RESUMEN
BACKGROUND: Depression and anxiety in children and adolescents have become one of the major public health threats. This study aimed to provide a comprehensive and accurate understanding of the current status of depression and anxiety in primary and secondary school students in Urumqi and to provide a basis for early intervention in depressed and anxious individuals. METHODS: All primary and secondary school students in 13 schools in the Urumqi S district were surveyed from March 2021 to November 2021, and depression and anxiety were screened using the Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS). RESULTS: Overall, 17,086 students participated, with 16,462 valid questionnaires and an effective rate of 96.3%; the numbers of primary, middle, and high school students were 3351, 10,469, and 2642, respectively, with 8493 male students and 7969 female students. The overall depression and anxiety detection rates of primary and secondary school students were 10.74 % and 14.85 %, respectively; the depression detection rates were 5.97 %, 12.05 %, and 11.62 % in elementary, middle, and high schools, respectively=114.8, P < 0.001), while that of anxiety were 9.16 %, 16.75 %, and 14.53 %, respectively (x2=127.5, P < 0.001); the overall depression combined with anxiety detection rate was 8.61 %, and the depression combined with anxiety detection rates in elementary, middle, and high school were 0.95 %, 6.27 %, and 1.39 %, respectively=86.34, P < 0.001). SDS scores in elementary, middle, and high school were (33.21 ± 10.16), (36.66 ± 12.83), and (36.90 ± 11.97), respectively, and SAS scores were (39.64 ± 8.41), (41.88 ± 10.03), (40.71 ± 9.26), respectively. The depression and anxiety scores of primary and secondary school students in Urumqi were lower than those of domestic norm; female students in the middle school group had the highest depression and anxiety scores among all school periods. The SDS and SAS individual scores showed differences in the frequency of specific symptoms and subjective feelings of depression and anxiety among students of different sex and school periods. Depression and anxiety detection rates were highest in secondary school and lowest in primary school; the detection rates of depression and anxiety were significantly higher in female students than in male students. Depression and anxiety scores were significantly lower in the primary school group than in the middle and high school groups, and depression and anxiety levels were significantly higher in female than in male students in each academic period. Female students were 2.045 (95 % confidence interval [CI]: 1.845-2.267) and 2.006 (95 % CI: 1.835-2.193) times more likely to have symptoms of depression and anxiety than male students, respectively. Middle school students were 7.112 (95 % CI: 3.639-13.898) and 5.499 (95 % CI: 3.302-9.155) times and high school students were 7.504(95 % CI: 3.740-15.058) and 5.093 (95 % CI: 2.966-8.744) times more likely to have symptoms of depression and anxiety than elementary school students, respectively. LIMITATIONS: The pandemic may have impacted the results of the study, and this study did not explore the influencing factors of anxiety and depression. CONCLUSION: Depression and anxiety symptoms exist in some primary and secondary school students in S District, Urumqi.
Asunto(s)
Ansiedad , Depresión , Niño , Adolescente , Humanos , Masculino , Femenino , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Ansiedad/diagnóstico , Ansiedad/epidemiología , Estudiantes , Instituciones Académicas , Encuestas y CuestionariosRESUMEN
BACKGROUND: Changes of toxic metals and essential elements during childhood may be the risk factor of autism spectrum disorder (ASD). This research established an accurate personalized predictive model of ASD behaviors among children by using the blood element detection index of children in Xinjiang, China. METHODS: A total of 1537 children (240 ASD behavior children and 1297 non-ASD behavior children) aged 0-7 were collected from September 2018 to September 2019 in Urumqi Children's Hospital and the health management institute of Xinjiang Medical University. For measuring the copper (Cu), zinc (Zn), magnesium (Mg), iron (Fe), calcium (Ca), lead (Pb), and cadmium (Cd), 80 µL of blood was taken from each participant's ring finger. Univariate logistic regression analysis was used to select predictors, then the multivariate logistic regression was used to establish the predictive model. The discriminability, calibration and clinical validity of the model were evaluated by the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test and decision curve analysis (DCA). RESULTS: Gender, concentrations of Pb, Ca and Zn in children's blood specimens were found to be the independent risk factors of ASD behaviors and were used to develop the nomogram model. The area under the ROC curve (AUC) in the development group (AUC = 0.778) and the validation group (AUC = 0.775) showed the model had discrimination ability. The calibration curve indicated the model was accurate, and the DCA proved its clinical application value. CONCLUSION: The nomogram model can be used as a reliable tool to predict the risk of ASD behaviors among children.
