天津市初中生健康危险行为潜在类别与抑郁症状的关联

侯常春; 梁明玥; 刘忠慧; 张欣; 孙志颖

doi:10.16835/j.cnki.1000-9817.2023.03.024

天津市初中生健康危险行为潜在类别与抑郁症状的关联

doi: 10.16835/j.cnki.1000-9817.2023.03.024

1.
天津市疾病预防控制中心业务与质量控制所，300011
2.
天津医科大学公共卫生学院
3.
天津市疾病预防控制中心环境健康与学校卫生研究所

详细信息

作者简介:
侯常春(1976-)，男，江西南昌人，硕士，主任医师，主要研究方向为环境卫生和学校卫生

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 R179 B844.2
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- 被引次数: 0
出版历程
- 收稿日期: 2022-09-20
- 修回日期: 2023-01-12
- 刊出日期: 2023-03-25

Association between latent classes of health risk behaviors and depressive symptoms among junior middle school students in Tianjin

1.
Business and Quality Control Institute, Tianjin Center for Disease Control and Prevention, Tianjin(300011), China

摘要

摘要: 目的探讨初中生健康危险行为的潜在类别及其与抑郁症状的关联，为识别抑郁症状高风险群体和制定有针对性的综合干预措施提供科学依据。方法采用多阶段分层整群抽样方法，抽取天津市16个区的8 175名初中生进行问卷调查，内容包括人口学特征、抑郁症状和健康危险行为。使用Mplus 8.3软件进行健康危险行为的潜在类别分析，使用SPSS 23.0软件进行描述和统计分析。结果天津市初中生抑郁症状检出率为17.8%，城区(19.4%)高于郊区(16.5%)(χ²=11.62)，女生(20.2%)高于男生(15.5%)(χ²=30.58)(P值均＜0.01)。经潜在类别分析，将天津市初中生健康危险行为分为健康组(84.0%)、不良饮食组(3.8%)和多种风险行为组(12.2%)3个潜在类别。多因素Logistic回归分析显示，在调整地区、年级、性别、家庭类型后，与健康组相比，不良饮食组和多种风险行为组的初中生检出抑郁症状的风险更高[OR值(95%CI)分别为2.82(2.17~3.66)，4.31(3.67~5.05)，P值均＜0.01)]。结论天津市初中生抑郁症状问题较为严峻，健康危险行为潜在类别与抑郁症状间存在关联。应根据各潜在类别的特征早期识别抑郁高风险初中生，制定有针对性的综合干预方案，使干预措施的成本-效益最大化。
- 危险行为 /
- 抑郁 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the prevalence of depressive symptoms among junior middle school students in Tianjin, and to explore the association between latent classes of health risk behaviors and depressive symptoms, so as to provide clues for identifying high-risk groups of depressive symptoms and a scientific basis for comprehensive intervention measures. Methods By using a multistage stratified cluster sampling method, 8 175 students in 16 districts of Tianjin were investigated with demographic characteristics, depressive symptoms, and health risk behaviors. Latent class analysis was performed by Mplus 8.3. SPSS 23.0. Results The prevalence of depressive symptoms among junior high school students in Tianjin was 17.8%, the prevalence of depressive symptoms in urban(19.4%) areas was higher than that in rural areas(16.5%), and that of female students(20.2%) was higher than that of male students(15.5%)(χ²=11.62, 30.58, P < 0.01). Health risk behaviors were classified into three groups: healthy group (84.0%), poor diet group (3.8%) and multiple risk behaviors group (12.2%). After adjusting for region, grade, gender, and family type, multivariate Logistic regression analysis showed that the poor diet group (OR=2.82, 95%CI=2.17-3.66) and the multiple risk behaviors group (OR=4.31, 95%CI=3.67-5.05) had a higher risk of depressive symptoms compared with the healthy group (P < 0.01). Conclusion Depressive symptoms are prevalent among junior middle school students in Tianjin. Different latent classes of health risk behaviors have different correlations with depressive symptoms. It is important to ensure early detection and personalized intervention for different types of health risk behavior among junior middle school students to maximize cost-effectiveness.
- Dangerous behavior /
- Depression /
- Mental health /
- Regression analysis /
- Students
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图 1 天津市初中生健康危险行为类别条件概率分布

