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摘要:
目的 利用中国教育追踪调查(China education panel survey, CEPS)小学队列的基线调查数据，以流行病学调查中心抑郁量表为测量工具，考察中国四年级学生的抑郁状况及其影响因素。方法应用Stata 18.0软件，采用χ2检验，比较不同特征的四年级学生抑郁的差异。采用logistic回归分析模型分析各因素对学生抑郁的影响。 结果 四年级学生抑郁检出率为15.23%。学生个人的认知能力测试水平(中∶低, OR=0.71, 95% CI: 0.61~0.83, P < 0.001; 高∶低, OR=0.65, 95% CI: 0.52~0.81, P < 0.001)、学业成绩(中∶低, OR=0.77, 95% CI: 0.66~0.88, P < 0.001; 高∶低, OR=0.61, 95% CI: 0.51~0.74, P < 0.001)、学业压力(中∶低, OR=1.33, 95% CI: 1.15~1.53, P < 0.001; 高∶低, OR=1.78, 95% CI: 1.47~2.14, P < 0.001)都会影响学生患抑郁症的风险。而在学校和家庭层面，良好的父母关系(坏∶好, OR=1.53, 95% CI: 1.32~1.78, P < 0.001)、师生关系(好∶不好, OR=0.81, 95% CI: 0.71~0.93, P=0.002)及同伴关系(好∶不好, OR=0.78, 95% CI: 0.68~0.89, P < 0.001)均能独立降低其抑郁风险。 结论 个人因素、家庭因素、学校乃至同伴因素均对学生抑郁情况产生不同程度的影响。鉴于此，应从个人、家庭和学校三方面协同发力，以期缓解学生抑郁程度，促进青少年心理健康。 Abstract:Objective Utilizing baseline survey data from the primary school cohort of the China education panel survey (CEPS), this study aims to examine the prevalence of depression among fourth-grade students in China and its influencing factors, using the epidemiological center depression scale as a measurement tool. Methods The study uses Stata 18.0 software and employs the chi-square test to compare the differences in depression in fourth-grade students with different characteristics. Logistic regression models are used to analyze the impact of various factors on students′ risk of depression. Results The depression detection rate among fourth-grade students was 15.23%. Specifically, student′s cognitive individual ability level (Middle ∶ Low, OR=0.71, 95% CI: 0.61-0.83, P < 0.001; High ∶ Low, OR=0.65, 95% CI: 0.52-0.81, P < 0.001), academic performance(Middle ∶ Low, OR=0.77, 95% CI: 0.66-0.88, P < 0.001; High ∶ Low, OR=0.61, 95% CI: 0.51-0.74, P < 0.001), and academic pressure(Middle ∶ Low, OR=1.33, 95% CI: 1.15-1.53, P < 0.001; High ∶ Low, OR=1.78, 95% CI: 1.47-2.14, P < 0.001) significantly affect the risk of developing depression. At the school and family levels, positive parental relationships(Bad ∶ Good, OR=1.53, 95% CI: 1.32-1.78, P < 0.001), teacher-student relationships (Good ∶ Bad, OR=0.81, 95% CI: 0.71-0.93, P=0.002), and peer relationships (Good ∶ Bad, OR=0.78, 95% CI: 0.68-0.89, P < 0.001) can reduce the depression risk independently. Conclusions Factors including personal attributes, family environment, school, and peers all have varying degrees of influence on their depressive states. In light of these findings, concerted efforts should be made from the individual, family, and school perspectives in order to alleviate the level of depression in primary school students and promote their mental health. -
Key words:
- Depression risk /
- Adolescent mental health /
- Fourth-grade students
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图 1 四年级学生抑郁得分的核密度图和累积分布图
