农村中学生睡眠质量抑郁症状及其与非自杀性自伤的关联

罗运娇; 严娜; 裴一霏; 陈倩; 王京京; 汤洁; 王宇豪; 王威

doi:10.16835/j.cnki.1000-9817.2023.02.015

农村中学生睡眠质量抑郁症状及其与非自杀性自伤的关联

doi: 10.16835/j.cnki.1000-9817.2023.02.015

徐州医科大学公共卫生学院，江苏 221000

基金项目:

国家自然科学基金项目 82003484

详细信息

作者简介:
罗运娇(1998-)，女，贵州凯里人，在读硕士，主要研究方向为流行病与卫生统计学

通讯作者:
王威，E-mail：weiwang90@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 G444 B844.2
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出版历程
- 收稿日期: 2022-10-10
- 修回日期: 2022-11-21
- 网络出版日期: 2023-03-02
- 刊出日期: 2023-02-25

Association of sleep quality, depressive symptoms with non-suicidal self-injury among rural middle school students

School of Public Health, Xuzhou Medical University, Xuzhou(221000), Jiangsu Province, China

摘要

摘要: 目的探讨农村中学生睡眠质量和抑郁症状及其交互作用与非自杀性自伤(non-suicidal self-injury, NSSI)的关联，为农村中学生NSSI的预防和早期干预提供参考依据。方法采用多阶段整群抽样的方法，在江苏省徐州市随机抽取4所农村中学，按照学校年级分层、班级随机选取的原则对1 723名中学生进行调查。使用纸质调查问卷(包括人口学因素、自伤行为评估简表、匹兹堡睡眠质量指数量表、抑郁自评量表)进行问卷调查，采用Logistic回归模型分析农村中学生睡眠质量和抑郁症状及其交互作用与NSSI的关联。结果 30.5%的中学生存在NSSI行为；单因素分析结果显示，女生NSSI报告率(33.0%)比男生(27.3%)高，有睡眠障碍和抑郁症状者NSSI报告率更高，分别为46.8%和43.6%。多因素Logistic回归分析结果显示，存在睡眠障碍的学生发生NSSI的风险是无睡眠障碍者的1.80倍(OR值95%CI=1.42~2.28，P < 0.01)；存在抑郁症状的学生发生NSSI的风险是无抑郁症状者的3.32倍(OR值95%CI=2.60~4.24，P < 0.01)。交互作用结果显示，睡眠障碍和抑郁症状对农村中学生NSSI行为的发生存在相加交互作用，超额危险度、归因比和交互作用指数分别为1.80，0.30和1.57。结论存在睡眠障碍和抑郁症状是农村中学生NSSI的相关因素，且两者存在相加交互作用。
- 睡眠 /
- 抑郁 /
- 自我伤害行为 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the association of sleep quality, depressive symptoms and their interaction with non-suicidal self-injury (NSSI) among rural middle school students, so as to provide a reference for early prevention and control of NSSI among rural middle school students. Methods A multi-stage cluster sampling method was used to randomly select four rural middle schools in Xuzhou, Jiangsu Province. A total of 1 723 middle school students were investigated according to the principle of grade stratification and class random selection. Paper questionnaires (including demographic factors, Non-Suicidal Self-Injury Short Scale, Pittsburgh Sleep Quality Index, Patient Health Questionnare-9) were used to conduct the questionnaire survey. Logistic regression model was used to analyze the association of sleep quality, depressive symptoms and their interaction with NSSI among rural middle school students. Results Totally 30.5% of middle school students had NSSI. Univariate results showed that girls (33.0%) had a higher incidence of NSSI than boys(27.3%), and those with sleep disorders and depressive symptoms had a higher incidence of NSSI, which was 46.8%, 43.6%. The results of multivariate Logistic regression showed that the risk of NSSI in students with sleep disorder was 1.80 times that in those without sleep disorder(OR 95%CI=1.42-2.28, P < 0.01). The risk of NSSI in students with depressive symptoms was 3.32 times higher than that in those without depressive symptoms(OR 95%CI=2.60-4.24, P < 0.01). The interaction results showed that there was additive interaction between sleep disturbance and depressive symptoms on the occurrence of NSSI behavior in rural middle school students, and the relative excess risk, attributable proportion and synergy index were 1.80, 0.30 and 1.57, respectively. Conclusion Sleep disorder and depressive symptoms are risk factors for NSSI among rural middle school students, and there is additive interaction between them.
- Sleep /
- Depression /
- Self-injurious behavior /
- Mental health /
- Regression analysis /
- Students
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表 1 不同组别农村中学生非自杀性自伤报告率比较

Table 1. Comparison of non-suicidal self-injury among different groups of rural middle school students

组别	选项	人数	有自伤行为人数	χ²值	P值
性别	男	741	202(27.3)	6.55	0.01
	女	982	324(33.0)
学段	初中	733	209(28.5)	2.44	0.12
	高中	990	317(32.0)
学习成绩	前60%	1 289	396(30.7)	0.09	0.76
	后40%	434	130(30.0)
独生子女	是	183	55(30.1)	0.02	0.88
	否	1 540	471(30.6)
父亲文化程度	初中及以下	933	301(32.3)	2.88	0.09
	高中及以上	790	225(28.5)
母亲文化程度	初中及以下	1 122	336(29.9)	0.51	0.47
	高中及以上	601	190(31.6)
家庭月收入/元	< 8 000	1 344	423(31.5)	2.57	0.11
	≥8 000	379	103(27.2)
睡眠障碍	是	506	237(46.8)	89.85	< 0.01
	否	1 217	289(23.7)
抑郁症状	是	912	398(43.6)	157.07	< 0.01
	否	811	128(15.8)
注：()内数字为报告率/%。

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表 2 农村中学生睡眠质量与抑郁症状对非自杀性自伤行为的相加交互作用分析(n=1 723)

Table 2. Additive interaction effect of sleep quality and depressive symptoms on non-suicidal self-injury among rural middle school students(n=1 723)

睡眠障碍	抑郁症状	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
是	是	1.79	0.14	156.13	< 0.01	5.96(4.51~7.89)
是	否	0.61	0.28	4.77	0.03	1.83(1.06~3.15)
否	是	1.20	0.14	73.55	< 0.01	3.33(2.53~4.39)
注：控制变量为性别；自变量以无睡眠障碍且无抑郁症状为参照组。

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