SEARCHCROSS-SECTIONALpsychiatry, pediatrics

cross-sectional·psychiatry, pediatrics, epidemiology, public health, observational study·PMC10357370

Association Between Comorbid Anxiety and Depression and Health Risk Behaviors Among Chinese Adolescents: Cross-Sectional Questionnaire Study

JMIR Public Health and Surveillance · 9 authors, 4 centres

AI SUMMARY

FIDELITY 100%

POPULATIONChinese adolescents (N=22,868)

INTERVENTION

COMPARISON

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AGENT 01 · STRUCTURED SUMMARY

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TL;DR

This cross-sectional study of 22,868 Chinese adolescents found that each health risk behavior (poor diet, smoking, physical inactivity, poor sleep) was individually associated with higher odds of comorbid anxiety and depression. The association was strongest for clustered health risk behaviors.

Full summary

770 CHARS

This cross-sectional questionnaire study analyzed data from the National Youth Cohort of 22,868 Chinese adolescents to evaluate associations between health risk behaviors (HRBs) and comorbid anxiety and depression symptoms, assessed via PHQ-9 and GAD-7 scales. The prevalence of comorbidity was 31.6%. After adjusting for potential confounders, binary logistic regression showed that each single HRB (poor diet, smoking, physical inactivity, poor sleep) was associated with higher odds of comorbidity. The strength of association increased with the level of clustered HRBs, with a high-risk HRB index having an adjusted odds ratio of 2.33 (95% CI 2.03-2.68). The study also found the association between clustered HRBs and comorbidity was stronger in boys than in girls.

PICO

PPOPULATION

Chinese adolescents (N=22,868)

OOUTCOME

Comorbid anxiety and depression symptoms

STUDY TYPE

cross-sectional

SPECIALTY

psychiatry

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10357370

Association Between Comorbid Anxiety and Depression and Health Risk Behaviors Among Chinese Adolescents: Cross-Sectional Questionnaire Study

JMIR Public Health and Surveillance

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ABSTRACT

Background Comorbidity of psychiatric disorders such as depression and anxiety is very common among children and adolescents. Few studies have examined how comorbid anxiety and depression are associated with health risk behaviors (HRBs) in adolescents, which could inform preventative approaches for mental health. Objective We evaluated the association between HRBs and comorbid anxiety and depression in a large adolescent cohort. Methods We used data from 22,868 adolescents in the National Youth Cohort (China). Anxiety and depression symptoms were assessed using the 9-item Patient Health Questionnaire scale and the 7-item Generalized Anxiety Disorder scale, respectively. Comorbidity was determined by the coexistence of anxiety and depression. HRBs including poor diet, smoking, physical inactivity, and poor sleep, as well as the above HRB scores, were added to obtain the total HRB score (HRB risk index). Based on single and total HRB scores, we divided participants into low-, medium-, and high-risk groups. Potential confounders included gender, presence of siblings, regional economic level, educational status, self-rated health, parental education level, self-reported family income, number of friends, learning burden, and family history of psychosis. Correlation analysis was used to explore associations between single risk behaviors. Binary logistic regression estimated the association between HRBs and anxiety-depression comorbidity before and after adjusting for potential confounders. Results The comorbidity rate of anxiety and depression among Chinese adolescents was 31.6% (7236/22,868). There was a statistically significant association between each HRB ( P <.05), and HRBs were positively associated with comorbid anxiety and depression in the above population. For single HRBs, adolescents with poor diet, smoking, and poor sleep (medium-risk) were more prone to anxiety-depression comorbidity after adjusting for confounders compared to low-risk adolescents. However, adolescents with all high-risk HRBs were more likely to have comorbid anxiety and depression after adjusting for confounders (poor diet odds ratio [OR] 1.50, 95% CI 1.39-1.62; smoking OR 2.17, 95% CI 1.67-2.81; physical inactivity OR 1.16, 95% CI 1.06-1.28; poor sleep OR 1.84, 95% CI 1.70-2.01). Moreover, in both unadjusted (medium risk OR 1.79, 95% CI 1.56-2.05; high risk OR 3.09, 95% CI 2.72-3.52) and adjusted (medium risk OR 1.57, 95% CI 1.37-1.80; high risk OR 2.33, 95% CI 2.03-2.68) models, HRB risk index, like clustered HRBs, was positively associated with anxiety-depression comorbidity, and the strength of the association was stronger than for any single HRB. In addition, we found that compared to girls, the association between clustered HRBs and anxiety-depression comorbidity was stronger in boys after adjustment. Conclusions We provide evidence that HRBs are related to comorbid anxiety and depression. Interventions that decrease HRBs may support mental health development in adolescence, with the potential to improve health and well-being through to adulthood.

CITATION EXPORT

Meng Wang, Xingyue Mou, Tingting Li et al.. Association Between Comorbid Anxiety and Depression and Health Risk Behaviors Among Chinese Adolescents: Cross-Sectional Questionnaire Study. JMIR Public Health and Surveillance. (2023). https://doi.org/10.2196/46289

AUTHORS

9 · 4 CENTRES

Meng Wang, Xingyue Mou, Tingting Li, Yi Zhang, Yang Xie, Shuman Tao, Yuhui Wan, Fangbiao Tao, Xiaoyan Wu

1 Department of Maternal, Child and Adolescent Health School of Public Health Anhui Medical University Hefei China
2 Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China Hefei China
3 Anhui Provincial Key Laboratory of Population Health and Aristogenics Anhui Medical University Hefei China
4 Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, National Health Commission of the People's Republic of China Hefei China

EDITOR / REVIEWER

Amaryllis Mavragani, Travis Sanchez, Ranran Song, Sunmoo Yoon