A follow-up study depressive and anxiety symptoms of children in Wuhan City, Hubei Province
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摘要:
目的 了解学龄期儿童的抑郁、焦虑症状变化趋势, 为儿童心理健康建设提供科学依据。 方法 采用整群抽样, 抽取武汉市硚口区某小学二至五年级学生, 分别于2020年6和12月进行问卷调查, 包括人口学信息、学生学习情况和抑郁、焦虑症状评价。 结果 共有963名学生完成两次调查。随访时小学生的抑郁、焦虑检出率(36.3%, 34.3%)与基线调查时(30.7%, 22.8%)相比显著升高(OR抑郁=1.45, 95% CI=1.16~1.83;OR焦虑=1.79, 95% CI=1.41~2.28, P值均 < 0.01)。父母为抗击新冠疫情一线人员对儿童抑郁、焦虑症状的影响均无统计学意义(P值均>0.05)。女生、学习效率变低、课堂上与老师互动较少对儿童抑郁或焦虑症状的影响有统计学意义(P值均 < 0.05)。 结论 小学生的心理健康状况需要持续关注, 应给予及时的心理保护, 预防心理问题的发生和进一步恶化。 Abstract:Objective To investigate the progression of depressive and anxiety symptoms of children, especially whose parents were frontline workers in the combat of the coronavirus disease 2019(COVID-19), and to provide evidence for children's mental health promotion. Methods In June and December 2020, two surveys were conducted among the children in a primary school in Qiaokou District, Wuhan.The questionnaire included demographic information, student learning conditions, and depressive/anxiety symptoms. Results A total of 963 children completed both surveys.The detection rate of depressive and anxiety symptoms at follow-up was significantly higher than that at the baseline survey (depressive symptoms: OR=1.45, 95% CI=1.16-1.83;anxiety symptoms: OR=1.79, 95% CI=1.41-2.28, P < 0.01).There was no statistically significant change in depressive/anxiety symptoms among children whose parents were frontline workers compared with those whose parents were not (P>0.05).Girls, lower learning efficiency, and less interaction with teachers in class were risk factors for depressive or anxiety symptoms of children (P < 0.05). Conclusion Mental health status of children requires continuous attention.Moreover, timely psychological protection should be given to prevent the occurrence of psychological problems and the further deterioration of psychological problems. -
Key words:
- Depression /
- Anxiety /
- Mental health /
- Affective symptoms /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。2) 汤建军 -
表 1 小学生基线与随访学习状况及心理状况基本特征比较
Table 1. The distribution of mental health and learning status of primary school students by time of survey
组别 人数 与上学期相比,本学期的学习效率 上课时与老师的互动 抑郁症状 焦虑症状 更高 差不多 更低 很多 偶尔或从不 是 否 是 否 基线 963 56(5.8) 368(38.2) 539(56.0) 466(48.4) 497(51.6) 296(30.7) 667(69.3) 220(22.8) 743(77.2) 随访 963 419(43.9) 427(44.7) 109(11.4) 409(42.7) 548(57.3) 349(36.3) 612(63.7) 327(34.3) 625(65.7) Z/χ2值 -20.36 8.83 9.49 41.46 P值 < 0.01 < 0.01 < 0.01 < 0.01 注:()内数字为构成比/%;部分资料数据有缺失。 表 2 小学生基线-随访抑郁、焦虑症状的影响因素分析(n=963)
Table 2. Association between demographic characteristics and depressive and anxiety symptoms of primary school students(n=963)
自变量 选项 抑郁症状 焦虑症状 OR值(OR值95%CI P值 OR值(OR值95%CI P值 时间 基线 1.00 1.00 随访 1.45(1.16~1.83) < 0.01 1.79(1.41~2.28) < 0.01 年龄 1.08(0.98~1.19) 0.11 1.09(0.99~1.20) 0.09 性别 男 1.00 1.00 女 1.25(1.00~1.57) 0.05 1.45(1.15~1.84) < 0.01 父亲为抗击疫情一线人员 是 1.00 1.00 否 1.01(0.79~1.29) 0.96 0.99(0.76~1.30) 0.96 母亲为抗击疫情一线人员 是 1.00 1.00 否 0.92(0.72~1.16) 0.48 1.14(0.89~1.45) 0.31 父亲文化程度 大学本科及以下 1.00 1.00 研究生及以上 1.07(0.83~1.38) 0.59 0.81(0.63~1.06) 0.13 母亲文化程度 大学本科及以下 1.00 1.00 研究生及以上 0.84(0.65~1.09) 0.18 1.11(0.85~1.45) 0.43 与上学期相比,本学期的学习效率 更高 1.00 1.00 差不多 1.03(0.79~1.34) 0.84 0.81(0.62~1.07) 0.14 更低 1.66(1.21~2.27) < 0.01 1.26(0.91~1.73) 0.16 上课时与老师的互动 很多,主动回答老师问题 1.00 1.00 偶尔或从不和老师互动 2.00(1.63~2.45) < 0.01 1.95(1.56~2.43) < 0.01 -
