Associations Among Screen Time, Sleep Duration and Depressive Symptoms Among Chinese Adolescents
Associations Among Screen Time, Sleep Duration and Depressive Symptoms Among Chinese Adolescents
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中国青少年屏幕时间、睡眠时间与抑郁症状之间的关联
DOI：
10.1016/j.jad.2021.01.082
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发表时间：
2021-02-14
影响因子：
6.6
通讯作者：
Lu, Ciyong
中科院分区：
文献类型：
--
作者：
Wang, Wanxin;Du, Xueying;Lu, Ciyong
目标：相对较少的研究探讨了屏幕时间（ST）、睡眠持续时间和抑郁症状之间的相互关系。本研究旨在确定（1）中国青少年的 ST、睡眠时间和抑郁症状之间的关系； （2）睡眠时长是否介导ST与抑郁症状的关系。方法：2019年1月至4月，对中国广州市10所高中一年级学生（n=1,976）进行整群抽样，收集自我报告的使用电子设备和互联网的ST、睡眠时长以及流行病学中心抑郁量表（CES-D）评分。进行广义混合线性模型和中介分析。结果：共收到自填问卷1,956份（回收率98.99%）。总样本中约有 25%（471/1,929 人使用互联网，399/1,928 人使用电子设备）报告 ST >2 小时/天。大约 8.9% (169/1,894) 报告 CES-D 分数 >28。使用电子设备的时间较长（估计=0.52，95%CI：0.24-0.80）、互联网使用（估计=0.82，95%CI：0.53-1.11）与抑郁症状呈正相关，而睡眠时间较少（估计=-1.85，95%CI：-2.27--1.43）与抑郁症状呈负相关。电子设备的使用通过睡眠持续时间对抑郁症状有显着的间接影响（间接影响=0.08，95%CI：0.01-0.15）。局限性：本研究仅包括来自广州的在校学生。这种横断面设计无法推断因果关系。结论：ST 和睡眠持续时间与抑郁症状严重程度显着相关。睡眠持续时间的间接影响表明 ST 与抑郁症状之间存在关联的可能机制。未来管理抑郁症状的干预措施应以睡眠时间为目标，并减少青少年的睡眠时间。
Objectives: Relatively few studies have explored the inter-relationship between screen time (ST), sleep duration and depressive symptoms. The study herein sought to determine (1) the relationships between ST, sleep duration and depressive symptoms among Chinese adolescents; (2) whether sleep duration mediates the relationships between ST and depressive symptoms.Methods: 1st grade students (n=1,976) from ten high schools in Guangzhou, China were invited through cluster sampling between January and April 2019. Self-reported ST with electronic devices and Internet, sleep duration, and The Center for Epidemiology Scale for Depression (CES-D) score were collected. Generalized mixed linear models and mediation analyses were conducted.Results: There were 1,956 self-reported questionnaires received (response rate: 98.99%). Approximately 25% (471/1,929 for Internet use, 399/1,928 for electronic device) of the total sample reported ST >2 hours/day. Approximately 8.9% (169/1,894) reported a CES-D score >28. Longer ST with electronic devices (estimate=0.52, 95%CI: 0.24-0.80), Internet usage (estimate=0.82, 95%CI: 0.53-1.11) were positively associated with depressive symptoms, while less sleep (estimate=-1.85, 95%CI:-2.27--1.43) was negatively associated with depressive symptoms. There is significant indirect effect of electronic device usage on depressive symptoms through sleep duration (indirect effect=0.08, 95%CI: 0.01-0.15). Limitations: This study only included school students from Guangzhou. Causal relationship cannot be inferred by this cross-sectional design.Conclusions: ST and sleep duration were significantly associated with depressive symptoms severity. The indirect effect of sleep duration suggests a possible mechanism of the association between ST and depressive symptoms. Future interventions to manage depressive symptoms should target sleep time and decrease ST among adolescents.