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中国循证儿科杂志

中国循证儿科杂志 ›› 2023, Vol. 18 ›› Issue (1): 42-51.DOI: 10.3969/j.issn.1673-5501.2023.01.007

• 论著 • 上一篇    下一篇

青少年24小时活动与心理健康研究的范围综述

缪宇铃1,肖昕怡1,姜艳蕊1,王广海1,2,3,江帆1,2,3,林青敏1   

  1. 1 上海交通大学医学院附属上海儿童医学中心儿科转化医学研究所，发育行为儿科上海，200127；2 上海交通大学医学院附属新华医院教育部和上海市环境与儿童健康重点实验室上海，200092；3 上海脑科学与类脑研究中心上海，201602
  • 收稿日期:2023-01-18 修回日期:2023-02-08 出版日期:2023-02-25 发布日期:2023-02-25
  • 通讯作者: 林青敏,江帆

24-hour movement behaviors and mental health among adolescents: A scoping review

MIAO Yuling1, XIAO Xinyi1, JIANG Yanrui1, WANG Guanghai1,2,3, JIANG Fan1,2,3, LIN Qingmin1

MIAO Yuling, XIAO Xinyi, JIANG Yanrui, WANG Guanghai, JIANG Fan, LIN Qingmin   

  1. 1 Pediatric Translational Medicine Institution, Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China;2 MOEShanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China;3 Shanghai Center for Brain Science and BrainInspired Technology, Shanghai 201602, China
  • Received:2023-01-18 Revised:2023-02-08 Online:2023-02-25 Published:2023-02-25
  • Contact: LIN Qingmin,email: lqmcrazy@126.com; JIANG Fan, email: fanjiang@shsmu.edu.cn

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摘要： 背景：由于睡眠、久坐行为和身体活动所构成的24 h活动与青少年心理健康关系的研究异质性极大等局限，难以得出足以指导临床实践的高质量证据集合。 目的：总结儿童青少年24 h活动（睡眠、久坐行为和身体活动）与心理健康关系的研究现状及其研究设计存在的问题并进行评价，为后续研究提供参考。 设计：范围综述。 方法：检索PubMed、Embase、Web of Science和中国知网数据库，检索时间为建库至2022年9月28日，以睡眠、久坐行为、身体活动、24 h活动、心理健康、青少年为检索词构建中英文检索式，纳入健康儿童青少年人群的24 h活动类型与心理健康之间的相关性或因果推断的研究。通过阅读文题、摘要和全文进行筛选，在数据提取和数据整合中，逐渐完善活动类型、测量方式、测量项目分类、测量具体项目的数据提取表格。 主要结局指标：青少年24 h活动和心理健康关系的研究类型及其测量工具。 结果：中英文数据库共检索到927篇文献，经去重、初筛和全文筛选后，最终纳入55篇文献，其中横断面研究45篇（82%），前瞻性队列研究10篇。睡眠：54篇描述了睡眠时长，4篇评估了睡眠质量、睡眠潜伏期、日间嗜睡情况和睡眠中断情况。久坐行为：50篇为主观报告，5篇为客观报告，46篇涉及屏幕暴露。身体活动：主观报告和客观评估中高强度身体活动时间分别为47篇和8篇。32篇文献关注了抑郁，9篇关注了焦虑，5篇关注了压力，35篇关注了其他心理健康结局（正性情绪、行为问题、生活满意度或健康相关生命质量、心理疾病及症状、情绪调节能力和手机成瘾）。44篇文献探索24 h活动与心理健康的相关性，8篇文献使用等时替代模型探索24 h活动结构的改变，3篇探索24 h活动影响心理健康的中介因素。 结论：青少年24 h活动与心理健康的关联研究尚少，所使用的测量工具有待规范统一，未来需针对现行24 h活动推荐时间建立等时替代模型或在真实世界进行干预研究，寻找既能够最大发挥24 h活动的健康效应，又能够让青少年人容易达到的24 h活动时间的推荐组合。

关键词: 青少年, 24 h活动, 睡眠, 久坐行为, 身体活动, 心理健康

Abstract: Background: Great heterogeneity exists in studies on the relationship between adolescents' mental health and 24-h movement consisting of sleep, sedentary behavior, and physical activity. Therefore, it is difficult to obtain high-quality evidence synthesis sufficient to guide clinical practice. Objective: To summarize and evaluate the current status of research on the relationship between 24-hour movement (sleep, sedentary behavior, and physical activity) and mental health in children and adolescents, as well as the problems in research design, so as to provide a reference for future research. Design: Scoping review. Methods: PubMed, Embase, Web of Science, and CNKI databases were searched from the inception to September 28, 2022, with the keywords of sleep, sedentary behavior, physical activity, 24-h movement, mental health, and adolescents to identify research on the correlation or causal inference between 24-h movement and mental health in healthy children and adolescents. Data extraction forms for movement type, measurement methods, classification of measurement items, and specific item measurement were gradually refined in the process of data extraction and synthesis after reading the text title, abstract, and full text for screening. Main outcome measures: Study types and measurement instruments for the relationship between 24-h movement and mental health in adolescents. Results: A total of 927 articles were retrieved from the English and Chinese databases, and after de-duplication, initial screening and full-text screening, 55 articles were finally included with 45 (82%) cross-sectional studies and 10 prospective cohort studies; 47 (85%) subjective reports and 8 objective monitoring articles. For sleep, 54 described sleep duration and 4 assessed sleep quality, sleep latency, daytime sleepiness, and sleep disruption. For sedentary behavior, there were 50 subjective reports, 5 objective reports, and 46 studies about screen exposure. For physical activity, hours of moderate-to-vigorous physical activity were assessed in 47 subjective reports and 8 objective reports. A total of 32 studies focused on depression, 9 on anxiety, 5 on stress, and 35 on other mental health outcomes (positive mood, behavioral problems, life satisfaction or health-related quality of life, mental illness and symptoms, emotion regulation skills, and cell phone addiction). Forty-four papers explored the correlation between 24-h movement and mental health, 8 papers explored changes in the structure of 24-h movement using isochronous substitution models, and 3 explored mediators of 24-h movement affecting mental health. Conclusions: There are few studies on the association between 24-h movement and mental health in adolescents, and the measurement tools used need to be standardized. In the future, isochronous substitution models or real-world intervention studies are needed to find the recommended 24-h movement packages that can maximize the health effects of the movement and are easy to achieve at the same time.

Key words: Adolescents, 24-h activity, Sleep, Sedentary behavior, Physical activity, Mental health