青少年颈肩腰背疼痛和心理亚健康状况及其关联

韩菲菲; 高欣; 谢阳; 陶舒曼; 万宇辉; 陶芳标

doi:10.16835/j.cnki.1000-9817.2024122

青少年颈肩腰背疼痛和心理亚健康状况及其关联

doi: 10.16835/j.cnki.1000-9817.2024122

安徽医科大学公共卫生学院儿少卫生与妇幼保健学系/出生人口健康教育部重点实验室/环境与人口健康安徽省重点实验室，合肥 230032

基金项目:

国家自然科学基金重点项目 82073578

详细信息

作者简介:
韩菲菲(1998-)，女，安徽合肥人，在读硕士，主要研究方向为环境暴露与母婴健康

通讯作者:
陶芳标，E-mail：fbtao@ahmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R441.1 B844.2
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出版历程
- 收稿日期: 2024-02-08
- 修回日期: 2024-03-15
- 网络出版日期: 2024-04-25
- 刊出日期: 2024-04-25

Status and correlation of neck-shoulder pain, low back pain and mental sub-health among adolescents

Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University/MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Hefei(230032), Anhui Province, China

摘要

摘要: 目的探讨青少年颈肩部疼痛(NSP)和腰背部疼痛(LBP)以及颈肩腰背疼痛与心理亚健康的关联，为促进青少年身心健康发展提供参考。方法 2019年10—12月，采用分层整群随机抽样方法从深圳、南昌、沈阳3个地区12所初、高中共抽取7 986名在校学生，使用青少年脊柱健康评定问卷(ASHY)和青少年心理健康评定简明问卷(BIOPHY)分别评定青少年NSP、LBP和心理亚健康状况。建立二元Logistic回归模型分析青少年NSP、LBP和颈肩腰背疼痛与心理亚健康的关联。结果青少年NSP、LBP、颈肩腰背疼痛和心理亚健康检出率分别为9.1%，9.8%，9.5%和10.0%，颈肩腰背疼痛与心理亚健康共患率为3.2%。在控制性别、年龄、是否独生子女、家庭居住地、父母文化程度等相关因素影响后，青少年NSP(OR=6.01，95%CI=5.02~7.19)、LBP(OR=5.08，95%CI=4.25~6.07)和颈肩腰背疼痛(OR=5.96，95%CI=4.98~7.12)与心理亚健康风险均呈正向关联(P值均 < 0.01)；对性别分层后，有NSP、LBP和颈肩腰背疼痛的男生(OR值分别为6.84，5.80，6.74)心理亚健康风险较女生更高(OR值分别为5.52，4.65，5.49)(P值均 < 0.01)。结论青少年NSP、LBP和颈肩腰背疼痛与心理亚健康存在正向关联，男生心理健康状况受NSP、LBP、颈肩腰背疼痛的影响更大。应采取措施改善青少年脊柱健康状况，以降低心理健康的发生风险。
- 肩痛 /
- 颈痛 /
- 腰痛 /
- 精神卫生 /
- 回归分析 /
- 青少年
Abstract: Objective To explore the association among neck-shoulder pain (NSP), low back pain (LBP) and co-occurring symptoms with mental sub-health in adolescents, so as to provide evidence for improving physical and mental health of adolescents. Methods Stratified cluster random sampling method was used to select 7 986 students from 12 middle and high schools in Shenzhen, Nanchang, and Shenyang cities from October to December 2019. The Assessment of Spinal Health of Youth (ASHY) and the Brief Instrument on Psychological Health of Youth (BIOPHY) were used to assess NSP, LBP and mental sub-health. Binary Logistic regression model was used to analyze the association between NSP, LBP and co-occurring symptoms with mental sub-health in adolescents. Results The detection rates of adolescents with NSP, LBP and co-occurring symptoms and mental sub-health were 9.1%, 9.8%, 9.5%, and 10.0%, respectively. The co-occurring rate of neck shoulder pain, low back pain and mental sub-health was 3.2%. After adjusting for confounding variables such as gender, age, being an only child, family residence, and parental education level, NSP (OR=6.01, 95%CI=5.02-7.19), LBP (OR=5.08, 95%CI=4.25-6.07), and co-occurring symptoms (OR=5.96, 95%CI=4.98-7.12) in adolescents were positively correlated with mental sub-health risk (P < 0.01). Stratifying the gender, boys with NSP, LBP and co-occurring symptoms (OR=6.84, 5.80, 6.74)had a higher risk of mental sub-health compared to girls (OR=5.52, 4.65, 5.49) (P < 0.01). Conclusions NSP, LBP and co-occurring symptoms in adolescents are associated with mental sub-health. The mental health status of boys is more affected by NSP, LBP and their co-occurring symptoms. Measures should be taken to improve spinal health in adolescents to reduce the incidence of mental sub-health.
- Shoulder pain /
- Neck pain /
- Low back pain /
- 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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表 1 不同人口学特征青少年NSP、LBP和颈肩腰背痛及心理亚健康检出率比较

