A network analysis of depression and anxiety and their influencing factors among adolescents with spinal curvature abnormalities

ObjectiveTo investigate the current status of depression and anxiety and their influencing factors among adolescents with spinal curvature abnormalities. MethodsFrom September 2021 to December 2022, a stratified cluster sampling method was used to select 2 855 adolescents with spinal curvature abnormalities from 28 middle schools in Shenzhen city to complete a questionnaire survey, explore the prevalence of depression and anxiety symptoms in this population, and establish logistic regression and mixed network models. ResultsThe number of adolescents with spinal curvature abnormalities who experienced depression and anxiety were 1 260 (44.1%) and 1 219 (42.7%), respectively, and the prevalence gradually increased with age (P<0.001). Among girls, 835 (48.6%) and 811 (47.2%) experienced depression and anxiety, respectively, while among boys, the numbers were 425 (37.4%) and 408 (35.9%), respectively. Girls (OR=1.40, 95%CI: 1.15–1.70), average peer relationships (OR=1.58, 95%CI: 1.19–2.09), average teacher-student relationships (OR=1.70, 95%CI: 1.36–2.11), moderate (OR=1.69, 95%CI: 1.30–2.19) or high (OR=4.61, 95%CI: 3.33–6.38) study pressure, acceptable (OR=1.50, 95%CI: 1.24–1.83) or poor (OR=1.77, 95%CI: 1.24–2.53) body image, sometimes (OR=1.40, 95%CI: 1.11–1.77) or often (OR=2.59, 95%CI: 1.69–3.98) experiencing neck and shoulder pain, sometimes (OR=1.58, 95%CI: 1.26–1.98) or often (OR=1.92, 95%CI: 1.25–2.95) experiencing lower back pain, poor sleep quality (OR=5.09, 95%CI: 4.19–6.18), and screen time ≥2 h/d (OR=1.25, 95%CI: 1.04–1.51) were associated with a higher risk of depression (all P<0.05). Girls (OR=1.37, 95%CI=1.13–1.64), average peer relationships (OR=1.62, 95%CI: 1.23–2.12), moderate (OR=2.14, 95%CI: 1.65–2.77) or high (OR=7.31, 95%CI: 5.30–10.08) study pressure, acceptable (OR=1.40, 95%CI: 1.15–1.69) or poor (OR=1.90, 95%CI: 1.35–2.68) body image, sometimes (OR=1.38, 95%CI: 1.10–1.74) or often (OR=2.20, 95%CI: 1.47–3.30) experiencing neck and shoulder pain, sometimes (OR=1.67, 95%CI: 1.34–2.08) or often (OR=1.76, 95%CI: 1.18–2.64) experiencing lower back pain, poor sleep quality (OR=3.11, 95%CI: 2.58–3.76), and screen time ≥2 h/d (OR=1.25, 95%CI: 1.04–1.50) were associated with a higher risk of anxiety (all P<0.05). In the network analysis, sleep quality (Weight=0.47) and peer relationships (Weight=0.25) had strong direct associations with depression, and study pressure (Weight=0.31) had a strong direct association with anxiety. ConclusionsThe prevalence of depression and anxiety symptoms is high among adolescents with spinal curvature abnormalities in Shenzhen city, and is influenced by factors such as sex, peer relationships, study pressure, body image, neck and shoulder pain, lower back pain, sleep quality, and screen time. Early attention to mental health issues in this population and the timely provision of reasonable and effective interventions are conducive to their physical and mental health development.