Association between Lifestyle Behaviors and Depressive Symptoms of middle school students in rural area of Miao nationality in Pingbian, Yunnan Province
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摘要:
目的 探讨云南屏边苗族地区农村中学生生活行为方式与抑郁症状的关联,为改变青少年不健康生活行为方式和改善抑郁症状提供数据支持。 方法 在云南屏边县随机整群选取2所中学的819名初中生,通过调查问卷面对面收集中学生生活行为方式数据,使用抑郁-焦虑-压力量表(Depression Anxiety Stress Scale,DASS-21)评估抑郁症状,使用广义线性模型分析生活行为方式与抑郁症状的关联。 结果 中学生抑郁症状检出率为33.21%,女生抑郁症状检出率高于男生(39.20%vs26.72%),差异有统计学意义(P < 0.05)。学习日视屏时间(β=0.283, 95%CI=0.114~0.452)、白天户外活动时间(β=-0.292,95%CI=-0.512~-0.071)、早餐行为(β=-0.263,95%CI=-0.455~-0.071)、新鲜食物消费(β=-0.291,95%CI=-0.529~-0.053)、零食消费(β=0.294,95%CI=0.019~0.569)均与中学生抑郁症状关联(P值均<0.05)。学习日视屏时间(β=0.297,95%CI=0.074~0.520)、白天户外活动时间(β=-0.369,95%CI=-0.673~-0.065)、早餐行为(β=-0.288,95%CI=-0.567~-0.010)、新鲜食物消费(β=-0.423,95%CI=-0.735~-0.110)与男生抑郁症状关联(P值均<0.05)。学习日视屏时间(β=0.306,95%CI=0.056~0.557)、抽烟(β=0.679,95%CI=0.044~1.314)、早餐行为(β=-0.304,95%CI=-0.576~-0.031)、西式快餐消费(β=-1.278,95%CI=-2.425~-0.131)与女生抑郁症状关联(P值均<0.05)。 结论 屏边苗族地区农村中学生抑郁症状检出率较高,并与不健康生活行为方式相关,改变不健康生活行为方式是预防青少年抑郁症状的关键。 Abstract:Objective To explore the association between lifestyle behaviors and depressive symptoms of middle school students in rural area of Miao nationality in Pingbian, Yunnan Province, and to provide a data reference for changing unhealthy lifestyle behaviors for improving depressive symptoms in adolescents. Methods A total of 819 middle school students from 2 middle schools were randomly selected. A face-to-face questionnaire survey was conducted to collect data on the lifestyle and behavior of middle school students. Depressive symptoms were assessed using the Depression Anxiety Stress Scale (DASS-21), and the association between lifestyle and depressive symptoms was analyzed using a generalized linear model. Results The detection rate of depressive symptoms in middle school students was 33.21%, and the detection rate of depression symptoms in girls was higher than that in boys (39.20% vs 26.72%), the difference was statistically significant (P < 0.05). Learn daily screen time (β= 0.283, 95%CI = 0.114 - 0.452), outdoor time during the day (β= -0.292, 95%CI = -0.512 - -0.071), breakfast behavior (β= -0.263, 95%CI = -0.455 - -0.071), fresh food consumption (β= -0.291, 95%CI = -0.529 - -0.053), snack consumption (β= 0.294, 95%CI = 0.019 - 0.569) were associated with depressive symptoms in middle school students (all P < 0.05). Learn daily screen time (β= 0.297, 95%CI = 0.074 - 0.520), Learn daily screen time (β= -0.369, 95%CI = -0.673 - -0.065), breakfast behavior (β= -0.288, 95%CI = -0.567 - -0.010), fresh food consumption (β= -0.423, 95%CI = -0.735 - -0.110) were associated with depressive symptoms in boys (all P < 0.05). Learn daily screen time (β= 0.306, 95%CI = 