Effects of learning and lifestyle behaviors during home confinement on depressive and anxiety symptoms among primary school students
-
摘要:
目的 了解小学生居家学习后心理健康状况的动态变化，探索居家学习生活方式对学龄期儿童心理健康状况的影响，为儿童心理健康干预提供依据。 方法 研究对象来自“同济心理健康队列”，通过方便抽样的方法抽取武汉市2所小学全体二至五年级小学生。第一阶段(T1)于2020年6月居家学习期间通过网络进行问卷调查，共回收有效问卷2 588份；第二阶段(T2)于2020年12月学校重新开放后通过向学校发送纸质问卷，成功随访2 424名小学生。将儿童2次调查的抑郁、焦虑症状结果分别结合起来对儿童的心理结局进行分类。采用无序多分类Logistic回归估计居家学习生活方式与小学生心理症状变化的关联。 结果 T1时小学生抑郁症状检出率为28.9%，焦虑症状检出率为21.0%；T2时抑郁症状检出率为35.6%，焦虑症状检出率为30.6%。小学生抑郁、焦虑症状的加重和持续与其居家学习生活方式存在一定的关联。上课集中精力(OR=0.63，95%CI=0.45~0.89)、与老师频繁互动(OR=0.74，95%CI=0.57~0.95)、居家期间参加体育锻炼(OR=0.60，95%CI=0.41~0.87)与小学生抑郁症状加重或持续呈负相关。玩电子游戏时长(OR=1.15，95%CI=1.06~1.24)、担心感染新冠病毒(OR=1.83，95%CI=1.39~2.42)与小学生焦虑呈正相关。男生(OR值分别为0.70，0.63)比女生更不容易受到抑郁、焦虑症状的困扰。 结论 小学生结束居家隔离回归学校后，抑郁、焦虑症状检出率升高，居家学习生活方式对小学生抑郁、焦虑症状存在一定的影响。应动态关注学龄期儿童的心理健康状况，及时采取合理的干预措施。 Abstract:Objective To examine the changes of depressive and anxiety symptoms in school-aged children during home confinement and to identify possible influence of learning and lifestyle behaviors on mental health changes. Methods The population of this study were obtained from the "Tongji Mental Health Cohort". Two primary schools in Wuhan were selected through cluster sampling and students in grade 2-5 were surveyed. This study was divided into two stages. In the first stage (T1=during home-learning), a total of 2 588 valid questionnaires were collected. In the second phase (T2=during school-learning), 2 424 children were followed up successfully. Combining the results of the depression and anxiety symptoms of the two surveys of children respectively to classify the children's psychological outcomes. Association between home-learning and lifestyle behaviors with the change of psychological symptoms in school-aged children were estimated by disordered multi-classification Logistic regression. Results The prevalence of depressive and anxiety symptoms were 28.9% and 21.0% in school-aged children at T1, 35.6% and 30.6% at T2, respectively. The aggravation and persistence of depressive and anxiety symptoms in children were partly related to their home-learning and lifestyle behaviors. Concentration in class(OR=0.63, 95%CI=0.45-0.89), frequent interaction with teachers (OR=0.74, 95%CI=0.57-0.95), participation in physical exercise at home (OR=0.60, 95%CI=0.41-0.87) was negatively associated with depressive symptoms in children. Time spent on playing video games (OR=1.15, 95%CI=1.06-1.24) and fear of infection with coronavirus disease 2019 (OR=1.83, 95%CI=1.39-2.42) were positively associated with anxiety in children. Boys(OR=0.70, 0.63) were more likely to suffer from depression and anxiety symptoms than girls. Conclusion The prevalence of depressive and anxiety symptoms among school-aged children increased when they went back to school after home confinement, suggesting more attention are needed for mental health intervention among school-aged children. -
Key words:
- Life style /
- Depression /
- Anxiety /
- Regression analysis /
- Mental health /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。2) 向真与邹丽为共同第一作者。 -
表 1 居家学习生活方式对小学生抑郁症状变化影响的无序多分类Logistic回归分析[n=2 424，OR值(OR值95%CI)]
Table 1. Disordering multi-classification Logistic regression analysis of the effects of learning and life styles during home confinement on changes in depressive symptoms of school-aged children[n=2 424, OR (OR 95%CI)]
自变量 选项 症状缓解组 症状加重组 症状持续组 年级 二 0.74(0.53~1.03) 0.84(0.60~1.16) 0.70(0.48~1.02) 三 0.83(0.61~1.13) 1.25(0.94~1.68) 0.97(0.69~1.36) 四 0.86(0.63~1.16) 0.85(0.62~1.16) 0.89(0.63~1.25) 性别 男 1.12(0.90~1.41) 0.88(0.71~1.09) 0.70(0.55~0.90)* 上课精力集中状况 十分认真 1.12(0.85~1.48) 0.67(0.49~0.91)* 0.63(0.45~0.89)* 与老师互动频率 频繁 0.97(0.76~1.24) 0.74(0.57~0.95)* 0.95(0.71~1.25)* 作业完成情况 及时完成 0.93(0.71~1.22) 0.85(0.66~1.09) 0.84(0.62~1.12) 上网课后考试成绩变化 一致或更高 0.78(0.61~1.00)* 0.75(0.60~0.95) 0.96(0.73~1.25) 玩电子游戏时长 1.05(0.98~1.13) 1.14(1.07~1.21)* 1.12(1.04~1.20)* 居家学习期间参加体育锻炼 5.32(2.27~12.46)* 0.60(0.41~0.87)* 1.73(0.96~3.12) 注：* P < 0.05；自变量分别以五年级、女生、上课精力集中状况中走神或看情况、与老师互动频率为从不或偶尔、作业完成情况为其他情况、上网课后考试成绩变化为未考试或更低、居家学习期间不参加体育锻炼作为参照，因变量以无症状组为参考；玩电子游戏时长为连续型变量。 
下载: 导出CSV
表 2 居家学习生活方式对小学生焦虑症状变化影响的无序多分类Logistic回归分析[n=2 424，OR值(OR值95%CI)]
Table 2. Disordering multi-classification Logistic regression analysis of the effects of learning and life styles during home confinement on changes in anxiety symptoms of school-aged children[n=2 424, OR (OR 95%CI)]
自变量 选项 症状缓解组 症状加重组 症状持续组 年级 二 0.53(0.33~0.84)* 1.81(1.27~2.58)* 0.59(0.38~0.91)* 三 0.84(0.57~1.26) 2.04(1.46~2.86) 0.93(0.64~1.34) 四 0.70(0.47~1.06) 1.41(0.99~2.00) 0.93(0.65~1.34) 性别 男 0.82(0.60~1.11) 0.57(0.45~0.71)* 0.63(0.48~0.82)* 上课精力集中状况 十分认真 0.70(0.46~1.07) 0.71(0.52~0.97)* 0.43(0.29~0.65)* 与老师互动频率 频繁 0.74(0.52~1.07) 0.86(0.66~1.12) 0.88(0.65~1.21)* 作业完成情况 及时完成 0.73(0.52~1.03) 0.84(0.65~1.10) 1.15(0.84~1.60) 玩电子游戏时长 1.15(1.06~1.24)* 1.14(1.07~1.22)* 1.16(1.07~1.25)* 会担心自己感染上新型冠状病毒 1.86(1.36~2.53)* 0.97(0.77~1.22) 1.83(1.39~2.42)* 居家学习期间参加体育锻炼 0.82(0.47~1.44) 1.06(0.65~1.71) 0.67(0.41~1.10) 注：* P < 0.05；自变量分别以五年级、女生、上课精力集中状况中走神或看情况、与老师互动频率为从不或偶尔、作业完成情况为其他情况、不担心自己感染上新型冠状病毒、居家学习期间不参加体育锻炼作为参照，因变量以无症状组为参考；玩电子游戏时长为连续型变量。
下载: 导出CSV
-
[1] 季成叶. 儿童少年卫生学[M]. 北京: 人民卫生出版社, 2012.JI C Y. Children and adolescent health[M]. Beijing: People's Medical Publishing House, 2012. [2] 芮秀文. 苏州市中小学生心理健康现状与影响因素研究[D]. 苏州: 苏州大学, 2006.RUI X W. A study on the mental health status of primary and middle school students in Suzhou and the effect factors of mental health[D]. Suzhou: Soochow University, 2006. [3] 徐学俊. 中小学生心理健康状况调查研究[J]. 吉林教育科学, 1998(2): 6-8. https://www.cnki.com.cn/Article/CJFDTOTAL-JLJK802.001.htmXU X J. Investigation on mental health status of primary and middle school students[J]. Jilin Educ Sci, 1998(2): 6-8. https://www.cnki.com.cn/Article/CJFDTOTAL-JLJK802.001.htm [4] 罗伟. 壮族地区中小学生心理健康状况[J]. 中国健康心理学杂志, 2013, 21(10): 1549-1552. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201310048.htmLUO W. Mental health status of primary and middle-school students in the Zhuang Nationality region[J]. Chin J Health Psychol, 2013, 21(10): 1549-1552. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201310048.htm [5] 傅小兰, 张侃, 陈雪峰, 等. 中国国民心理健康发展报告[M]. 北京: 社会科学文献出版社, 2019.FU X L, ZHANG K, CHEN X F, et al. Chinese national mental health development report[M]. Beijing: Social Sciences Academic Press, 2019. [6] QIN Z, SHI L, XUE Y, et al. Prevalence and risk factors associated with self-reported psychological distress among children and adolescents during the COVID-19 pandemic in China[J]. JAMA Netw Open, 2021, 4(1): e2035487. doi: 10.1001/jamanetworkopen.2020.35487 [7] SHEN K, YANG Y, WANG T, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement[J]. World J Pediatr, 2020, 16(3): 223-231. doi: 10.1007/s12519-020-00343-7 [8] SHEN K L, YANG Y H, JIANG R M, et al. Updated diagnosis, treatment and prevention of COVID-19 in children: experts' consensus statement (condensed version of the second edition)[J]. World J Pediatr, 2020, 16(3): 232-239. doi: 10.1007/s12519-020-00362-4 [9] SINGH S, ROY D, SINHA K, et al. Impact of COVID-19 and lockdown on mental health of children and adolescents: a narrative review with recommendations[J]. Psychiatry Res, 2020, 293: 113429. doi: 10.1016/j.psychres.2020.113429 [10] LIU J J, BAO Y, HUANG X, et al. Mental health considerations for children quarantined because of COVID-19[J]. Lancet Child Adolesc Health, 2020, 4(5): 347-349. doi: 10.1016/S2352-4642(20)30096-1 [11] WADE M, PRIME H, BROWNE D T. Why we need longitudinal mental health research with children and youth during (and after) the COVID-19 pandemic[J]. Psychiatry Res, 2020, 290: 113143. doi: 10.1016/j.psychres.2020.113143 [12] ALLGAIER A K, FRUHE B, PIETSCH K, et al. Is the children's depression inventory short version a valid screening tool in pediatric care? A comparison to its full-length version[J]. J Psychosom Res, 2012, 73(5): 369-374. doi: 10.1016/j.jpsychores.2012.08.016 [13] LI J, ZHANG W, CHEN W, et al. Applications of the Chinese version of the primary care PTSD screen for DSM-5 (PC-PTSD-5) for children[J]. J Affect Disord, 2019, 254: 109-114. doi: 10.1016/j.jad.2019.05.021 [14] DE LA VEGA R, RACINE M, SANCHEZ-RODRIGUEZ E, et al. Psychometric properties of the short form of the Children's Depression Inventory (CDI-S) in young people with physical disabilities[J]. J Psychosom Res, 2016, 90: 57-61. doi: 10.1016/j.jpsychores.2016.09.007 [15] 王凯. 儿童焦虑性情绪障碍筛查表的中国城市常模(英文)[J]. 中国临床康复, 2005, 9(4): 254-256. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF200504115.htmWANG K. Chinese urban norm for screening anxiety related emotional disorders in children(English)[J]. Chin J Clin Rehabil, 2005, 9(4): 254-256. