Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.
The University of Hong Kong, LKS Faculty of Medicine, Hong Kong Special Administrative Region, China.
Soc Sci Med. 2024 Nov;360:117336. doi: 10.1016/j.socscimed.2024.117336. Epub 2024 Sep 14.
Limited understanding exists regarding the cumulative impact of childhood household dysfunction (CHD) on adolescent depressive symptoms in developing countries, as well as the role of lifestyles in this association. This study aims to explore the associations of individual and cumulative CHD indicators with depressive symptoms among Chinese adolescents. Additionally, we investigate potential interactions and joint associations of CHD and lifestyles on depressive symptoms.
In the second phase of the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research, data on depressive symptoms, CHD indicators, lifestyle factors, and other covariates were collected from 3106 students (mean [SD] age, 15.16 [1.52] years). Linear and logistic mixed-effects models were employed, with both stratified and joint analyses conducted.
Except for parental death, each CHD indicator was associated with an increased risk of depressive symptoms. The accumulation of CHD indicators exhibited a positive, graded association with depressive symptoms scores (β = 3.22, 95% CI: 2.48 to 3.97 for one CHD indicator; β = 5.45, 95% CI: 4.41 to 6.49 for two or more CHD indicators, all P < 0.01). A significant interaction was found between the number of CHD indicators and the healthy lifestyle score (interaction β = -0.40, 95% CI: -0.78 to -0.03, P < 0.05), indicating that healthy lifestyles may mitigate the risk of depressive symptoms in individuals experiencing CHD. For example, the OR for having depressive symptoms among adolescents with favourable lifestyles compared with those with unfavourable lifestyles was 0.21 (95% CI: 0.10 to 0.45, P < 0.01) among those experiencing CHD. Moreover, adolescents with two or more CHD indicators and unfavourable lifestyles faced the highest risk of having depressive symptoms (OR = 8.03, 95% CI: 4.83 to 13.34, P < 0.01) compared with those with no CHD indicator and favourable lifestyles.
These findings underscore the importance of promoting comprehensive healthy lifestyles and reducing CHD exposure for the prevention of depressive symptoms in adolescents.
在发展中国家，人们对童年期家庭功能障碍（CHD）对青少年抑郁症状的累积影响以及生活方式在这种关联中的作用知之甚少。本研究旨在探讨个体和累积 CHD 指标与中国青少年抑郁症状之间的关联。此外，我们还研究了 CHD 和生活方式对抑郁症状的潜在交互作用和联合作用。
在青少年心理和行为健康纵向研究的第二阶段，从 3106 名学生（平均[标准差]年龄 15.16[1.52]岁）中收集了抑郁症状、CHD 指标、生活方式因素和其他协变量的数据。采用线性和逻辑混合效应模型，进行分层和联合分析。
除父母死亡外，每个 CHD 指标都与抑郁症状风险增加相关。CHD 指标的累积与抑郁症状评分呈正相关，呈递增趋势（β=3.22，95%CI：1 个 CHD 指标为 2.48 至 3.97；β=5.45，95%CI：2 个或更多 CHD 指标为 4.41 至 6.49，均 P<0.01）。还发现 CHD 指标数量与健康生活方式评分之间存在显著交互作用（交互β=-0.40，95%CI：-0.78 至-0.03，P<0.05），表明健康的生活方式可能降低经历 CHD 的个体患抑郁症状的风险。例如，与生活方式不良的青少年相比，生活方式良好的青少年患抑郁症状的比值比（OR）为 0.21（95%CI：0.10 至 0.45，P<0.01）。此外，与生活方式良好的青少年相比，有两个或更多 CHD 指标且生活方式不良的青少年患抑郁症状的风险最高（OR=8.03，95%CI：4.83 至 13.34，P<0.01）。
这些发现强调了促进全面健康生活方式和减少 CHD 暴露对于预防青少年抑郁症状的重要性。
