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Article(id=1259565860629373883, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1259565853893378510, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2026050, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1752681600000, receivedDateStr=2025-07-17, revisedDate=1760716800000, revisedDateStr=2025-10-18, acceptedDate=null, acceptedDateStr=null, onlineDate=1778233502776, onlineDateStr=2026-05-08, pubDate=1774368000000, pubDateStr=2026-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1778233502776, onlineIssueDateStr=2026-05-08, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1778233502776, creator=13701087609, updateTime=1778233502776, updator=13701087609, issue=Issue{id=1259565853893378510, tenantId=1146029695717560320, journalId=1256213402557890569, year='2026', volume='47', issue='3', pageStart='319', pageEnd='416', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1778233501170, creator=13701087609, updateTime=1778233964926, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1259567799123493033, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1259565853893378510, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1259567799123493034, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1259565853893378510, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=369, endPage=373, ext={EN=ArticleExt(id=1259565862609085375, articleId=1259565860629373883, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Association between exposure to entertainment screen content on mobile phones and symptoms of anxiety-depression co-morbidity among college students, columnId=1259565855189418448, journalTitle=Chinese Journal of School Health, columnName=Mental Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To determine the association between exposure to entertainment screen content on mobile phones and symptoms of anxiety-depression co-morbidity among college students, so as to provide evidence for mental health interventions.

Methods

A baseline survey was conducted from April to May 2019.A total of 1 135 college students were selected from one university each in Shangrao City, Jiangxi Province and Hefei City, Anhui Province using cluster random sampling method.A follow-up study was conducted in November 2019, resulting in 1 110 matched valid responses.Self-rating questionnaires were used to assess the exposure of entertainment screen content.The Depression Anxiety Stress Scale-21(DASS-21) and the Patient Health Questionnaire-9(PHQ-9) were used to evaluate the anxiety symptoms, depressive symptoms, and symptoms of anxiety-depression co-morbidity among college students.A multivariate binary Logistic regression model was constructed following initial intergroup comparisons with Chi-square test to determine the association between baseline exposure to mobile entertainment screen content and the risk of symptoms of anxiety-depression co-morbidity at baseline and the 6-month follow-up.

Results

The prevalence rates of symptoms of anxiety-depression co-morbidity among college students were 25.4% and 20.6% at baseline and follow-up, respectively.After adjusting for confounding factors such as gender, self-rated family economic status and self-rated health status, the results of multivariate binary Logistic regression analysis showed that compared with the appropriate exposure level group, the exposure of entertainment screen content on mobile phones at baseline, including frequent exposure to reading (OR=1.65, 95%CI=1.14-2.39), occasional exposure to other entertainment screen content (OR=1.46, 95%CI=1.01-2.10) and frequent exposure to other entertainment screen content (OR=1.76, 95%CI=1.20-2.60), increased the co-occurrence risk of symptoms of anxiety-depression co-morbidity among college students during the follow-up period (all P < 0.05).

Conclusion

Occasional or frequert exposure to mobile entertainment screen content can increase the risk of symptoms of anxiety-depression co-morbidity among college students.

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目的

了解大学生手机娱乐性视屏内容暴露与焦虑抑郁症状共存的关联, 为大学生群体心理健康干预提供参考依据。

方法

2019年4-5月, 采用整群随机抽样方法在江西省上饶市和安徽省合肥市各选取1所高校共1 135名大一学生进行基线调查, 并于2019年11月进行随访调查, 匹配后获得有效人数1 110人。采用自评问卷调查大学生手机娱乐性视屏内容暴露情况, 使用抑郁-焦虑-压力自评量表(DASS-21)和患者健康问卷-9项(PHQ-9)评估大学生焦虑症状、抑郁症状以及焦虑抑郁症状共存情况。组间比较采用χ2检验, 构建多因素二元Logistic回归模型, 探究基线手机娱乐性内容暴露与基线和半年后随访时大学生焦虑抑郁症状共存发生风险的关联。

结果

基线和随访时大学生焦虑抑郁症状共存检出率分别为25.4%和20.6%。调整性别、自评家庭经济状况、自评健康状况等混杂因素后, 多因素二元Logistic回归分析结果显示, 与适度暴露水平组相比, 基线时手机娱乐性视屏内容暴露中的频繁暴露于阅读(OR=1.65, 95%CI=1.14~2.39)、偶尔暴露于其他娱乐性内容(OR=1.46, 95%CI=1.01~2.10)以及频繁暴露于其他娱乐性内容(OR=1.76, 95%CI=1.20~2.60)均增加随访期大学生焦虑抑郁症状共存风险(P值均 < 0.05)。

