Association between depression and anxiety symptoms with physical activity among rural returning adolescents
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摘要:
目的 了解农村回流青少年抑郁焦虑症状及其与体力活动相关因素的关联，为开展抑郁焦虑症状的干预提供参考。 方法 于2020年4—6月，采取随机整群分层抽样法从上饶市6个县选取3 495名中学生为研究对象，运用患者健康问卷(PHQ-9)和广泛性焦虑量表(GAD-7)分别评估抑郁焦虑症状，使用国际体力活动调查问卷评估其1周体力活动情况。采用χ2检验和Logistic回归分析回流与非回流及总体青少年抑郁焦虑症状与体力活动相关因素的关联强度。 结果 农村回流与非回流青少年抑郁、焦虑症状发生与“就读类型”“家庭经济情况”“父亲职业”“母亲职业”“每周体育课次数”“每周体力活动水平”均相关(χ2值分别为78.21，16.56，135.44，107.75，7.10，8.62；97.94，24.26，124.07，90.36，9.60，8.34，P值均＜0.05)。多因素Logistic回归分析显示，农村回流与非回流及总体青少年“是否抑郁”与“每周体育课次数”有相关性(非回流青少年，2次，OR=1.22，95%CI=1.01~1.49；回流青少年，1次，OR=1.85，95%CI=1.06~3.23；总体，1次，OR=1.34，95%CI=1.01~1.77，2次，OR=1.20，95%CI=1.01~1.43)；回流青少年“是否焦虑”与“每周体育课次数”有相关性(1次，OR=2.10，95%CI=1.21~3.63)(P值均＜0.05)。 结论 每周低频次体育课可能是农村回流青少年抑郁或焦虑症状发生的影响因素。农村中小学应适当增加体育课程数量或安排体育延时课，以促进青少年心理健康发展。 Abstract:Objective To understand the symptoms of depression and anxiety among rural returning adolescents and to analyze their association with physical activity-related factors, so as to provide reference for interventions targeting depression and anxiety symtoms in the population. Methods From April to June 2020, 3 495 middle school students were selected from 6 counties and districts of Shangrao City by random cluster stratified sampling sampling. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to evaluate the depressive and anxiety symptoms among middle school students. The International Physical Activity Questionnaire was used to assess their physical activity levels during the past week. Chi-square test and Logistic regression analysis were used to determine the strength of the association between depression and anxiety symptoms and physical activity-related factors in returning and non-returning adolescents as well as the overall population. Results Univariate analysis showed significant differences in the prevalence of depressive and anxiety symptoms between rural returning and non-returning adolescents and the overall population in terms of "type of school" "family economic situation" "parental occupation" "number of sports classes per week" and "level of physical activity per week" (χ2=78.21, 16.56, 135.44, 107.75, 7.10, 8.62; 97.94, 24.26, 124.07, 90.36, 9.60, 8.34, P < 0.05). Multivariate regression analysis showed a correlation between the occurrence of depression and the number of sports classes per week for rural returning and non-returning adolescents and the overall population (number of sports classes per week for non-returning was 2 times, OR=1.22, 95%CI=1.01-1.49; returning adolescents for 1 time, OR=1.85, 95%CI=1.06-3.23; the overall