太原市中学生睡眠时型与心理健康问题的关联

永忠甜; 王凯; 刘瑾; 车国瑜; 武美琼; 韩江涛; 陈晋; 王莉

doi:10.16835/j.cnki.1000-9817.2023.07.017

太原市中学生睡眠时型与心理健康问题的关联

doi: 10.16835/j.cnki.1000-9817.2023.07.017

永忠甜¹,
王凯¹,
刘瑾¹,
车国瑜¹,
武美琼¹,
韩江涛²,
陈晋²,
王莉^1, ,

1.
山西医科大学公共卫生学院儿少卫生教研室，太原 030001
2.
太原市中小学学生卫生保健所

基金项目:

中国青少年行为健康新型风险因素监测与队列研究横向合作项目

详细信息

作者简介:
永忠甜(1996-)，女，云南楚雄人，在读硕士，主要研究方向为儿童青少年健康促进

通讯作者:
王莉，E-mail: wangli_1@sxmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: B844.2 R179
计量
- 文章访问数: 836
- HTML全文浏览量: 455
- PDF下载量: 46
- 被引次数: 0
出版历程
- 收稿日期: 2023-05-24
- 修回日期: 2023-06-01
- 网络出版日期: 2023-07-25
- 刊出日期: 2023-07-25

Relationship between chronotype and mental health problems among middle school students in Taiyuan

1.
Department of Child and Adolescent Health, School of Public Health, Shanxi Medical University, Taiyuan(030001), China

摘要

摘要: 目的了解太原市中学生心理健康问题现状及其与睡眠时型的关系，为促进中学生心理健康提供科学依据。方法于2021年10—11月，采用多阶段分层随机整群抽样方法，在太原市3所初中和2所高中各年级随机抽取2 621名学生进行问卷调查，内容包括一般人口学特征、心理健康状况和睡眠时型。采用χ²检验、Spearman相关分析和Logistic回归分析中学生睡眠时型与心理健康问题的关联性。结果中学生睡眠为清晨型、中间型、夜晚型的构成比分别为17.9%，65.6%和16.4%，心理健康问题总检出率为13.8%。不同年级、感知家庭经济状况、朋友数量、睡眠时型的中学生心理健康问题检出率差异均有统计学意义(χ²值分别为42.69，29.15，46.02，93.99，P值均 < 0.05)。Logistic回归分析结果显示，控制年级、感知家庭经济状况、朋友数量协变量后，夜晚型睡眠时型与中学生心理健康问题呈正相关，清晨型睡眠时型与中学生心理健康问题呈负相关(OR值分别为2.84，0.61，P值均 < 0.05)。结论中学生睡眠时型与心理健康问题有关，睡眠时型为夜晚型的发生风险更高，睡眠时型为清晨型的发生风险较低；调整睡眠时型可改善中学生的心理健康水平。
- 睡眠 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To examine mental health problems among adolescents in Taiyuan City and its relationship to chronotype, so as to give a scientific basis for supporting mental health of middle school students. Methods From October to November 2021, a total of 2 621 pupils were enrolled from three junior high schools and two senior high schools in Taiyuan by using a multi-stage stratified cluster random sampling method to investigate demographic characteristics, mental health status, and chronotype. Chi-squared test, Spearman correlation analysis and Logistic regression were used to analyze the relationship between sleep patterns and mental health problems in middle school students. Results The proportion of morning, intermediate and evening types of middle school students sleep were 17.9%, 65.6%, and 16.4%, respectively. The overall detection rate of mental health problems was 13.8%, which was statistically significant among middle school students in different grades, self-perceived family economic status, the number of friends and sleep patterns (χ²=42.69, 29.15, 46.02, 93.99, P < 0.05). After adjusting for grade, self-perceived family economic status and the number of friends, Logistic regression analysis revealed that mental health problems were positively associated with evening type (OR=2.84) and negatively associated with morning type (OR=0.61)(P < 0.05). Conclusion Chronotype is associated with mental health problems among middle school students, with a higher risk for evening type and a lower risk for morning type. Mental health of middle school students can be enhanced by changing their chronotype.
- Sleep /
- Mental health /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同组别中学生睡眠时型分布比较