Figure 1. Conditional probability distribution of health risk behaviors among junior middle school students in Tianjin

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表 1 天津市不同组别初中生抑郁症状检出率比较

Table 1. Prevalence of depressive symptoms among junior middle school students in Tianjin

组别	选项	人数	抑郁症状	χ²值	P值
地区	城区	3 517	683(19.4)	11.62	＜0.01
	郊县	4 658	769(16.5)
年级	初一	2 772	439(15.8)	10.90	＜0.01
	初二	2 679	495(18.5)
	初三	2 724	518(19.0)
性别	男	4 259	661(15.5)	30.58	＜0.01
	女	3 916	791(20.2)
民族	汉族	7 762	1 371(17.7)	1.02	0.31
	少数民族	413	81(19.6)
家庭类型	核心家庭	4 185	667(15.9)	52.34	＜0.01
	大家庭	2 838	503(17.7)
	单亲家庭	708	170(24.0)
	重组家庭	206	62(30.1)
	隔代家庭	212	43(20.3)
	其他	26	7(26.9)
注： ()内数字为检出率/%。

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表 2 天津市初中生健康危险行为潜在类别模型拟合指数

Table 2. Fit index of latent class model of health risk behaviors among junior middle school students in Tianjin

类别数量	AIC值	BIC值	aBIC值	Entropy值	LMR检验	条件概率
1	65 035.65	65 133.78	65 089.29	—	—	1
2	62 763.43	62 966.69	62 874.53	0.74	＜0.01	0.87/0.13
3	62 418.85	62 727.23	62 587.41	0.80	＜0.01	0.84/0.12/0.04
4	62 341.76	62 755.28	62 567.79	0.79	0.30	0.87/0.06/0.04/0.03
5	62 282.98	62 801.64	62 566.48	0.78	0.42	0.85/0.08/0.03/0.02/0.01

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表 3 不同人口统计学特征初中生健康危险行为潜在类别分布比较

Table 3. Demographic characteristics of latent classes of health risk behaviors in junior middle school students

人口统计学指标		人数	健康组	不良饮食组	多种风险行为组	χ²值	P值
地区	城区	3 517	2 998(85.2)	116(3.3)	403(11.5)	43.97	＜0.01
	郊县	4 658	4 165(89.4)	157(3.4)	336(7.2)
年级	初一	2 772	2 504(90.3)	84(3.0)	184(6.6)	37.93	＜0.01
	初二	2 679	2 340(87.3)	89(3.3)	250(9.3)
	初三	2 724	2 319(85.1)	100(3.7)	305(11.2)
性别	男	4 259	3 635(85.3)	155(3.6)	469(11.0)	45.89	＜0.01
	女	3 916	3 528(90.1)	118(3.0)	270(6.9)
民族	汉族	7 762	6 796(87.6)	259(3.3)	707(9.1)	0.88	0.64
	少数民族	413	367(88.9)	14(3.4)	32(7.7)
家庭类型	核心家庭	4 185	3 738(89.3)	115(2.7)	332(7.9)	50.63^*	＜0.01
	大家庭	2 838	2 475(87.2)	106(3.7)	257(9.1)
	单亲家庭	708	590(83.3)	29(4.1)	89(12.6)
	重组家庭	206	163(79.1)	13(6.3)	30(14.6)
	隔代家庭	212	180(84.9)	7(3.3)	25(11.8)
	其他	26	17(65.4)	3(11.5)	6(23.1)
注： ()内数字为构成比/%；*为Fisher精确概率。

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