结论

偶尔或频繁暴露于手机娱乐性视屏内容可增加大学生焦虑抑郁症状共存的发生风险。

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伍晓艳，E-mail：
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孙雪莲(1990-)，女，安徽合肥人，在读硕士，主要研究方向为儿童青少年健康

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孙雪莲(1990-)，女，安徽合肥人，在读硕士，主要研究方向为儿童青少年健康

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Behav Inf Technol, 2020, 39(9): 944-956., articleTitle=null, refAbstract=null), Reference(id=1259565909337825600, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1259565860629373883, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=27, rfOrder=30, authorNames=null, journalName=null, refType=null, unstructuredReference=VENKATESH V, SPEIER C, MORRIS M G. User acceptance enablers in individual decision making about technology: toward an integrated model[J]. 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Comparison of baseline detection rates of anxiety, depressive and symptoms of anxiety-depression co-morbidities among college students with different demographic characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学指标选项人数焦虑症状抑郁症状焦虑抑郁症状共存
检出人数χ2值检出人数χ2值检出人数χ2值
性别男432145(33.6)7.10**187(43.3)0.11129(29.9)7.41**
女703184(26.2)297(42.2)159(22.6)
自评家庭经济状况差272101(37.1)11.56**133(48.9)7.21*91(33.5)12.35**
中等800212(26.5)330(41.3)183(22.9)
好6316(25.4)21(33.3)14(22.2)
自评学业负荷程度重419148(35.3)14.67**199(47.5)6.93*130(31.0)11.68**
一般695173(24.9)275(39.6)152(21.9)
轻218(38.1)10(47.6)6(28.6)
自评学习成绩水平差23994(39.3)22.27**114(47.7)3.5082(34.3)20.39**
中等696197(28.3)291(41.8)175(25.1)
好20038(19.0)79(39.5)31(15.5)
母亲受教育程度小学及以下497151(30.4)1.04227(45.7)3.33130(26.2)0.32
初中/高中/中专575162(28.2)232(40.3)143(24.9)
大专及以上6316(25.4)25(39.7)15(23.8)
父亲受教育程度小学及以下25796(37.4)11.60**127(49.4)6.54*85(33.1)10.53**
初中/高中/中专763205(26.9)313(41.0)178(23.3)
大专及以上11528(24.3)44(38.3)25(21.70)
自评健康状况好672150(22.3)48.99**242(36.0)40.66**127(18.9)56.31**
一般418151(36.1)208(49.8)133(31.8)
差4528(62.2)34(75.6)28(62.2)
吸烟否1 034279(27.0)22.67**427(41.3)8.62**240(23.2)28.72**
是10150(49.5)57(56.4)48(47.5)
饮酒否874235(26.9)8.13**345(39.5)15.61**201(23.0)11.33**
是26194(36.0)139(53.3)87(33.3)
生活应激事件无158(53.3)4.37*10(66.7)3.588(53.3)6.27*
有1 120321(28.7)474(42.3)280(25.0)
自评睡眠质量好984232(23.6)105.14**360(36.6)110.97**196(19.9)116.26**
差15197(64.2)124(82.1)92(60.9)
), ArticleFig(id=1259565894343188679, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1259565860629373883, language=CN, label=表1, caption=

