文献快报(5):体力活动可显著改善儿童青少年抑郁症状

正体力活动对儿童青少年心理健康的益处逐渐受到关注。研究提示体力活动可缓解抑郁症状,成人重症抑郁的综合治疗方案中已开始纳入运动处方(每周3天以上、每天45 min中等强度的运动)。也有学者提出相反的关联:体力活动降低、静坐时间增加会增加罹患抑郁的风险。成年人群研究表明运动有助于预防重症抑郁发生,但儿童青少年群体中是否存在类似关联,需开展荟萃分析,明确体力活动对儿童青少年抑郁症状的最佳保护效应,为心理健康促进中纳入体力活动提供理论支撑。     

儿童青少年体力活动与身心健康研究进展

近几十年,儿童青少年体力活动水平下降趋势明显,导致其健康水平下降,新冠肺炎疫情的暴发与蔓延进一步加重了该趋势。在疫情防控常态化背景下,为深入解析体力活动与儿童青少年身心健康之间的关系,促进儿童青少年身心健康水平,追踪梳理了国内外相关主题文献,分析了体力活动对儿童青少年健康体适能、认知和心理健康的积极影响,发现相关健康效应存在显著的体力活动类型、强度和时间差异等,进而提出了体力活动相关研究的若干问题。     

改善儿童青少年体力活动水平是实现健康中国的重要保障

儿童青少年健康对于实现“健康中国”意义重大,但目前儿童青少年健康问题呈现多发、高发和低龄化趋势,环境、家庭和个人生活行为方式等影响因素日益复杂多样,给保护和促进儿童青少年健康带来诸多难题。新型冠状病毒肺炎疫情的暴发与蔓延更是对儿童青少年健康促进带来更为严峻的挑战。鉴于体力活动对改善儿童青少年健康所具有的重要意义,应该紧握“体力活动”抓手,积极探索通过体力活动改善儿童青少年健康的途径和方法,为实现“健康中国”的目标提供重要保障。     

体力活动联合视屏时间对南京市儿童青少年超重肥胖的影响

目的探讨南京市儿童青少年体力活动和视屏时间与超重肥胖之间的关联,为防控儿童青少年肥胖提供参考依据。方法采用多阶段整群随机抽样的方法,于2018年5—6月选择南京市36所学校4～12年级学生(9～17岁儿童青少年)共4 401人进行问卷调查和身高、体重测量。根据性别、年龄和体质指数(BMI)将调查对象划分为超重肥胖组和体重正常组,采用国际体力活动问卷调查体力活动水平和视屏时间,logistic回归方法分析体力活动和视屏时间对南京市儿童青少年超重和肥胖的影响。结果南京市儿童青少年超重肥胖率为27.7%(1 219人),体力活动充足率为21.1%(930人),视屏时间较短率为96.3%(4 237人)。体力活动充足以及视屏时间较短的学生BMI值分别低于体力活动不充足以及视屏时间过长学生。体力活动不充足且视屏时间过长组超重肥胖的发病率最高(39.7%)。在调整了相关混杂因素后,logistic回归分析结果显示,体力活动不充足且视屏时间较短组以及体力活动充足且视屏时间较短组超重肥胖的风险分别为体力活动不充足且视屏时间过长组的0.54倍(95%CI=0.37～0.77)和0.64倍(95%CI=0.43～0.94)。结论采取有效措施增加南京市儿童青少年身体活动的同时也要减少视屏时间,以有效控制超重和肥胖的发生。     

基于计划行为理论分析青少年休闲性体力活动的影响因素

运用计划行为理论对青少年休闲性体力活动进行检验与评估,为培养学生形成规律的行为习惯,并提出相应干预措施提供理论依据.方法 选取上海市353名7~15岁学生同时完成TPB量表调查和1周加速度器测量,分析青少年休闲性体力活动的影响因素.结果 青少年平均每天休闲性体力活动时间为(15.26±11.21) min,行为意向是青少年休闲性体力活动唯一直接影响因素,贡献率为8.9%.行为态度和感知行为控制联合预测行为意向33.2%的变异量,主观规范对休闲性行为和行为意向影响均无统计学意义.影响男生行为意向的重要因素是行为态度和感知行为控制,其贡献率为40.3%;影响女生行为意向的只有感知行为控制,其贡献率为27.4%.结论 我国青少年休闲性体力活动水平低于国外,计划行为理论对青少年休闲性体力活动的预测达到了中等影响水平.     