0.056 - 0.557), smoking (β= 0.679, 95%CI = 0.044 - 1.314), breakfast behavior (β= -0.304, 95%CI = -0.576 - -0.031), western fast food consumption (β= -1.278, 95%CI = -2.425 - -0.131) were associated with depressive symptoms in girls (all P < 0.05). Conclusion The study suggests that the prevalence of depressive symptoms is high among middle school students in rural area of Miao nationality in Pingbian, and it is related to unhealthy lifestyle behaviors. Changing unhealthy lifestyle behaviors may be an effective way to improve middle school students in the area. -
Key words:
- Depressive symptoms /
- Lifestyle behaviors /
- Dietary behavior /
- Middle school students
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表 1 不同人口学特征中学生抑郁症状检出率比较 [n(%)]
Table 1. Comparison of the detection rate of depressive symptoms in middle school students with different demographic characteristics [n(%)]
人口统计学指标 选项 无抑郁症状 抑郁症状 χ2 P 年龄(岁) 12 9(75.00) 3(25.00) 1.256 0.869 13 175(68.36) 81(31.64) 14 247(66.22) 126(33.78) 15 106(65.84) 55(34.16) ≥16 10(58.82) 7(41.18) 性别 男 288(73.28) 105(26.72) 14.363 <0.001** 女 259(60.80) 167(39.20) 民族 苗族 359(65.99) 185(34.01) 0.463 0.496 其他民族 188(68.36) 87(31.64) 家庭居住地 农村 537(66.96) 265(33.04) 0.497 0.481 城镇 10(58.82) 7(41.18) 独生子女 是 38(60.32) 25(39.68) 1.289 0.256 否 509(67.33) 247(32.67) 家庭类型 双亲家庭a 431(68.63) 197(31.37) 23.080 <0.001** 单亲家庭 59(67.82) 28(32.18) 组合家庭b 50(65.79) 26(34.21) 其他 7(25.00) 21(75.00) 家庭经济条件 差 10(55.56) 8(44.44) 11.090 0.026* 较差 49(53.26) 43(46.74) 中等 395(69.06) 177(30.94) 较好 75(70.09) 32(29.91) 好 18(60.00) 12(40.00) 父亲文化程度 文盲 117(65.00) 63(35.00) 7.025 0.135 小学毕业 192(70.85) 79(29.15) 初中 199(62.78) 118(37.22) 高中/中专 35(77.78) 10(22.22) 大专及以上 4(66.67) 2(33.33) 母亲文化程度 文盲 220(66.07) 113(33.93) 1.595 0.810 小学毕业 171(66.02) 88(33.98) 初中 135(69.59) 59(30.41) 高中/中专 18(66.67) 9(33.33) 大专及以上 3(50.00) 3(50.00) 父亲职业 农民 397(68.80) 180(31.20) 4.617 0.329 公职人员c 8(57.14) 6(42.86) 工人 107(61.49) 67(38.51) 商人 11(73.33) 4(26.67) 其他 24(61.54) 15(38.46) 母亲职业 农民 407(67.72) 194(32.28) 4.333 0.363 公职人员c 3(37.50) 5(62.50) 工人 93(65.03) 50(34.97) 商人 14(73.68) 5(26.32) 其他 30(62.50) 18(37.50) 学习压力 很重 43(44.79) 53(55.21) 31.817 <0.001** 重 158(62.95) 93(37.05) 一般 326(73.09) 120(26.91) 轻 17(77.27) 5(22.73) 很轻 3(75.00) 1(25.00) 家庭变故 是 105(60.69) 68(39.31) 3.673 0.055 否 442(68.42) 204(31.58) 住院经历 是 219(63.66) 125(36.34) 2.613 0.106 否 328(69.05) 147(30.95) 抑郁症家族史 是 4(19.05) 17(80.95) 22.146 <0.001** 否 543(68.05) 255(31.95) 注:()内数字为检出率/%。a指均为生父母,b指有继父或继母,c指公务员及事业单位人员;*P < 0.05 ,**P < 0.01。 表 2 中学生生活行为方式与抑郁症状的关联(n=819)
Table 2. Association between lifestyle behaviors and depressive symptoms among middle school students (n=819)
