网络成瘾和电子屏幕时间与抑郁症状的关联性研究

杜文秀; 顾叶青; 孟革; 张卿; 刘莉; 武汉章; 牛凯军

Abstract

杜文秀,顾叶青,孟革,张卿,刘莉,武汉章,牛凯军.网络成瘾和电子屏幕时间与抑郁症状的关联性研究[J].Chinese journal of Epidemiology,2022,43(11):1731-1738

网络成瘾和电子屏幕时间与抑郁症状的关联性研究

Associations between internet addiction, screen time and depressive symptoms

Received:March 30, 2022

DOI：10.3760/cma.j.cn112338-20220330-00246

KeyWord: 网络成瘾电子屏幕时间抑郁症状队列研究

English Key Word: Internet addiction Screen time Depressive symptom Cohort study

FundProject:中国队列共享平台资助项目（CCC2020003）

Author Name	Affiliation	E-mail
Du Wenxiu	Nutritional Epidemiology Institute/School of Public Health, Tianjin Medical University, Tianjin 300070, China School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
Gu Yeqing	Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China
Meng Ge	Nutritional Epidemiology Institute/School of Public Health, Tianjin Medical University, Tianjin 300070, China
Zhang Qing	Health Management Centre, Tianjin Medical University General Hospital, Tianjin 300052, China
Liu Li	Health Management Centre, Tianjin Medical University General Hospital, Tianjin 300052, China
Wu Hanzhang	Nutritional Epidemiology Institute/School of Public Health, Tianjin Medical University, Tianjin 300070, China School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
Niu Kaijun	Nutritional Epidemiology Institute/School of Public Health, Tianjin Medical University, Tianjin 300070, China School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China Health Management Centre, Tianjin Medical University General Hospital, Tianjin 300052, China	nkj0809@gmail.com

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Abstract:

目的探讨网络成瘾、电子屏幕时间与抑郁症状发生的关联。方法选取2013-2019年天津慢性低度炎症与健康（TCLSIH）队列中6 932名正常体检的60岁以下成年人为研究对象。通过自我报告问卷评估研究对象网络成瘾程度、电脑/手机使用时间和电视使用时间。采用抑郁自评量表（SDS）评估研究对象的抑郁症状。根据SDS总分分为无抑郁症状组（<45分）和有抑郁症状组（≥45分）。使用Cox比例风险回归模型评估网络成瘾和电子屏幕时间与发生抑郁症状的关联。结果调整潜在的混杂因素后，与没有网络成瘾者相比，以前有网络成瘾者、轻度网络成瘾者、中/重度网络成瘾者随访期间发生抑郁症状的HR值（95%CI）分别为0.83（0.56~1.23）、1.20（1.03~1.41）、1.48（1.16~1.89）。网络成瘾与出现抑郁症状之间的线性关联有统计学意义（趋势性P<0.001）；与使用电脑/手机0~h/d者相比，使用手机1~、3~、5~、>10 h/d者随访期间发生抑郁症状的HR值（95%CI）分别为0.59（0.40~0.88）、0.58（0.40~0.85）、0.52（0.36~0.76）、0.69（0.45~1.05）。电脑/手机使用时间与随访期间出现抑郁症状之间的关联存在“U”形趋势（趋势性P<0.001）；未调整和初步潜在混杂因素后，与每天不使用电视者相比，电视使用时间≥3 h/d者随访期间发生抑郁症状的HR值（95%CI）分别为1.36（1.09~1.69）和1.34（1.07~1.68）。电视使用时间与出现抑郁症状之间存在关联（趋势性P<0.001）。结论网络成瘾和电视使用时间与随访期间抑郁症状风险的增加有关，而电脑/手机使用时间与随访期间抑郁症状风险的降低有关。

English Abstract:

Objective To understand the associations between internet addiction, screen time (computer/mobile devices use and television watching time) and depressive symptoms in adults. Methods A total of 6 932 adults aged <60 years from the Tianjin Chronic Low-grade Sgstemic Inflammation and Health (TCLSIH) Cohort of 2013-2019 were surveyed. The information about their computer/mobile devices use and television watching time were collected by using a self-reported questionnaire. The depressive symptoms were assessed using the self-rating depression scale (SDS). The adults surveyed were divided into two groups:non-depressive symptom group (SDS score <45) and depressive symptom group (SDS score ≥ 45). The associations between internet addiction, screen time and depressive symptoms were estimated using Cox proportional hazard regression models, with adjusting for multiple confounders. Results After adjusting for confounding factors, the hazard ratios (HRs) of depressive symptom in the adults who had internet addiction before, had light internet addiction and had moderate or severe internet addiction were 0.83 (95%CI:0.56-1.23), 1.20 (95%CI:1.03-1.41) for light and 1.48 (95%CI:1.16-1.89), respectively, compared with those without internet addiction. The linear trend test results of the association between internet addiction and depressive symptoms was significant (trend P<0.001). Compared with the adults who used computer/mobile devices for <1 hour/day, the HRs of depressive symptoms in those who used computer/mobile devices for >1 hour, >3 hours, >5 hours and >10 hours were 0.59 (95%CI:0.40-0.88), 0.58 (95%CI:0.40-0.85), 0.52 (95%CI:0.36-0.76) and 0.69 (95%CI:0.45-1.05) respectively, a U-shaped association was found between computer/mobile devices use time and depressive symptoms (trend P<0.001). Compared with the adults who never watch TV, the HR of depressive symptoms was 1.36 (95%CI:1.09-1.69) for those watching TV for ≥ 3 hours/day in crude model and 1.34 (95%CI:1.07-1.68) for those watching TV for ≥ 3 hours/day in adjusted model (trend P<0.001). Conclusion Our findings suggested that internet addiction and television watching time were associated with an increased risk of depressive symptoms, while computer/mobile device use time was associated with a reduced risk of depressive symptoms.

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