居家学习生活方式对小学生抑郁焦虑的影响

  目的  了解小学生居家学习后心理健康状况的动态变化，探索居家学习生活方式对学龄期儿童心理健康状况的影响，为儿童心理健康干预提供依据。  方法  研究对象来自“同济心理健康队列”，通过方便抽样的方法抽取武汉市2所小学全体二至五年级小学生。第一阶段(T1)于2020年6月居家学习期间通过网络进行问卷调查，共回收有效问卷2 588份；第二阶段(T2)于2020年12月学校重新开放后通过向学校发送纸质问卷，成功随访2 424名小学生。将儿童2次调查的抑郁、焦虑症状结果分别结合起来对儿童的心理结局进行分类。采用无序多分类Logistic回归估计居家学习生活方式与小学生心理症状变化的关联。  结果  T1时小学生抑郁症状检出率为28.9%，焦虑症状检出率为21.0%；T2时抑郁症状检出率为35.6%，焦虑症状检出率为30.6%。小学生抑郁、焦虑症状的加重和持续与其居家学习生活方式存在一定的关联。上课集中精力(OR=0.63，95%CI=0.45~0.89)、与老师频繁互动(OR=0.74，95%CI=0.57~0.95)、居家期间参加体育锻炼(OR=0.60，95%CI=0.41~0.87)与小学生抑郁症状加重或持续呈负相关。玩电子游戏时长(OR=1.15，95%CI=1.06~1.24)、担心感染新冠病毒(OR=1.83，95%CI=1.39~2.42)与小学生焦虑呈正相关。男生(OR值分别为0.70，0.63)比女生更不容易受到抑郁、焦虑症状的困扰。  结论  小学生结束居家隔离回归学校后，抑郁、焦虑症状检出率升高，居家学习生活方式对小学生抑郁、焦虑症状存在一定的影响。应动态关注学龄期儿童的心理健康状况，及时采取合理的干预措施。

Effects of learning and lifestyle behaviors during home confinement on depressive and anxiety symptoms among primary school students

  Objective  To examine the changes of depressive and anxiety symptoms in school-aged children during home confinement and to identify possible influence of learning and lifestyle behaviors on mental health changes.  Methods  The population of this study were obtained from the "Tongji Mental Health Cohort". Two primary schools in Wuhan were selected through cluster sampling and students in grade 2-5 were surveyed. This study was divided into two stages. In the first stage (T1=during home-learning), a total of 2 588 valid questionnaires were collected. In the second phase (T2=during school-learning), 2 424 children were followed up successfully. Combining the results of the depression and anxiety symptoms of the two surveys of children respectively to classify the children's psychological outcomes. Association between home-learning and lifestyle behaviors with the change of psychological symptoms in school-aged children were estimated by disordered multi-classification Logistic regression.  Results  The prevalence of depressive and anxiety symptoms were 28.9% and 21.0% in school-aged children at T1, 35.6% and 30.6% at T2, respectively. The aggravation and persistence of depressive and anxiety symptoms in children were partly related to their home-learning and lifestyle behaviors. Concentration in class(OR=0.63, 95%CI=0.45-0.89), frequent interaction with teachers (OR=0.74, 95%CI=0.57-0.95), participation in physical exercise at home (OR=0.60, 95%CI=0.41-0.87) was negatively associated with depressive symptoms in children. Time spent on playing video games (OR=1.15, 95%CI=1.06-1.24) and fear of infection with coronavirus disease 2019 (OR=1.83, 95%CI=1.39-2.42) were positively associated with anxiety in children. Boys(OR=0.70, 0.63) were more likely to suffer from depression and anxiety symptoms than girls.  Conclusion  The prevalence of depressive and anxiety symptoms among school-aged children increased when they went back to school after home confinement, suggesting more attention are needed for mental health intervention among school-aged children.