浙江省2018—2021年中学生抑郁症状及影响因素分析

顾昉; 杨颖; 郑卫军; 孟佳; 李娟娟; 沈郁; 高雷; 邹艳; 章荣华

doi:10.16835/j.cnki.1000-9817.2024105

浙江省2018—2021年中学生抑郁症状及影响因素分析

doi: 10.16835/j.cnki.1000-9817.2024105

顾昉¹,
杨颖²,
郑卫军²,
孟佳¹,
李娟娟¹,
沈郁¹,
高雷¹,
邹艳¹,
章荣华¹

1.
浙江省疾病预防控制中心营食所学校卫生科，杭州 310051
2.
浙江中医药大学公共卫生学院

详细信息

作者简介:
顾昉(1974-)，女，浙江海宁人，硕士，主任医师，主要研究方向为学校卫生与儿少卫生

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 G444 G478
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- 被引次数: 0
出版历程
- 收稿日期: 2024-01-04
- 修回日期: 2024-01-24
- 网络出版日期: 2024-04-25
- 刊出日期: 2024-04-25

Analysis of depressive symptoms and influencing factors among middle and high school students from 2018 to 2021 in Zhejiang Province

1.
Division of School Health, Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou (310051), Zhejiang Province, China

摘要

摘要: 目的了解浙江省中学生抑郁症状的流行特征及影响因素，为实施相应的干预措施提供科学依据。方法基于2018—2021年学生常见病和健康影响因素监测与干预项目中中学生健康状况及影响因素部分，采用多阶段分层整群随机抽样方法，在浙江省11个市纳入所调查的所有初中、普通高中(简称普高)、职业高中(简称职高)，共计73 309名中学生，2018—2021年分别为6 008，21 917，23 712，21 672名。采用χ²检验和Logistic回归模型对中学生抑郁症状的影响因素进行分析。结果 2018—2021年中学生抑郁症状检出率为14.8%，女生(17.1%)高于男生(12.7%)，高中阶段(普高17.1%，职高17.6%)高于初中阶段(12.5%)(χ²值分别为278.77，327.22，P值均 < 0.05)。单因素分析显示，不同年份(2018：16.7%，2019：17.9%，2020：13.1%，2021：13.0%)、住校(是：16.3%，否：13.5%)、体质量指数分类(非超重肥胖：14.8%，超重：14.2%，肥胖：15.7%)、每周运动天数(0~2 d：17.1%，3~5 d：12.5%，6~7 d：13.1%)及有无校园欺凌(有：35.5%，无：10.7%)的中学生抑郁症状检出率差异均有统计学意义(χ²值分别为293.40，118.35，7.83，287.24，4 978.84，P值均 < 0.05)。多因素Logistic回归分析显示，女生、普高、职高、肥胖、遭受校园欺凌与抑郁均呈正相关(OR值分别为1.65，1.70，1.60，1.12，5.21)，每周运动3~5和6~7 d与抑郁均呈负相关(OR值分别为0.77，0.81)(P值均 < 0.01)。结论浙江省中学生抑郁症状问题突出。应加强中学生的心理健康教育，从家庭、学校、社会等方面给予关注，以减少中学生抑郁症状的发生。
- 抑郁 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the prevalence and associated factors of depressive symptoms among middle and high school students in Zhejiang Province, so as to provide scientific basis for the implementation of depressive intervention. Methods Based on the health status and associated factors of middle and high school students in the project "Monitoring of Common Diseases and Health Influencing Factors of Students" during 2018 to 2021, a total of 73 309 students including middle school, ordinary high school and vocational high school surveyed in 11 cities of Zhejiang Province were selected by multi-stage stratified cluster random sampling method. From 2018 to 2021, there were 6 008, 21 917, 23 712 and 21 672 students, respectively. The Chi-square test and Logistic regression model were used to analyze the influencing factors of depressive symptoms in middle and high school students. Results From 2018 to 2021, depressive symptoms detection rate of middle school students was 14.8%, with higher rate in girls (17.1%) than in boys (12.7%), higher rate in high school (17.1% in ordinary high school, 17.6% in vocational high school) than middle school (12.5%)(χ²=278.77, 327.22, P < 0.05). Univariate analysis showed that there were statistically significant differences in depressive symptoms detection rate among middle school students with different years (2018: 16.7%, 2019: 17.9%, 2020: 13.1%, 2021: 13.0%), residence (yes: 16.3%, no: 13.5%), body mass index classification (not overweight or obesity: 14.8%, overweight: 14.2%, Obesity: 15.7%), weekly exercise days (0-2 d: 17.1%, 3-5 d: 12.5%, 6-7 d: 13.1%) and bullying (yes: 35.5%, no: 10.7%) (χ²=293.40, 118.35, 7.83, 287.24, 4 978.84, P < 0.05). Multivariate Logistic regression analysis showed that female students, ordinary high schools, vocational high schools, obesity, school bullying were positively correlated with depression (OR=1.65, 1.70, 1.60, 1.12, 5.21), exercise 3 to 5 days per week, exercise 6 to 7 days per week were negatively correlated with depression (OR=0.77, 0.81, P < 0.01). Conclusions Depressive symptoms among middle and high school students in Zhejiang Province are prominent. Strengthening mental health education for students and providing attention and support from families, schools, and society are essential steps to reduce the occurrence of depressive symptoms among these students.
- Depression /
- Mental health /
- Regression analysis /
- Students
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表 1 不同组别中学生2018—2021年抑郁症状检出率比较