不同人口学特征大学生焦虑、抑郁及焦虑抑郁症状共存基线检出率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学指标选项人数焦虑症状抑郁症状焦虑抑郁症状共存
检出人数χ2值检出人数χ2值检出人数χ2值
性别男432145(33.6)7.10**187(43.3)0.11129(29.9)7.41**
女703184(26.2)297(42.2)159(22.6)
自评家庭经济状况差272101(37.1)11.56**133(48.9)7.21*91(33.5)12.35**
中等800212(26.5)330(41.3)183(22.9)
好6316(25.4)21(33.3)14(22.2)
自评学业负荷程度重419148(35.3)14.67**199(47.5)6.93*130(31.0)11.68**
一般695173(24.9)275(39.6)152(21.9)
轻218(38.1)10(47.6)6(28.6)
自评学习成绩水平差23994(39.3)22.27**114(47.7)3.5082(34.3)20.39**
中等696197(28.3)291(41.8)175(25.1)
好20038(19.0)79(39.5)31(15.5)
母亲受教育程度小学及以下497151(30.4)1.04227(45.7)3.33130(26.2)0.32
初中/高中/中专575162(28.2)232(40.3)143(24.9)
大专及以上6316(25.4)25(39.7)15(23.8)
父亲受教育程度小学及以下25796(37.4)11.60**127(49.4)6.54*85(33.1)10.53**
初中/高中/中专763205(26.9)313(41.0)178(23.3)
大专及以上11528(24.3)44(38.3)25(21.70)
自评健康状况好672150(22.3)48.99**242(36.0)40.66**127(18.9)56.31**
一般418151(36.1)208(49.8)133(31.8)
差4528(62.2)34(75.6)28(62.2)
吸烟否1 034279(27.0)22.67**427(41.3)8.62**240(23.2)28.72**
是10150(49.5)57(56.4)48(47.5)
饮酒否874235(26.9)8.13**345(39.5)15.61**201(23.0)11.33**
是26194(36.0)139(53.3)87(33.3)
生活应激事件无158(53.3)4.37*10(66.7)3.588(53.3)6.27*
有1 120321(28.7)474(42.3)280(25.0)
自评睡眠质量好984232(23.6)105.14**360(36.6)110.97**196(19.9)116.26**
差15197(64.2)124(82.1)92(60.9)
), ArticleFig(id=1259565894762619082, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1259565860629373883, language=EN, label=Tab.2, caption=

Comparison of the detection rates of symptoms of anxiety-depression co-morbidity among college students with different entertainment screen content exposure on mobile phones

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手机娱乐性视屏内容选项基线随访
人数检出人数χ2值人数检出人数χ2值
社交媒体偶尔510138(27.1)3.04497109(21.9)3.02
适度21859(27.1)21549(22.8)
频繁40791(22.4)39871(17.8)
看图片视频偶尔34390(26.2)0.1933173(22.1)0.94
适度31178(25.1)30658(19.0)
频繁481120(24.9)47398(20.7)
玩游戏偶尔699169(24.2)1.59683129(18.9)3.31
适度26470(26.5)25860(23.3)
频繁17249(28.5)16940(23.7)
阅读偶尔521136(26.1)1.20505122(24.2)7.46*
适度27874(26.6)27652(18.8)
频繁33678(23.2)32955(16.7)
其他娱乐性偶尔25268(27.0)0.4425368(26.9)9.53**
内容适度35486(24.3)34873(21.0)
频繁529134(25.3)50988(17.3)
), ArticleFig(id=1259565895211409614, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1259565860629373883, language=CN, label=表2, caption=

不同手机娱乐性视屏内容暴露大学生焦虑抑郁症状共存检出率比较

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手机娱乐性视屏内容选项基线随访
人数检出人数χ2值人数检出人数χ2值
社交媒体偶尔510138(27.1)3.04497109(21.9)3.02
适度21859(27.1)21549(22.8)
频繁40791(22.4)39871(17.8)
看图片视频偶尔34390(26.2)0.1933173(22.1)0.94
适度31178(25.1)30658(19.0)
频繁481120(24.9)47398(20.7)
玩游戏偶尔699169(24.2)1.59683129(18.9)3.31
适度26470(26.5)25860(23.3)
频繁17249(28.5)16940(23.7)
阅读偶尔521136(26.1)1.20505122(24.2)7.46*
适度27874(26.6)27652(18.8)
频繁33678(23.2)32955(16.7)
其他娱乐性偶尔25268(27.0)0.4425368(26.9)9.53**
内容适度35486(24.3)34873(21.0)
频繁529134(25.3)50988(17.3)
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大学生手机娱乐性视屏内容暴露与焦虑抑郁症状共存的关联
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孙雪莲 1 , 李婷婷 1 , 陶舒曼 2 , 谢阳 1 , 杨娅娟 3 , 邹立巍 1 , 陶芳标 1, 2 , 伍晓艳 1, 2
中国学校卫生 | 心理卫生 2026,47(3): 369-373
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中国学校卫生 | 心理卫生 2026, 47(3): 369-373
大学生手机娱乐性视屏内容暴露与焦虑抑郁症状共存的关联
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孙雪莲1, 李婷婷1, 陶舒曼2, 谢阳1, 杨娅娟3, 邹立巍1, 陶芳标1, 2, 伍晓艳1, 2
作者信息
  • 1安徽医科大学公共卫生学院儿少卫生与妇幼保健学系, 合肥 230032
  • 2出生人口健康教育部重点实验室/安徽省环境与人口健康重点实验室
  • 3安徽医科大学护理学院

