To explore the correlation between traditional Chinese medicine (TCM) constitution and depressive symptom among school-aged children and adolescents, so as to provide evidences for informing constitution-based regulation and prevention of depressive symptom.

From June to December 2024, a total of 4 729 students aged 6-14 were recruited by cluster random sampling from 10 primary schools in Baoding (Hebei Province), Heze and Liaocheng (Shandong Province). General information, TCM constitution and depressive symptom were collected. Restricted cubic spline (RCS) models were used to analyze related factors and threshold effects of depressive symptom. Binary Logistic regression was applied to examine the association between depressive symptom and TCM constitution, with subgroup analyses conducted.

The detection rate of depressive symptom among the included children and adolescents was 25.82%. RCS analyses indicated non-linear associations between depressive symptom and age (inflection point at 10 years old), bedtime (inflection point at 22:00), and wake-up time (inflection point at 6:30) (all P_{non-linearity} < 0.01). Linear associations were observed with body mass index (BMI) and sleep duration (all P_{non-linearity}>0.05). After adjusting for covariates such as age, BMI and sleep status, binary Logistic regression analyses showed that Yin-deficient constitution (OR=1.26, 95%CI=1.09-1.45) and Phlegm-dampness constitution (OR=1.42, 95%CI=1.11-1.82) were significantly associated with depressive symptom among children and adolescents (all P < 0.05).

Depressive symptom among school-aged children and adolescents is primarily associated with Yin-deficiency and Phlegm-dampness constitutions in TCM constitution. Active attention should be paid to susceptible TCM constitution among children and adolescents. Targeted health guidance and interventions should be implemented to improve TCM constitution health status for preventing the occurrence of depressive symptom.

To explore the association between mental health and muscle strength among Chinese adolescents aged 13-18, providing a theoretical foundation and intervention strategies for mental health promotion.

Data were obtained from the 2019 Chinese National Survey on Students' Constitution and Health, including 98 631 Chinese adolescents aged 13-18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well-being was measured with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Based on the gender- and age-specific Z-scores of various test items [grip strength, standing long jump, pull-ups (for males), and sit-ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual-factor Model (DFM) of mental health, participants were categorized into four groups: troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents.

In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well-being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well-being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance (χ²=176.13, 780.42, both P < 0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age (χ_trend²=258.47) and a gradual upward trend with increasing muscle strength levels (χ_trend²=123.14), and both boys and girls exhibited similar trends (χ_trend²=103.83, 168.46; 57.00, 67.34) (all P < 0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% (OR=1.29); for every unit increase in the Z-score for pull-ups, the likelihood of being in a completely mental health state increased by 6% (OR=1.06) among boys; for every 1 unit increase in sit-up Z-score, the likelihood of being in a completely mental health state increased by 19% (OR=1.19) among girls (all P < 0.05).

The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.

To explore the impact mechanism of psychological health work in colleges on the psychological health status of college students, in order to provide a basis and practical guidance for optimizing the psychological health service system in colleges and formulating scientific and effective psychological capital intervention strategies.

Through stratified cluster random sampling, 1 148 colleges students were selected from 7 colleges in Shanghai from October to November 2024. A survey was conducted using the Satisfaction Questionnaire for Psychological Health Work in colleges, Psychological Capital Questionnaire (PCQ) and Symptom Checklist-90 (SCL-90). Spearman correlation analysis, multiple Logistic regression analysis and structural equation model pathway analysis were conducted to analyze the relationship of psychological health work in colleges and psychological capital with psychological health status of college students.

