中学阶段居住方式对高校学生心理健康的影响：一项基于2024年江苏高校的横断面研究-现代医学

中学阶段居住方式对高校学生心理健康的影响：一项基于2024年江苏高校的横断面研究

单位：1. 江苏卫生健康职业学院医务室, 江苏南京 211800;
2. 南通大学公共卫生学院, 江苏南通 226019;
3. 镇江市高等专科学校护理学院, 江苏镇江 212028;
4. 南京市第二医院科研科, 江苏南京 210018;
5. 东南大学医院中医科, 江苏南京 210018;
6. 南京医

关键词：居住方式高校学生焦虑抑郁睡眠质量症状自评

分类号：R179

出版年·卷·期（页码）：2026·45·第四期（608-618）

摘要：

目的： 探讨中学阶段未与双亲同住对高校学生心理健康状况的影响。方法： 多阶段分层随机抽取江苏省20所高校的23 590名学生进行横断面研究。按照中学阶段(初中和高中)远超半数时间是否与父亲和母亲共同居住分为同住组与未同住组，未同住组包括与父亲同住、与母亲同住、与祖/外祖父母同住或与其他亲戚长辈同住。通过匹兹堡睡眠治疗指数(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)和症状自评量表(SCL-90)在线调查心理健康状况。采用倾向性评分匹配(PSM)控制混杂因素，并通过倾向性评分(PS)、逆概率加权(IPTW)和二分类Logistic回归模型进行敏感性分析。结果： 同住组16 063名，未同住组7 527名。同住组睡眠障碍、焦虑症状、抑郁症状及SCL-90阳性检出率分别为10.3%、18.5%、4.6%和17.1%，未同住组上述指标检出率分别为12.9%、21.3%、5.9%和19.6%。PSM后单因素Logistic回归显示，相比于同住组，未同住组发生睡眠障碍、焦虑症状、抑郁症状、和SCL-90阳性的风险分别升高至1.29倍(95%CI 1.16～1.43)、1.19倍(95%CI 1.10～1.30)、1.30倍(95%CI 1.12～1.51)和1.18倍(95%CI 1.09～1.29)。PS、IPTW和二分类Logistic回归均证实了分析结果的稳健性。年级分层分析结果显示，除大一新生在睡眠障碍及大三学生在睡眠障碍、抑郁症状和SCL-90阳性检出方面差异无统计学意义外，其余年级未同住组发生睡眠障碍、焦虑症状、抑郁症状、和SCL-90阳性的风险均显著高于同住组。结论： 中学阶段未与双亲同住对高校学生心理健康具有显著负面影响。了解中学阶段的居住方式有助于优化高校学生心理健康干预，有针对性提升其心理健康水平。

Objective: To investigate the impact of not living with parents during middle school on college students' mental health. Methods: A cross-sectional study was conducted using multi-stage stratified random sampling of 23 590 students from 20 universities in Jiangsu. Students were categorized based on whether they lived with both parents for over half of their middle school years(junior and senior high school). The non-cohabiting group included those living with single parent, grandparents, or other relatives. Mental health status was assessed online using the Pittsburgh Sleep Quality Index(PSQI), Self-Rating Anxiety Scale(SAS), Self-Rating Depression Scale(SDS), and Symptom Checklist-90(SCL-90). We used Propensity Score Matching(PSM) to control confounding factors. Sensitivity analyses were conducted by using propensity score(PS), Inverse Probability of Treatment Weighting(IPTW), and binary Logistic regression models. Results: A total of 16 063 students lived with both parents, while 7 527 students did not. The prevalence rates of sleep disorders, anxiety symptoms, depressive symptoms, and a positive SCL-90 result were 10.3%, 18.5%, 4.6%, and 17.1%, respectively, in the group living with both parents, compared to 12.9%, 21.3%, 5.9%, and 19.6%, respectively, in the group not living with both parents. PSM-matched univariate Logistic regression analysis revealed that, compared to students living with both parents, those not living with both parents had a significantly higher risk of sleep disorders(OR=1.29, 95%CI 1.16-1.43), anxiety symptoms(OR=1.19, 95%CI 1.10-1.30), depressive symptoms(OR=1.30, 95%CI 1.12-1.51), and a positive SCL-90 result(OR=1.18, 95%CI 1.09-1.29). PS, IPTW, and binary Logistic regression analyses all confirmed the robustness of the results. The grade-stratified analysis revealed that, except for freshmen showing no significant differences in sleep disorders and junior students exhibiting no significant differences in sleep disorders, depressive symptoms, or positive SCL-90 results, all other grades demonstrated significantly higher risks of sleep disorders, anxiety symptoms, depressive symptoms, and positive SCL-90 results compared to the group living with parents. Conclusion: Not living with both parents during middle school has a significant negative impact on the mental health of college students. Understanding living arrangements during middle school can help optimize mental health interventions for college students and target improvements in their mental well-being.

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