Table 1. Comparison of the distribution characteristics of sleep chronotype in different groups among middle school students

组别	选项	人数	夜晚型	中间型	清晨型	χ²值	P值
性别	男	1 303	213(16.3)	840(64.5)	250(19.2)	2.82	0.24
	女	1 318	218(16.5)	880(66.8)	220(16.7)
年级	初一	431	31(7.2)	227(52.7)	173(40.1)	233.86	＜0.01
	初二	445	62(13.9)	278(62.5)	105(23.6)
	初三	412	66(16.0)	285(69.2)	61(14.8)
	高一	449	82(18.3)	324(72.2)	43(9.6)
	高二	447	91(20.4)	309(69.1)	47(10.5)
	高三	437	99(22.7)	297(68.0)	41(9.4)
家庭居住地^*	农村	199	18(9.0)	135(67.8)	46(23.1)	35.69	＜0.01
	乡镇	665	79(11.9)	440(66.2)	146(22.0)
	城市	1 746	332(19.0)	1 138(65.2)	276(15.8)
是否独生子女^*	是	1 090	206(18.9)	716(65.7)	168(15.4)	13.20	< 0.01
	否	1 484	217(14.6)	976(65.8)	291(19.6)
父亲文化程度^*	小学及以下	243	30(12.3)	159(65.4)	54(22.2)	15.65	0.02
	初中	974	146(15.0)	633(65.0)	195(20.0)
	高中或中专	725	132(18.2)	474(65.4)	119(16.4)
	大专及以上	653	122(18.7)	432(66.2)	99(15.2)
母亲文化程度^*	小学及以下	272	35(12.9)	175(64.3)	62(22.8)	19.20	< 0.01
	初中	975	150(15.4)	626(64.2)	199(20.4)
	高中或中专	695	126(18.1)	466(67.1)	103(14.8)
	大专及以上	658	119(18.1)	439(66.7)	100(15.2)
感知家庭经济状况^*	差或较差	276	51(18.5)	183(66.3)	42(15.2)	9.51	0.05
	中等	1 902	306(16.1)	1 266(66.6)	330(17.4)
	较好或好	426	69(16.2)	260(61.0)	97(22.8)
朋友数量/个^*	≤2	641	108(16.8)	418(65.2)	115(17.9)	3.71	0.45
	3~5	1 250	205(16.4)	835(66.8)	210(16.8)
	≥6	713	115(16.1)	454(63.7)	144(20.2)
注： ()内数字为构成比/%。*表示数据有缺失。

下载: 导出CSV

表 2 不同组别中学生心理健康问题检出率比较

Table 2. Comparison of the detection rates of mental health problems among middle school students in different groups

组别	选项	人数	心理健康问题检出人数	χ²值	P值
性别	男	1 303	175(13.4)	0.38	0.54
	女	1 318	188(14.3)
年级	初一	431	39(9.0)	42.69	< 0.01
	初二	445	53(11.9)
	初三	412	50(12.1)
	高一	449	57(12.7)
	高二	447	63(14.1)
	高三	437	101(23.1)
家庭居住地^*	农村	199	33(16.6)	2.66	0.27
	乡镇	665	82(12.3)
	城市	1 746	247(14.1)
是否独生子女^*	是	1 090	161(14.8)	1.40	0.24
	否	1 484	195(13.1)
父亲文化程度^*	小学及以下	243	33(13.6)	1.30	0.73
	初中	974	128(13.1)
	高中或中专	725	109(15.0)
	大专及以上	653	93(14.2)
母亲文化程度^*	小学及以下	272	39(14.3)	0.66	0.88
	初中	975	136(13.9)
	高中或中专	695	101(14.5)
	大专及以上	658	86(13.1)
感知家庭经济	差或较差	276	64(23.2)	29.15	< 0.01
状况^*	中等	1 902	226(11.9)
	较好或好	426	71(16.7)
朋友数量/个^*	≤2	641	140(21.8)	46.02	< 0.01
	3~5	1 250	143(11.4)
	≥6	713	77(10.8)
睡眠时型	夜晚型	431	121(28.1)	93.99	< 0.01
	中间型	1 720	207(12.0)
	清晨型	470	35(7.4)
注： ()内数字为检出率/%。*表示数据有缺失。

