Relationship between school bullying, sleep duration and depressive symptoms among middle school students in Anhui Province
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摘要:
目的 了解安徽省中学生遭受校园欺凌和睡眠时间与抑郁症状的关系,为减少中学生抑郁症状的发生提供参考。 方法 于2020年9—11月,采用分层整群随机抽样方法,选取安徽省35 364名在校中学生,采用流调中心抑郁量表(CES-D)评估抑郁症状,并对遭受校园欺凌、睡眠时间等信息进行问卷调查。采用Logistic回归方法分析遭受校园欺凌和睡眠时间对中学生抑郁症状的影响,并采用相乘和相加作用模型分析其交互作用。 结果 中学生抑郁症状检出率为19.29%。在调整性别、居住地区、学段、家庭结构类型、吸烟等混杂因素后,Logistic回归分析结果显示,遭受校园欺凌、睡眠不足均与中学生抑郁症状有关联,其OR(95%CI)值分别为3.34(3.14~3.55)和1.48(1.37~1.61)。交互作用分析显示,遭受校园欺凌和睡眠不足对抑郁症状无相乘交互作用(OR=1.17,95%CI=0.98~1.39,P>0.05),但具有相加交互作用(OR=4.84,95%CI=4.36~5.37,P < 0.05),交互作用的超额相对危险度为1.50(1.39~1.59),归因比为0.31(0.26~0.36),交互作用指数为1.64(1.47~1.89)。 结论 遭受校园欺凌和睡眠不足与中学生抑郁症状关联,二者具有协同作用。预防中学生遭受校园欺凌同时保证充足的睡眠,利于降低抑郁症状的发生。 Abstract:Objective To understand the relationship between school bullying, sleep duration and depressive symptoms among middle school students in Anhui Province, and to provide reference for depression prevention among middle school students. Methods Stratified cluster random sampling was used to select 35 364 middle school students in Anhui Province. Depressive symptoms assessed by the Center for Epidemiological Survey-Depression Scale (CES-D), school bullying and sleep duration were self-reported through questionnaire survey, which was administered during September to November 2020. Logistic regression was used to analyze the effects of school bullying and sleep duration on depressive symptoms in middle school students, and the interaction effects were analyzed using multiplicative and additive effects models. Results The total rate of depressive symptoms among middle school students was 19.29%. After controlling for gender, residence, school level, family structure, smoking and other confounding factors, logistic regression analyses showed that school bullying and sleep deprivation were both associated with depressive symptoms in middle school students with OR(95%CI) values of 3.34(3.14-3.55) and 1.48(1.37-1.61), respectively. Interaction analysis revealed no multiplicative interaction between school bullying and sleep deprivation on depressive symptoms (OR=1.17, 95%CI=0.98-1.39), but additive interactions were observed in the association (OR=4.84, 95%CI=4.36-5.37). The relative excess risk of interactions was 1.50(1.39-1.59), with attributable proportions being 0.31(0.26-0.36) and synergy index being 1.64(1.47-1.89). Conclusion School bullying and sleep deprivation are significantly associated with depressive symptoms synergistically among middle school students. Therefore, school bullying prevention and sufficient sleep can help alleviate depressive symptoms. -
Key words:
- Violence /
- Sleep /
- Depression /
- Mental health /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同组别中学生抑郁症状检出率比较
Table 1. Comparison of the rate of depressive symptoms among middle school students with different characteristics
组别 选项 人数 抑郁症状人数 χ2值 P值 性别 男 18 039 2 901(16.08) 243.53 < 0.01 女 17 325 3 921(22.63) 居住地区 城区 20 107 4 106(20.42) 38.21 < 0.01 郊县 15 257 2 716(17.80) 学段 初中 18 062 2 986(16.53) 201.69 < 0.01 普通高中 13 462 3 084(22.91) 职业高中 3 840 752(19.58) 家庭结构类型 核心家庭 16 081 2 914(18.12) 25.93 < 0.01 非核心家庭 19 283 3 908(20.27) 超重/肥胖 是 11 279 2 215(19.64) 1.28 0.26 否 24 085 4 607(19.13) 是否吸烟 是 2 109 644(30.54) 182.14 < 0.01 否 33 255 6 178(18.58) 每周中高强度运动频率/d < 3 15 384 3 386(22.01) 129.30 < 0.01 ≥3 19 980 3 436(17.20) 遭受校园欺凌 无 28 795 4 449(15.45) 1 468.30 < 0.01 有 6 569 2 373(36.12) 睡眠时间 充足 6 068 918(15.13) 81.50 < 0.01 不足 29 296 5 904(20.15) 注:()内数字为检出率/%。 表 2 中学生遭受校园欺凌和睡眠时间对抑郁症状的相乘交互作用(n=35 364)
Table 2. Analysis of the multiplicative interaction between school bullying and sleep duration on depressive symptoms among middle school students(n=35 364)
模型 交互变量 β值 P值 OR值(OR值95%CI) 1 遭受校园欺凌 0.78 < 0.01 2.18(1.58~3.00) 睡眠不足 0.30 < 0.01 1.34(1.23~1.47) 遭受校园欺凌×睡眠不足 0.19 0.03 1.21(1.02~1.44) 2 遭受校园欺凌 0.91 < 0.01 2.49(1.80~3.46) 睡眠不足 0.35 < 0.01 1.42(1.29~1.55) 遭受校园欺凌×睡眠不足 0.16 0.07 1.17(0.98~1.39) 注:模型1未调整混杂因素,模型2调整性别、居住地区、学段、家庭结构类型、超重/肥胖、是否吸烟、中高强度运动频率。 -
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