[Comorbidity of anxiety symptoms and depression symptoms among middle and high school students in Zhejiang Province].

Objective: To analyze the epidemiological patterns of comorbidity of anxiety symptoms and depression symptoms among middle and high school students in Zhejiang Province and to provide evidence for making strategy and evaluation of intervention. Methods: Through a multi-stage sampling design, 28 043 students from 376 schools in 30 counties/districts were recruited and surveyed using anonymous self-administered questionnaires in classrooms under the supervision of trained staff between April and June 2022. Anxiety symptoms were assessed using generalized Anxiety Disorders 7-Item Scale, and depression symptoms were assessed using Patient Health Questionnaire 9-Item Depression Scale. A total of 27 004 students were included in the final analysis. Results: The overall prevalence of comorbidity of anxiety symptoms and depression symptoms was 11.54% (95%CI: 10.90%-12.19%), higher among girls (15.42%, 95%CI: 14.47%- 16.38%) than boys (8.05%, 95%CI: 7.43%-8.67%) (P<0.001), higher among students living in rural areas (12.35%, 95%CI: 11.49%-13.22%) than those in urban areas (10.06%, 95%CI: 9.27%-10.86%) (P<0.001). The prevalence of comorbidity of students attending middle school, academic high school, and vocational high school was 11.73% (95%CI: 10.82%-12.64%), 12.49% (95%CI: 11.20%- 13.79%), and 9.98% (95%CI: 8.68%-11.27%), respectively (P=0.025). The prevalence of comorbidity was higher among students in divorced/widow/separated families (16.64%, 95%CI: 14.86%-18.43%) than those in intact families (10.82%, 95%CI: 10.14%-11.50%) (P<0.001). The wealthier the families, the lower the prevalence of comorbidity (P<0.001). The prevalence of comorbidity was higher among cigarettes smokers in the past 30 days (21.70%,95%CI: 18.24%- 25.16%) than non-smokers (11.13%, 95%CI: 10.51%-11.76%), higher among alcohol drinkers in the past 30 days (19.36%, 95%CI: 17.58%-21.14%) than non-drinkers (10.05%, 95%CI: 9.43%- 10.68%), higher among students engaging in physical fight in the past 12 months (18.42%, 95%CI: 16.75%-20.09%) than those without physical fight (10.45%, 95%CI: 9.81%-11.10%). The more frequently students engaged in physical exercise, the lower the prevalence of comorbidity (P<0.001). The poorer the academic performance self-reported, the higher the prevalence of comorbidity (P<0.001). Conclusion: More than one-tenth of middle and high school students in Zhejiang Province have comorbidity of anxiety symptoms and depression symptoms, and more attention should be paid to adolescent mental health.目的： 对浙江省中学生焦虑抑郁症状共病的流行特征进行分析，为制定防治策略及评估干预效果提供依据。 方法： 采用多阶段分层整群抽样和自我管理式问卷调查方法，于2022年4-6月对浙江省30个市（县、区）376所学校的28 043名初中、普通高中和非普通高中的学生采用统一的问卷进行匿名调查。焦虑症状判定采用广泛性焦虑量表，抑郁症状判定采用患者健康问卷抑郁量表，最终纳入分析27 004名。 结果： 中学生焦虑抑郁症状共病率为11.54%（95%CI：10.90%~12.19%），女生（15.42%，95%CI：14.47%~16.38%）高于男生（8.05%，95%CI：7.43%~8.67%）（P<0.001）；农村（12.35%，95%CI：11.49%~13.22%）高于城市（10.06%，95%CI：9.27%~10.86%）（P<0.001）；初中、普通高中和非普通高中学生共病率分别为11.73%（95%CI：10.82%~12.64%）、12.49%（95%CI：11.20%~13.79%）和9.98%（95%CI：8.68%~11.27%）（P=0.025）；离异/丧偶/分居家庭的学生共病率（16.64%，95%CI：14.86%~18.43%）高于在婚家庭（10.82%，95%CI：10.14%~11.50%）（P<0.001）；家庭经济状况越好，共病率越低（P<0.001）；过去30 d吸烟者共病率（21.70%，95%CI：18.24%~25.16%）高于未吸烟者（11.13%，95%CI：10.51%~11.76%）；过去30 d饮酒者共病率（19.36%，95%CI：17.58%~21.14%）高于未饮酒者（10.05%，95%CI：9.43%~10.68%）；共病率随每周体育活动天数增加而降低（P<0.001）；自报学习成绩越差的学生，共病率越高（P<0.001）；过去12个月参与过打架者共病率（18.42%，95%CI：16.75%~20.09%）高于未参与过者（10.45%，95%CI：9.81%~11.10%）。 结论： 浙江省中学生焦虑抑郁症状共病率较高，应关注中学生心理健康。.