宁波市中学生体力活动与行为危险因素关系分析

探讨青少年学生行为危险因素对体力活动水平的影响,为提高青少年健康水平提供依据.方法 采用分层整群随机抽样方法,在宁波市内抽取3个县(区)市,再从抽中的县(区)市所有中学(初中、高中)中随机抽样49个班级的2 161名学生,进行问卷调查.结果 单因素分析发现,是否每天看电视、有无打架受伤和喝汽水饮料行为在不同体力活动水平学生中的报告率差异有统计学意义(P值均<0.05).Logistic回归分析发现,年龄、性别、看电视情况对不同体力活动水平影响存在统计学意义(x2=121.01,P=0.00,R2=0.12).结论 每天看电视是青少年学生体力活动的危险因素.应针对青少年体力活动水平的危险因素进行干预,提高青少年健康水平.     

锻炼动机与中学生休闲体力活动的关系

探讨青少年体力活动的动机特点及其与课外体力活动的关系,为促使青少年养成体力活动行为习惯提供参考.方法 采用分层整群随机抽样的方法抽取芜湖、马鞍山市16所中学的946名学生,采用体力活动动机量表和休闲体力活动量表进行问卷调查.结果 青少年体力活动动机由强到弱排序是:健康(4.09±0.71)、乐趣(3.61±0.82)、能力(3.40±0.83)、社交(3.30±0.84)和外貌(2.79±0.83);男生的乐趣动机、能力动机和社交动机高于女生(F值分别为12.21,18.12,6.58,P值均<0.05);随年级增加,青少年的外貌动机和社交动机有所加强,但乐趣动机、能力动机和健康动机呈下降趋势(F值分别为28.01,6.47,15.34,17.17,18.81,P值均<0.05).乐趣动机和能力动机有效预测青少年体力活动(β值分别为0.101,0.176,P值均<0.05),但社交动机、外貌动机和健康动机与青少年体力活动无关;内部动机对体力活动的激发和维持作用大于外部动机.层次回归分析表明,性别、年级因素不能调节动机与青少年体力活动的关系(△R2值分别为0.004,0.007,P值均>0.05).结论 激发内部动机是促进青少年积极参加休闲体力活动的有效手段.     

BMI在体力活动与高血压关联中的中介效应

目的 探讨体重指数(body mass index, BMI)在体力活动和高血压关联中的中介效应。方法 基于西南区域自然人群队列成都市基线调查数据,剔除变量缺失后最终纳入分析18 657人。采用多因素logistic回归分析体力活动与高血压患病的关联以及BMI对高血压患病的关联。通过中介效应模型探讨BMI在成都市居民体力活动与高血压关联中的中介效应。结果 18 657名研究对象中有6 110人(占32.7%)患有高血压。调整可能的混杂因素后,体力活动与高血压之间呈负相关,OR(95%CI)为0.990(0.988～0.992),BMI与高血压之间存在较强的正相关关联,OR(95%CI)为1.197 (1.184～1.210)。中介效应分析显示,BMI在体力活动与高血压之间的关联中存在中介效应,中介占比7.22%。结论 BMI是体力活动与高血压之间关系的重要中介因素。提示居民增强体力活动,降低BMI,可能降低高血压患病情况。     

体力活动模式对儿童青少年学习成绩的影响

体力活动有利于提高儿童青少年身心健康,越来越多的研究表明体力活动对提高儿童青少年学习成绩有积极作用.本文对现有文献进行回顾分析,探究体力活动模式与儿童青少年学习成绩之间的关系,分析不同时长、频次、强度和类型的体力活动对儿童青少年学习成绩的影响,为提高儿童青少年体力活动的质量和效果提供依据.高质量证据支持长时间、高频次、...     

青少年体力活动与抑郁症状的相关性

目的 分析青少年体力活动与抑郁症状之间的相关性，为前瞻性预防青少年抑郁提供参考。方法 在上海、乌鲁木齐、长沙、昆明4座城市采用随机整群抽样方式抽取8 102名青少年，分别采用“中国7～18岁儿童青少年体力活动水平评价问卷”和流调中心用抑郁量表(CES-D)对青少年进行体力活动调查和抑郁症状评估，采用多因素Logistic回归分析对青少年体力活动与抑郁症状的相关性进行分析。结果 青少年中高强度体力活动(MVPA)达标比例为37.0%,抑郁症状检出率为25.6%。分学段、性别后，MVPA达标组抑郁症状检出率均低于MVPA未达标组(χ²=7.62～34.54,P值均<0.05)。抑郁症状程度严重青少年具有低强度体力活动(LPA)时间长、高强度体力活动(VPA)时间短的特点，抑郁症状程度较轻或无症状青少年MVPA时长更长。不同抑郁症状程度青少年总体LPA、VPA;男生LPA,女生LPA、VPA;初中生LPA、VPA,高中生LPA、中强度体力活动(MPA)、MVPA差异均有统计学意义(H值分别为46.48,10.31,18.06,25.02,29.54,30.25,1...     