population for 1 time, OR=1.34, 95%CI=1.01-1.77 and 2 times, OR=1.20, 95%CI=1.01-1.43, P < 0.05). There was a correlation between anxiety symptoms and the number of sports classes per week for returning adolescents (number of sports classes per week for returning adolescents was 1 time, OR=2.10, 95%CI=1.21-3.63, P < 0.05). Conclusion A low frequency of weekly sports classes may be a risk factor for depressive or anxiety symptoms in rural and returning adolescents. Rural primary and secondary schools should appropriately increase the number of physical education courses or arrange sports extended classes to promote the development of adolescent mental health. -
Key words:
- Depression /
- Anxiety /
- Motor activity /
- Regression analysis /
- Mental health /
- Adolescent
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表 1 非回流与回流青少年抑郁症状的人口学特征构成比比较
Table 1. Comparison of constituent ratio for demography characteristics among returning and non-returning adolescents with depression symptoms
组别 抑郁症状检出人数 性别 学段 就读类型 家庭经济状况 男 女 初中 高中 寄宿 走读 差 一般 好 回流 225 93(41.3) 132(58.7) 101(44.9) 124(55.1) 38(16.9) 187(83.1) 27(12.0) 164(72.9) 34(15.1) 非回流 963 437(45.4) 526(54.6) 449(46.6) 514(53.4) 475(49.3) 488(50.7) 195(20.2) 691(71.8) 77(8.0) χ2值 1.21 0.22 78.21 16.56 P值 0.27 0.64 < 0.01 < 0.01 组别 抑郁症状检出人数 父亲职业 母亲职业 公务员 工人 公司职员 商人 农民 其他 公务员 工人 公司职员 商人 农民 其他 回流 225 46(20.4) 46(20.4) 22(9.8) 39(17.3) 7(3.2) 65(28.9) 39(17.3) 19(8.4) 30(13.3) 28(12.5) 10(4.5) 99(44.0) 非回流 963 27(2.8) 383(39.8) 60(6.2) 110(11.4) 123(12.8) 260(27.0) 38(3.9) 274(28.5) 76(7.9) 72(7.5) 139(14.4) 364(37.8) χ2值 135.44 107.75 P值 < 0.01 < 0.01 注： ()内数字为构成比/%。 
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表 2 非回流与回流青少年焦虑症状的人口学特征构成比比较
Table 2. Comparison of constituent ratio for demography characteristics among returning and non-returning adolescents with anxiety symptoms
组别 焦虑症状检出人数 性别 学段 就读类型 家庭经济状况 男 女 初中 高中 寄宿 走读 差 一般 好 回流 259 114(44.0) 145(56.0) 127(49.0) 132(51.0) 38(14.7) 221(85.3) 28(10.8) 185(71.4) 46(17.8) 非回流 998 443(44.4) 555(55.6) 471(47.2) 527(52.8) 486(48.7) 512(51.3) 195(19.5) 715(71.6) 88(8.9) χ2值 0.01 0.28 97.94 24.26 P值 0.91 0.60 < 0.01 < 0.01 组别 焦虑症状检出人数 父亲职业 母亲职业 公务员 工人 公司职员 商人 农民 其他 公务员 工人 公司职员 商人 农民 其他 回流 259 49(18.9) 59(22.8) 30(11.6) 38(14.7) 9(3.5) 74(28.5) 41(15.8) 27(10.4) 34(13.1) 35(13.5) 11(4.2) 111(43.0) 非回流 998 29(2.9) 414(41.5) 68(6.8) 125(12.5) 110(11.0) 252(25.3) 42(4.2) 279(28.0) 84(8.4) 98(9.8) 125(12.5) 370(37.1) χ2值 124.07 90.36 P值 < 0.01 < 0.01 注： ()内数字为构成比/%。
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表 3 非回流与回流青少年抑郁症状的体力活动相关因素构成比比较
