山东省中小学生睡眠与心理健康的相关性

裴亚兴; 王雪纯; 孔令敏; 冉晓妤; 魏梦珂; 高杰

doi:10.16835/j.cnki.1000-9817.2023.11.018

山东省中小学生睡眠与心理健康的相关性

doi: 10.16835/j.cnki.1000-9817.2023.11.018

1.
潍坊医学院公共卫生学院，山东 261053
2.
山东省妇幼保健院妇幼健康发展研究中心

基金项目:

2021年度山东省青少年研究规划一般课题 SDQY20210211

详细信息

作者简介:
裴亚兴(1997-)，男，山西运城人，在读硕士，主要研究方向为儿少卫生与妇幼保健

通讯作者:
高杰，E-mail：agao1224@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: B844.2 Q428
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- 被引次数: 0
出版历程
- 收稿日期: 2023-07-18
- 修回日期: 2023-08-11
- 网络出版日期: 2023-11-27
- 刊出日期: 2023-11-25

Analysis of the correlation between sleep and mental health among primary and secondary school students in Shandong Province

1.
School of Public Health, Weifang Medical University, Weifang (261053), Shandong Province, China

摘要

摘要: 目的了解山东省青少年睡眠与心理健康状况及其相关性，为青少年身心健康管理提供依据。方法于2023年2—3月，采用多阶段分层随机整群抽样法，在山东省抽取济南、青岛、潍坊3个市，每市分别抽取1个城区和1个乡镇，在城区和乡镇分别抽取1所初中和1所高中，再从各学校各年级中随机抽取4个班，以班内所有学生为调查对象，共3 667人，采用匹兹堡睡眠质量指数量表(PSQI)简表和中国中学生心理健康量表(MMHI-60)进行问卷调查。结果山东省青少年睡眠不足的发生率为37.44%，心理问题检出率为46.41%。青少年心理可分为4个潜类别：心理免疫组(39.6%)、心理低危组(12.2%)、心理中危组(13.2%)和心理高危组(35.0%)。多因素Logistic回归分析结果显示，性别、学段、睡眠时间和睡眠质量是心理潜类别的相关因素(OR=1.39~9.55，P值均 < 0.05)；以心理免疫组为参照，睡眠不足和睡眠质量差的青少年更倾向归于心理低、中、高危组。结论山东省青少年睡眠与心理健康状况不容乐观。综合防控心理问题需要关注青少年睡眠状况。
- 睡眠 /
- 精神卫生 /
- 回归分析 /
- 青少年
Abstract: Objective To investigate the sleep and mental health status of adolescents in Shandong Province, to explore the correlation between sleep and mental health, so as to provide a basis for adolescent physical and mental health management. Methods From February to March 2023, a multistage stratified whole cluster sampling method was used to randomly select 3 cities in Shandong Province, one urban area and one township in each city, one junior high school and one senior high school in the urban area and the township, respectively, and then 4 classes were randomly selected from each grade level of each school, and all 3 667 students in the classes were surveyed by using the Pittsburgh Sleep Quality Index Scale (PSQI) short form and the Chinese Middle School Students' Mental Health Inventory (MMHI-60). Results The prevalence of sleep deprivation among adolescents in Shandong Province was 37.44%, and the detection rate of psychological problems was 46.41%. Adolescent psychology could be divided into four latent categories: psychological immune group (39.6%), psychological low-risk group (12.2%), psychological medium-risk group (13.2%) and psychological high-risk group (35.0%). Multifactorial Logistic regression analyses showed that gender, school year, sleep duration and sleep quality were influencing factors for the psychological latent categories (OR=1.39-9.55, P < 0.05), and that adolescents with sleep deprivation and poor sleep quality were more inclined to be classified as being in the psychological medium-and high-risk groups. Conclusions The sleep and mental health of adolescents in Shandong Province is not very good. Comprehensive prevention and control of psychological problems should not only focus on personality and psychological characteristics, but also need to be combined with the sleep condition of adolescents.
- Sleep /
- Mental health /
- Regression analysis /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 山东省青少年心理健康4个潜在类别条件概率分布

