青少年超重肥胖及校园欺凌与抑郁的关系研究

目的 了解青少年超重肥胖及校园欺凌对抑郁的联合作用，为防控青少年抑郁提供科学证据。方法 2020年于自贡市进行一次横断面调查，共调查三个区两个县的11所中学。对所有研究对象进行抑郁、校园欺凌等问卷调查和身高、体重等体格测量。使用多重线性模型和logistic模型在控制协变量后分析超重肥胖与校园欺凌的联合作用与抑郁的关系。结果 3 022名青少年（51.8%男性；平均年龄14.5岁）纳入本研究，超重肥胖率为17.3%，校园欺凌率为20.2%，抑郁平均得分为11.8，抑郁倾向占比25.6%。超重肥胖青少年相对于体重正常青少年其受到校园欺凌的可能性更高（23.3% vs 19.5%，P = 0.046）。相对于无超重肥胖且未受到校园欺凌的青少年，无超重肥胖但受到校园欺凌的青少年和超重肥胖且受到校园欺凌的青少年抑郁得分更高（β = 3.88，P＜0.001； β = 5.04，P＜0.001）、抑郁倾向更明显（OR = 2.37，95%CI:1.88～2.98，P＜0.001；OR = 3.11，95%CI:2.07～4.65，P＜0.001）；超重肥胖但未受到校园欺凌的青少年的抑郁得分和抑郁倾向无差异。无超重肥胖且未受到校园欺凌、超重肥胖但未受到校园欺凌、无超重肥胖但受到校园欺凌、超重肥胖且受到校园欺凌四组抑郁的患病风险呈上升趋势（OR = 1.49，95%CI:1.35～1.63，P＜0.001）。结论 需关注超重肥胖青少年的校园欺凌现象，以预防其出现抑郁倾向。

Study on relationship of overweight/obesity and school bullying with depression in adolescents

Objective To understand the joint effect of adolescent overweight/obesity and school bullying on depression, and to provide scientific evidence for the prevention and control of adolescent depression. Methods A cross-sectional survey was conducted in 11 middle schools from two counties and three districts of Zigong in 2020. Participants were asked to complete a questionnaire to collect information for depression and bullying at school and to undergo physical examinations for weight and height. Multiple linear models and logistic models were used to analyze the association of overweight/obesity and bullying at school with depression after controlling for covariates. Results In total 3 022 adolescents (51.8% male; mean age: 14.5 years) were included in this study, with overweight/obesity rate of 17.3%, school bullying rate of 20.2%, mean depression score of 11.8, and depressive tendency of 25.6%. Overweight and obese adolescents were more likely to be bullied in school than normal weight adolescents (23.3% vs. 19.5%, P=0.046). Adolescents who were not overweight and obese but were bullied at school had higher depression scores (β=3.88, P<0.001; β=5.04, P<0.001) and more pronounced depressive tendencies (OR=2.37, 95%CI: 1.88-2.98, P<0.001; OR=3.11, 95%CI: 2.07-4.65, P<0.001) than adolescents who were not overweight and obese and were not bullied at school. There were no differences in depression scores and depressive tendencies among adolescents who were overweight and obese but not exposed to school bullying. There was an increasing risk of depression in four groups: no overweight/obesity and no school bullying, overweight/obesity but no school bullying, no overweight/obesity but school bullying, and overweight/obesity and school bullying (OR=1.49, 95%CI: 1.35-1.63, P<0.001). Conclusion Attention to school bullying in overweight and obese adolescents is needed to prevent depressive tendencies.