Table 3. Comparison of constituent ratio for physical activity related factors among returning and non-returning adolescents with depression symptoms
组别 抑郁症状检出人数 每周体育课次数 平均每天体育锻炼时间/h 每周体力活动水平 每周是否有适度体力活动 1 2 3 ＜1 1~2 ＞2 低 中 高 是 否 回流 225 26(11.6) 43(19.1) 156(69.3) 106(47.1) 61(27.1) 58(25.8) 46(20.4) 119(52.9) 60(26.7) 65(28.9) 160(71.1) 非回流 963 64(6.6) 222(23.1) 677(70.3) 423(43.9) 281(29.2) 259(26.9) 289(30.0) 432(44.9) 242(25.1) 339(35.2) 624(64.8) χ2值 7.10 0.77 8.62 3.24 P值 ＜0.05 0.68 ＜0.05 0.07 组别 抑郁症状检出人数 每周是否有剧烈体力活动 每天步行时间/h 每天久坐时间/h 是 否 ＜1 1~3 ＞3 ＜1 1~3 ＞3 回流 225 110(48.9) 115(51.1) 197(87.6) 24(10.7) 4(1.7) 23(10.2) 32(14.2) 170(75.6) 非回流 963 446(46.3) 517(53.7) 790(82.0) 129(13.4) 44(4.6) 115(11.9) 162(16.8) 686(71.3) χ2值 0.49 5.24 1.69 P值 0.49 0.07 0.43 注： ()内数字为构成比/%。
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表 4 非回流与回流青少年焦虑症状的体力活动相关因素构成比比较
Table 4. Comparison of constituent ratio for physical activity related factors among returning and non-returning adolescents with anxiety symptoms
组别 焦虑症状检出人数 每周体育课次数 平均每天体育锻炼时间/h 每周体力活动水平 每周是否有适度体力活动 1 2 3 ＜1 1~2 ＞2 低 中 高 是 否 回流 259 31(12.0) 49(18.9) 179(69.1) 116(44.8) 74(28.6) 69(26.6) 53(20.5) 134(51.7) 72(27.8) 77(29.7) 182(70.3) 非回流 998 64(6.4) 222(22.2) 712(71.4) 442(44.3) 288(28.9) 268(26.8) 294(29.5) 461(46.2) 243(24.3) 335(33.6) 663(66.4) χ2值 9.60 0.02 8.34 1.37 P值 ＜0.05 0.99 ＜0.05 0.24 组别 焦虑症状检出人数 每周是否有剧烈体力活动 每天步行时间/h 每天久坐时间/h 是 否 ＜1 1~3 ＞3 ＜1 1~3 ＞3 回流 259 124(47.9) 135(52.1) 226(87.3) 29(11.2) 4(1.5) 26(10.0) 39(15.1) 194(74.9) 非回流 998 460(46.1) 538(53.9) 816(81.8) 142(14.2) 40(4.0) 112(11.2) 179(17.9) 707(70.9) χ2值 0.26 5.70 1.71 P值 0.61 0.06 0.42 注： ()内数字为构成比/%。
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表 5 非回流与回流及总体青少年抑郁焦虑症状与体力活动相关因素的Logistic回归分析
Table 5. Logistic regression analysis of factors related to depression and anxiety symptoms and physical activity among returning, non-returning and overall adolescents
因变量 自变量 选项 回流青少年(n=745) 非回流青少年(n=2 750) 总体(n=3 495) β值 OR值(95%CI) β值 OR值(95%CI) β值 OR值(95%CI) 抑郁 每周体育课次数 2 0.02 1.03(0.68~1.54) 0.20 1.22(1.01~1.49)* 0.18 1.20(1.01~1.43)* 1 0.61 1.85(1.06~3.23)* 0.16 1.17(0.84~1.62) 0.30 1.34(1.01~1.77)* 每周体力活动水平 中等 0.08 1.08(0.74~1.57) -0.16 0.85(0.70~1.03) -0.12 0.88(0.74~1.05) 低 -0.13 0.88(0.55~1.39) 0.10 1.11(0.89~1.38) 0.06 1.06(0.87~1.29) 焦虑 每周体育课次数 2 0.03 1.03(0.69~1.52) 0.13 1.13(0.93~1.37) 0.12 1.12(0.94~1.33) 1 0.74 2.10(1.21~3.63)* 0.08 1.08(0.78~1.50) 0.27 1.31(0.99~1.73) 每周体力活动水平 中等 -0.05 0.95(0.66~1.36) -0.07 0.94(0.77~1.14) -0.07 0.93(0.79~1.11) 低 -0.22 0.81(0.52~1.25) 0.14 1.15(0.92~1.43) 0.07 1.07(0.88~1.30) 注：自变量控制“就读类型”“家庭经济情况”“父亲职业”和“母亲职业”因素；*P < 0.05。
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