The scores of satisfaction with college psychological health work, PCQ, and SCL-90 were [2.78(2.55, 3.02), 3.08(2.85, 3.32), 1.56(1.42, 1.78)]. Spearman correlation analysis results showed that the four dimensions scores of satisfaction with psychological health work in colleges (satisfaction with psychological health course teaching, satisfaction with practical activities, satisfaction with psychological counseling services and satisfaction with crisis intervention and management) were negatively correlated with SCL-90 score of college students (r=-0.26, -0.31, -0.24, -0.21); the four dimensions scores of psychological capital (self-confidence, optimism, resilience, and hope) of college students were negatively correlated with SCL-90 score (r=-0.29, -0.34, -0.28, -0.29) (all P < 0.05). The results of multiple Logistic regression analysis showed that after adjusting for confounding factors such as gender, grade level, parents' highest education level, major type, and physical health status, compared with college students who were "very satisfied" with their psychological health work, those who were "very dissatisfied" and "dissatisfied" with their psychological health work had a higher proportion of poor psychological health status (OR=2.15, 1.68); compared to college students with higher level of psychological capital, those with lower level of psychological capital had a higher proportion of poor psychological health status (OR=2.73, 2.05) (all P < 0.05). The results of structural equation modeling path analysis showed that the satisfaction of psychological health work in colleges indirectly reduced psychological health risks by increasing psychological capital among colleges (β=0.12, P < 0.05), with mediation effect accounting for 60% of the total effect.

The satisfaction with psychological health work in colleges is positively correlated with both psychological health status and psychological capital among college students; and psychological capital, as an intermediary bridge, further amplifies and transmits the positive impact of satisfaction with psychological health work in colleges on psychological health among college students.

To explore the bidirectional associations among body mass index Z-scores (BMI Z-scores) and weight stigma with depressive symptoms in adolescents, thereby providing evidence for targeted intervention strategies.

A stratified cluster random sampling method was employed to select 18 301 adolescents aged 12-18 years from all 12 prefectures (103 counties) in the Inner Mongolia Autonomous Region, and two waves of longitudinal surveys were conducted in September 2023 (T1) and September 2024 (T2) among the adolescents. Weight stigma was assessed by using a self-developed questionnaire, depressive symptom was measured with the Center for Epidemiologic Studies Depression Scale (CES-D), and BMI Z-scores were calculated according to the World Health Organization standards. Pearson correlation analysis was used to examine associations among variables, and cross-lagged panel models were constructed to investigate the dynamic bidirectional relationships among the three variables.

Adolescents' BMI Z-scores and weight stigma with depressive symptoms all exhibited autoregressive stability across the two time points (autoregressive paths, all P < 0.01). Cross-lagged model comparisons indicated that the bidirectional path model achieved the best fit (χ²=12.65, RMSEA=0.017, CFI=1.000; △χ²=193.39, P < 0.01), supporting dynamic bidirectional associations among the three variables. After adjusting for gender, age, subjective social status and only-child status, T1 BMI Z-scores among adolescents positively predicted T2 weight stigma (β=0.061), and T1 weight stigma positively predicted T2 depressive symptoms (β=0.608); in the reverse direction, T1 depressive symptoms predicted T2 weight stigma (β=0.003), and T1 weight stigma predicted T2 BMI Z-scores (β=0.081) (all P < 0.01).

There is a bidirectional cross-lagged relationship among adolescents' BMI Z-scores and weight stigma with depressive symptoms, suggesting that weight stigma may serve as a key psychological variable linking obesity and depressive symptoms. Greater attention should be paid to the potential threat of weight stigma to adolescents' mental health, with intervention strategies expanded from a solely physiological focus to encompass psychosocial dimensions.

To systematically review the development and changes in mental health policies within the National Outline for Children's Development in China from 1992 to 2030, providing a reference basis for future formulation of mental health policies among children and adolescent in China.

Based on the four editions of the National Outline for Children's Development in China across different periods from 1992 to 2030, word frequency analysis was used to reveal shifts in policy priorities, and an internationally recognized framework for adolescent health policy analysis was applied to conduct a textual review.

