21.5)	0.30	116(18.6)	0.48
	城镇	324	94(29.0)		70(21.6)		61(18.8)
	市区	163	45(27.6)		32(19.6)		27(16.6)
独生子女	是	260	82(31.5)	1.30	58(22.3)	0.22	49(18.8)	2.78
	否	850	237(28.7)		178(20.9)		155(18.2)
家庭经济条件	差	268	97(36.2)	9.59^*	69(25.7)	4.44	67(25.0)	12.37^*
	中等	785	207(26.4)		157(20.0)		130(16.6)
	好	57	15 (26.3)		10(17.5)		7(12.3)
健康状况	好	655	145(22.1)	46.72^**	112(17.1)	21.96^**	95(14.5)	46.32^**
	一般	411	147(35.8)		106(25.8)		92(22.4)
	差	44	27(61.4)		18(40.9)		17(38.6)
吸烟	没有	1 009	269(26.7)	23.40^**	195(19.3)	24.81^**	165(16.4)	31.18^**
	＞1 d	101	50(49.5)		41(40.6)		39(38.6)
饮酒	没有	855	228(26.7)	7.80^*	165(19.3)	8.57^*	137(16.0)	14.05^*
	＞1 d	255	91(35.7)		71(27.8)		67(26.3)
生活事件	0	320	64(20.0)	16.77^**	47(14.7)	11.61^*	40(12.5)	18.60^**
	≥1	790	235(32.3)		189(23.9)		164(20.8)
注： ()内数据为检出率/%；P＜0.05，*P＜0.01。

下载: 导出CSV

表 2 大学生睡眠时长对手机依赖与焦虑抑郁共病症状关联间的调节效应(n=1 110)

Table 2. Moderating effect of sleep duration on the association between cell phone dependence and co-morbid symptoms among college students(n=1 110)

常量与变量	基线		随访
常量与变量	β值	t值	β值	t值
常量	10.43	32.01^**	9.21	24.27^**
手机依赖	0.85	23.51^**	0.44	10.51^**
睡眠时长	0.72	2.95^*	0.07	0.25
手机依赖×睡眠时长	0.08	4.47^**	0.04	1.99^*
R²值	0.34		0.09
F值	190.37^**		37.93^**
注： P＜0.05，*P＜0.01。

下载: 导出CSV

参考文献(32)

