Hua Yiwen, Xue Hui, Zhang Xiyan, Fan Lijun, Tian Yong, Wang Xin, Ni Xiaoyan, Du Wei, Zhang Fengyun, Yang Jie
School of Public Health, Southeast University, Nanjing 210096, China.
Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
Brain Sci. 2023 May 6;13(5):769. doi: 10.3390/brainsci13050769.
Self-harm in young people is common, and previous studies have shown that insufficient sleep or depression was associated with self-harm. However, the joint association of insufficient sleep and depression with self-harm is unknown. We employed representative population-based data from the "Surveillance for Common Disease and Health Risk Factors Among Students in Jiangsu Province 2019" project. College students reported their self-harm behavior over the past year. Rate ratios (RRs) and corresponding 95% confidence intervals (CIs) for self-harm in relation to sleep and depression were modeled using negative binomial regression with a sample population as an offset, adjusting for age, gender, and region. The instrumental variable approach was used for the sensitivity analyses. Of the study population, approximately 3.8% reported self-harm behaviors. Students with sufficient sleep experienced a lower risk of self-harm than those with insufficient sleep. Compared with students with sufficient sleep and the absence of depression, the adjusted risk of self-harm was elevated 3-fold (1.46-4.51) in those reporting insufficient sleep in the absence of depression, 11-fold (6.26-17.77) in those with sufficient sleep and definite depression, and 15-fold (8.54-25.17) in those with both insufficient sleep and definite depression. The sensitivity analyses indicate that insufficient sleep remained a contributing risk factor for self-harm. Lack of sleep in young people is significantly associated with self-harm, particularly in the presence of depression. The provision of mental health care and attention to sleep deprivation are particularly important for college students.
青少年自残行为很常见，先前的研究表明睡眠不足或抑郁与自残行为有关。然而，睡眠不足和抑郁与自残行为的联合关联尚不清楚。我们使用了来自“2019年江苏省学生常见疾病及健康危险因素监测”项目的具有代表性的基于人群的数据。大学生报告了他们过去一年中的自残行为。以样本量作为偏移量，采用负二项回归模型对与睡眠和抑郁相关的自残行为的率比（RRs）及相应的95%置信区间（CIs）进行建模，并对年龄、性别和地区进行了调整。敏感性分析采用了工具变量法。在研究人群中，约3.8%的人报告有自残行为。睡眠充足的学生自残风险低于睡眠不足的学生。与睡眠充足且无抑郁的学生相比，在无抑郁但睡眠不足的学生中，调整后的自残风险升高了3倍（1.46 - 4.51），在睡眠充足且有明确抑郁的学生中升高了11倍（6.26 - 17.77），在睡眠不足且有明确抑郁的学生中升高了15倍（8.54 - 25.17）。敏感性分析表明，睡眠不足仍然是自残行为的一个促成风险因素。青少年睡眠不足与自残行为显著相关，尤其是在存在抑郁的情况下。为大学生提供心理健康护理并关注睡眠剥夺尤为重要。
