[Association between life behavior patterns and symptoms of anxiety and depression among adolescents in Jinan]

Objective: The purpose of this study is to understand the current situation of anxiety and depression among adolescents in Jinan, and to explore the relationship between their life behavior patterns and the two, so as to provide a scientific basis for formulating effective prevention and control strategies and measures to reduce the incidence of anxiety and depression among adolescents. Methods: The study adopted a stratified cluster sampling method to conduct a questionnaire survey among middle school students in Jinan from September to November 2023. Cluster analysis method was used to reveal the common characteristics of adolescents with anxiety, depression and both, and binary logistic regression was used to analyze the relationship between different demographic characteristics, different life behavior patterns and anxiety and depression. Results: A total of 13 171 middle school students were surveyed in this study, of which 25.78%, 15.88% and 13.09% were having anxious, depressed and experiencing both emotions, respectively. After controlling for other variables, female, students with <8 hours of sleep per day and internet addiction were more likely to experience anxiety, while ≤2 hours of video screen time per day was a protective factor for anxiety (OR=0.568, 95%CI: 0.512-0.632). In the depression group, the risk of depression among female students, urban students, students with <3 days of exercise per week, students with <8 hours of sleep per day, and students with internet addiction was 1.349, 1.140, 1.157, 2.962, and 4.977 times higher than that of the control group, respectively. Video screen time ≤2 hours per day was also a protective factor for depression (OR=0.528, 95%CI: 0.468-0.595). Furthermore, the risk of anxiety, depression and comorbidity of anxiety and depression among students in the high video screen time pattern was 2.368, 2.722 and 2.830 times higher than that in the high exercise frequency pattern, respectively. Conclusions: Female students, students with <8 hours of sleep per day and internet addiction were the common risk factors of anxiety and depression. Urban students and students with <3 days of exercise per week increased the risk of depression. High video screen time increased the risks of anxiety, depression, and their comorbidity, while video screen time ≤2 hours per day exerted a protective effect. It is recommended that prevention and control interventions among adolescents focus on reducing video screen time, increasing physical activity, and ensuring adequate sleep.