Association between modifiable lifestyle behaviors and depressive symptoms among Chinese adolescents: a longitudinal analysis from 2019 to 2021.

BACKGROUND

The incidence of depression in adolescents is high, and depression has a great impact on children and adolescents, while the effects of changeable lifestyle on depression in adolescents are inconsistent, and there is a lack of longitudinal research results. To fill these knowledge gaps, we conducted a longitudinal study in Shanghai to evaluate the association between modifiable lifestyle behaviors and depression symptoms in adolescents.

METHODS

A total of 4314 students participated in the survey each year from 2019 to 2021 was included in this study. Students' physical activity behavior, screen behavior, and sleep behavior were collected by questionnaires. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D scale).

RESULTS

The detection rate of depressive symptoms in the study subjects was 23.6% in 2019, 23.2% in 2020, and 26.6% in 2021, and the trend test showed a significant upward trend in three years (P-trend = 0.001). Also, the detection rate of depressive symptoms in girls was higher than that of boys, but a significant rising trend was observed in boys over time (P-trend = 0.010). The generalized estimating equation analysis revealed that Students with TV time ≥ 2 h/day(OR = 1.29, 95%CI: 1.15, 1.46), computer time ≥ 2 h/day (OR = 1.20, 95%CI: 1.07, 1.36), mobile screen time ≥ 2 h/day(OR = 1.18, 95% CI: 1.08, 1.29), internet addiction(OR = 2.46, 95% CI: 1.81, 3.35), and inadequate sleep duration(OR = 0.66, 95% CI: 0.60, 0.72) were associated with an increased likelihood of detecting depressive symptoms. Students who participated in moderate-to-vigorous physical activity (MVPA) for a minimum of 60 min 1 to 4 days per week (OR = 0.77, 95%CI: 0.68, 0.86) or 5 to 7 days per week (OR = 0.73, 95%CI: 0.64, 0.84) exhibited a reduced likelihood of depressive symptoms in comparison to students who did not engage in MVPA for at least 60 min per week (P < 0.05).

CONCLUSION

We presented the climbing trend of depressive symptom rate over three years and identified several alarming factors that were associated with adolescent depression symptoms in Shanghai, China, notably in lower level MPVA, electronic devices use, and inadequate sleep with increasing depression.