Zhang Y H, Cai S, Chen Z Y, Zhang Y, Jiang J N, Liu Y F, Dang J J, Zhong P L, Shi D, Dong Y H, Hu P J, Zhu G R, Ma J, Song Y
Institute of Child and Adolescent Health, Peking University/School of Public Health, Peking University, Beijing 100191, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2023 Oct 10;44(10):1545-1551. doi: 10.3760/cma.j.cn112338-20230514-00298.
To analyze the association between the occurrence of spermarche and menarche and psychological distress among Chinese Han children and adolescents aged 9 to 18 years. Data were drawn from the 2019 Chinese National Survey on Students' Constitution and Health, and a total of 54 438 boys aged 11 to 18 years and 76 376 girls aged 9 to 18 years with psychological distress, spermarche/menarche records were included in the final analysis. The occurrence of spermarche/menarche was recorded by physicians, and psychological distress was classified according to the Kessler Psychological Distress Scale scores. The chi-square test was used to compare the difference between groups in the occurrence of spermarche/menarche, and the multinomial logistic regression model and stratification analysis was established to analyze the association between psychological distress and spermarche/menarche. The incidence of spermarche/menarche in 2019 ranged from 6.3% to 96.5% for eight age groups of Chinese boys and 2.8% to 99.0% for ten age groups of girls. The rates of high psychological distress among boys and girls were 32.5% and 32.7%. Among boys aged 11 to 18 years, the rate of high psychological distress increased with age, with a trend test <0.001, and the difference in the rate of high psychological distress between those who had and had not had their spermarche was not statistically significant in all age groups. Among girls aged 9 to 18 years, the rate of high psychological distress increased with age, with a trend <0.001; the rate of high psychological distress was higher in the group with menarche at age 10 and 12 than in the group without menarche (all <0.05). High psychological distress was positively correlated with spermarche among boys aged 13-15 years living in urban areas and hight level economic development areas (=1.11, 95%: 1.02-1.21;=1.18, 95%: 1.06-1.32). Overall, high psychological distress was positively correlated with menarche in girls aged 9-12 and 13-15 years (=1.33, 95%: 1.25-1.42; =1.22, 95%: 1.07-1.39). High psychological distress was positively correlated with menarche among girls aged 9-12 years living in different regions except for the Northeast region, in areas with different levels of economic development, and in urban and rural areas, in girls aged 13-15 years living in urban, central, and western regions, and in girls aged 16-18 years residing in the central region. This study found an association between the occurrence of spermarche/menarche and psychological distress among Chinese Han children and adolescents aged 9 to 18 years in 2019, which was particularly significant among girls aged 9 to 12 years and boys aged 13 to 15 years living in areas with higher levels of socioeconomic development.
分析中国9至18岁汉族儿童及青少年首次遗精和月经初潮的发生情况与心理困扰之间的关联。数据来自2019年中国学生体质与健康调研，最终分析纳入了54438名11至18岁有心理困扰、有首次遗精记录的男孩以及76376名9至18岁有心理困扰、有月经初潮记录的女孩。首次遗精/月经初潮由医生记录，心理困扰根据凯斯勒心理困扰量表得分进行分类。采用卡方检验比较首次遗精/月经初潮发生率在组间的差异，并建立多项逻辑回归模型和分层分析以分析心理困扰与首次遗精/月经初潮之间的关联。2019年中国八个年龄组男孩的首次遗精发生率为6.3%至96.5%，十个年龄组女孩的月经初潮发生率为2.8%至99.0%。男孩和女孩的高心理困扰发生率分别为32.5%和32.7%。在11至18岁男孩中，高心理困扰发生率随年龄增长而升高，趋势检验P<0.001，在所有年龄组中，有和没有首次遗精者的高心理困扰发生率差异无统计学意义。在9至18岁女孩中，高心理困扰发生率随年龄增长而升高，趋势检验P<0.001；月经初潮年龄为10岁和12岁组的高心理困扰发生率高于无月经初潮组（均P<0.05）。在居住于城市地区和经济发展水平高的地区的13至15岁男孩中，高心理困扰与首次遗精呈正相关（β=1.11，95%CI：1.02-1.21；β=1.18，95%CI：1.06-1.32）。总体而言，在9至12岁和13至15岁女孩中，高心理困扰与月经初潮呈正相关（β=1.33，95%CI：1.25-1.42；β=1.22，95%CI：1.07-1.39）。在除东北地区外的不同地区、不同经济发展水平地区以及城乡的9至12岁女孩中，高心理困扰与月经初潮呈正相关；在城市、中部和西部地区的13至15岁女孩以及中部地区的16至18岁女孩中，高心理困扰与月经初潮呈正相关。本研究发现2019年中国9至18岁汉族儿童及青少年首次遗精/月经初潮的发生情况与心理困扰之间存在关联，这在社会经济发展水平较高地区的9至12岁女孩和13至15岁男孩中尤为显著。