[1]	MA C, ZHOU L, XU W, et al. Associations of physical activity and screen time with suboptimal health status and sleep quality among Chinese college freshmen: a cross-sectional study[J]. PLoS One, 2020, 15(9): e0239429. doi: 10.1371/journal.pone.0239429
[2]	LIU F, ZHOU N, CAO H, et al. Chinese college freshmen's mental health problems and their subsequent help-seeking behaviors: a cohort design (2005-2011)[J]. PLoS One, 2017, 12(10): e0185531. doi: 10.1371/journal.pone.0185531
[3]	KESSLER R C, ANGERMEYER M, ANTHONY J C, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative[J]. World Psychiatry, 2007, 6(3): 168-176. https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsRW5nTmV3UzIwMjEwMzAyEhJQdWJNZWQwMDAwMDEzNTE0NTAaCHpjbGV4a2N1
[4]	耿梦龙, 陶芳标. 儿童内外化行为共病现象及对未来发展的影响[J]. 中国学校卫生, 2018, 39(4): 637-640. doi: 10.16835/j.cnki.1000-9817.2018.04.048 GENG M L, TAO F B. Co-morbidities of internalizing behaviors in children and their impact on future development[J]. Chin J Sch Health, 2018, 39(4): 637-640. doi: 10.16835/j.cnki.1000-9817.2018.04.048
[5]	WASZCZUK M A, ZAVOS H M, GREGORY A M, et al. The phenotypic and genetic structure of depression and anxiety disorder symptoms in childhood, adolescence, and young adulthood[J]. JAMA Psychiatry, 2014, 71(8): 905-916. doi: 10.1001/jamapsychiatry.2014.655
[6]	LI L, LOK G K I, MEI S L, et al. Prevalence of depression and its relationship with quality of life among university students in Macau, Hong Kong and mainland China[J]. Sci Rep, 2020, 10(1): 15798. doi: 10.1038/s41598-020-72458-w
[7]	LAMERS F, VAN OPPEN P, COMIJS HC, et al. Comorbidity patterns of anxiety and depressive disorders in a large cohort study: the Netherlands Study of Depression and Anxiety (NESDA)[J]. J Clin Psychiatry, 2011, 72(3): 341-348. doi: 10.4088/JCP.10m06176blu
[8]	KESSLER R C, MCGONAGLE K A, ZHAO S, et al. Lifetime and 12-month prevalence of DSM-Ⅲ-R psychiatric disorders in the United States. Results from the National Comorbidity Survey[J]. Arch Gen Psychiatry, 1994, 51(1): 8-19. doi: 10.1001/archpsyc.1994.03950010008002
[9]	施慎逊, 张明园, 吴文源, 等. 抑郁症与焦虑障碍共病临床特征研究[J]. 上海精神医学, 2009, 21(4): 198-202. doi: 10.3969/j.issn.1002-0829.2009.04.002 SHI S X, ZHANG M Y, WU W Y, et al. Multi-center study of the clinical features in depression comorbidity with anxiety disorders[J]. Shanghai Arch Psychiatry, 2009, 21(4): 198-202. doi: 10.3969/j.issn.1002-0829.2009.04.002
[10]	KIRCANSKI K, LEMOULT J, ORDAZ S, et al. Investigating the nature of co-occurring depression and anxiety: Comparing diagnostic and dimensional research approaches[J]. J Affect Disord, 2017, 216: 123-135. doi: 10.1016/j.jad.2016.08.006
[11]	师建国. 手机依赖综合征[J]. 临床精神医学杂志, 2009, 19(2): 138-139. http://www.cnki.com.cn/Article/CJFDTotal-LCJS200902045.htm SHI J G. Cell phone dependence syndrome[J]. J Clin Psychiatry Med, 2009, 19(2): 138-139. http://www.cnki.com.cn/Article/CJFDTotal-LCJS200902045.htm
[12]	中国互联网络信息中心. 第46次《中国互联网络发展状况统计报告》[J]. 国家图书馆学刊, 2020, 29(6): 19. China Internet Network Information Center. 46th Statistical Report on the Development of the Internet in China[J]. J National Library Chin, 2020, 29(6): 19.
[13]	EICHENBERG C, SCHOTT M, SCHROIFF A. Problematic smartphone use-comparison of students with and without problematic smartphone use in light of personality[J]. Front Psychiatry, 2021, 28(11): 599241. http://www.researchgate.net/publication/348840886_Problematic_Smartphone_Use-Comparison_of_Students_With_and_Without_Problematic_Smartphone_Use_in_Light_of_Personality
[14]	DEMIRCI K, AKGÖNÜL M, AKPINAR A. Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students[J]. J Behav Addict, 2015, 4(2): 85-92. doi: 10.1556/2006.4.2015.010
[15]	CHATTU V K, MANZAR M D, KUMARY S, et al. The Global Problem of Insufficient Sleep and Its Serious Public Health Implications[J]. Healthcare (Basel), 2018, 7(1): 1. http://www.onacademic.com/detail/journal_1000041695255299_d564.html
[16]	陶舒曼, 付继玲, 王惠, 等. 青少年手机使用依赖自评问卷编制及其在大学生中的应用[J]. 中国学校卫生, 2013, 34(1): 26-29. http://www.cjsh.org.cn/article/id/zgxxws201301009 TAO S M, FU J L, WANG H, et al. Development of a self-assessment questionnaire on adolescent cell phone use dependence and its application among college students[J]. Chin J Sch Health, 2013, 34(1): 26-29. http://www.cjsh.org.cn/article/id/zgxxws201301009