Table 1. Comparison of detection rates of NSP, LBP and co-occurring symptoms and mental sub-health in adolescents with different demographic characteristics

人口学指标	人数	NSP		LBP		颈肩腰背疼痛		心理亚健康
人口学指标	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	3 866	323(11.7)	5.41^*	338(8.7)	9.99^*	337(8.7)	4.91^*	356(9.2)	5.44^*
女	4 120	406(9.9)		447(10.8)		419(10.2)		444(10.8)
是否独生子女
是	2 769	300(10.8)	14.87^**	333(12.0)	23.07^*	323(11.7)	23.90^**	310(11.2)	6.52^*
否	5 217	429(8.2)		452(8.7)		433(8.3)		490(9.4)
家庭居住地
农村	1 089	86(7.9)	2.40	96(8.8)	1.79	86(7.9)	3.85	111(10.2)	17.67^*
乡镇	1 459	133(9.1)		140(9.6)		137(9.4)		149(10.2)
城市	5 438	510(9.4)		549(10.1)		533(9.8)		540(9.9)
家庭经济条件
差	1 030	144(14.0)	33.55^**	157(15.2)	39.62^**	154(15.0)	41.54^**	171(16.6)	57.08^*
中等	5 284	445(8.4)		485(9.2)		455(8.6)		473(9.0)
好	1 672	140(8.4)		143(8.6)		147(8.8)		156(9.3)
父亲文化程度
小学及以下	942	103(10.9)	17.55^*	105(11.1)	7.48	101(10.7)	13.15^*	113(12.0)	6.64
初中	2 485	179(7.2)		215(8.7)		192(7.7)		233(9.4)
高中	2 370	237(10.0)		252(10.6)		244(10.3)		248(10.5)
大专及以上	2 189	210(9.6)		213(9.7)		219(10.0)		206(9.4)
母亲文化程度
小学及以下	1 459	116(8.0)	12.45	141(9.7)	1.09	124(8.5)	17.67^*	152(10.4)	2.17
初中	2 432	196(8.1)		217(8.9)		191(7.9)		249(10.2)
高中	2 181	232(10.6)		231(10.6)		242(11.1)		224(10.3)
大专及以上	1 914	185(9.7)		196(10.2)		199(10.4)		175(9.1)
注： ()内数字为检出率/%；P < 0.05，*P < 0.01。

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参考文献(28)

