天津市初中生健康危险行为潜在类别与抑郁症状的关联

  目的  探讨初中生健康危险行为的潜在类别及其与抑郁症状的关联，为识别抑郁症状高风险群体和制定有针对性的综合干预措施提供科学依据。  方法  采用多阶段分层整群抽样方法，抽取天津市16个区的8 175名初中生进行问卷调查，内容包括人口学特征、抑郁症状和健康危险行为。使用Mplus 8.3软件进行健康危险行为的潜在类别分析，使用SPSS 23.0软件进行描述和统计分析。  结果  天津市初中生抑郁症状检出率为17.8%，城区(19.4%)高于郊区(16.5%)(χ2=11.62)，女生(20.2%)高于男生(15.5%)(χ2=30.58)(P值均＜0.01)。经潜在类别分析，将天津市初中生健康危险行为分为健康组(84.0%)、不良饮食组(3.8%)和多种风险行为组(12.2%)3个潜在类别。多因素Logistic回归分析显示，在调整地区、年级、性别、家庭类型后，与健康组相比，不良饮食组和多种风险行为组的初中生检出抑郁症状的风险更高[OR值(95%CI)分别为2.82(2.17~3.66)，4.31(3.67~5.05)，P值均＜0.01)]。  结论  天津市初中生抑郁症状问题较为严峻，健康危险行为潜在类别与抑郁症状间存在关联。应根据各潜在类别的特征早期识别抑郁高风险初中生，制定有针对性的综合干预方案，使干预措施的成本-效益最大化。

Association between latent classes of health risk behaviors and depressive symptoms among junior middle school students in Tianjin

  Objective  To investigate the prevalence of depressive symptoms among junior middle school students in Tianjin, and to explore the association between latent classes of health risk behaviors and depressive symptoms, so as to provide clues for identifying high-risk groups of depressive symptoms and a scientific basis for comprehensive intervention measures.  Methods  By using a multistage stratified cluster sampling method, 8 175 students in 16 districts of Tianjin were investigated with demographic characteristics, depressive symptoms, and health risk behaviors. Latent class analysis was performed by Mplus 8.3. SPSS 23.0.  Results  The prevalence of depressive symptoms among junior high school students in Tianjin was 17.8%, the prevalence of depressive symptoms in urban(19.4%) areas was higher than that in rural areas(16.5%), and that of female students(20.2%) was higher than that of male students(15.5%)(χ2=11.62, 30.58, P < 0.01). Health risk behaviors were classified into three groups: healthy group (84.0%), poor diet group (3.8%) and multiple risk behaviors group (12.2%). After adjusting for region, grade, gender, and family type, multivariate Logistic regression analysis showed that the poor diet group (OR=2.82, 95%CI=2.17-3.66) and the multiple risk behaviors group (OR=4.31, 95%CI=3.67-5.05) had a higher risk of depressive symptoms compared with the healthy group (P < 0.01).  Conclusion  Depressive symptoms are prevalent among junior middle school students in Tianjin. Different latent classes of health risk behaviors have different correlations with depressive symptoms. It is important to ensure early detection and personalized intervention for different types of health risk behavior among junior middle school students to maximize cost-effectiveness.