[17]	LOVIBOND P F, LOVIBOND S H. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories[J]. Behav Res Ther, 1995, 33(3): 335-343. doi: 10.1016/0005-7967(94)00075-U
[18]	GOMEZ R, SUMMERS M, SUMMERS A, et al. Depression anxiety stress scales-21: measurement and structural invariance across ratings of men and women[J]. Assessment, 2014, 21(4): 418-426. doi: 10.1177/1073191113514106
[19]	王蜜源, 刘佳, 吴鑫, 等. 近十年中国大学生抑郁症患病率的Meta分析[J]. 海南医学院学报, 2020, 26(9): 686-693, 699. https://d.wanfangdata.com.cn/periodical/hainanyxyxb202009010 WANG M Y, LIU J, WU X, et al. The prevalence of depression among students in Chinese universities over the past decade: a meta-analysis[J]. J Hainan Med Univ, 2020, 26(9): 686-693, 699. https://d.wanfangdata.com.cn/periodical/hainanyxyxb202009010
[20]	王黎恩, 王极盛. 医科大学生的生活事件与焦虑[J]. 中国临床康复, 2006, 10(6): 20-23. http://www.cnki.com.cn/Article/CJFDTotal-XDKF200606007.htm WANG L E, WANG J S. Life events and anxiety in medical university students[J]. Chin J Clin Rehabil, 2006, 10(6): 20-23. http://www.cnki.com.cn/Article/CJFDTotal-XDKF200606007.htm
[21]	BITSIKA V, SHARPLEY CF. Comorbidity of anxiety-depression among Australian university students: implications for student counsellors[J]. Br J Guid Counc, 2012, 40(4): 385-394. doi: 10.1080/03069885.2012.701271
[22]	王若琦, 韦润峰, 张玲童, 等. 医学本科生和硕士研究生焦虑和抑郁共病状态研究[J]. 中国继续医学教育, 2019, 11(18): 57-59. doi: 10.3969/j.issn.1674-9308.2019.18.025 WANG R Q, WEI R F, ZHANG L T, et al. Study on the comorbidity state of anxiety and depression among medical undergraduates and postgraduates[J]. Chin Contin Med Educ, 2019, 11(18): 57-59. doi: 10.3969/j.issn.1674-9308.2019.18.025
[23]	LIU C H, STEVENS C, WONG S H M, et al. The prevalence and predictors of mental health diagnoses and suicide among U.S. college students: implications for addressing disparities in service use[J]. Depress Anxiety, 2019, 36(1): 8-17. doi: 10.1002/da.22830
[24]	ALKHATEEB A, ALBOALI R, ALHARBI W, et al. Smartphone addiction and its complications related to health and daily activities among university students in Saudi Arabia: a multicenter study[J]. J Family Med Prim Care, 2020, 9(7): 3220-3224. doi: 10.4103/jfmpc.jfmpc_1224_19
[25]	HAUG S, CASTRO RP, KWON M, et al. Smartphone use and smartphone addiction among young people in Switzerland[J]. J Behav Addict, 2015, 4(4): 299-307. doi: 10.1556/2006.4.2015.037
[26]	何雯, 夏赟. 大学生手机成瘾与心理需求、手机使用的关系研究[J]. 西南师范大学学报(自然科学版), 2021, 46(2): 105-111. http://qikan.cqvip.com/Qikan/Article/Detail?id=7104085461 HE W, XIA Y. On relationship among college students' mobile phone addiction, psychological needs and mobile phone use[J]. J Southwest Chin Norm Univ (Nat Sci Edi), 2021, 46(2): 105-111. http://qikan.cqvip.com/Qikan/Article/Detail?id=7104085461
[27]	TANG C S K, WU A M S, YAN E C W, et al. Relative risks of Internet-related addictions and mood disturbances among college students: a 7-country/region comparison[J]. Public Health, 2018, 165: 16-25. doi: 10.1016/j.puhe.2018.09.010
[28]	LIU S, WING Y K, HAO Y, et al. The associations of long-time mobile phone use with sleep disturbances and mental distress in technical college students: a prospective cohort study[J]. Sleep, 2019, 42(2): 1-10. http://www.ncbi.nlm.nih.gov/pubmed/30395300
[29]	LI X, BUXTON O M, LEE S, et al. Sleep mediates the association between adolescent screen time and depressive symptoms[J]. Sleep Med, 2019, 57: 51-60. doi: 10.1016/j.sleep.2019.01.029
[30]	LEMOLA S, PERKINSON-GLOOR N, BRAND S, et al. Adolesc-ents' electronic media use at night, sleep disturbance, and depressive symptoms in the smartphone age[J]. J Youth Adolesc, 2015, 44(2): 405-418. doi: 10.1007/s10964-014-0176-x
[31]	JENSEN J L, JONES C R, KARTSONAKI C, et al. Sleep phase delay in cystic fibrosis: a potential new manifestation of cystic fibrosis transmembrane regulator dysfunction[J]. Chest, 2017, 152(2): 386-393. doi: 10.1016/j.chest.2017.03.057
[32]	PAREKH P K, MCCLUNG C A. Circadian mechanisms underlying reward-related neurophysiology and synaptic plasticity[J]. Front Psychiatry, 2016, 6: 187. http://core.ac.uk/download/pdf/82856400.pdf