[1]	吴淑芳, 杨贵丽, 黄招兰, 等. 大学生上网时间与肩颈病的关系及预防对策[J]. 中国学校卫生, 2016, 37(1): 84-86. doi: 10.16835/j.cnki.1000-9817.2016.01.025 WU S F, YANG G L, HUANG Z L, et al. Investigation and countermeasures of internet-surfing and neck and shoulder diseases among university students[J]. Chin J Sch Health, 2016, 37(1): 84-86. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2016.01.025
[2]	KAMPER S J, YAMATO T P, WILLIAMS, et al. The prevalence, risk factors, prognosis and treatment for back pain in children and adolescents: an overview of systematic reviews[J]. Best Pract Res Clin Rheumatol, 2016, 30(6): 1021-1036. doi: 10.1016/j.berh.2017.04.003
[3]	COHEN S P. Epidemiology, diagnosis, and treatment of neck pain[J]. Mayo Clin Proc, 2015, 90(2): 284-299. doi: 10.1016/j.mayocp.2014.09.008
[4]	GROENEWALD C B, ESSNER B S, WRIGHT D, et al. The economic costs of chronic pain among a cohort of treatment-seeking adolescents in the United States[J]. J Pain, 2014, 15(9): 925-933. doi: 10.1016/j.jpain.2014.06.002
[5]	OCHSMANN E B, PINZÓN C L E, LETZEL S, et al. Prevalence of diagnosis and direct treatment costs of back disorders in 644 773 children and youths in Germany[J]. BMC Musculoskelet Disord, 2010, 11: 193. doi: 10.1186/1471-2474-11-193
[6]	李力生, 井蕊, 王泓午. 大学生心理亚健康及心理症状的相关研究[J]. 中国健康心理学杂志, 2011, 19(8): 990-992. https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201108045.htm LI L S, JIN R, WANG H W, et al. Study on mental sub-health and psychological symptoms among undergraduate students[J]. Chin J Health Psychol, 2011, 19(8): 990-992. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JKXL201108045.htm
[7]	陈洁瑜, 余克强, 孙晓敏, 等. 健康促进生活方式对亚健康状态转化的影响[J]. 南方医科大学学报, 2017, 37(2): 184-191. https://www.cnki.com.cn/Article/CJFDTOTAL-DYJD201702008.htm CHEN J Y, YU K Q, SUN X M, et al. Effect of health-promoting lifestyle on outcomes of suboptimal health status[J]. J South Med Univ, 2017, 37(2): 184-191. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-DYJD201702008.htm
[8]	MCGORRY P D, MEI C, CHANEN A, et al. Designing and scaling up integrated youth mental health care[J]. World Psychiatry, 2022, 21(1): 61-76. doi: 10.1002/wps.20938
[9]	KIELING C, BUCHWEITZ C, CAYE A, et al. Worldwide prevalence and disability form mental disorder across childhood and adolescence: evidence from the global burden of disease study[J]. JAMA Psychiatry, 2024. DOI: 10.1001/jamapsychiatry.2023.5051.
[10]	SOLMI M, RADUA J, OLIVOLA M, et al. Age at onset of mental disorders worldwide: large-scale Meta-analysis of 192 epidemiological studies[J]. Mol Psychiatry, 2022, 27(1): 281-295. doi: 10.1038/s41380-021-01161-7
[11]	MERIKANGAS K R. Time trends in the global prevalence of mental disorders in children and adolescents: gap in data on US youth[J]. J Am Acad Child Adolesc Psychiatry, 2018, 57(5): 306-307. doi: 10.1016/j.jaac.2018.03.002
[12]	KLEINERT S. Adolescent health: an opportunity not to be missed[J]. Lancet, 2007, 369(9567): 1057-1058. doi: 10.1016/S0140-6736(07)60374-2
[13]	GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet Psychiatry, 2022, 9(2): 137-150. doi: 10.1016/S2215-0366(21)00395-3
[14]	HARTVIGSEN J, NATVIG B, FERREIRA M. Is it all about a pain in the back?[J]. Best Pract Res Clin Rheum, 2013, 27(5): 613-623. doi: 10.1016/j.berh.2013.09.008