Figure 1. Kernel density plot and cumulative distribution of depression scores for fourth-grade elementary school students
表 1 不同个人特征四年级学生的抑郁检出率
Table 1. Detection rates for depression among fourth graders with different personal characteristics
特征 Characteristic 人数 Number of people 抑郁检出率 Depression detection rate/% 轻度抑郁检出率 Mild depression detection rate/% 重度抑郁检出率 Detection rate of major depression/% χ2值 value P值 value 性别 Gender 20.47 <0.001 女 Female 6 328 13.76 12.15 1.61 男 Male 6 782 16.58 14.52 2.06 是否为独生子女 Only child or not 57.23 <0.001 否 No 8 747 16.89 14.92 1.97 是 Yes 4 363 11.89 10.29 1.60 认知能力测试水平 Level of cognitive ability testing 284.13 <0.001 低 Low 1 892 27.28 24.37 2.91 中 Middle 8 714 14.24 12.46 1.78 高 High 2 504 9.55 8.27 1.28 学业成绩 Academic performance 406.69 <0.001 低 Low 2 743 26.87 23.48 3.39 中 Middle 6 722 13.82 12.12 1.70 高 High 3 645 9.05 8.09 0.96 学业压力 Academic pressure 786.11 <0.001 低 Low 6 426 7.78 7.05 0.73 中 Middle 5 334 19.13 16.99 2.14 高 High 1 350 35.26 29.26 6.00 睡眠质量 Sleep quality 1 300.00 <0.001 好 Good 11 622 11.41 10.51 0.90 差 Bad 1 488 44.96 35.75 9.21 肥胖情况 Obesity 8.91 0.063 正常 Normal 10 161 15.58 13.82 1.76 超重 Overweight 1 627 14.07 11.92 2.15 肥胖 Obesity 1 322 13.92 11.80 2.12 吸烟 Smoking 228.68 <0.001 否 No 12 753 14.47 12.80 1.67 是 Yes 357 42.29 34.17 8.12 饮酒 Drinking 210.03 <0.001 否 No 10 458 13.12 11.85 1.27 是 Yes 2 652 23.53 19.42 4.11 性格-外向性 Personality-extroversion 222.21 <0.001 弱 Weak 10 181 17.72 15.67 2.05 强 Strong 2 929 6.56 5.43 1.13 性格-宜人性 Personality-pleasantness 230.71 <0.001 弱 Weak 10 586 17.54 15.49 2.05 强 Strong 2 524 5.51 4.52 0.99 性格-严谨性 Personality-rigor 524.66 <0.001 弱 Weak 9 050 20.01 17.77 2.24 强 Strong 4 060 4.56 3.60 0.96 性格-神经质 Personality-neuroticism 2 000.00 <0.001 弱 Weak 12 014 11.63 11.03 0.60 强 Strong 1 096 54.65 39.14 15.51 性格-开放性 Personality-openness 169.35 <0.001 弱 Weak 8 992 17.85 15.99 1.86 强 Strong 4 118 9.49 7.67 1.82 
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表 2 不同家庭特征四年级学生的抑郁检出率
Table 2. Detection rates for depression among fourth graders with different family characteristics
特征 Characteristic 人数 Number of people 抑郁检出率 Depression detection rate/% 轻度抑郁检出率 Mild depression detection rate/% 重度抑郁检出率 Detection rate of major depression/% χ2值 value P值 value 父亲受教育程度 Father′s educational attainment 90.81 < 0.001 初中及以下 Junior high school and below 5 361 18.64 16.64 2.00 高中 High school 3 206 13.51 12.01 1.50 大专及以上 College degree and above 4 543 12.42 10.50 1.92 母亲受教育程度 Mother′s educational attainment 87.45 < 0.001 初中及以下 Junior high school and below 5 718 18.15 16.28 1.87 高中 High school 3 014 14.66 12.87 1.79 大专及以上 College degree and above 4 378 11.79 9.94 1.85 居住情况 Residency 93.76 < 0.001 与父母双方同住 Living with parents 9 143 13.29 11.78 1.51 与父母一方同住 Living