下载: 导出CSV

表 3 中学生睡眠时型与心理健康问题检出率Logistic回归分析(n=2 621)

Table 3. Logistic regression analysis of the association between sleep chronotype and mental health problems among middle school students(n=2 621)

调整前后	睡眠时型	β值	标准误	Wald χ²值	P值	OR值(95%CI)
调整前	夜晚型	1.05	0.13	64.72	< 0.01	2.85(2.21~3.68)
	清晨型	-0.53	0.19	7.75	< 0.01	0.59(0.41~0.86)
调整后	夜晚型	1.04	0.14	59.36	< 0.01	2.84(2.18~3.70)
	清晨型	-0.49	0.20	5.92	0.02	0.61(0.41~0.91)

下载: 导出CSV

参考文献(23)

[1]	KIELING C, BAKER-HENNINGHAM H, BELFER M, et al. Child and adolescent mental health worldwide: evidence for action[J]. Lancet, 2011, 378(9801): 1501-1525. doi: 10.1016/S0140-6736(11)60313-9
[2]	SCHULTE-KÖRNE G. Mental health problems in a school setting in children and adolescents[J]. Deutsch Arzteblatt Inter, 2016, 113(11): 183-190.
[3]	XU L, LI C, LI J, et al. The economic burden of mental disorders in children and adolescents in China: a cross-sectional study[J]. Lancet, 2019, 394(Suppl 1): S48.
[4]	OGINSKA H, MOJSA-KAJA J, MAIRESSE O. Chronotype description: in search of a solid subjective amplitude scale[J]. Chronobiol Int, 2017, 34(10): 1388-1400. doi: 10.1080/07420528.2017.1372469
[5]	仇亚萍, 石君, 曾庆宏, 等. 在校大学生熬夜与其健康危害认知相关性调查分析[J]. 社区医学杂志, 2020, 18(9): 638-641. https://www.cnki.com.cn/Article/CJFDTOTAL-SQYX202009004.htm QIU Y P, SHI J, ZENG Q H, et al. Research on the link between staying up late and health risks for college students[J]. J Commun Med, 2020, 18(9): 638-641. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SQYX202009004.htm
[6]	AU J, REECE J. The relationship between chronotype and depressive symptoms: a Meta-analysis[J]. J Affect Disord, 2017, 218: 93-104. doi: 10.1016/j.jad.2017.04.021
[7]	VAN DEN BERG J F, KIVELA L, ANTYPA N. Chronotype and depressive symptoms in students: an investigation of possible mechanisms[J]. Chronobiol Int, 2018, 35(9): 1248-1261. doi: 10.1080/07420528.2018.1470531
[8]	KNAPEN S E, RIEMERSMA-VAN D L R, ANTYPA N, et al. Social jetlag and depression status: results obtained from the Netherlands study of depression and anxiety[J]. Chronobiol Int, 2018, 35(1): 1-7. doi: 10.1080/07420528.2017.1374966
[9]	LESTER D. Morningness-eveningness, current depression, and past suicidality[J]. Psychol Rep, 2015, 116(2): 331-336. doi: 10.2466/16.02.PR0.116k18w5
[10]	李双, 程兢, 李艳平, 等. 锦州市大学生昼夜节律紊乱与抑郁焦虑症状关联[J]. 中国学校卫生, 2022, 43(5): 731-735. doi: 10.16835/j.cnki.1000-9817.2022.05.021 LI S, CHENG J, LI Y P, et al. The association between sadness and anxiety among Jinzhou university students and circadian rhythm disorder[J]. Chin J Sch Health, 2022, 43(5): 731-735. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.05.021
[11]	陶舒曼, 万宇辉, 伍晓艳, 等. 《青少年心理健康评定简明问卷》的心理学评价及应用[J]. 中国学校卫生, 2020, 41(9): 1331-1334. doi: 10.16835/j.cnki.1000-9817.2020.09.014 TAO S M, WAN Y H, WU X Y, et al. Concise Questionnaire for Adolescent Mental Health Assessment application and psychological assessment[J]. Chin J Sch Health, 2020, 41(9): 1331-1334. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2020.09.014