Asunto(s)
Trastorno del Espectro Autista , Nomogramas , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/epidemiología , Cadmio , Calcio , Niño , Cobre , Estudios Transversales , Humanos , Hierro , Plomo , Magnesio , Estudios Retrospectivos , ZincRESUMEN
BACKGROUND: Postpartum depression(PPD) and anxiety(PPA) have become the one of major public health threats. However, the research evidence on PPD and PPA in Xinjiang is insufficient. This research reports the incidence of PPD and PPA in the past 4 years, and analyzes the impact of sociodemographic and obstetric factors on postpartum mental health. METHODS: The selected research objects are parturients who have undergone postpartum health check-ups in a tertiary hospital in Urumqi from January 2018 to September 2021. The study obtained the socio-demographic and obstetric information of the puerpera through general survey questionnaires, and used the PHQ-9 and GAD-7 scales to screen for PPD and PPA. Furthermore, after univariate analysis of related influencing factors of PPD and PPA, multiple binary logistic regression analysis was used to further explore the relationship between PPD and PPA and various influencing factors. RESULTS: A total of 7,703 parturients were included in this study. The incidence of PPD (PHQ-9 ≥ 10) was 9.7% in 2018, 11.1% in 2019, 13.3% in 2020, and 14.2% in 2021 (χ2 = 18.386, P < 0001). The incidence of PPA(GAD-7 ≥ 10) was 8.1% in 2018,8.6% in 2019, 11.4% in 2020, and 9.8% in 2021 (χ2 = 16.895, P = 0.001). The six factors that were statistically different after univariate analysis were included in the multivariate binary logistic regression analysis. The final results suggested that women who delivery in 2020 were 1.405 times (95%CI:1.145-1.723) more likely to suffer from depression than those who delivery in 2018 and 1.688 times (95%CI:1.237-2.303) than that in 2021. Compared with puerpera with formal jobs, the incidence of PPD among puerpera who were self-employed (AOR = 1.372,95%CI:1.085-1.735) or unemployed(AOR = 1.348,95%CI:1.137-1.599) was on the rise. Moreover, studies have shown that mixed feeding (AOR = 1.515,95%CI: 1.296-1.772) or artificial feeding (AOR = 1.736,95%CI: 1.299-2.321) 6 weeks postpartum was associated with a higher risk of depression, and puerpera who delivered female infants (AOR = 0.780, 95%CI: 0.626-0.971) were less likely to report depressive symptoms. Simultaneously, for PPA, women who delivered in 2020 were 1.418 times (95%CI: 1.065-1.887) more likely to suffer from anxiety than those who delivered in 2018. Women aged 18-29 years (AOR = 2.070,95%CI:1.229-3.487) were more likely to report PPA than those over the age of 29. Similarly, women who selected cesarean section delivery (AOR = 1.332,95%CI:1.087-1.632) were more likely to have PPA. Mixed feeding (AOR = 1.436,95%CI: (1.193-1.729) ) or artificial feeding (AOR = 1.742,95%CI: 1.243-2.441) at 6 weeks postpartum was associated with a higher risk of anxiety. While puerpera who delivered female infants (AOR = 0.746,95%CI: 0.567-0.982) were less likely to report anxiety symptoms. CONCLUSION: This study shows that in Xinjiang, the incidence of postpartum depression and anxiety was on the rise from 2018 to 2020, and although there was a slight decline in 2021, it was still higher than in 2019. Simultaneously, the proportion of overweight or obese, cesarean section, and non-breastfeeding women had increased year by year. Factors such as maternal age, occupation, mode of delivery, feeding pattern and neonatal gender may help to identify high-risk patients. Therefore, primary, secondary, and tertiary prevention should be given priority to reduce the incidence of postpartum depression and anxiety in high-risk groups.