Zhu Xingchen, An Na, Tang Zaixiang, Huang Jianping, Ren Qingxin, Wu Yue
Nantong Center for Disease Control and Prevention, Nantong, China.
Department of Biostatistics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, 215123, Jiangsu, P.R. China.
BMC Public Health. 2025 Jan 2;25(1):17. doi: 10.1186/s12889-024-21252-8.
The emergence of the COVID-19 pandemic led to increased levels of depression among adolescents in 2019. However, the situation regarding adolescent depression in the later stages of the pandemic remains unclear. This study investigated depressive symptoms status and changing trends among middle and junior high school students from 2019 to 2023.
Data were collected from 9,920 middle and junior high school students between 2019 and 2023 via multistage stratified cluster sampling. Students were administered an online survey, completed the Chinese version of the Center for Epidemiologic Studies Depression Scale, and answered questions regarding basic information, such as birth date. Univariate and multivariate analyses were performed to examine the factors that influenced depressive symptoms. Furthermore, Trend X Test and Logistic regression was employed to analyze the changing trends of depressive symptoms among the participants.
Of the students, 14.5% and 5.8% could have and had definitely experienced depressive symptoms, respectively. Junior high school students (AOR = 1.409, 95%CI = 1.164-1.706) had a higher risk of definite depressive symptoms. Males (possible depressive symptoms: AOR = 0.803, 95%CI = 0.716-0.902; definite depressive symptoms: AOR = 0.829, 95%CI = 0.695-0.988) were less likely to experience depressive symptoms. Families with parental absence (single-parent families, reconstituted families, and families where both parents are absent), less than one hour of outdoor activity and less than eight hours of sleep, increased the risk of both possible and definite depressive symptoms. Detection rate of depressive symptoms among middle school students followed an inverted U-shape trend; it rose in 2020 and 2021 and declined in 2022 and 2023. Detection rates of depressive symptoms among junior high school students in 2020, 2022, and 2023 decreased compared with 2019 (p < 0.05).
Educational stage, sex, family type, and duration of outdoor activities and sleep were factors that influenced depressive symptoms among middle and junior high school students. A proportion of middle school students with depressive symptoms exhibited an increasing and decreasing trend from 2019 to 2023. Students exposed to risk factors require additional attention, with timely early intervention to mitigate the impact of environmental stress and prevent the further development of depressive symptoms into a more severe and less manageable state.
2019年新冠疫情的出现导致青少年抑郁水平上升。然而，疫情后期青少年抑郁的情况仍不明确。本研究调查了2019年至2023年初中和高中学生的抑郁症状状况及变化趋势。
通过多阶段分层整群抽样，收集了2019年至2023年期间9920名初中和高中学生的数据。学生接受了在线调查，完成了中文版的流行病学研究中心抑郁量表，并回答了有关基本信息的问题，如出生日期。进行单因素和多因素分析以检查影响抑郁症状的因素。此外，采用趋势X检验和逻辑回归分析参与者中抑郁症状的变化趋势。
分别有14.5%和5.8%的学生可能有且肯定经历过抑郁症状。初中生（比值比=1.409，95%置信区间=1.164-1.706）有明确抑郁症状的风险更高。男性（可能的抑郁症状：比值比=0.803，95%置信区间=0.716-0.902；明确的抑郁症状：比值比=0.829，95%置信区间=0.695-0.988）出现抑郁症状的可能性较小。父母不在身边的家庭（单亲家庭、重组家庭和父母双方都不在的家庭）、户外活动少于一小时和睡眠少于八小时，增加了可能和明确抑郁症状的风险。中学生抑郁症状检出率呈倒U形趋势；在2020年和2021年上升，在2022年和2023年下降。与2019年相比，2020年、2022年和2023年初中生抑郁症状检出率下降（p<0.05）。
教育阶段、性别、家庭类型以及户外活动和睡眠时间是影响初中和高中学生抑郁症状的因素。一部分有抑郁症状的中学生在2019年至2023年期间呈现出先上升后下降的趋势。暴露于风险因素的学生需要额外关注，及时进行早期干预，以减轻环境压力的影响，防止抑郁症状进一步发展为更严重且更难控制的状态。