[12]	李伟霞, 穆叶色·艾则孜, 谢植涛, 等. 清晨型与夜晚型量表-5项测评技工学校学生的效度和信度[J]. 中国心理卫生杂志, 2016, 30(6): 406-412. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201606004.htm LI W X, MUYESE A, XIE Z T, et al. Validity and reliability of the Chinese version of Morningness/Eveningness Questionnaire-5 items (MEQ-5) in students of technical schools[J]. Chin J Ment Health, 2016, 30(6): 406-412. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201606004.htm
[13]	查晓丽, 朱卓妍, 伍晓艳, 等. 安徽某高校大学生睡眠行为和时型与情绪症状的随访研究[J]. 中国学校卫生, 2021, 42(8): 1206-1211. doi: 10.16835/j.cnki.1000-9817.2021.08.020 ZHA X L, ZHU Z Y, WU X Y, et al. Follow-up study on sleep behavior, chronotype and emotional symptoms of college students in Anhui Province[J]. Chin J Sch Health, 2021, 42(8): 1206-1211. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.08.020
[14]	丛皓, 郭菲, 陈祉妍. 青少年昼夜偏好类型及其与睡眠质量关系[J]. 中国公共卫生, 2019, 35(10): 1400-1403. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201910026.htm CONG H, GUO F, CHEN Z Y. The link between circadian preference and adolescent sleep quality[J]. Chin J Public Health, 2019, 35(10): 1400-1403. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201910026.htm
[15]	朱莹莹, 马晓晴, 唐卓仪, 等. 不同睡眠时型对心理行为活动的影响及其作用机制[J]. 心理技术与应用, 2021, 9(10): 629-640. https://www.cnki.com.cn/Article/CJFDTOTAL-XLJS202110007.htm ZHU Y Y, MA X Q, TANG Z Y, et al. Various sleep patterns' effects on psychological behavior and their mechanisms[J]. Psychol Technol Appl, 2021, 9(10): 629-640. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLJS202110007.htm
[16]	KIM J, NOH J W, KIM A, et al. Demographic and socioeconomic influences on sleep patterns among adolescent students[J]. Int J Environ Res Public Health, 2020, 17(12): 4378.
[17]	王琪延, 佟志伟. 男性"晚睡晚起"女性"早睡早起"[J]. 中国统计, 2007(11): 21-22. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTJ200711011.htm WANG Q Y, TONG Z W. Males "go to bed late and get up late" while females "go to bed early and get up early"[J]. Chin Stat, 2007(11): 21-22. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTJ200711011.htm
[18]	DUFFY J F, CAIN S W, CHANG A M, et al. Sex difference in the near-24-hour intrinsic period of the human circadian timing system[J]. Proc Natl Acad Sci USA, 2011, 108(Suppl 3): 15602-15608.
[19]	GIANNOTTI F, CORTESI F, SEBASTIANI T, et al. Circadian preference, sleep and daytime behaviour in adolescence[J]. J Sleep Res, 2002, 11(3): 191-199.
[20]	张亚利, 靳娟娟, 俞国良. 2010—2020中国内地初中生心理健康问题检出率的元分析[J]. 心理科学进展, 2022, 30(5): 965-977. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD202205002.htm ZHANG Y L, JIN J J, YU G L. A Meta-analysis of mental health issues among pupils in mainland China's junior middle schools from 2010 to 2020[J]. Adv Psychol Sci, 2022, 30(5): 965-977. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD202205002.htm
[21]	ASHBROOK L H, KRYSTAL A D, FU Y H, et al. Genetics of the human circadian clock and sleep homeostat[J]. Neuropsychopharmacology, 2020, 45(1): 45-54.
[22]	陈永进, 黄惠珍, 支愧云, 等. 睡眠时型与抑郁的关系及其机制[J]. 心理科学进展, 2020, 28(10): 1713-1722. https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD202010009.htm CHEN Y J, HUANG H Z, ZHI K Y, et al. The connection between sleep chronotype and depression and its mechanism[J]. Adv Psychol Sci, 2020, 28(10): 1713-1722. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLXD202010009.htm
[23]	BAUDUCCO S, RICHARDSON C, GRADISAR M. Chronotype, circadian rhythms and mood[J]. Curr Opin Psychol, 2020, 34: 77-83.