Care Their Diet and Mind: Association between Eating Habits and Mental Health in Chinese Left-behind Children

Studies have shown that the prevalence of mental health problems is high among left-behind children (LBC). Modifiable eating habits may play an important role in promoting mental health among these adolescents. This study aimed to investigate the situation of dietary habits and their association with mental health problems in a sample of Chinese LBC. We conducted this cross-sectional study in an economically disadvantaged area of China in May 2020. Information on socio-demographic factors, eating habits (the frequency of eating carbohydrates, fruits, vegetables, protein, and breakfast), and mental health problems (insomnia, depression, and anxiety) were collected among local adolescents. Among 8939 adolescents were recruited, a total of 3314 LBC (1455 males and 1859 females, aged 12–17 years) were identified and included in the current study. Associations between dietary habits and mental health were analyzed by generalized linear models. Results indicated that the dietary pattern was unhealthy among LBC and even worse in females. Compared to routinely eating breakfast and fruits, lower frequencies of eating breakfast and fruits were identified as two significant factors with higher risks of mental health problems. Moreover, the association was more pronounced in females. Therefore, improving diet quality, particularly the frequency of eating breakfast and fruit intake may be an effective approach in the mental health promotion for LBC, especially for females.     

Prevalence and correlates of mental health problems and treatment among adolescents seen in primary care

PurposeIn this study, we describe the characteristics of adolescents with mental health problems among those presenting to primary care clinics in urban areas.MethodsThe sample included 1,076 adolescents aged 12–18 years who presented to federally qualified community health clinics in urban cities in the Midwest. Bivariate and multivariate logistic regression analyses were conducted to examine the associations between having a mental health problem with demographic characteristics, health-related variables, and other risk and promotive factors. We also examined the use of health services and involvement in activities among those with mental health problems.ResultsApproximately 14% of adolescents screened positive for a mental health problem; among those with a mental health problem, 42.8% received mental health services in the past 3 months. In the multivariate logistic regression analysis, adolescents who were female, with poorer grades, fair to poor self-reported health, using drugs, and lower parental monitoring were more likely to have a mental health problem. In bivariate analyses, adolescents with mental health problems were less likely to participate in school activities and community activities and more likely to use emergency room services.ConclusionsAdolescents with mental health problems were more likely to have several other difficulties including poor grades, poor self-rated health, drug/alcohol use, and sexual activity. This study highlights the importance of screening youth with multidimensional needs and referring them to the appropriate services.     

Mental health problems among young people on remand: has anything changed since 1989?

Objectives: To determine whether the prevalence of mental health problems among adolescents on court ordered remand in South Australia has changed since 1989. To compare the prevalence of mental health problems reported among adolescents on remand in 1989 and 2008/09 with the prevalence among adolescents in the general community. Method: Mental health problems were identified using the Youth Self‐Report (YSR), which was completed by 11–17 year olds on remand in South Australia in 1989 (n=100) and in 2008/09 (n=197), and 13–17 year olds (n=1,283) in the national survey of mental health problems among Australian adolescents conducted in 1998. Results: Although adolescents on remand reported somewhat fewer mental health problems in 2008/09 than were reported in 1989, the prevalence of problems in both groups of adolescents on remand was significantly higher than that reported for adolescents in the general community. Conclusion: Adolescents on remand have a much higher prevalence of mental health problems than other adolescents in the community, with little change evident over the past 20 years. Implications: To reduce the high levels of mental health problems experienced by adolescents on remand, interventions need to provide effective management and treatment both during the time adolescents are on remand and after they return to the general community.     

当前儿童青少年心理健康状况解读与对策建议

近年来全球儿童青少年心理障碍发病呈递增趋势。针对中国现状，国家陆续出台许多相关政策与法规，并积极构建社会各层次心理卫生服务平台，以降低儿童心理行为问题发生率。文章围绕当前国内外儿童青少年心理行为问题发生、发展特点，阐述了身心关联的因素，解读致病因果关系及其模型，重点阐述了临床视角的部分观点，并提出相关对策及建议。     

青少年传统欺凌、网络欺凌与心理健康的关系研究

目的 调查青少年受欺凌的流行特点,探究遭受传统欺凌、网络欺凌以及欺凌数量对青少年心理健康的影响。方法 采用分层整群随机抽样方法,分别选取华中某市城市、农村青少年3 174名。采用自制受欺凌问卷和《中国中学生心理健康量表》(MMHI - 60)调查青少年校园欺凌及心理健康状况。结果 13.4%(424/3 174)的青少年至少遭受过一种类型的校园欺凌,其中受言语欺凌报告率最高(9.9%),网络欺凌最低(2.9%);受欺凌报告率男生高于女生(χ2 = 6.48,P = 0.011),七年级最高21.6%(114/3 174)。心理健康问题的检出率为10.3%（328/3 174）;受任意类型的欺凌均与心理健康问题相关,遭受多种类型欺凌者发生心理健康问题的风险高于单一受欺凌者;传统欺凌(言语欺凌、躯体欺凌、关系欺凌)对心理健康的独立影响高于网络欺凌。结论 青少年遭受欺凌与心理健康问题的产生密切相关,传统欺凌仍然是影响青少年心理健康的重要因素,应积极治理校园欺凌,促进青少年心理健康发展。     