    • 孙雪莲(1990-)，女，安徽合肥人，在读硕士，主要研究方向为儿童青少年健康

通讯作者:

伍晓艳，E-mail：
Association between exposure to entertainment screen content on mobile phones and symptoms of anxiety-depression co-morbidity among college students
Xuelian SUN1, Tingting LI1, Shuman TAO2, Yang XIE1, Yajuan YANG3, Liwei ZOU1, Fangbiao TAO1, 2, Xiaoyan WU1, 2
Affiliations
  • Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China
出版时间: 2026-03-25 doi: 10.16835/j.cnki.1000-9817.2026050
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摘要
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目的

了解大学生手机娱乐性视屏内容暴露与焦虑抑郁症状共存的关联, 为大学生群体心理健康干预提供参考依据。

方法

2019年4-5月, 采用整群随机抽样方法在江西省上饶市和安徽省合肥市各选取1所高校共1 135名大一学生进行基线调查, 并于2019年11月进行随访调查, 匹配后获得有效人数1 110人。采用自评问卷调查大学生手机娱乐性视屏内容暴露情况, 使用抑郁-焦虑-压力自评量表(DASS-21)和患者健康问卷-9项(PHQ-9)评估大学生焦虑症状、抑郁症状以及焦虑抑郁症状共存情况。组间比较采用χ2检验, 构建多因素二元Logistic回归模型, 探究基线手机娱乐性内容暴露与基线和半年后随访时大学生焦虑抑郁症状共存发生风险的关联。

结果

基线和随访时大学生焦虑抑郁症状共存检出率分别为25.4%和20.6%。调整性别、自评家庭经济状况、自评健康状况等混杂因素后, 多因素二元Logistic回归分析结果显示, 与适度暴露水平组相比, 基线时手机娱乐性视屏内容暴露中的频繁暴露于阅读(OR=1.65, 95%CI=1.14~2.39)、偶尔暴露于其他娱乐性内容(OR=1.46, 95%CI=1.01~2.10)以及频繁暴露于其他娱乐性内容(OR=1.76, 95%CI=1.20~2.60)均增加随访期大学生焦虑抑郁症状共存风险(P值均 < 0.05)。

结论

偶尔或频繁暴露于手机娱乐性视屏内容可增加大学生焦虑抑郁症状共存的发生风险。

注视, 眼  /  焦虑  /  抑郁  /  共病现象  /  回归分析  /  学生
Objective

To determine the association between exposure to entertainment screen content on mobile phones and symptoms of anxiety-depression co-morbidity among college students, so as to provide evidence for mental health interventions.

Methods

A baseline survey was conducted from April to May 2019.A total of 1 135 college students were selected from one university each in Shangrao City, Jiangxi Province and Hefei City, Anhui Province using cluster random sampling method.A follow-up study was conducted in November 2019, resulting in 1 110 matched valid responses.Self-rating questionnaires were used to assess the exposure of entertainment screen content.The Depression Anxiety Stress Scale-21(DASS-21) and the Patient Health Questionnaire-9(PHQ-9) were used to evaluate the anxiety symptoms, depressive symptoms, and symptoms of anxiety-depression co-morbidity among college students.A multivariate binary Logistic regression model was constructed following initial intergroup comparisons with Chi-square test to determine the association between baseline exposure to mobile entertainment screen content and the risk of symptoms of anxiety-depression co-morbidity at baseline and the 6-month follow-up.

Results

The prevalence rates of symptoms of anxiety-depression co-morbidity among college students were 25.4% and 20.6% at baseline and follow-up, respectively.After adjusting for confounding factors such as gender, self-rated family economic status and self-rated health status, the results of multivariate binary Logistic regression analysis showed that compared with the appropriate exposure level group, the exposure of entertainment screen content on mobile phones at baseline, including frequent exposure to reading (OR=1.65, 95%CI=1.14-2.39), occasional exposure to other entertainment screen content (OR=1.46, 95%CI=1.01-2.10) and frequent exposure to other entertainment screen content (OR=1.76, 95%CI=1.20-2.60), increased the co-occurrence risk of symptoms of anxiety-depression co-morbidity among college students during the follow-up period (all P < 0.05).

