背景:青少年中不健康的生活方式行为已成为世界范围内重大的公共卫生问题,然而,关于不健康行为对非自杀性自我伤害(NSSI)的影响的调查很少,自杀意念(SI)和自杀未遂(SA)。本研究旨在调查七种不健康行为的患病率及其与NSSI的关系。SI和SA,并探讨上述关联是否因性别而异。
方法:本研究通过多阶段纳入了74,152名青少年,分层集群,2021年随机抽样方法。关于不健康行为的信息(身体活动不足,目前吸烟,当前饮酒,过多的屏幕时间,作业时间长,睡眠不足和不健康的BMI),NSSI,SI,收集SA和其他人口统计数据。抽样权重用于估计患病率,并进行加权逻辑回归模型。进行了性别分层分析和敏感性分析。
结果:概述,青少年有五种以上不健康行为的加权患病率为5.2%,男孩的患病率高于女孩(6.5%vs.8%)。目前吸烟,当前饮酒,过度使用屏幕,作业时间长,睡眠不足,不健康的BMI与NSSI显著相关,SI和SA。此外,生活方式风险得分高的青少年与NSSI风险增加相关(5-7vs.0:OR6.38,95%CI5.24-7.77),SI(5-7vs.0:或7.67,95%CI6.35-9.25),和SA(5-7vs.0:OR9.57,95%CI6.95-13.17)。在不健康行为与NSSI的关联中发现了显著的性别差异,SI和SA。
结论:不健康行为在中国青少年中相当普遍。有多种不健康行为的青少年与NSSI的风险增加有关,SI,SA。建议实施以学校和家庭为基础的干预措施,以促进健康的生活方式,作为青少年自我伤害行为和自杀的预防措施。
BACKGROUND: Unhealthy lifestyle behaviors among adolescents have emerged as a significant public health concern worldwide, however, there is little investigation on the impact of unhealthy behaviors on non-suicidal self-injury (NSSI), suicidal ideation (SI) and suicide attempt (SA). This study aimed to investigate the prevalence of seven unhealthy behaviors as well as their associations with NSSI, SI and SA, and to explore whether the aforementioned associations differ across sex.
METHODS: A total of 74,152 adolescents were included in this study via a multi-stage, stratified cluster, random sampling method in 2021. Information about unhealthy behaviors (insufficient physical activity, current smoking, current drinking, excessive screen time, long homework time, insufficient sleep and unhealthy BMI), NSSI, SI, SA and other demographics was collected. Sampling weights were used to estimate the prevalence, and the weighted logistic regression models were performed. Stratified analyses by sex and sensitive analyses were conducted.
RESULTS: Overview, the weighted prevalence of adolescents had more than five unhealthy behaviors were 5.2%, with boys showing a higher prevalence than girls (6.5% vs.3.8%). Current smoking, current drinking, excessive screen use, long homework time, insufficient sleep, and unhealthy BMI were significantly associated with NSSI, SI and SA. Moreover, adolescents with high lifestyle risk scores were associated with an increased risk of NSSI (5-7 vs. 0: OR 6.38, 95% CI 5.24-7.77), SI (5-7 vs. 0: OR 7.67, 95% CI 6.35-9.25), and SA (5-7 vs. 0: OR 9.57, 95% CI 6.95-13.17). Significant sex differences were found in the associations of unhealthy behaviors with NSSI, SI and SA.
CONCLUSIONS: Unhealthy behaviors are quite common among Chinese adolescents. Adolescents with multiple unhealthy behaviors are associated with increased risks of NSSI, SI, and SA. The implementation of school and family-based interventions to promote healthy lifestyles is recommended as a preventive measure against self-injurious behavior and suicidality in adolescents.