背景:云南省与缅甸接壤,老挝,还有越南,它是中国最长的边界之一。我们旨在确定2018年至2022年云南省青少年(12-18岁)中COVID-19的患病率和对抑郁症状的影响,中国西南。
目的:我们评估了COVID-19流行对青少年心理健康的影响,为了减少心理紧急综合症的影响并促进健康,快乐的青春期成长。
方法:这种纵向,观察性研究使用了2018年至2022年(COVID-19之前和期间)云南青少年抑郁症状的学生健康调查数据。我们使用了多级,2018年在3个县分层抽样,2019年至2022年在16个县分层抽样。在每个县,研究人群按性别和居住地(城市或农村)分类,每组大小相等。根据流行病学研究中心抑郁量表(CES-D)评分诊断抑郁症状。我们使用方差分析来评估按性别分层的平均CES-D得分的差异,年龄,residence,grade,和种族。卡方检验用于比较不同变量的抑郁症状。为了可比性,以2010年中国人口普查为标准人群计算年龄标准和性别标准人群患病率.使用无条件逻辑回归分析确定COVID-19与抑郁症状标准化患病率风险之间的关联。
结果:所有参与者的抑郁症状的标准化患病率为32.98%:2018年为28.26%,2019年为30.89%,2020年为29.81%,2021年为28.77%,2022年为36.33%。在COVID-19之前,患病率为30.49%,在COVID-19早期为29.29%,在COVID-19大流行期间为36.33%。与COVID-19之前相比,早期COVID-19发生抑郁症状的风险高0.793(95%CI0.772-0.814)倍,比COVID-19期间高1.071(95%CI1.042-1.100)倍。抑郁症状平均每年增加1.61%。在疫情期间,女生抑郁症状患病率(36.87%)高于男生(28.64%),女孩的加速速度比男孩快。按年龄组划分的抑郁症状患病率和加速率如下:27.14%和1.09%(12-13岁),33.99%和1.8%(14-15年),36.59%和1.65%(16-18年)。汉族(32.89%)和少数民族(33.10%)之间的患病率没有差异。然而,前者的加速度比后者快。高中生的比率最高(34.94%)。然而,职业高中学生的加速率最快(2.88%),其次是初中生(2.32%)。农村居民(35.10%)的患病率高于城镇居民(30.16%)。
结论:从2018年到2022年,云南省青少年抑郁症状患病率持续上升,中国,特别是在COVID-19大流行期间。这代表了应给予更多关注的紧急公共卫生问题。有效,应采取综合的心理和生活方式干预措施,以降低青少年心理健康问题的患病率。
BACKGROUND: Yunnan province borders Myanmar, Laos, and Vietnam, giving it one of the longest borders in
China. We aimed to determine the trends in prevalence and impact of COVID-19 on depressive symptoms among adolescents (12-18 years) from 2018 to 2022 in Yunnan, southwest
China.
OBJECTIVE: We evaluated the impact of the COVID-19 epidemic on adolescents\' mental health, with the aim of reducing the effect of psychological emergency syndrome and promoting healthy, happy adolescent growth.
METHODS: This longitudinal, observational study used Students\' Health Survey data on adolescents\' depressive symptoms from 2018 to 2022 (before and during COVID-19) in Yunnan. We used multistage, stratified sampling in 3 prefectures in 2018 and 16 prefectures from 2019 to 2022. In each prefecture, the study population was classified by gender and residence (urban or rural), and each group was of equal size. Depressive symptoms were diagnosed based on Center for Epidemiological Studies Depression Scale (CES-D) scores. We used ANOVA to assess the differences in mean CES-D scores stratified by gender, age, residence, grade, and ethnicity. Chi-square tests were used to compare depressive symptoms by different variables. For comparability, the age-standard and gender-standard population prevalences were calculated using the 2010
China Census as the standard population. The association between COVID-19 and the risk of a standardized prevalence of depressive symptoms was identified using unconditional logistic regression analysis.
RESULTS: The standardized prevalence of depressive symptoms for all participants was 32.98%: 28.26% in 2018, 30.89% in 2019, 29.81% in 2020, 28.77% in 2021, 36.33% in 2022. The prevalences were 30.49% before COVID-19,29.29% in early COVID-19, and 36.33% during the COVID-19 pandemic. Compared with before COVID-19, the risks of depressive symptoms were 0.793 (95% CI 0.772-0.814) times higher in early COVID-19 and 1.071 (95% CI 1.042-1.100) times higher than during COVID-19. The average annual increase in depressive symptoms was 1.61%. During the epidemic, the prevalence of depressive symptoms in girls (36.87%) was higher than that in boys (28.64%), and the acceleration rate of girls was faster than that of boys. The prevalences of depressive symptoms and acceleration rates by age group were as follows: 27.14% and 1.09% (12-13 years), 33.99% and 1.8% (14-15 years), 36.59% and 1.65% (16-18 years). Prevalences did not differ between Han (32.89%) and minority (33.10%) populations. However, the acceleration rate was faster for the former than for the latter. The rate for senior high school students was the highest (34.94%). However, the acceleration rate for vocational high school students was the fastest (2.88%), followed by that for junior high school students (2.32%). Rural residents (35.10%) had a higher prevalence and faster acceleration than urban residents (30.16%).
CONCLUSIONS: From 2018 to 2022, there was a significant, continuous increase in the prevalence of depressive symptoms among adolescents in Yunnan,
China, especially during the COVID-19 pandemic. This represents an emergency public health problem that should be given more attention. Effective, comprehensive psychological and lifestyle intervention measures should be used to reduce the prevalence of mental health issues in adolescents.