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  • Title: [Research on the association between unhealthy lifestyle and psychological distress among Chinese children and adolescents aged 9-18 years].
    Author: Jiang JN, Zhang Y, Chen L, Liu JY, Cai S, Chen ZY, Wang RL, Zhang YH, Song Y, Ma J, Dong YH.
    Journal: Zhonghua Liu Xing Bing Xue Za Zhi; 2023 Oct 10; 44(10):1567-1574. PubMed ID: 37875443.
    Abstract:
    Objective: To evaluate the level of psychological distress among Chinese children and adolescents and analyze its lifestyle influencing factors. Methods: Data were obtained from the 2019 Chinese National Survey on Students' Constitution and Health. A lotal of 120 285 Han Chinese children and adolescents aged 9-18 years with complete information on the psychological distress scale and lifestyle factors were selected, including 58 432 boys and 61 853 girls. The Kessler Psychological Distress Scale (K10) measured psychological distress, and lifestyles such as physical activity, sedentary behavior, diet, and sleep were also investigated. K10 scores of different genders were compared using the t-test, and the levels of psychological distress were compared using the χ2 test. Logistic regression was used to analyze lifestyle risk factors associated with high psychological distress, and multiple linear regression was used to find the relationship between K10 scores and lifestyle scores. Results: The average K10 score for Han Chinese children and adolescents aged 9-18 years was 21.25±7.35, with girls (21.43±7.35) scoring higher than boys (21.06±7.36), the difference was statistically significant (t=8.72, P<0.001). The rate of high psychological distress was 29.81%, with girls (31.08%) reporting higher rates than boys (28.46%), the difference was statistically significant (χ2=98.54,P<0.001). 56.10% of children and adolescents have unhealthy lifestyles, with girls (58.77%) reporting higher rates than boys (53.27%), the difference was statistically significant (χ2=368.53,P<0.001). Except for insufficient outdoor activities for girls (P=0.128), lifestyles such as insufficient physical activity, insufficient muscle-and-bone exercises, long screen time, not eating breakfast, eggs and dairy products every day, drinking sugary beverages once or more per day, and not having enough sleep are all risk factors for high psychological distress (all P<0.001). For every additional healthy lifestyle score, the K10 score decreased by 0.98 [β=-0.98 (95%CI: -1.01- -0.95)] points (P<0.001). K10 scores in each region negatively correlate with lifestyle scores (all P<0.001). Among them, the K10 score in the eastern region showed the slightest decrease as the lifestyle score increased, while the western region showed the most decrease. Conclusions: The prevalence of psychological distress and unhealthy lifestyle in Chinese children and adolescents are high and interrelated. Compared those with healthy lifestyles, children and adolescents with unhealthy lifestyles are at greater risk of high psychological distress. Therefore, promoting healthy lifestyles for children and adolescents may be one of the important ways to improve their mental health. 目的： 分析我国儿童青少年不健康生活方式与心理困扰的关联。 方法： 利用2019年全国学生体质与健康调研数据，选择心理困扰量表信息及生活方式信息完整的9~18岁汉族儿童青少年120 285名，其中男生58 432名，女生61 853名。心理困扰通过凯斯勒心理困扰量表（K10）测量，同时采用问卷调查体育锻炼及久坐情况、饮食和睡眠情况等生活方式。采用t检验比较男女生的K10评分，采用χ2检验比较其心理困扰情况；采用logistic回归分析影响高心理困扰的生活方式因素，采用多元线性回归分析K10评分与生活方式得分的变化关系。 结果： 2019年我国9~18岁汉族儿童青少年的K10评分为21.25±7.35，女生的K10评分（21.43±7.35）高于男生（21.06±7.36），差异有统计学意义（t=8.72，P<0.001）；高心理困扰率为29.81%，女生高心理困扰率（31.08%）高于男生（28.46%），差异有统计学意义（χ2=98.54，P<0.001）。56.10%的儿童青少年总体生活方式不健康，女生（58.77%）高于男生（53.27%），差异有统计学意义（χ2=368.53，P<0.001）。除女生的户外活动是否达标与心理困扰高低无统计学关联外（P=0.128），身体活动不达标、肌肉骨骼练习不达标、视屏时间不达标、不是每日吃早餐、不是每日吃鸡蛋、不是每日喝奶制品、每日喝含糖饮料次数≥1、睡眠不达标及不健康生活方式组合均与高心理困扰呈正相关（均P<0.001）。生活方式得分每增加1分，K10评分下降0.98分［β=-0.98（95%CI：-1.01~ -0.95）］（P<0.001）。各区域K10评分均与生活方式得分呈显著负相关（均P<0.001），其中东部地区K10评分随生活方式得分增加的下降最少，西部地区下降最多。 结论： 我国儿童青少年心理困扰与不健康生活方式的健康问题流行水平均较高，且两者存在关联，相对于生活方式健康的儿童青少年，生活方式不健康者发生高心理困扰的风险较大，促进儿童青少年的健康生活方式可能是改善其心理健康状态的重要方法之一。.
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