Figure 1. Probability distribution of four potential categories of adolescent mental health in Shandong Province

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表 1 山东省青少年心理健康潜类别模型拟合指标

Table 1. Fitting index of the latent category model of adolescent mental health in Shandong Province

类别	k	AIC值	BIC值	aBIC值	Entropy值	P_LMR值	P_BLRT值	类别概率
C1	10	50 179.3	50 241.4	50 209.6	-	-	-	1.00
C2	21	26 017.8	26 148.1	26 081.4	0.98	<0.01	<0.01	0.50/0.50
C3	32	23 647.4	23 846.0	23 744.4	0.93	<0.01	<0.01	0.17/0.44/0.39
C4	43	23 303.3	23 570.3	23 433.6	0.87	<0.01	<0.01	0.35/0.12/0.13/0.40
C5	54	23 265.0	23 600.2	23 428.6	0.88	0.02	<0.01	0.35/0.11/0.40/0.02/0.12
C6	65	23 252.5	23 656.0	23 449.5	0.82	0.64	<0.01	0.03/0.09/0.40/0.32/0.05/0.10

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表 2 不同组别青少年心理潜类别分布比较

Table 2. Comparison of the distribution of psychotropic categories among different groups of adolescents

组别	选项	人数	心理免疫组	心理低危组	心理中危组	心理高危组	Z/H/r值	P值
性别	男	1 828	819(44.80)	212(11.60)	225(12.31)	572(31.29)	-6.27	<0.01
	女	1 839	632(34.37)	237(12.89)	259(14.08)	711(38.66)
学段	初中	1 537	878(57.12)	173(11.26)	146(9.50)	340(22.12)	-18.41	<0.01
	高中	2 130	573(26.90)	276(12.96)	338(15.87)	943(44.27)
独生子女	是	997	359(36.01)	135(13.54)	156(15.65)	347(34.80)	-1.58	0.11
	否	2 670	1 092(40.90)	314(11.76)	328(12.28)	936(35.06)
家庭结构	完整家庭	3 393	1 354(39.91)	419(12.35)	443(13.06)	1 177(34.69)	2.84	0.24
	跟随父母一方	226	79(34.96)	28(12.39)	32(14.16)	87(38.50)
	跟随祖父母	48	18(37.50)	2(4.17)	9(18.75)	19(39.58)
家庭月收入/元	<2 000	222	102(45.95)	27(12.16)	31(13.96)	62(27.93)	0.05	<0.01
	2 000~<4 000	809	350(43.26)	96(11.87)	84(10.38)	279(34.49)
	4 000~<8 000	1 278	511(39.98)	150(11.74)	152(11.89)	465(36.38)
	8 000~10 000	665	244(36.69)	79(11.88)	104(15.64)	238(35.79)
	>10 000	693	244(35.21)	97(14.00)	113(16.31)	239(34.49)
睡眠时间	充足	2 294	1 058(46.12)	282(12.29)	261(11.38)	693(30.21)	-10.59	<0.01
	不足	1 373	393(28.62)	167(12.16)	223(16.24)	590(42.97)
睡眠质量	好	2 681	1 338(49.91)	352(13.13)	336(12.53)	655(24.43)	-24.36	<0.01
	差	986	113(11.46)	97(9.84)	148(15.01)	628(63.69)
注：( )内数字为构成比/%。

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表 3 山东省青少年心理潜类别的多因素Logistic回归分析

Table 3. Multivariate Logistic regression analysis of the psychological latent category among adolescents in Shandong Province