模型 生活行为 标准误 Wald $ {\chi }^{2} $ P β(95%CI) 模型1 学习日视屏时间 0.090 10.807 0.001** 0.294(0.119~0.470) 休息日视屏时间 0.099 0.362 0.548 0.059(−0.134~0.252) 白天户外活动时间 0.117 6.728 0.009** −0.304(−0.534~−0.074) 抽烟支数 0.235 0.872 0.351 0.220(−0.242~0.681) 喝酒杯数 0.251 5.035 0.025* 0.563(0.071~1.055) 吃早餐天数 0.101 13.039 <0.001** −0.364(−0.561~−0.166) 吃夜宵天数 0.130 5.455 0.020* 0.304(0.049~0.560) 西式快餐 0.332 0.946 0.331 −0.323(−0.973~0.327) 中式快餐 0.203 0.09 0.764 −0.061(−0.458~0.336) 外卖快餐 0.334 0.002 0.961 −0.016(−0.670~0.638) 腌制肉 0.171 0.08 0.777 −0.049(−0.384~0.287) 新鲜水果蔬菜/肉类/牛奶 0.128 9.054 0.003** −0.384(−0.634~−0.134) 罐头、面包、奶酪 0.130 0.584 0.445 0.099(−0.155~0.354) 饮料 0.155 0.537 0.464 −0.114(−0.418~0.190) 甜食 0.149 6.478 0.011* 0.380(0.087~0.673) 零食 0.149 2.46 0.117 0.234(−0.058~0.527) 腌制菜 0.155 0.068 0.794 −0.041(−0.345~0.264) 烧烤 0.163 0.255 0.614 0.082(−0.236~0.400) 模型2 学习日视屏时间 0.086 10.726 0.001** 0.283(0.114~0.452) 休息日视屏时间 0.096 0.206 0.650 0.044(−0.145~0.232) 白天户外活动时间 0.112 6.733 0.009** −0.292(−0.512~−0.071) 抽烟支数 0.228 1.133 0.287 0.243(−0.204~0.690) 喝酒杯数 0.244 1.345 0.246 0.283(−0.195~0.762) 吃早餐天数 0.098 7.215 0.007** −0.263(−0.455~−0.071) 吃夜宵天数 0.123 3.523 0.061 0.232(−0.010~0.473) 西式快餐 0.325 0.188 0.665 −0.141(−0.778~0.496) 中式快餐 0.193 0.332 0.564 −0.111(−0.490~0.267) 外卖快餐 0.329 0.053 0.817 −0.076(−0.721~0.569) 腌制肉 0.164 0.894 0.344 −0.155(−0.475~0.166) 新鲜水果蔬菜/肉类/牛奶 0.122 5.721 0.017* −0.291(−0.529~−0.053) 罐头、面包、奶酪 0.123 0.178 0.673 0.052(−0.189~0.293) 饮料 0.149 0.185 0.668 −0.064(−0.355~0.227) 甜食 0.144 2.413 0.120 0.223(−0.058~0.504) 零食 0.140 4.402 0.036* 0.294(0.019~0.569) 腌制菜 0.148 0.008 0.929 −0.013(−0.303~0.277) 烧烤 0.154 1.999 0.157 0.218(−0.084~0.519) 注:模型1未控制变量,模型2控制民族、家庭居住地、是否独生子女、家庭类型、家庭经济条件、父/母文化程度、父/母职业、学习压力、家庭变故、住院经历、抑郁症家族史;*P < 0.05 ,**P < 0.01。 表 3 中学生生活行为方式与抑郁症状的分性别分析(n=819)(1)
Table 3. Gender analysis of lifestyle behaviors and depressive symptoms in middle school students (n=819)(1)
模型 分层 生活行为 标准误 Wald $ {\chi }^{2} $ P β(95%CI) 模型1 男生 学习日视屏时间 0.116 6.601 0.010* 0.298(0.071~0.525) 休息日视屏时间 0.134 0.086 0.769 0.039(−0.222~0.301) 白天户外活动时间 0.160 6.570 0.010* −0.409(−0.722~−0.096) 抽烟支数 0.328 0.816 0.366 −0.296(−0.938~0.346) 喝酒杯数 0.324 2.796 0.094 0.542(−0.093~1.177) 吃早餐天数 0.144 6.059 0.014* −0.353(−0.635~−0.072) 吃夜宵天数 0.175 5.771 0.016* 0.421(0.077~0.764) 西式快餐 0.384 0.003 0.956 −0.021(−0.774~0.732) 中式快餐 0.285 0.188 0.665 0.123(−0.435~0.682) 外卖快餐 0.406 0.155 0.694 0.160(−0.635~0.955) 腌制肉 0.223 0.393 0.531 −0.140(−0.577~0.298) 新鲜水果蔬菜/肉类/牛奶 0.167 10.919 0.001** −0.552(−0.879~−0.225) 罐头、面包、奶酪 0.175 2.202 0.138 0.260(−0.083~0.604) 饮料 0.211 0.012 0.914 −0.023(−0.437~0.391) 甜食 0.205 6.491 0.011* 0.523(0.121~0.925) 零食 0.208 0.140 0.708 0.078(−0.330~0.487) 腌制菜 0.197 0.129 0.720 0.071(−0.315~0.456) 烧烤 0.207 0.002 0.966 0.009(−0.397~0.414) 女生 学习日视屏时间 0.133 5.614 0.018* 0.316(0.055~0.577) 休息日视屏时间 0.143 0.842 0.359 0.132(−0.149~0.412) 