云南大学生手机依赖与抑郁症状的纵向关联

陶剑; 刘月芹; 杨品; 杨洁茹; 吴后艳; 周菲惠; 潘丽娟; 徐洪吕

doi:10.16835/j.cnki.1000-9817.2024114

云南大学生手机依赖与抑郁症状的纵向关联

doi: 10.16835/j.cnki.1000-9817.2024114

陶剑^{1, 2},
刘月芹^{1, 2},
杨品³,
杨洁茹^{1, 2},
吴后艳^{1, 2},
周菲惠^{1, 2},
潘丽娟^{1, 2},
徐洪吕^{1, 2, ,}

1.
昆明学院医学院，云南 650214
2.
昆明学院社区护理研究团队
3.
大理护理职业学院

基金项目:

国家自然科学基金项目 82160622

云南省“兴滇英才支持计划”青年人才专项项目 XDYC-QNRC-2022-0289

昆明学院引进人才科研项目 YJL2103

详细信息

作者简介:
陶剑(1973-)，男，云南红河人，博士，副教授，主要研究方向为青少年心理行为健康

通讯作者:
徐洪吕，E-mail：x_hl@126.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 B844.2 TN916.9 TN711
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出版历程
- 收稿日期: 2023-12-22
- 修回日期: 2024-01-30
- 网络出版日期: 2024-04-25
- 刊出日期: 2024-04-25

Longitudinal association between mobile phone dependence and depressive symptoms in Yunnan college students

TAO Jian^{1, 2},
LIU Yueqin^{1, 2},
YANG Pin³,
YANG Jieru^{1, 2},
WU Houyan^{1, 2},
ZHOU Feihui^{1, 2},
PAN Lijuan^{1, 2},
XU Honglü^{1, 2
, ,}