Conclusion

Occasional or frequert exposure to mobile entertainment screen content can increase the risk of symptoms of anxiety-depression co-morbidity among college students.

Fixation, ocular  /  Anxiety  /  Depression  /  Comorbidity  /  Regression analysis  /  Students
孙雪莲, 李婷婷, 陶舒曼, 谢阳, 杨娅娟, 邹立巍, 陶芳标, 伍晓艳. 大学生手机娱乐性视屏内容暴露与焦虑抑郁症状共存的关联. 中国学校卫生, 2026 , 47 (3) : 369 -373 . DOI: 10.16835/j.cnki.1000-9817.2026050
Xuelian SUN, Tingting LI, Shuman TAO, Yang XIE, Yajuan YANG, Liwei ZOU, Fangbiao TAO, Xiaoyan WU. Association between exposure to entertainment screen content on mobile phones and symptoms of anxiety-depression co-morbidity among college students[J]. Chinese Journal of School Health, 2026 , 47 (3) : 369 -373 . DOI: 10.16835/j.cnki.1000-9817.2026050
正文
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随着信息技术的飞速发展，移动设备承载的娱乐性视屏内容日益普及，已成为日常生活的重要组成部分[1]。娱乐性视屏内容以较短的编辑片段、快速变化的场景和节奏刺激用户的感官，让用户在短时间内获得满足，包括社交媒体、游戏、短视频等[2-3]。大学生是移动设备的主要用户群体[4]，更容易暴露在手机娱乐性视屏内容中。中国互联网络信息中心第53次统计报告指出，我国手机上网普及率达99.9%，10~29岁网民占28.4%，其中大学生群体占比尤为显著[4]。同时，娱乐性视屏内容如网络游戏用户规模也呈现出快速增长的趋势，占整体网民的51.0%[5]。
一项横断面研究指出大学生对智能手机的过度使用，包括娱乐功能与抑郁风险的增加呈正相关[6]。另一项纵向研究发现，延长社交媒体使用时间会加剧抑郁和焦虑症状[7]。焦虑抑郁症状共存是指同时出现焦虑和抑郁2种心理问题的症状，该症状在大学生群体中较为常见，且对身心健康产生极大的负面影响[8-9]。本研究采用纵向设计，评估手机娱乐性视屏内容与大学生焦虑抑郁症状共存之间的关联，为大学生群体焦虑抑郁症状共存的早期预防以及身心健康的有效促进提供实证基础。
1　对象与方法
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1.1　对象
2019年4—5月，采用整群随机抽样方法抽取研究对象。先采用随机数字表法在江西省上饶市和安徽省合肥市各选取1所高校，以专业和班级为单位，再用随机数字表法抽取化学、体育、公共卫生以及护理专业4个专业大一学生进行调查。发放问卷1 179份，回收有效问卷1 135份，有效回收率96.3%；并于同年11月对上述对象进行随访，经数据匹配后获得有效随访人数1 110名。其中男生419名，女生691名；基线时平均年龄为(18.82±1.17)岁。所有参与调查的对象均签署知情同意书，并通过安徽医科大学伦理委员会批准(批号：20170291)。
1.2　方法
采用自编大学生健康相关行为及心理健康问卷，以学校和班级为单位实施调查，大学生使用个人移动设备扫描二维码访问并完成电子版调查问卷。
1.2.1　一般人口学资料
包括性别、自评家庭经济状况(差、中等、好)、自评学业负荷程度(重、一般、轻)、自评学习成绩水平(差、中等、好)、父母受教育程度以及自评健康状况(好、一般、差)、生活方式(吸烟行为定义为在近30 d内至少单日吸烟≥1次, 饮酒行为定义为在近30 d内至少单日饮酒≥1杯)[10]，生活应激事件(是否经历恋爱失败、考试失败、家庭变故等任一负性生活事件)，自评睡眠质量(好、差)等。
