Objective To understand the relationship between school bullying, sleep duration and depressive symptoms among middle school students in Anhui Province, and to provide reference for depression prevention among middle school students.
Methods Stratified cluster random sampling was used to select 35 364 middle school students in Anhui Province. Depressive symptoms assessed by the Center for Epidemiological Survey-Depression Scale (CES-D), school bullying and sleep duration were self-reported through questionnaire survey, which was administered during September to November 2020. Logistic regression was used to analyze the effects of school bullying and sleep duration on depressive symptoms in middle school students, and the interaction effects were analyzed using multiplicative and additive effects models.
Results The total rate of depressive symptoms among middle school students was 19.29%. After controlling for gender, residence, school level, family structure, smoking and other confounding factors, logistic regression analyses showed that school bullying and sleep deprivation were both associated with depressive symptoms in middle school students with OR (95% CI) values of 3.34 (3.14–3.55) and 1.48 (1.37–1.61), respectively. Interaction analysis revealed no multiplicative interaction between school bullying and sleep deprivation on depressive symptoms ( OR = 1.17, 95% CI = 0.98–1.39), but additive interactions were observed in the association ( OR = 4.84, 95% CI = 4.36–5.37). The relative excess risk of interactions was 1.50 (1.39–1.59), with attributable proportions being 0.31 (0.26–0.36) and synergy index being 1.64 (1.47–1.89).
Conclusion School bullying and sleep deprivation are significantly associated with depressive symptoms synergistically among middle school students. Therefore, school bullying prevention and sufficient sleep can help alleviate depressive symptoms.
【摘要】 目的 了解安徽省中学生遭受校园欺凌和睡眠时间与抑郁症状的关系, 为减少中学生抑郁症状的发生提供参 考。 方法 于2020年9一11月, 采用分层整群随机抽样方法, 选取安徽省 35 364 名在校中学生, 采用流调中心抑郁量表 (CES-D)评估抑郁症状, 并对遭受校园欺凌、睡眠时间等信息进行问卷调查。采用Logistic回归方法分析遭受校园欺凌和 睡眠时间对中学生抑郁症状的影响, 并采用相乘和相加作用模型分析其交互作用。 结果 中学生抑郁症状检出率为 19.29%。在调整性别、居住地区、学段、家庭结构类型、吸烟等混杂因素后, Logistic回归分析结果显示, 遭受校园欺凌、睡眠 不足均与中学生抑郁症状有关联, 其 OR (95% CI) 值分别为 3.34(3.14~3.55)和1.48(1.37~1.61)。交互作用分析显示, 遭 受校园欺凌和睡眠不足对抑郁症状无相乘交互作用 ( OR =1.17, 95% CI = 0.98~1.39, P>0.05), 但具有相加交互作用 ( OR = 4.84, 95% CI = 4.36~5.37, P<0.05), 交互作用的超额相对危险度为 1.50(1.39~1.59), 归因比为 0.31(0.26~0.36), 交互作用 指数为 1.64(1.47~1.89)。 结论 遭受校园欺凌和睡眠不足与中学生抑郁症状关联, 二者具有协同作用。预防中学生遭受 校园欺凌同时保证充足的睡眠, 利于降低抑郁症状的发生。