1.
Medical College, Kunming University, Kunming (650214), Yunnan Province, China

摘要

摘要: 目的分析手机依赖与大学生抑郁症状的纵向关联，为大学生心理健康教育提供理论依据。方法于2021年11月—2023年6月，采用整群随机抽样方法从云南省2所高校抽取2 515名大一年级学生进行问卷调查，包括基线调查(2021年11月，T1)和3次随访(2022年6月，T2；2022年11月，T3；2023年6月，T4)。应用青少年手机使用依赖自评问卷和抑郁-焦虑-压力量表-21(DASS-21)评估大学生手机依赖情况和抑郁症状；采用χ²检验对抑郁症状检出率进行单因素分析，应用广义估计方程进行手机依赖症状与抑郁症状的关联分析。结果云南大学生抑郁症状检出率T1、T2、T3、T4时点分别为23.02%，33.36%，34.79%，35.51%。在时点T1、T2、T3、T4不同自评学习负担，时点T1、T2、T3不同亲密朋友数量，时点T1不同父亲文化程度，时点T2、T4不同母亲文化程度，时点T4不同性别，时点T3、T4不同专业，时点T2、T3、T4不同学历，时点T1、T2不同家庭居住地，时点T1、T2、T4不同自评家庭经济条件的大学生抑郁症状检出率差异均有统计学意义(χ²值分别为59.68，49.38，16.70，39.31；55.35，26.01，16.69；10.22；14.87，11.51；14.90；27.81，50.28；9.75，7.42，24.76；6.06，4.47；15.88，14.58，15.85，P值均<0.05)。在广义估计方程模型控制人口学变量及混杂因素后，手机依赖、手机依赖戒断症状、手机依赖身心影响与抑郁症状均呈正相关(β值分别为0.11，0.14，0.14，P值均<0.01)；进一步分性别分析显示，男生和女生的抑郁症状与手机依赖、手机依赖戒断症状、手机依赖身心影响均存在关联(β值分别为0.13，0.13，0.18；0.10，0.13，0.13，P值均<0.01)。结论大学生抑郁症状与手机依赖呈正相关，家庭经济条件、学习负担、亲密朋友数量是持续影响抑郁症状的因素。应引导大学生关注手机过度使用对身心健康的影响，合理使用手机，降低大学生抑郁症状发生率。
- 便携式电话 /
- 行为，成瘾 /
- 抑郁 /
- 精神卫生 /
- 学生
Abstract: Objective To analyze the longitudinal association between mobile phone dependence and depressive symptoms in college students, so as to provide a theoretical basis for psychological health education among college students. Methods From November 2021 to June 2023, 2 515 first-year students from 2 universities in Yunnan Province were surveyed with a questionnaire by a cluster random sampling method, including baseline survey (November 2021, T1) and three follow-up visits (June 2022, T2; November 2022, T3; June 2023, T4). The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use and the Depression Anxiety Stress Scales-21 (DASS-21) were used to evaluate mobile phone dependence and depressive symptoms of college students. The χ² test was used to analyze the difference in depressive symptoms among different demographic groups, and a generalized estimation equation model was established to analyze the association between mobile phone dependence symptoms and depressive symptoms. Results The detection rates of depressive symptoms among university students in Yunnan Province at time points T1, T2, T3, and T4 were 23.02%, 33.36%, 34.79% and 35.51%, respectively. There were statistically significant differences in the detection rates of depressive symptoms among college students with different sacademic burden (T1, T2, T3, T4), different number of close friends (T1, T2, T3), as well as their father's educational level (T1), mother's educational level (T2, T4), gender (T4), major (T3, T4), education (T2, T3, T4), family residency (T1, T2), and family economic conditions (T1, T2, T4) (χ²=59.68, 49.38, 16.70, 39.31; 55.35, 26.01, 16.69; 10.22; 14.87, 11.51; 14.90; 27.81, 50.28; 9.75, 7.42, 24.76; 6.06, 4.47; 15.88, 14.58, 15.85, P<0.05). After controlling for demographic variables and confounding factors in the generalized estimation equation model, mobile phone dependence (β=0.11), withdrawal symptoms of mobile phone dependence (β=0.14), and the physical and mental effects of mobile phone dependence (β=0.14) were all positively correlated with depressive symptoms (P<0.01). Further gender analysis showed that depressive symptoms in both boys (β=0.13, 0.13, 0.18) and girls (β=0.10, 0.13, 0.13) were associated with mobile phone dependence, withdrawal symptoms of mobile phone dependence and the physical and mental effects of mobile phone dependence (P<0.01). Conclusions Depressive symptoms of college students are positively correlated with mobile phone dependence, and family economic conditions, academic burden and number of close friends are factors that continued to affect depressive symptoms. College students should be guided to pay attention to the impact of excessive use of mobile phones on their physical and mental health, use mobile phones reasonably to reduce the incidence of depressive symptoms among college students.
- Cellular phone /
- Behavior, addictive /
- Depression /
- Mental health /
- Students
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表 1 不同人口统计学特征大学生抑郁症状检出率比较

Table 1. Comparison of depressive symptoms detection rates among college students with different demographic characteristics