with one parent 2 659 19.03 16.32 2.71 不与父母同住 Not live with parents 1 308 21.03 18.58 2.45 家庭经济状况 Household financial situation 123.10 < 0.001 困难 difficulty 2 352 22.41 20.28 2.13 中等 Medium 9 896 13.79 11.96 1.83 富裕 Wealthy 862 12.07 10.79 1.28 家庭所在地区-城乡 The area where the home is located-urban and rural 113.38 < 0.001 城市 City 8 914 13.20 11.41 1.79 城镇 Town 987 15.20 13.88 1.32 农村 Rural 3 209 20.85 18.70 2.15 父亲是否经常醉酒 Whether the father was often drunk 105.96 < 0.001 否 No 11 365 14.03 12.47 1.56 是 Yes 1 745 23.03 19.31 3.72 父母是否经常吵架 Whether the parents often quarrel 340.01 < 0.001 否 No 11 067 12.76 11.32 1.44 是 Yes 2 043 28.58 24.52 4.06 与父母的关系 Relationship with parents 464.22 < 0.001 好 Good 6 453 10.51 9.27 1.24 一般 Not so good 3 778 13.81 12.33 1.48 坏 Bad 2 879 27.65 23.97 3.68 教养方式 Parenting style 50.07 < 0.001 放任 Indulge 8 255 16.90 14.96 1.94 严格 Strict 4 855 12.38 10.69 1.69 亲子互动评价 Parent-child interaction evaluation 212.64 < 0.001 好 Good 3 004 11.18 9.82 1.36 一般 Not so good 6 720 13.20 11.49 1.71 差 Bad 3 386 22.83 20.29 2.54 学业期望 Academic expectations 162.53 < 0.001 本科以下 Bachelor′s degree or below 3 524 21.82 19.21 2.61 本科及以上 Bachelor′s degree or above 9 586 12.80 11.24 1.56
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表 3 不同学校与同伴特征四年级学生的抑郁检出率
Table 3. Detection rates for depression among fourth graders with different school and peer characteristics
特征 Characteristic 人数 Number of people 抑郁检出率 Depression detection rate/% 轻度抑郁检出率 Mild depression detection rate/% 重度抑郁检出率 Detection rate of major depression/% χ2值 value P值 value 学校所在地区 The area where the school is located 94.17 < 0.001 城市 City 9 442 13.65 11.85 1.80 乡镇 Township 1 781 16.34 14.43 1.91 农村 Rural 1 887 22.04 20.03 2.01 学校排名 School ranking 68.57 < 0.001 高 High 2 512 10.35 8.64 1.71 一般 Not so good 6 427 15.62 13.86 1.76 低 Low 4 171 17.55 15.49 2.06 是否配备心理咨询室 Whether there is a psychological counseling room 9.09 0.029 没有 No 1 587 17.08 15.63 1.45 有 Yes 11 523 14.97 13.07 1.90 学校氛围 School atmosphere 1 300.00 < 0.001 好 Good 6 326 6.45 5.64 0.81 一般 Not so good 5 273 18.08 16.71 1.37 差 Bad 1 511 42.03 34.15 7.88 班主任性别 Gender of the class teacher 17.18 0.001 女性 Female 12 070 14.90 13.02 1.88 男性 Male 1 040 18.94 17.50 1.44 与班主任的关系 Relationship with the class teacher 909.90 < 0.001 好 Good 5 635 6.24 5.48 0.76 一般 Not so good 5 949 18.48 16.51 1.97 差 Bad 1 526 35.71 30.34 5.37 与老师的关系 Relationship with teachers 24.19 < 0.001 不好 Bad 4 324 17.16 14.71 2.45 好 Good 8 786 14.27 12.72 1.55 与同学的关系 Relationships with classmates 170.15 < 0.001 不好 Bad 7 265 18.89 16.70 2.19 好 Good 5 845 10.68 9.26 1.42 好友数量/个 Number of friends/piece 198.45 < 0.001 没有朋友 No friends 104 43.27 28.85 14.42 1~5 4 801 18.47 15.87 2.60 ≥6 8 205 12.96 11.72 1.24 身体欺凌 Physical bullying 875.04 < 0.001 没有 No 7 522 7.23 6.47 0.76 有 Yes 5 588 25.98 22.67 3.31 言语欺凌 Verbal bullying 575.38 < 0.001 没有 No 4 801 5.33 4.83 0.50 有 Yes 8 309 20.94 18.32 2.62 社交欺凌 Social bullying 1 300.00 < 0.001 没有 No 8 274 6.72 6.08 0.64 有 Yes 4 836 29.78 25.87 3.91 网络欺凌 Cyberbullying 1 400.00 < 0.001 没有 No 11 626 11.03 9.72 1.31 有 Yes 1 484 48.11 42.05 6.06