Word frequency analysis revealed that the term "psychological" appeared 6 times in the National Outline for Children's Development in China (2001-2010) but increased to 20 times in the National Outline for Children's Development in China (2021-2030) (abbreviated as the National Outline of 2021), while the term "health" rose from 4 times in the National Outline for Children's Development Plan in China in the 1990s to 68 times in the National Outline of 2021. The scope of mental health policy interventions expanded to encompass five key areas: health, safety, education, welfare and legal protection. Textual analysis highlighted that the policies of the National Outline for Children's Development in China were demand-driven, prioritized vulnerable groups and continuously broadened their coverage, emphasizing sustainability and appropriateness, and monitoring/evaluation mechanisms. By 2023, 42.3% of primary schools and 64.8% of secondary schools employed full-time mental health education teachers. However, the National Outline for Children's Development in China lacked direct evidence of children and adolescents participation in policy formulation, and publicly available mental health data disaggregated by age and gender remained limited.

Mental health policies of children and adolescents in China have evolved from nonexistence to gradual refinement, yet institutionalized channels for youth involvement in policy development and evaluation remain insufficient, and transparency in age- and gender-specific mental health data needs improvement.

To investigate the iodine nutrition status of children in water-borne iodine-excess areas in Hebei Province, so as to provide references for scientific prevention and control of water-borne iodine-excess hazards.

From March to September each year during 2018 to 2023, a cross-sectional survey was conducted in 39 water-borne iodine-excess counties (measured in 2017) from 5 cities (Cangzhou, Hengshui, Xingtai, Handan and Langfang) in Hebei Province. The survey included the detection of iodine content in residents' drinking water, the measurement of thyroid volume in children aged 6-12, the detection of salt iodine and urinary iodine. The iodine nutrition status and water iodine distribution of 6-12 year-old children were evaluated from different perspectives such as years, gender, and age. Kruskal-Wallis H test, Mann-Whitney U test and Chi-square test were used for group comparison.

A total of 38 755 children were surveyed from 2018 to 2023, and 1 270 drinking water samples were tested across the province. The mass volume concentration of iodine in water showed a decreasing trend over the years (Z=-30.87, P < 0.01). Among 38 470 salt samples monitored from children 's home, 24 790 were not non-iodized salt, with a non-iodized salt rate of 64.44%. A total of 31 989 urine samples were collected from children aged 8-10 years, with the median urine iodine was 245.94 μg/L. Comparing the results of urinary iodine in children from different years, the median urinary iodine from 2018 to 2023 were 328.0, 339.3, 267.8, 279.1, 291.3, 186.5 μg/L, respectively, with statistically significant differences (H=4 138.40, P < 0.01). Further pairwise comparisons showed that the median urinary iodine of children in 2023 was lower than in all other years (Z=-51.59 to -11.41, all P < 0.01). Among children aged 6-12 years, 1 150 cases of goiter were detected and the rate of goiter was 3.0%; and the goiter rates in boys and girls were 2.8% and 3.1%, with no significant difference between the sexes (χ²=2.76, P>0.05). There were significant differences in the rate of goiter among different years and ages (χ²=324.02, 191.61, both P < 0.05).

With the progress of water reform in water-borne iodine-excess areas of Hebei Province, children's iodine nutrition has reduced from excessive state to suitable state. It is necessary to continue to expand the coverage of water-based iodine reduction projects, and strengthen the monitoring of iodine nutrition status of key populations in water-borne iodine-excess areas.

To explore the cross-sectional and longitudinal associations between 24-hour movement behaviors and physical fitness in preschool children, and to adopt the method of equal time substitution analysis to evaluate the impact of time redistribution of different activity behaviors on physical fitness scores, so as to provide a scientific basis for promoting the health of preschool children.

A total of 193 preschool children aged 3-6 years were selected from three Shanghai districts (Jing'an, Baoshan, Jiading) from October to December 2023 by the stratified cluster random sampling method. The 24-hour movement behaviors were monitored via 7-day accelerometry, and physical fitness was measured according to the National Physical Fitness Measurement Standards (Revised 2023, preschool section). From October to December 2024, the follow-up of physical fitness among preschool children used the same testing method. The comparison between groups was conducted by t-test. Compositional regression analyses evaluated the relationship of 24-hour movement behaviors and physical fitness among preschool children.