人口学指标	分类	人数	T1		T2		T3		T4
人口学指标	分类	人数	检出人数	χ²值	检出人数	χ²值	检出人数	χ²值	检出人数	χ²值
性别	男	697	164(23.53)	0.14	232(33.29)	< 0.01	259(37.16)	2.38	289(41.46)	14.90^**
	女	1 818	415(22.83)		607(33.39)		616(33.88)		604(33.22)
年龄/岁	17~18	697	142(20.37)	3.83	228(32.71)	0.18	238(34.15)	0.44	248(35.58)	0.08
	19~20	1 670	402(24.07)		561(33.59)		588(35.21)		594(35.57)
	21~24	148	35(23.65)		50(33.78)		49(33.11)		51(34.46)
民族	汉族	1 810	400(22.10)	3.10	592(32.71)	1.24	622(34.36)	0.52	629(34.75)	1.61
	少数民族	705	179(25.39)		247(35.04)		253(35.89)		264(37.45)
专业	工科	266	61(22.93)	9.07	88(33.08)	4.67	91(34.21)	27.81^**	101(37.97)	50.28^**
	管理学	341	87(25.51)		116(34.02)		153(44.87)		151(44.28)
	教育学	129	20(15.50)		40(31.01)		42(32.56)		40(31.01)
	理学	399	96(24.06)		129(32.33)		146(36.59)		160(40.10)
	农学	264	60(22.73)		81(30.68)		89(33.71)		88(33.33)
	文学	203	53(26.11)		63(31.03)		71(34.98)		79(38.92)
	医学	848	183(21.58)		295(34.79)		254(29.95)		238(28.07)
	其他	65	19(29.23)		27(41.54)		29(44.62)		36(55.38)
学历	本科	1 894	429(22.65)	0.60	600(31.68)	9.75^**	687(36.27)	7.42^*	724(38.23)	24.76^**
	专科	621	150(24.15)		239(38.49)		188(30.27)		169(27.21)
家庭居住地	农村	2 087	500(23.96)	6.06^*	715(34.26)	4.47^*	726(34.79)	< 0.01	755(36.18)	2.40
	城市	428	79(18.46)		124(28.97)		149(34.81)		138(32.24)
独生子女	是	381	80(21.00)	1.04	119(31.23)	0.91	132(34.65)	< 0.01	142(37.27)	0.61
	否	2 134	499(23.38)		720(33.74)		743(34.82)		751(35.19)
家庭类型	双亲家庭	2 187	513(23.46)	2.62	730(33.38)	0.92	759(34.71)	0.75	767(35.07)	2.65
	单亲家庭	171	37(21.65)		53(30.99)		57(33.33)		69(40.35)
	组合家庭^a	121	21(17.36)		44(36.36)		46(38.02)		46(38.02)
	其他	36	8(22.22)		12(33.33)		13(36.11)		11(30.56)
亲密家庭经济条件	差	198	57(28.79)	15.88^**	65(32.83)	14.58^*	67(33.84)	3.40	89(44.95)	15.85^**
	较差	600	163(27.17)		235(39.17)		227(37.83)		227(37.83)
	中等	1 612	342(21.22)		512(31.76)		547(33.93)		551(34.18)
	较好	88	13(14.77)		21(23.86)		28(31.82)		21(23.86)
	好	17	4(23.53)		6(35.29)		6(35.29)		5(29.41)
自评学习负担	很重	117	49(41.88)	59.68^**	48(41.03)	49.38^**	49(41.88)	16.70^**	57(48.72)	39.31^**
	重	872	251(28.78)		362(41.51)		342(39.22)		364(41.74)
	一般	1 489	274(18.40)		421(28.27)		471(31.63)		463(31.09)
	轻	28	4(14.29)		7(25.00)		10(35.71)		8(28.57)
	很轻	9	1(11.11)		1(11.11)		3(33.33)		1(11.11)
亲密朋友数量/个	0	28	17(60.71)	55.35^**	15(53.57)	26.01^**	14(50.00)	16.69^**	12(42.86)	5.82
	1~2	317	103(32.49)		136(42.90)		137(43.22)		125(39.43)
	3~4	474	129(27.22)		171(36.08)		171(36.08)		180(37.97)
	≥5	1 696	330(19.46)		517(30.48)		553(32.61)		576(33.96)
父亲文化程度	文盲	483	135(27.95)	10.22^*	188(38.92)	8.64	177(36.65)	3.62	194(40.17)	6.87
	小学	622	142(22.83)		202(32.48)		219(35.21)		221(35.53)
	初中	926	207(22.35)		299(32.29)		303(32.72)		320(34.56)
	高中/中专	321	61(19.00)		100(31.15)		113(35.20)		107(33.33)
	大专及以上	163	34(20.86)		50(30.67)		63(38.65)		51(31.29)
母亲文化程度	文盲	840	213(25.36)	7.65	322(38.33)	14.87^*	302(35.95)	6.97	335(39.88)	11.51^*
	小学	597	139(23.28)		180(30.15)		202(33.84)		206(34.51)
	初中	725	161(22.21)		230(31.72)		235(32.41)		234(32.28)
	高中/中专	242	49(20.25)		76(31.40)		87(35.95)		83(34.30)
	大专及以上	111	17(15.32)		31(27.93)		49(44.14)		35(31.53)
父亲职业	公职人员^b	136	32(23.53)	6.85	43(31.62)	8.47	55(40.44)	6.32	45(33.09)	8.73
	工人	66	8(12.12)		24(36.36)		24(36.36)		22(33.33)
	公司职员	110	22(20.00)		30(27.27)		39(35.45)		35(31.82)
	商人	1 557	375(24.08)		530(34.04)		543(34.87)		560(35.97)
	农民	334	77(23.05)		124(37.13)		122(36.53)		136(40.72)
	其他	312	65(20.83)		88(28.21)		92(29.49)		95(30.45)
母亲职业	公职人员^b	81	12(14.81)	9.29	21(25.93)	5.99	28(34.57)	1.89	26(32.10)	2.68
	工人	67	11(16.42)		21(31.34)		23(34.33)		23(34.33)
	公司职员	111	20(18.02)		33(29.73)		43(38.74)		35(31.53)
	商人	1 666	409(24.55)		581(34.87)		587(35.23)		601(36.07)
	农民	204	45(22.06)		64(31.37)		68(33.33)		78(38.24)
	其他	386	82(21.24)		119(30.83)		126(32.64)		130(33.68)
注： ()内数字为检出率/%；P<0.05，*P<0.01。a有继父或继母，b公务员及事业单位人员；文盲指未上过学。