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF200504115.htm [16] SU L, WANG K, FAN F, et al. Reliability and validity of the screen for child anxiety related emotional disorders (SCARED) in Chinese children[J]. J Anx Disord, 2008, 22(4): 612-621. doi: 10.1016/j.janxdis.2007.05.011 [17] RAO W W, XU D D, CAO X L, et al. Prevalence of depressive symptoms in children and adolescents in China: a meta-analysis of observational studies[J]. Psychiatry Res, 2019, 272: 790-796. doi: 10.1016/j.psychres.2018.12.133 [18] 管玥, 周红伟. 小学生睡眠质量与焦虑情绪的现状及关系研究[J]. 中国社会医学杂志, 2020, 37(4): 382-385. doi: 10.3969/j.issn.1673-5625.2020.04.013GUAN Y, ZHOU H W. A study on the status and relationship between sleep quality and anxiety among school-aged children[J]. Chin J Soc Med, 2020, 37(4): 382-385. doi: 10.3969/j.issn.1673-5625.2020.04.013 [19] DUAN L, ZHU G. Psychological interventions for people affected by the COVID-19 epidemic[J]. Lancet Psychiatry, 2020, 7(4): 300-302. doi: 10.1016/S2215-0366(20)30073-0 [20] XIANG YT, YANG Y, LI W, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed[J]. Lancet Psychiatry, 2020, 7(3): 228-229. doi: 10.1016/S2215-0366(20)30046-8 [21] ROUSSOS A, GOENJIAN A K, STEINBERG A M, et al. Posttraumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia, Greece[J]. Am J Psychiatry, 2005, 162(3): 530-537. doi: 10.1176/appi.ajp.162.3.530 [22] SPRANG G, SILMAN M. Posttraumatic stress disorder in parents and youth after health-related disasters[J]. Disast Med Public Health Prep, 2013, 7(1): 105-110. doi: 10.1017/dmp.2013.22 [23] WANG C, PAN R, WAN X, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China[J]. Brain Behav Immun, 2020, 87: 40-48. doi: 10.1016/j.bbi.2020.04.028 [24] TAQUET M, LUCIANO S, GEDDES J R, et al. Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA[J]. Lancet Psychiatry, 2021, 8(2): 130-140. doi: 10.1016/S2215-0366(20)30462-4 [25] DOMINGUES-MONTANARI S. Clinical and psychological effects of excessive screen time on children[J]. J Paediatr Child Health, 2017, 53(4): 333-338. doi: 10.1111/jpc.13462 [26] MARINELLI M, SUNYER J, ALVAREZ-PEDREROL M, et al. Hours of television viewing and sleep duration in children: a multicenter birth cohort study[J]. JAMA Pediatr, 2014, 168(5): 458-464. doi: 10.1001/jamapediatrics.2013.3861 [27] GIANFREDI V, BLANDI L, CACITTI S, et al. Depression and objectively measured physical activity: a systematic review and Meta-analysis[J]. Int J Environ Res Public Health, 2020, 17(10): 3738. doi: 10.3390/ijerph17103738 [28] MCMAHON E M, CORCORAN P, O'REGAN G, et al. Physical activity in European adolescents and associations with anxiety, depression and well-being[J]. Eur Child Adolesc Psychiatry, 2017, 26(1): 111-122. doi: 10.1007/s00787-016-0875-9 [29] 王美芳. 体育锻炼有效缓解学生焦虑的实验研究[J]. 华夏教师, 2019(3): 23. https://www.cnki.com.cn/Article/CJFDTOTAL-HXJS201903018.htmWANG M F. An experimental study of physical exercise effectively alleviating students' anxiety[J]. Chin Teach, 2019(3): 23. https://www.cnki.com.cn/Article/CJFDTOTAL-HXJS201903018.htm -
点击查看大图
表(2)
计量
- 文章访问数: 568
- HTML全文浏览量: 300
- PDF下载量: 41
- 被引次数: 0