At baseline, moderate-to-vigorous physical activity (MVPA) time was significantly higher in boys [(84.10±25.78)min/d] than in girls [(70.44±25.98)min/d]; the composite physical fitness score was significantly higher in boys (71.65±8.69) than in girls (68.84±9.89), and the differences were statistically significant (t=3.65, 2.10, both P < 0.01). After adjusting for gender, age and body mass index, the results of component multiple linear regression analysis showed that MVPA time proportion was positively correlated with the composite physical fitness score at baseline among preschool children (β=6.61), but was negatively correlated with two-legged continuous hopping time at 1 year (β=-1.12) (both P < 0.05). Light physical activity (LPA) time proportion was negatively correlated with walking on the balance beam time at 1 year (β=-4.44), and sedentary behavior (SB) time proportion was negatively correlated with the composite score of physical fitness at baseline (β=-6.55) (both P < 0.05). Isotemporal substitution analysis revealed that replacing 10 minutes of sleep (SP), SB, and LPA with MVPA increased the baseline physical fitness composite score by 0.750, 0.689 and 0.575 units, respectively; at 1-year follow-up, the composite score increased by 1.440, 1.419 and 1.430 units, respectively (all P < 0.05). Conversely, replacing MVPA with 10 minutes of SP, SB, and LPA, resulted in decreases in baseline physical fitness composite scores of 0.836, 0.777 and 0.669 units, and reductions of 1.613, 1.592 and 1.598 units at 1-year follow-up (all P < 0.05).

Preschool children's 24-hour movement behaviors, especially MVPA, are closely related to physical health. Implementing appropriate strategies to increase physical activity and reduce sedentary time may improve the physical fitness of preschoolers.

To understand the indoor light-at-night (LAN) exposure intensity during sleep among children and adolescents in Shanghai, so as to provide a basis for exploring potential health risks and formulating effective interventions.

From April to December in 2024, a total of 628 students in grades 4-7 were recruited from three schools in Shanghai. A portable illuminance meter was used to measure LAN for one week, and participants recorded their sleep time. The Kruskal-Wallis H test was used for comparison between groups, and the error bar chart was used to show the trend and variation range of average LAN exposure intensity in different sleep periods.

The indoor LAN exposure intensity of children and adolescents in Shanghai was [2.4(0.8, 5.9)lx] during sleep, and 28.8% of children and adolescents were exposed to indoor LAN≥5 lx. There was no significant differences in indoor LAN exposure intensity between boys [2.4(1.0, 5.9)lx] and girls [2.3(0.7, 5.9)lx] (Z=-0.86, P>0.05). The indoor LAN exposure intensity of primary school students [2.9(1.1, 6.6)lx] was higher than that of junior high school students [1.0(0.3, 3.1)lx] (Z=-5.87), and indoor LAN exposure intensity of students in the main urban area [3.2(1.1, 7.8)lx] was higher than that of rural students [1.6(0.5, 4.3)lx] (Z=-5.23)(both P < 0.05). The indoor LAN exposure intensity showed an overall decreasing trend during sleep of children and adolescents (tau=-0.81, P=0.02), with a slight increase before waking up.

Indoor LAN exposure intensity among children and adolescents in Shanghai is generally high, especially among primary school students and students living in the main urban area. Health policy and education should be strengthened to reduce the impact of LAN on children and adolescent health.

To explore the effects of parenting style on emotional and behavioral problems (EBPs) of preschool children and to provide theoretical reference for promoting children's physical and mental health.

In October-November 2021, a stratified cluster random sampling method was adopted to select 3 575 preschool children aged 3-6 years from 12 kindergartens in Hefei. Data on parenting styles and children's EBPs were collected through electronic questionnaires. Binary Logistic regression model was used to explore the effects of parenting styles on children's EBPs.