以学校为基础的儿童青少年心理健康促进干预研究进展

随着中国经济的快速发展,儿童青少年的心理健康问题受到社会的广泛关注。早期存在的心理健康问题会增加成年后精神疾病发生风险,给家庭和社会带来沉重的负担。研究对国外以学校为基础的儿童青少年心理健康促进干预研究进展进行综述,旨在为中国出台相关政策早期防控和干预儿童青少年心理健康问题提供借鉴。     

Severity of Victimization and Co-Occurring Mental Health Disorders Among Substance Using Adolescents

Background  

Co-occurring mental health disorders are widespread among substance using adolescents. Severity of victimization may be an important factor in explaining co-occurrence of mental health problems among adolescents with substance misuse problems.     

青少年社会时差与心理健康关联的研究进展

青少年时期是童年期向成年期过渡的阶段,同时也是青少年生长发育和心理发展的重要时期。社会时差是休息日睡眠中点时间与工作日睡眠中点时间的绝对差值,是反应昼夜节律紊乱的一种新型指标。有研究证明,青少年社会时差与心理健康问题存在关联性,减小社会时差有益于青少年心理健康。本文简述了青少年社会时差及其流行状况,阐述社会时差与心理健康之间的可能机制,为青少年社会时差在预防控制心理健康问题时提供理论依据。     

The influence of parental education on child mental health in Spain

Purpose

To analyze the association between parental education and offspring’s mental health in a nationally representative Spanish sample, and assess the contribution of other socioeconomic factors to the association.

Methods

We conducted a secondary analysis of data on 4- to 15-year-olds participating in the 2006 Spanish National Health Survey. Mental health was assessed using the parent-reported Strengths & Difficulties Questionnaire. Parents’ respective educational levels were summarized in a single variable. Univariate and multivariate analyses, controlling for family-, child- and parent-related characteristics, were used to study the association.

Results

The final sample comprised 5,635 children. A strong association between parental education and parent-reported child mental health was observed among 4- to 11-year-olds, with odds ratios (ORs) increasing as parental educational level decreased. Where both parents had a sub-university level, maternal education showed a stronger association than did paternal education. Following adjustment for covariates, parental education continued to be the strongest risk factor for parent-reported child mental health problems, OR = 3.7 (95% CI 2.4–5.8) for the lowest educational level, but no association was found among 12- to 15-year-olds. Male sex, immigrant status, activity limitation, parent’s poor mental health, low social support, poor family function, single-parent families, low family income and social class were associated with parent-reported child mental health problems in both age groups.

Conclusions

Our results show that there is a strong association between parental education and parent-reported child mental health, and that this is indeed stronger than that for income and social class. Among adolescents, however, the effect of parental education would appear to be outweighed by other factors.     

青少年睡眠习惯与心理健康的相关性研究

目的 分析青少年中睡眠习惯和心理行为健康之间的相关性,为预防和改善青少年群体心理健康提供参考依据。方法 通过分层整群抽样的方式调查了4 966名11～20岁的青少年。青少年睡眠卫生评估量表修订版(M-ASHS)用来测量其睡眠状况及行为习惯。儿童长处和不足问卷(Strengths and Difficulties Questionnaire,SDQ)用来评估青少年心理行为健康状况。结果 参与调查的青少年中,46.4%工作日平均每天睡眠时间少于8 h,7.6%周末平均睡眠时间少于8 h,47.5%工作日入睡时间晚于22:00点,39.8%周末入睡时间晚于22:30,45.2%周末觉醒时间晚于8:00,22.55%睡眠规律性差;8.7%的青少年存在心理行为问题,在控制了潜在的混杂因素后,工作日平均睡眠时间少于8 h/d (OR=1.77,CI:1.13~2.76,P=0.012),周末的平均睡眠时间少于8 h/d(OR=1.65,CI:1.12~2.43,P=0.011),工作日入睡时间晚于22:00点(OR=1.73,CI:1.30~2.31,P<0.001),周末入睡时间晚于22:30点(OR=1.37,CI:1.07~1.77,P=0.014),周末的觉醒时间晚于8点(OR=1.30,CI:1.02~1.66,P=0.032),睡眠不规律(OR=3.11,CI:2.41~4.01,P<0.001)等5个睡眠习惯变量与青少年心理问题显著相关。结论 应加强对青少年的睡眠卫生教育,帮助其培养良好的睡眠习惯,特别是充足的睡眠时间和规律的作息习惯,以促进其心理健康。