[1] 陶芳标. 学校卫生的根本任务是实现学生健康全面覆盖[J]. 中国学校卫生, 2020, 41(1): 1-4. doi: 10.16835/j.cnki.1000-9817.2020.01.001TAO F B. Universal health coverage for students as the fundamental task of school health[J]. Chin J Sch Health, 2020, 41(1): 1-4. doi: 10.16835/j.cnki.1000-9817.2020.01.001 [2] World Health Organization. Adolescent mental health[EB/OL]. (2020-09-28)[2021-11-17]. http://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health. [3] HUANG Y, WANG Y, WANG H, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2019, 6(3): 211-224. doi: 10.1016/S2215-0366(18)30511-X [4] LU J, XU X, HUANG Y, et al. Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2021, 8(11): 981-990. doi: 10.1016/S2215-0366(21)00251-0 [5] 傅小兰, 张侃. 中国国民心理健康发展报告(2019—2020)[M]. 北京: 社会科学文献出版社, 2021.FU X L, ZHANG K. Report on national mental health development in China (2019-2020)[M]. Beijing: Social Sciences Academic Press, 2021. [6] VERBOOM C E, SIJTSEMA J J, VERHULST F C, et al. Longitudinal associations between depressive problems, academic performance, and social functioning in adolescent boys and girls[J]. Dev Psychol, 2014, 50, (1): 247-257. doi: 10.1037/a0032547 [7] DRAY J, BOWMAN J, CAMPBELL E, et al. Systematic review of universal resilience-focused interventions targeting child and adolescent mental health in the school setting[J]. J Am Acad Child Adolesc Psychiatry, 2017, 56(10): 813-824. doi: 10.1016/j.jaac.2017.07.780 [8] UHER R, ZWICKER A. Etiology in psychiatry: embracing the reality of poly-gene-environmental causation of mental illness[J]. World Psychiatry, 2017, 16(2): 121-129. doi: 10.1002/wps.20436 [9] RACINE N, MCARTHUR B A, COOKE J E, et al. Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a Meta-analysis[J]. JAMA Pediatr, 2021, 175(11): 1142-1150. doi: 10.1001/jamapediatrics.2021.2482 [10] PAPPA S, NTELLA V, GIANNAKAS T, et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and Meta-analysis[J]. Brain Behav Immun, 2020, 88: 901-907. doi: 10.1016/j.bbi.2020.05.026 [11] 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 [12] WANG K, SU L Y, ZHU Y. Norms of the screen for child anxiety related emotional disorders in Chinese urban children[J]. Chin J Clinic Psychol, 2002, 10(4): 270-272. [13] 李婷, 王宏, 刁华, 等. 同伴教育对青春期中小学生心理健康干预效果评价[J]. 中国学校卫生, 2020, 41(3): 375-378, 382. doi: 10.16835/j.cnki.1000-9817.2020.03.015LI T, WANG H, DIAO H, et al. Application of peer education in mental health education for adolescent primary and middle school students[J]. Chin J Sch Health, 2020, 41(3): 375-378, 382. doi: 10.16835/j.cnki.1000-9817.2020.03.015 [14] 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 [15] 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. Study on sleep quality and anxiety of achool-aged children in Wuhan[J]. Chin J Soc Med, 2020, 37(4): 382-385. doi: 10.3969/j.issn.1673-5625.2020.04.013 [16] 刘影, 肖雅岚, 伍珍琼, 等. 成都市一至九年级学生网络成瘾与焦虑调查分析[J]. 预防医学情报杂志, 2020, 36(12): 1589-1593, 1605. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202012011.htmLIU Y, XIAO Y L, WU Z Q, et al. Investigation and analysis of internet addiction and anxiety among students from grade 1 to 9 in Chengdu[J]. J Prev Med Inform, 2020, 36(12): 1589-1593, 1605. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202012011.htm [17] MAGIATI I, PONNIAH K, OOI Y P, et al. Self-reported depression and anxiety symptoms in school-aged Singaporean children[J]. Asia Pac Psychiatry, 2015, 7(1): 91-104. doi: 10.1111/appy.12099 [18] FRIGERIO A, PESENTI S, MOLTENI M, et al. Depressive symptoms as measured by the CDI in a population of northern Italian children[J]. Eur Psychiatry, 2001, 16(1): 33-37. doi: 10.1016/S0924-9338(00)00533-2 [19] CHEN X, QI H, LIU R, et al. Depression, anxiety and associated factors among Chinese adolescents during the COVID-19 outbreak: a comparison of two cross-sectional studies[J]. Transl Psychiatry, 2021, 11(1): 148. doi: 10.1038/s41398-021-01271-4 [20] CZEISLER M E, LANE R I, WILEY J F, et al. Follow-up survey of US adult reports of mental health, substance use, and suicidal ideation during the COVID-19 pandemic, September 2020[J]. JAMA Netw Open, 2021, 4(2): e2037665. doi: 10.1001/jamanetworkopen.2020.37665 [21] PHIRI P, RAMAKRISHNAN R, RATHOD S, et al. An evaluation of the mental health impact of SARS-CoV-2 on patients, general public and healthcare professionals: a systematic review and Meta-analysis[J]. E Clinic Med, 2021, 34: 100806. [22] LIU S, YANG L, ZHANG C, et al. Online mental health services in China during the COVID-19 outbreak[J]. Lancet Psychiatry, 2020, 7(4): e17-e18. doi: 10.1016/S2215-0366(20)30077-8 [23] LEE J. Mental health effects of school closures during COVID-19[J]. Lancet Child Adolesc Health, 2020, 4(6): 421. doi: 10.1016/S2352-4642(20)30109-7 [24] SHAN W, ZHANG Y, ZHAO J, et al. Association between maltreatment, positive parent-child interaction, and psychosocial well-being in young children[J]. J Pediatr, 2019, 213: 180-186. doi: 10.1016/j.jpeds.2019.06.050 [25] MA L, GAO L, CHIU D T, et al. Depressive symptoms prevalence, associated family factors, and gender differences: a national cohort study of middle school students in China[J]. J Affect Disord, 2020, 274: 545-552. doi: 10.1016/j.jad.2020.05.128 [26] NEARCHOU F, FLINN C, NILAND R, et al. Exploring the Impact of COVID-19 on mental health outcomes in children and adolescents: a systematic review[J]. Int J Environ Res Public Health, 2020, 17(22): 8479. doi: 10.3390/ijerph17228479 [27] 张新明. 课堂师生互动与学生学业成绩之间的关系研究[J]. 当代教育科学, 2017(6): 65-69. doi: 10.3969/j.issn.1672-2221.2017.06.015ZHANG X M. Association study between classroom teacher-student interaction and student academic achievement[J]. Contemp Educ Sci, 2017(6): 65-69. doi: 10.3969/j.issn.1672-2221.2017.06.015 [28] GAO Y, HU D, PENG E, et al. Depressive symptoms and the link with academic performance among rural Taiwanese children[J]. Int J Environ Res Public Health, 2020, 17(8): 2778. doi: 10.3390/ijerph17082778 [29] 王琳, 王建红, 李晓萌, 等. 新型冠状病毒肺炎疫情期间医务人员及其子女心理应激反应调查分析[J]. 教育生物学杂志, 2020, 8(3): 160-166. doi: 10.3969/j.issn.2095-4301.2020.03.002WANG L, WANG J H, LI X M, et al. Analysis of psychological stress response of medical staff and their children during corona virus disease 2019 outbreak[J]. J Biol Educ, 2020, 8(3): 160-166. doi: 10.3969/j.issn.2095-4301.2020.03.002 [30] SOLERDELCOLL M, ARANGO C G. Sugranyes, calling for the integration of children's mental health and protection into COVID-19 responses[J]. Revist De Psiquiatr Salud Ment, 2021, 14(2): 113-116. doi: 10.1016/j.rpsm.2021.02.004 -

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