Table 1. Comparison of depressive symptoms detection rate of middle school students in different groups during 2018-2021

组别	统计值	2018年		2019年		2020年		2021年		合计
组别	统计值	人数	检出人数	人数	检出人数	人数	检出人数	人数	检出人数	人数	检出人数
性别
男		3 141	474(15.1)	11 360	1 752(15.4)	12 193	1 337(11.0)	11 155	1 239(11.1)	37 849	4 802(12.7)
女		2 867	528(18.4)	10 557	2 173(20.6)	11 519	1 768(15.3)	10 517	1 584(15.1)	35 460	6 053(17.1)
	χ²值		11.93		99.14		100.00		74.71		278.77
	P值		< 0.01		< 0.01		< 0.01		< 0.01		< 0.01
居住地
城区		3 828	665(17.4)	13 653	2 471(18.1)	14 134	1 781(12.6)	13 706	1 853(13.5)	45 321	6 770(14.9)
郊县		2 180	337(15.5)	8 264	1 454(17.6)	9 578	1 324(13.8)	7 966	970(12.2)	27 988	4 085(14.6)
	χ²值		3.66		0.89		7.50		8.02		1.61
	P值		0.06		0.35		< 0.01		< 0.01		0.21
学段
初中		3 001	414(13.8)	11 281	1 828(16.2)	12 028	1 344(11.2)	11 037	1 076(9.7)	37 347	4 662(12.5)
普高		2 249	471(20.9)	7 958	1 601(20.1)	8 873	1 310(14.8)	8 376	1 315(15.7)	27 456	4 697(17.1)
职高		758	117(15.4)	2 678	496(18.5)	2 811	451(16.0)	2 259	432(19.1)	8 506	1 496(17.6)
	χ²值		48.22		49.40		82.21		231.60		327.22
	P值		< 0.01		< 0.01		< 0.01		< 0.01		< 0.01
住校
是		3 295	626(19.0)	10 012	1 920(19.2)	11 114	1 624(14.6)	9 417	1 362(14.5)	33 838	5 532(16.3)
否		2 713	376(13.9)	11 905	2 005(18.4)	12 598	1 481(11.8)	12 255	1 461(11.9)	39 471	5 323(13.5)
	χ²值		28.28		20.17		42.33		30.36		118.35
	P值		< 0.01		< 0.01		< 0.01		< 0.01		< 0.01
民族
汉族		5 878	987(16.8)	21 498	3 855(17.9)	23 156	3 015(13.0)	21 120	2 766(13.1)	71 652	10 623(14.8)
其他民族		130	15(11.5)	419	70(16.7)	556	90(16.2)	552	57(10.3)	1 657	232(14.0)
	χ²值		2.53		0.42		4.78		3.64		0.87
	P值		0.11		0.52		0.03		0.06		0.35
BMI分类
非超重肥胖		4 739	799(16.9)	16 802	2 979(17.7)	17 569	2 305(13.1)	15 957	2 083(13.1)	55 067	8 166(14.8)
超重		815	130(16.0)	3 219	562(17.5)	3 777	467(12.4)	3 550	451(12.7)	11 361	1 610(14.2)