白天户外活动时间 0.166 1.008 0.315 −0.167(−0.493~0.159) 抽烟支数 0.336 3.698 0.054 0.646(−0.012~1.305) 喝酒杯数 0.383 3.015 0.083 0.665(−0.086~1.416) 吃早餐天数 0.143 7.513 0.006** −0.392(−0.672~−0.112) 吃夜宵天数 0.191 0.679 0.410 0.158(−0.217~0.532) 西式快餐 0.591 2.259 0.133 −0.889(−2.047~0.270) 中式快餐 0.284 0.933 0.334 −0.274(−0.831~0.282) 外卖快餐 0.555 0.183 0.668 −0.238(−1.326~0.850) 腌制肉 0.255 0.004 0.951 0.016(−0.485~0.516) 新鲜水果蔬菜/肉类/牛奶 0.192 0.911 0.340 −0.184(−0.561~0.193) 罐头、面包、奶酪 0.190 0.417 0.519 −0.123(−0.496~0.250) 饮料 0.238 0.001 0.980 0.006(−0.46~0.472) 甜食 0.217 0.109 0.741 0.072(−0.353~0.497) 零食 0.219 1.991 0.158 0.310(−0.120~0.740) 腌制菜 0.241 0.132 0.717 −0.087(−0.560~0.385) 烧烤 0.247 0.628 0.428 0.195(−0.288~0.679) 注:模型1未控制变量,模型2控制民族、家庭居住地、是否独生子女、家庭类型、家庭经济条件、父/母文化程度、父/母职业、学习压力、家庭变故、住院经历、抑郁症家族史;*P < 0.05 ,**P < 0.01。 表 3 中学生生活行为方式与抑郁症状的分性别分析(n=819)(2)
Table 3. Gender analysis of lifestyle behaviors and depressive symptoms in middle school students (n=819)(2)
模型 分层 生活行为 标准误 Wald χ2 P β(95%CI) 模型2 男生 学习日视屏时间 0.114 6.815 0.009** 0.297(0.074~0.520) 休息日视屏时间 0.130 0.005 0.945 0.009(−0.245~0.263) 白天户外活动时间 0.155 5.672 0.017* −0.369(−0.673~−0.065) 抽烟支数 0.332 0.905 0.341 −0.316(−0.966~0.335) 喝酒杯数 0.323 1.232 0.267 0.359(−0.275~0.992) 吃早餐天数 0.142 4.112 0.043* −0.288(−0.567~−0.010) 吃夜宵天数 0.167 3.065 0.080 0.292(−0.035~0.618) 西式快餐 0.381 0.744 0.389 0.328(−0.418~1.074) 中式快餐 0.270 <0.001 0.986 −0.005(−0.534~0.525) 外卖快餐 0.394 0.214 0.643 0.182(−0.589~0.954) 腌制肉 0.214 0.994 0.319 −0.214(−0.634~0.206) 新鲜水果蔬菜/肉类/牛奶 0.160 7.017 0.008** −0.423(−0.735~−0.110) 罐头、面包、奶酪 0.169 0.104 0.747 0.054(−0.276~0.385) 饮料 0.205 0.198 0.657 −0.091(−0.492~0.310) 甜食 0.195 3.109 0.078 0.344(−0.038~0.726) 零食 0.202 1.194 0.274 0.221(−0.175~0.616) 腌制菜 0.186 0.424 0.515 0.121(−0.243~0.485) 烧烤 0.198 0.454 0.501 0.134(−0.255~0.522) 女生 学习日视屏时间 0.128 5.736 0.017* 0.306(0.056~0.557) 休息日视屏时间 0.141 0.014 0.907 −0.016(−0.292~0.259) 白天户外活动时间 0.159 0.951 0.329 −0.155(−0.466~0.156) 抽烟支数 0.324 4.397 0.036* 0.679(0.044~1.314) 喝酒杯数 0.369 0.470 0.493 0.253(−0.470~0.976) 吃早餐天数 0.139 4.779 0.029* −0.304(−0.576~−0.031) 吃夜宵天数 0.183 0.449 0.503 0.122(−0.236~0.480) 西式快餐 0.585 4.771 0.029* −1.278(−2.425~−0.131) 中式快餐 0.271 0.791 0.374 −0.241(−0.773~0.290) 外卖快餐 0.563 0.192 0.661 −0.247(−1.349~0.856) 腌制肉 0.253 0.019 0.890 −0.035(−0.531~0.461) 新鲜水果蔬菜/肉类/牛奶 0.184 0.003 0.960 −0.009(−0.369~0.351) 罐头、面包、奶酪 0.184 0.008 0.930 −0.016(−0.376~0.344) 饮料 0.225 0.089 0.765 0.067(−0.374~0.509) 甜食 0.207 0.025 0.875 0.033(−0.373~0.438) 零食 0.206 3.269 0.071 0.373(−0.031~0.778) 腌制菜 0.230 0.986 0.321 −0.229(−0.680~0.223) 烧烤 0.233 0.566 0.452 0.175(−0.281~0.632) 注:模型1未控制变量,模型2控制民族、家庭居住地、是否独生子女、家庭类型、家庭经济条件、父/母文化程度、父/母职业、学习压力、家庭变故、住院经历、抑郁症家族史;*P < 0.05 ,**P < 0.01。 -
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