1.2.2　大学生手机娱乐性视屏内容暴露
娱乐性视屏内容暴露是指通过电子屏幕进行的、以娱乐休闲为主导的活动，其内容包括但不限于浏览社交媒体、观看图片与视频以及玩游戏[3]。根据文献[11]自编调查问卷，内容包括社交媒体、图片视频(看图片或视频)、游戏、阅读、其他娱乐性内容(下载、购物、搜索或查询、赌博、拍照或拍视频)5个条目。采用3级评分，1为偶尔使用(0或1~2次/周)，2为适度使用(1~2次/d)，3为频繁使用(每天很多次)。该问卷的Cronbach α系数为0.78。
1.2.3　焦虑症状
使用抑郁-焦虑-压力量表(Depression Anxiety Stress Scale-21，DASS-21)[12-13]进行评估，该量表包含抑郁、焦虑、压力3个分量表，各含7个条目。焦虑分量表的7个条目用于评估受试者近7 d的焦虑症状水平，采用4级评分(0=“完全不符合”至3=“完全符合”)，总分为0~21分。以总分≥8分判定为存在焦虑症状，得分越高表明焦虑症状越严重。基线和半年后随访该分量表Cronbach α系数分别为0.90和0.91。
1.2.4　抑郁症状
采用患者健康问卷(Patient Health Questionnaire-9，PHQ-9)评估大学生抑郁症状[14]。该问卷共有9个条目，采用Likert 4级评分标准(0=“完全不会”至3=“几乎每天”)，量表总分为0~27分，总分≥5分判定为存在抑郁症状，得分越高表明抑郁症状越严重。该问卷基线和半年随访时Cronbach α系数分别为0.91和0.94。
1.3　质量控制
在实施调查前对调查员开展系统化培训，确保调查员能精准掌握问卷内容和要求。调查过程中要求大学生于限定时间内完成电子问卷填写，调查员提供现场答疑与技术指导。调查后调查人员即时筛查所填问卷是否存在逻辑矛盾、信息缺失等问题，并及时纠正，以保障问卷填写的完整性与数据有效性。
1.4　统计学分析
采用SPSS 23.0软件分析数据，计量资料用(x±s)描述，计数资料用频数与构成比进行统计描述，使用χ2检验评估基线不同人口统计学特征大学生焦虑、抑郁和焦虑抑郁症状共存以及不同手机娱乐性内容暴露的大学生焦虑抑郁症状共存检出率的差异。构建多因素二元Logistic回归模型，探究基线手机娱乐性视屏内容暴露与基线和半年后随访时大学生焦虑抑郁症状共存发生风险的关联。以手机娱乐性视屏内容作为自变量(以“适度”水平为参照组)，因变量是二分类的焦虑抑郁症状共存(否=0，是=1)，并应用逐步回归法调整混杂变量。检验水准α=0.05。
2　结果
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2.1　基线大学生焦虑、抑郁和焦虑抑郁症状共存检出情况
大学生焦虑、抑郁及焦虑抑郁症状共存检出率依次为29.0%(329名)、42.6%(484名)和25.4%(288名)。男生焦虑和焦虑抑郁症状共存检出率均高于女生(P值均 < 0.01)。大学生焦虑、抑郁和焦虑抑郁症状共存的检出率在不同自评家庭经济状况、自评学业负荷程度、父亲受教育程度、自评健康状况、吸烟、饮酒及自评睡眠质量间差异均有统计学意义(P值均 < 0.05)。见表 1。
2.2　不同手机娱乐性视屏内容暴露大学生焦虑抑郁症状共存检出率比较
见表 2。
基线时大学生手机娱乐性视屏内容暴露占比达96.5%(1 095名)；随访期间大学生焦虑、抑郁及焦虑抑郁症状共存的检出率分别为25.0%(278名)、32.1%(356名)和20.6%(229名)。偶尔暴露于阅读和其他娱乐性内容的大学生在随访期间的焦虑抑郁症状共存检出率均较高(P值均 < 0.05)。
2.3　大学生手机娱乐性视屏内容暴露与焦虑抑郁症状共存关联的多因素二分类Logistic回归分析
