Latent classes of health related behaviors and their association with cooccurrence of anxiety and depressive symptoms among junior and senior high school students
10.16835/j.cnki.1000-9817.2026272
- VernacularTitle:中学生健康相关行为潜类别及其与焦虑抑郁症状共存的关联
- Author:
JIANG Xiaomei, QIN Wenxia, RU Jianguo, LI Sihan, DENG Qiuwen, CUI Haichen, ZHENG Yanling, MA Jinfeng
1
Author Information
1. School of Public Health and Management, Guangxi University of Traditional Chinese Medicine, Nanning 530200, Guangxi Zhuang Autonomous Region, China
- Publication Type:Journal Article
- Keywords:
Health behavior;
Anxiety;
Depression;
Comorbidity;
Students;
Regression analysis
- From:
Chinese Journal of School Health
2026;47(10):1435-1440
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the association between health related behaviors and anxiety, depressive symptoms, and their co-occurrence among junior and senior high school students, so as to provide evidence for developing targeted mental health promotion strategies.
Methods:From September to December 2023, a stratified cluster random sampling method was used to select 6 150 junior and senior high school students from 8 districts (counties) in a northwest region of China. The Generalized Anxiety Disorder-7 and Center for Epidemiologic Studies Depression Scale were used to assess anxiety and depressive symptoms, and their co-occurrence. Latent class analysis was used to identify latent classes of health related behaviors among junior and senior high school students, and Logistic regression models were used to analyze the association of the latent category of health related behaviors with anxiety and depressive symptoms, and their co-occurrence.
Results:The detection rates of anxiety and depressive symptoms, and their co-occurrence were 8.0%, 22.0%, and 7.3%, respectively, among junior high school students, and 8.3%, 26.6%, and 7.6%, respectively, among senior high school students. Latent classes of health related behaviors were classified into four classes:the comprehensive high risk behavior group (586 students, 9.5%), the Internet addiction group (376 students, 6.1%), the insufficient sleep group (1 151 students, 18.7%), and the low risk behavior group (4 037 students, 65.6%). After controlling for confounding factors such as gender, ethnicity, and monitoring sites, Logistic regression model analysis showed that, compared with the low risk behavior group, the comprehensive high risk behavior group had elevated risks of anxiety and depressive symptoms, and their co-occurrence (junior high school students: OR =3.81, 5.52, 3.88; senior high school students: OR =4.57, 4.12, 5.43; all P <0.05). The Internet addiction group had elevated risks of anxiety and depressive symptoms, and their co-occurrence among junior high school students ( OR =1.89, 2.81, 1.89), and an elevated risk of depressive symptoms among senior high school students ( OR =2.41) (all P <0.05). The insufficient sleep group had an elevated risk of their co-occurrence among junior high school students ( OR =1.47), and elevated risks of anxiety and their co-occurrence among senior high school students ( OR =1.71, 1.99) (all P <0.05).
Conclusion:Latent classes of health related behaviors among junior and senior high school students are associated with anxiety and depressive symptoms, and their co-occurrence, as well as differences across school stages.