因变量	常数与自变量	β值	标准误	Wald χ²值	P值	OR值(95%CI)
低危组	常数	4.67	0.33	202.78	<0.01
(n=449)	性别	0.33	0.11	8.91	<0.01	1.39(1.12~1.73)
	学段	0.85	0.11	58.02	<0.01	2.35(1.88~2.92)
	睡眠时间	0.39	0.12	11.03	<0.01	1.47(1.17~1.85)
	睡眠质量	1.07	0.15	48.87	<0.01	2.91(2.16~3.93)
中危组	常数	6.13	0.33	337.05	<0.01
(n=484)	性别	0.33	0.11	8.94	<0.01	1.39(1.12~1.72)
	学段	1.20	0.12	107.72	<0.01	3.30(2.64~4.14)
	睡眠时间	0.71	0.11	39.20	<0.01	2.03(1.63~2.54)
	睡眠质量	1.48	0.14	106.71	<0.01	4.37(3.30~5.78)
高危组	常数	6.39	0.27	548.63	<0.01
(n=1 283)	性别	0.39	0.09	19.90	<0.01	1.48(1.25~1.76)
	学段	1.32	0.09	212.34	<0.01	3.73(3.13~4.45)
	睡眠时间	0.60	0.09	42.96	<0.01	1.83(1.53~2.19)
	睡眠质量	2.26	0.12	373.65	<0.01	9.55(7.59~12.00)

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参考文献(21)

