超重/肥胖和感知超重对屏幕使用时间与自杀倾向之间关联的中介作用：来自美国青少年风险行为监测系统的结果
Mediation of the association between screen time and suicidality by overweight/obesity and perceived overweight: results from the youth risk behavior surveillance system of the United States.
作者信息
Gao Hong, Wang Yifei, Wang Xugang, Gao Ming
机构信息
Department of Mental Health, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Taiyuan University of Technology, Shanxi, China.
出版信息
Front Psychiatry. 2024 Mar 4;15:1287021. doi: 10.3389/fpsyt.2024.1287021. eCollection 2024.
AIM
Adolescent suicide is a major public health concern, and modifiable risk factors associated with adolescent suicide remain poorly understood. This study aimed to assess the association between screen time and overweight/obesity and self-perceived overweigh and suicidality in adolescents.
METHODS
Adolescents from the United States Youth Risk Behavior Surveillance System (YRBSS) between 2013 and 2019 were included in this cross-sectional study. The outcome was suicidality, including considered suicide, made a suicide plan, attempted suicide, and injurious suicide attempt. Multivariable logistic regression model was used to investigate the associations between screen time, overweight/obesity, self-perceived overweight, and suicidality, and expressed as odds ratio (OR) and 95% confidence interval (CI). Mediation analysis was used to explore the role of overweight/obesity and self-perceived overweight on the association between screen time and suicidality.
RESULTS
A total of 30,731 adolescents were included, of which 6,350 (20.65%) had suicidality, including 5,361 (17.45%) with considered suicide, 4,432 (14.42%) with made a suicide plan, 2,300 (7.45%) with attempted suicide, and 677 (2.21%) with injurious suicide attempt. Adolescents with screen time ≥3h were related to higher odds of suicidality (OR=1.35, 95%CI: 1.23-1.46), overweight/obesity (OR=1.27, 95%CI: 1.19-1.38), and self-perceived overweight (OR=1.38, 95%CI: 1.30-1.48) after adjusting confounders. Adolescents with overweight/obesity (OR=1.30, 95%CI: 1.19-1.43) and self-perceived overweight (OR=1.54, 95%CI: 1.39-1.70) were associated with higher odds of suicidality. The association between screen time and suicidality was 4.67% mediated by overweight/obesity and 9.66% mediated by self-perceived overweight. Moreover, the mediating role of overweight/obesity was observed only in females, whereas there were no sex differences in the mediating effect of self-perceived overweight.
CONCLUSION
Both overweight/obesity and self-perceived overweight mediated the association between screen time and suicidality.
目的
青少年自杀是一个重大的公共卫生问题，与青少年自杀相关的可改变风险因素仍未得到充分了解。本研究旨在评估青少年的屏幕使用时间与超重/肥胖、自我感知超重及自杀倾向之间的关联。
方法
本横断面研究纳入了2013年至2019年美国青少年风险行为监测系统（YRBSS）中的青少年。结局指标为自杀倾向，包括考虑自杀、制定自杀计划、自杀未遂以及有伤害性的自杀未遂。采用多变量逻辑回归模型研究屏幕使用时间、超重/肥胖、自我感知超重与自杀倾向之间的关联，并以比值比（OR）和95%置信区间（CI）表示。采用中介分析来探讨超重/肥胖和自我感知超重在屏幕使用时间与自杀倾向关联中的作用。
结果
共纳入30731名青少年，其中6350名（20.65%）有自杀倾向，包括5361名（17.45%）考虑自杀、4432名（14.42%）制定自杀计划、2300名（7.45%）自杀未遂以及677名（2.21%）有伤害性的自杀未遂。在调整混杂因素后，屏幕使用时间≥3小时的青少年自杀倾向（OR=1.35，95%CI：1.23 - 1.46）、超重/肥胖（OR=1.27，95%CI：1.19 - 1.38）及自我感知超重（OR=1.38，95%CI：1.30 - 1.48）的几率更高。超重/肥胖（OR=1.30，95%CI：1.19 - 1.43）及自我感知超重（OR=1.54，95%CI：1.39 - 1.70）的青少年自杀倾向几率更高。屏幕使用时间与自杀倾向之间的关联有4.67%由超重/肥胖介导，9.66%由自我感知超重介导。此外，超重/肥胖的中介作用仅在女性中观察到，而自我感知超重的中介作用不存在性别差异。
结论
超重/肥胖和自我感知超重均介导了屏幕使用时间与自杀倾向之间的关联。
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