肥胖		454	73(16.1)	1 896	384(20.3)	2 366	333(14.1)	2 165	289(13.3)	6 881	1 079(15.7)
	χ²值		0.54		7.90		3.78		0.53		7.83
	P值		0.76		0.02		0.15		0.77		0.02
每周运动天数/d
0~2		2 985	584(19.6)	10 759	2 222(20.7)	11 407	1 678(14.7)	10 360	1 586(15.3)	35 511	6 070(17.1)
3~5		2 349	322(13.7)	7 933	1 194(15.1)	9 388	1 067(11.4)	8 221	906(11.0)	27 891	3 489(12.5)
6~7		674	96(14.2)	3 225	509(15.8)	2 917	360(12.3)	3 091	331(10.7)	9 907	1 296(13.1)
	χ²值		35.68		109.07		52.28		91.49		287.24
	P值		< 0.01		< 0.01		< 0.01		< 0.01		< 0.01
遭受校园欺凌
无		4 796	585(12.2)	17 275	2 329(13.5)	20 267	1 846(9.1)	18 705	1 746(9.3)	61 043	6 506(10.7)
有		1 212	417(34.4)	4 642	1 596(34.4)	3 445	1 259(36.5)	2 967	1 077(36.3)	12 266	4 349(35.5)
	χ²值		343.39		1 087.10		1 947.84		1 643.51		4 978.84
	P值		< 0.01		< 0.01		< 0.01		< 0.01		< 0.01
合计		6 008	1 002(16.7)	21 917	3 925(17.9)	23 712	3 105(13.1)	21 672	2 823(13.0)	73 309	10 855(14.8)
注：()内数字为检出率/%。

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表 2 中学生出现抑郁症状的多因素Logistic回归(n=73 309)

Table 2. Multivariate Logistic regression of depressive symptoms in middle school students(n=73 309)

自变量	选项	β值	标准误	Wald χ²值	P值	OR值(95%CI)
年份	2018					1.00
	2019	0.08	0.04	3.70	0.06	1.08(1.00~1.17)
	2020	-0.19	0.04	21.56	< 0.01	0.83(0.76~0.90)
	2021	-0.19	0.04	19.99	< 0.01	0.83(0.76~0.90)
性别	男					1.00
	女	0.50	0.02	484.89	< 0.01	1.65(1.58~1.72)
学段	初中					1.00
	普高	0.53	0.03	385.33	< 0.01	1.70(1.61~1.79)
	职高	0.47	0.04	168.35	< 0.01	1.60(1.49~1.72)
BMI分类	非超重肥胖					1.00
	超重	-0.02	0.03	0.35	0.55	0.98(0.92~1.04)
	肥胖	0.12	0.04	9.58	< 0.01	1.12(1.04~1.21)
每周运动	0~2					1.00
天数/d	3~5	-0.26	0.02	113.50	< 0.01	0.77(0.74~0.81)
	6~7	-0.21	0.04	34.58	< 0.01	0.81(0.76~0.87)
遭受校园	无					1.00
欺凌	有	1.65	0.02	4 680.81	< 0.01	5.21(4.97~5.46)

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