Xiang Zhen, Luo Xiaomin, Zheng Ruimin, Jiang Qi, Zhu Kaiheng, Feng Yanan, Xiao Pei, Zhang Quan, Wu Xufang, Fan Yixi, Song Ranran
Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, China.
J Affect Disord. 2022 Dec 1;318:62-69. doi: 10.1016/j.jad.2022.08.095. Epub 2022 Sep 2.
The effect of school-based greenness exposure on mental health among adolescents remains unclear. The study aimed to estimate the associations between school-based greenness and depressive and anxiety symptoms among adolescents and explore potential modifier and mediator between the associations.
A cross-sectional survey involving 15,559 adolescents was conducted in China. The Chinese version of the Center for Epidemiologic Studies Depression 9-Item Scale and the Generalized Anxiety Disorder 7-Item Scale were used to assess the depressive and anxiety symptoms among adolescents. The Normalized Difference Vegetation Index within a 400 m and 800 m zone surrounding schools was used to indicate the adolescents' exposure to greenness. We estimated daily concentrations of PM, PM, and NO from the China High Air Pollutants dataset. Multiple logistic regression models were used.
Higher exposure to greenness surrounding schools was negatively associated with depressive (OR: 0.774, 95%CI: 0.685-0.875) and anxiety symptoms (0.740, 0.669-0.818). We observed stronger associations between greenness and depressive and anxiety symptoms among girls, lower age group (11-15 years), and adolescents born to parents with lower education levels. PM (proportion mediated estimates: 14.3 %; 95 % CI: 4.2 %, 24.5 %) and PM (10.5 %; 95 % CI: 3.0 %, 17.9 %) mediated the associations between greenness exposure and depressive symptoms. The number of days adolescents attended physical education classes per week mediated -22.8 % (95 % CI: -38.5 %, -7.1 %) and -9.7 % (95 % CI: -15.5 %, -3.8 %) of the effects of greenness on depressive and anxiety symptoms.
Increasing the greenness and improving the environment surrounding schools is effective in promoting the mental health of adolescents.
基于学校的绿色环境暴露对青少年心理健康的影响尚不清楚。本研究旨在评估基于学校的绿色环境与青少年抑郁和焦虑症状之间的关联，并探讨这些关联之间潜在的调节因素和中介因素。
在中国对15559名青少年进行了横断面调查。使用中文版的流行病学研究中心抑郁9项量表和广泛性焦虑障碍7项量表来评估青少年的抑郁和焦虑症状。用学校周围400米和800米区域内的归一化植被指数来表示青少年对绿色环境的暴露情况。我们从中国高空气污染物数据集中估算了PM、PM和NO的每日浓度。使用了多重逻辑回归模型。
学校周围更高的绿色环境暴露与抑郁症状（比值比：0.774，95%置信区间：0.685 - 0.875）和焦虑症状（0.740，0.669 - 0.818）呈负相关。我们观察到在女孩、低年龄组（11 - 15岁）以及父母教育水平较低的青少年中，绿色环境与抑郁和焦虑症状之间的关联更强。PM（中介比例估计值：14.3%；95%置信区间：4.2%，24.5%）和PM（10.5%；95%置信区间：3.0%，17.9%）介导了绿色环境暴露与抑郁症状之间的关联。青少年每周参加体育课的天数介导了绿色环境对抑郁和焦虑症状影响中的 -22.8%（95%置信区间：-38.5%，-7.1%）和 -9.7%（95%置信区间：-15.5%，-3.8%）。
增加绿色环境并改善学校周边环境对促进青少年心理健康是有效的。