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表 4 学生抑郁的个人因素logistic回归分析模型分析
Table 4. Logistic regression model analysis of individual factors for the risk of depression
变量 Variable OR值 value (95% CI) P值 value 性别 Gender 女 Female 1.00 男 Male 0.68(0.60~0.77) < 0.001 认知能力测试水平 Level of cognitive ability testing 低 Low 1.00 中 Middle 0.71(0.61~0.83) > < 0.001 高 High 0.65(0.52~0.81) < 0.001 学业成绩 Academic performance 低 Low 1.00 中 Middle 0.77(0.66~0.88) < 0.001 高 High 0.61(0.51~0.74) < 0.001 学业压力 Academic pressure 低 Low 1.00 中 Middle 1.33(1.15~1.53) < 0.001 高 High 1.78(1.47~2.14) < 0.001 睡眠质量 Sleep quality 好 Good 1.00 差 Bad 3.02(2.60~3.50) < 0.001 吸烟 Smoking 否 No 1.00 是 Yes 1.66(1.24~2.23) 0.001 饮酒 Drinking 否 No 1.00 是 Yes 1.20(1.05~1.39) 0.009 性格-外向性 Personality-extroversion 弱 Weak 1.00 强 Strong 0.70(0.57~0.86) 0.001 性格-宜人性 Personality-pleasantness 弱 Weak 1.00 强 Strong 0.70(0.56~0.88) 0.002 性格-严谨性 Personality-rigor 弱 Weak 1.00 强 Strong 0.45(0.36~0.55) < 0.001 性格-神经质 Personality-neuroticism 弱 Weak 1.00 强 Strong 8.63(7.26~10.26) < 0.001 性格-开放性 Personality-openness 弱 Weak 1.00 强 Strong 0.79(0.67~0.94) 0.009
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表 5 学生抑郁的家庭因素logistic回归分析模型分析
Table 5. Logistic regression model analysis of family factors for the risk of depression
变量 Variable OR值 value (95% CI) P值 value 父母是否经常吵架 Whether the parents often quarrel 否 No 1.00 是 Yes 1.34(1.16~1.55) <0.001 与父母的关系 Relationship with parents 好 Good 1.00 一般 Not so good 1.00(0.86~1.17) 0.955 坏 Bad 1.53(1.32~1.78) <0.001 亲子互动评价 Parent-child interaction evaluation 好 Good 1.00 一般 Not so good 1.11(0.94~1.32) 0.213 差 Bad 1.19(1.00~1.43) 0.052
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表 6 学生抑郁的学校和同伴因素logistic回归分析模型分析
Table 6. Logistic regression model analysis of school and peer factors for the risk of depression
变量 Variable OR值 value (95% CI) P值 value 学校氛围 School atmosphere 好 Good 1.00 一般 Not so good 1.58(1.36~1.85) < 0.001 差 Bad 2.43(1.99~2.96) < 0.001 与班主任的关系 Relationship with the class teacher 好 Good 1.00 一般 Not so good 1.40(1.20~1.65) < 0.001 差 Bad 1.94(1.57~2.39) < 0.001 与老师的关系 Relationship with teachers 不好 Bad 1.00 好 Good 0.81(0.71~0.93) 0.002 与同学的关系 Relationships with classmates 不好 Bad 1.00 好 Good 0.78(0.68~0.89) < 0.001 身体欺凌 Physical bullying 没有 No 1.00 有 Yes 1.42(1.23~1.63) < 0.001 社交欺凌 Social bullying 没有 No 1.00 有 Yes 2.49(2.17~2.85) < 0.001 网络欺凌 Cyberbullying 没有 No 1.00 有 Yes 2.86(2.46~3.33) < 0.001
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