[15]	曹钰璇, 陶舒曼, 邹立巍, 等. 大学生不同睡眠特征与心血管代谢风险的关联[J]. 中国学校卫生, 2024, 45(1): 25-29. doi: 10.16835/j.cnki.1000-9817.2024014 CAO Y X, TAO S M, ZOU L Y, et al. Association of different sleep characteristics and cardiometabolic risk in college students[J]. Chin J Sch Health, 2024, 45(1): 25-29. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024014
[16]	陶舒曼, 万宇辉, 伍晓艳, 等. 《青少年脊柱健康评定问卷》编制及常模的研制[J]. 中华预防医学杂志, 2021, 55(9): 1051-1058. TAO S M, WAN Y H, WU X Y, et al. The development and national norm of the assessment of spinal health of youths[J]. Chin J Prev Med, 2021, 55(9): 1051-1058. (in Chinese)
[17]	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, 1338. doi: 10.16835/j.cnki.1000-9817.2020.09.014 TAO S M, WAN Y H, WU X Y, et al. Evaluation and application of brief instrument on psychological health of youths[J]. Chin J Sch Health, 2020, 41(9): 1331-1334, 1338. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2020.09.014
[18]	HAKALA P T, RIMPELÄ A H, SAARNI L A, et al. Frequent computer-related activities increase the risk of neck-shoulder and low back pain in adolescents[J]. Eur J Public Health, 2006, 16(5): 536-541. doi: 10.1093/eurpub/ckl025
[19]	SHAN Z, DENG G, LI J, et al. Correlational analysis of neck/shoulder pain and low back pain with the use of digital products, physical activity and psychological status among adolescents in Shanghai[J]. PLoS One, 2013, 8(10): e78109. doi: 10.1371/journal.pone.0078109
[20]	HOY D, BAIN C, WILLIAMS G, et al. A systematic review of the global prevalence of low back pain[J]. Arthrit Rheum, 2012, 64(6): 2028-2037. doi: 10.1002/art.34347
[21]	CALVO-MUÑOZ I, GOMZ-CONESA A, SANCHEZ-MECA J, et al. Prevalence of low back pain in children and adolescents: a Meta-analysis[J]. BMC Pediatr, 2013, 13(1): 14. doi: 10.1186/1471-2431-13-14
[22]	LARDON A, LEBOEUF-YDE C, SCANFF C L, et al. Is puberty a risk factor for back pain in the young?A systematic critical literature review[J]. Chiropr Man Therap, 2014, 22(1): 27. doi: 10.1186/s12998-014-0027-6
[23]	KUMAGAI G, WADA K, KUDO H, et al. The effect of low back pain and neck-shoulder stiffness on health-related quality of life: a cross-sectional population-based study[J]. BMC Musculoskelet Disord, 2021, 22(1): 14. doi: 10.1186/s12891-020-03871-5
[24]	NAKAMURA M, NISHIWAKI Y, USHIDA T, et al. Prevalence and characteristics of chronic musculoskeletal pain in Japan[J]. J Orthop Sci, 2011, 16(4): 424-432. doi: 10.1007/s00776-011-0102-y
[25]	SOLIDAKI E, CHATZI L, BITSIOS P, et al. Work-related and psychological determinants of multisite musculoskeletal pain[J]. Scand J Work Environ Health, 2010, 36(1): 54-61. doi: 10.5271/sjweh.2884
[26]	IOB E, PINGAULT J B, MUNAFÒ M R, et al. Testing the causal relationships of physical activity and sedentary behaviour with mental health and substance use disorders: a Mendelian randomisation study[J]. Mol Psychiatry, 2023, 28(8): 3429-3443. doi: 10.1038/s41380-023-02133-9
[27]	裴亚星, 王雪纯, 孔令敏, 等. 山东省中小学生睡眠与心理健康的相关性[J]. 中国学校卫生, 2023, 44(11): 1674-1678. doi: 10.16835/j.cnki.1000-9817.2023.11.018 PEI Y X, WANG X C, KONG L M, et al. Analysis of the correlation between sleep and mental health among primary and secondary school students in Shandong Province[J]. Chin J Sch Health, 2023, 44(11): 1674-1678. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.11.018
[28]	BOMYSOAD R N, FRANCIS L A. Adverse childhood experiences and mental health conditions among adolescents[J]. J Adolesc Health, 2020, 67(6): 868-870. doi: 10.1016/j.jadohealth.2020.04.013