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表 2 大学生手机依赖与抑郁症状的关联(n=2 515)

Table 2. Association of mobile phone dependence with depressive symptoms among college students(n=2 515)

模型	自变量	标准误	β值(95%CI)	Wald χ²值	P值
模型1	手机依赖	0.00	0.11(0.11~0.12)	1 956.15	< 0.01
	手机依赖戒断症状	0.02	0.14(0.11~0.17)	77.87	< 0.01
	手机依赖身心影响	0.02	0.14(0.11~0.18)	56.32	< 0.01
	手机依赖渴求性	0.03	0.01(-0.04~0.06)	0.16	0.69
模型2	手机依赖	0.00	0.11(0.10~0.11)	1 792.36	< 0.01
	手机依赖戒断症状	0.02	0.14(0.10~0.17)	72.10	< 0.01
	手机依赖身心影响	0.02	0.14(0.11~0.18)	59.11	< 0.01
	手机依赖渴求性	0.03	0.00(-0.05~0.41)	0.01	0.91
注：模型1，未控制变量；模型2，控制性别、民族、专业分类、学历、家庭居住地、家庭经济条件、朋友数量、父母亲文化程度、喝酒、抽烟、经历过家庭变故、住院经历、考试失败、恋爱失败、抑郁症家族史、身体活动、外卖快餐消费。

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表 3 不同性别大学生手机依赖与抑郁症状的关联分析

Table 3. Association between mobile phone dependence and depressive symptoms in college students of different genders

性别	自变量	模型1				模型2
性别	自变量	标准误	β值(95%CI)	Wald χ²值	P值	标准误	β值(95%CI)	Wald χ²值	P值
男生	手机依赖	0.01	0.14(0.13~0.15)	766.90	< 0.01	0.01	0.13(0.12~0.14)	677.91	< 0.01
(n=697)	手机依赖戒断症状	0.04	0.14(0.07~0.22)	15.30	< 0.01	0.04	0.13(0.06~0.20)	13.80	< 0.01
	手机依赖身心影响	0.04	0.18(0.09~0.26)	16.75	< 0.01	0.04	0.18(0.10~0.26)	17.82	< 0.01
	手机依赖渴求性	0.06	0.10(-0.02~0.21)	2.52	0.11	0.06	0.07(-0.04~0.19)	1.58	0.21
女生	手机依赖	0.00	0.10(0.09~0.11)	1 183.18	< 0.01	0.00	0.10(0.09~0.10)	1 088.78	< 0.01
(n=1 818)	手机依赖戒断症状	0.02	0.14(0.10~0.17)	59.99	< 0.01	0.02	0.13(0.09~0.16)	53.25	< 0.01
	手机依赖身心影响	0.02	0.13(0.09~0.18)	42.66	< 0.01	0.02	0.13(0.09~0.17)	42.84	< 0.01
	手机依赖渴求性	0.03	-0.02(-0.08~0.03)	0.70	0.40	0.03	-0.02(-0.08~0.04)	0.52	0.47
注：模型1，未控制变量；模型2，控制民族、专业分类、学历、家庭居住地、家庭经济条件、朋友数量、父母亲文化程度、喝酒、抽烟、经历过家庭变故、住院经历、考试失败、恋爱失败、抑郁症家族史、身体活动、外卖快餐消费。

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