模型1未调整任何混杂因素，结果显示，基线时暴露于任何手机娱乐性视屏内容与基线时的焦虑抑郁症状共存的关联均无统计学意义(OR=0.80~1.28，95%CI=0.55~1.88，P值均>0.05)；基线时频繁暴露于阅读(OR=1.58，95%CI=1.11~2.26)和其他娱乐性内容(OR=1.87，95%CI=1.30~2.68)均增加随访期间大学生焦虑抑郁症状共存的风险(P值均 < 0.05)。模型2调整性别、家庭经济状况、自评健康状况等混杂因素后，结果显示，基线时暴露于任何娱乐性视屏内容与基线时的焦虑抑郁症状共存的关联均无统计学意义(OR=1.02~1.28，95%CI=0.64~1.89，P值均>0.05)；基线时频繁暴露于阅读(OR=1.65，95%CI=1.14~2.39)、偶尔(OR=1.46，95%CI=1.01~2.10)以及频繁暴露于其他娱乐性内容(OR=1.76，95%CI=1.20~2.60)均增加随访大学生焦虑抑郁症状共存的风险(P值均 < 0.05)。
3　讨论
收起
本研究结果显示，基线时大学生手机娱乐性视屏内容暴露占比达96.5%，与国外一项研究结果一致[15]，提示应关注手机娱乐性视屏内容在大学生群体中的暴露问题。本研究基线调查中，大学生焦虑抑郁症状共存的检出率为25.4%；随访调查中，焦虑抑郁症状共存的检出率为20.6%。与国内一项针对医学院大学生的研究结果基本一致[16]，但低于Ghandour等[17]研究结果。可能与不同研究中的研究设计、样本量大小、调查工具以及社会文化背景不同等因素有关，从而导致大学生焦虑抑郁共存症状检出率存在差异。
既往研究发现，视屏时间与青少年心理健康损害呈非线性剂量反应关系，当日均视屏时间为0~1 h，对青少年心理健康具有积极作用；当日均视屏时间>1 h，心理健康损害风险随时间延长逐步升高[18]。本研究以“适度”使用手机娱乐性视屏内容为参考，多因素二元Logistic回归分析结果显示，基线时大学生任何手机娱乐性视屏内容的暴露与基线时的焦虑抑郁症状共存的关联均无统计学意义，可能是与大学生在入学前就患有焦虑或抑郁症状有关[19]。基线时大学生手机娱乐性内容的暴露包括阅读及其他娱乐性内容的暴露与随访的大学生焦虑抑郁症状共存有关联。提示手机娱乐性视屏内容的暴露可能是大学生焦虑抑郁症状共存的风险因素，与国内一项针对手机功能与大学生抑郁症状关联的研究结果一致，即手机娱乐模式的使用与大学生抑郁症状概率的增加相关[20]，且与一项关于大学生手机娱乐功能沉迷与焦虑等心理健康问题关联的研究结果也类似[21]。可能解释这一关联的机制有：大学生大多习惯在睡前使用手机，智能手机屏幕发出的蓝光会抑制身体褪黑激素释放，导致昼夜节律紊乱；而昼夜节律紊乱与下丘脑-垂体-肾上腺轴功能失调致使的皮质醇水平分泌紊乱，以及大脑中的多巴胺分泌减少有关，从而引发焦虑和抑郁等心理问题[22-23]。
近期有研究发现，社交媒体、网络游戏等娱乐性视屏内容的暴露与抑郁或焦虑等心理健康问题均呈负相关[24-26]，与本文研究结果相反，该发现可能和使用与满足理论有关。使用与满足理论从用户的心理动机和需求角度出发，强调用户在媒介选择和使用中的主体作用，最终构建“需求激发-媒介适配-满足反馈”的闭环行为系统[27]，故社交媒体、游戏等手机娱乐性视屏内容的暴露可能会成为降低大学生焦虑抑郁症状共存等心理健康问题的因素。因此，未来仍需更多研究探讨手机娱乐性视屏内容的暴露与焦虑抑郁症状共存的关联情况。
本研究尚存在以下局限性：首先，研究对象为大学生，人群代表性有限、结论外推性不佳，未来研究可在不同年龄段人群中加以验证；其次，自评问卷收集的娱乐性视屏内容和焦虑抑郁症状共存数据可能存在回忆偏倚，但得益于大规模纵向队列，本研究有效降低了该局限的影响。
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doi: 10.16835/j.cnki.1000-9817.2026050
  • 接收时间：2025-07-17
  • 首发时间：2026-05-08
  • 出版时间：2026-03-25
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  • 收稿日期：2025-07-17
  • 修回日期：2025-10-18
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    1安徽医科大学公共卫生学院儿少卫生与妇幼保健学系, 合肥 230032
    2出生人口健康教育部重点实验室/安徽省环境与人口健康重点实验室
    3安徽医科大学护理学院

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