[1]	薛云云, 肖煜吟, 付航, 等. 青少年心理健康现状及改善对策: 基于上海市3家医院的调查结果[J]. 中国卫生政策研究, 2019, 12(2): 65-69. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWZ201902010.htm XUE Y Y, XIAO Y Y, FU H, et al. The status quo of child and adolescent mental health in china and its improvement strategies: based on survey results of three hospitals in Shanghai[J]. Chin J Health Policy Res, 2019, 12(2): 65-69. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWZ201902010.htm
[2]	ORBEN A, TOMOVA L, BLAKEMORE S J. The effects of social deprivation on adolescent development and mental health[J]. Lancet Child Adolesc Health, 2020, 4(8): 634-640. doi: 10.1016/S2352-4642(20)30186-3
[3]	丁文清, 周苗, 宋菲. 中国学龄儿童青少年心理健康状况Meta分析[J]. 宁夏医科大学学报, 2017, 39(7): 785-791, 795. https://www.cnki.com.cn/Article/CJFDTOTAL-XNXY201707012.htm DING W Q, ZHOU M, SONG F. Meta-analysis on the mental health status among children and adolescents in China[J]. J Ningxia Med Univ, 2017, 39(7): 785-791, 795. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XNXY201707012.htm
[4]	VERMEULEN M C M, VAN DER HEIJDEN K B, KOCEVSKA D, et al. Associations of sleep with psychological problems and well-being in adolescence: causality or common genetic predispositions?[J]. J Child Psychol Psychiatry, 2021, 62(1): 28-39. doi: 10.1111/jcpp.13238
[5]	BOOTH S A, CARSKADON M A, YOUNG R, et al. Sleep duration and mood in adolescents: an experimental study[J]. Sleep, 2021, 44(5): zsaa253. doi: 10.1093/sleep/zsaa253
[6]	TAROKH L, SALETIN J M, CARSKADON M A. Sleep in adolescence: physiology, cognition and mental health[J]. Neurosci Biobehav Rev, 2016, 70: 182-188. doi: 10.1016/j.neubiorev.2016.08.008
[7]	PALMER C A. Tired teens: sleep disturbances and heightened vulnerability for mental health difficulties[J]. Lancet Child Adolesc Health, 2020, 66(5): 520-521.
[8]	中华人民共和国教育部. 中国青少年儿童睡眠健康白皮书2019年[C]//艾瑞咨询系列研究报告. 上海: 上海艾瑞市场咨询有限公司, 2019: 185-235. Ministry of Education of the PRC. White paper on sleep health of Chinese adolescents 2019[C]//Ariel consults on a series of research reports. Shanghai: Shanghai Research Market Consulting Co., LTD, 2019: 185-235. (in Chinese)
[9]	刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, 29(2): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm LIU X C, TANG M Q, HU L, et al. Reliability and validity of the Pittsburgh Sleep Quality Index[J]. Chin J Psychiatry, 1996, 29(2): 103-107. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm
[10]	中华人民共和国教育部办公厅关于进一步加强中小学生睡眠管理工作的通知[EB/OL]. (2021-04-02)[2023-06-20]. http://www.gov.cn/zhengce/zhengceku/2021-04/02/content_5597443.htm. Circular of the General Office of the Ministry of Education of the PRC on further strengthening sleep management for primary and secondary school students[EB/OL]. (2021-04-02)[2023-06-20]. http://www.gov.cn/zhengce/zhengceku/2021-04/02/content_5597443.htm. (in Chinese)
[11]	王极盛, 李焰, 赫尔实. 中国中学生心理健康量表的编制及其标准化[J]. 社会心理科学, 1997(4): 15-20. WANG J S, LI Y, HE E S. Development and standardization of Mental Health Scale for Middle School Students in China[J]. J Soc Psychol, 1997(4): 15-20. (in Chinese)
[12]	WHEATON A G, CLAUSSEN A H. Short sleep duration among infants, children, and adolescents aged 4 months-17 years - United States, 2016-2018[J]. MMWR, 2021, 70(38): 1315-1321.
[13]	闫静弋, 于连龙, 张俊黎. 2010—2012年山东省6~17岁儿童青少年睡眠状况[J]. 卫生研究, 2018, 47(5): 725-727, 732. https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201805009.htm YAN J Y, YU L L, ZHANG J L. Sleep conditions of children and adolescents aged 6-17 years old in Shandong Province in 2010-2012[J]. J Hyg Res, 2018, 47(5): 725-727, 732. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WSYJ201805009.htm
[14]	岳彩镇, 杨志雯, 费秀芬, 等. 重庆市某区青少年心理健康状况及影响因素分析[J]. 保健医学研究与实践, 2021, 18(3): 15-21. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ202103004.htm YUE C Z, YANG Z W, FEI X F, et al. A study on the mental health status and influencing factors of adolescents in a district in Chongqing[J]. J Prev Med Res Pract, 2021, 18(3): 15-21. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ202103004.htm
[15]	曹薇. 新冠肺炎疫情防控背景下贵州省初中生心理健康现状及常模的建立[J]. 遵义师范学院学报, 2022, 24(4): 157-161. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYSF202204040.htm CAO W. The establishment of the norm and mental health status of junior high school students in Guizhou Province under the background of COVID-19 epidemic prevention and control[J]. J Zunyi Norm Univ, 2022, 24(4): 157-161. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZYSF202204040.htm
[16]	YUAN J, LUO Y, YAN J H, et al. Neural correlates of the females' susceptibility to negative emotions: an insight into gender-related prevalence of affective disturbances[J]. Hum Brain Mapp, 2009, 30(11): 3676-3686.
[17]	TEMPESTA D, SOCCI V, DE GENNARO L, et al. Sleep and emotional processing[J]. Sleep Med Rev, 2018, 40: 183-195.
[18]	ASARNOW L D, MIRCHANDANEY R. Sleep and mood disorders among youth[J]. Child Adolesc Psychiatr Clin N Am, 2021, 30(1): 251-268.
[19]	LEWIS L D. The interconnected causes and consequences of sleep in the brain[J]. Science, 2021, 374(6567): 564-568.
[20]	AHRENS A M, AHMED O J. Neural circuits linking sleep and addiction: animal models to understand why select individuals are more vulnerable to substance use disorders after sleep deprivation[J]. Neurosci Biobehav Rev, 2020, 108: 435-444.
[21]	ANTCZAK D, SANDERS T, DEL POZO CRUZ B, et al. Day-to-day and longer-term longitudinal associations between physical activity, sedentary behavior, and sleep in children[J]. Sleep, 2021, 44(4): 219.