The detection rates of emotional symptoms, conduct problems, hyperactivity, peer interaction problems, and prosocial behavior problems were 15.5% (n=554), 23.2% (n=830), 22.4% (n=802), 38.2% (n=1 367), and 29.5% (n=1 055) in preschool children, respectively. Binary Logistic regression analysis showed that after adjusting for covariates such as child's age, sex, and preterm birth, a high authoritative parenting style reduced the risk of EBPs in children (OR=0.29-0.78), while a high authoritarian (OR=1.36-2.15) and high permissive (OR=1.36-1.68) parenting style in mothers increased the risk of EBPs in children (all P < 0.05). Further stratified analysis indicated that among children with fathers exhibiting high authoritative, high authoritarian, or high permissive parenting styles, a high authoritative parenting style in mothers reduced the risk of peer interaction problems and prosocial behavior problems (OR=0.51, 0.30; 0.44, 0.23; 0.51, 0.29, all P < 0.05). Among children with fathers exhibiting a high authoritative parenting style, a high authoritarian parenting style in mothers increased the risk of emotional problems (OR=2.59), and both high authoritarian and high permissive parenting styles in mothers increased the risk of conduct problems (OR=3.25, 2.09) and hyperactivity problems (OR=2.35, 2.87) (all P < 0.05). Among children with fathers exhibiting high authoritarian or high permissive parenting styles, a high authoritarian parenting style in mothers increased the risk of EBPs (OR=1.65-2.71, 1.62-2.52, all P < 0.05).

Parenting style is an important factor affecting EBPs of preschool children, and appropriate parenting style is beneficial for children's psychological development.

To investigate the changing trends for associations of anxiety and depressive symptoms with smartphone addiction among middle school students, so as to provide a scientific basis for preventing smartphone addiction in middle school students.

From 2022 to 2023, a method of combining convenient sampling with cluster sampling was used to select 8 923 middle school students from 27 junior high schools and 3 senior high schools in a district of Shenzhen City between September 2022 (baseline, T1) and September 2023 (follow-up, T2). The Smartphone Addiction Scale-Short Version (SAS-SV), Patients Health Questionnaire-9 Item (PHQ-9), and Generalized Anxiety Disorder 7-item Scale (GAD-7) were administered to assess smartphone addiction, anxiety and depressive symptoms. Mixed-effects models were used to analyze the association of anxiety and depressive symptoms with smartphone addiction among middle school students.

From September 2022 to September 2023, the reported prevalence of smartphone addiction increased from 24.22% to 25.25% (χ²=45.71); and smartphone addiction scores [24.00(16.00, 32.00), 25.00(16.00, 33.00)], anxiety symptom scores [2.00(0.00, 7.00), 3.00(0.00, 7.00)] and depressive symptom scores[3.00(0.00, 8.00), 5.00(0.00, 9.00)] all significantly increased (Z=-17.43, -42.38, -41.57) (all P < 0.05). There were statistically significant difference in the distribution of anxiety and depression symptom levels among middle school students in 2022 and 2023 (χ²=85.15, 106.85, both P < 0.05). After adjusting for covariates such as age, gender and family background, mixed-effects models revealed dose-response associations of anxiety and depressive symptoms with smartphone addiction among middle school students: mild anxiety symptom(OR=3.22), moderate-to-severe anxiety symptom (OR=5.36), mild depressive symptom (OR=3.32) and moderate-to-severe depressive symptom (OR=6.13) were significantly associated with higher risks of smartphone addiction (all P < 0.05). Interaction effect analysis found that co-existing anxiety and depressive symptoms synergistically increased addiction risk by 5.60 times (OR=5.60) compared to the asymptomatic group, with 32% of the combined risk attributable to their interaction (S=1.64, AP=0.32)(both P < 0.05).

Anxiety and depressive symptoms are significantly associated with smartphone addiction, exhibiting a synergistic effect. Attention should be paid to emotional issues and smartphone addiction among middle school students.