Factors Related To Loneliness And Its Relationship With Depressive Symptoms Among Middle School Students In Guangzhou

Background:Loneliness is considered to be a mental health problem.Most people have experienced loneliness at some stage of their lives,which is a subjective and painful experience.Teenagers are a vulnerable group to loneliness.When there is a difference between the actual social relationships and the desired social relationships,loneliness occurs.As they age,teenagers begin to face pressure from various aspects,especially during adolescence.They face changes in personal personality,family relationships,interpersonal relationships,identity exploration,cognition,and physical maturity,which increase the risk of social isolation and loneliness for teenagers.Teenagers often experience negative emotions such as anxiety,depression,and loss due to loneliness,which may increase the risk of various mental health problems,including depression,anxiety,suicidal ideation,and sleep problems.In order to realize the prevalence,distribution characteristics and related factors of loneliness among secondary school students in Guangzhou.To explore the relationship between loneliness and depressive symptoms among secondary school students in Guangzhou.Methods:A multi-stage cluster random sampling method was used to randomly select twelve schools in Guangzhou.Include six grades from junior one to senior three to complete the questionnaire survey.Feeling of loneliness was assessed with the short-form of the UCLA Loneliness Scale.School cohesion was assessed with Student Perceptions of School Cohesion Scale（SPSC）.Social support was assessed by Social Support Rating Scale（SSRS）.The depression symptoms were evaluated with Patient Health Questionnaire（PHQ·9）.Quality control:Using web platform of Redcap to manage electronic data,staff training maintain order and ensure students’correct understanding of the scale.Rate,frequency,mean,standard deviation,median,inter quartile range,morbidity rate were used to describe the prevalence of loneliness among secondary school students.Chi-square analysis,non-parametric analysis methods such as rank sum test and unconditional multivariate logistic regression were used to analyze the related factors of loneliness and the relationship of depressive symptoms in secondary school students.Result:1.8682 valid questionnaires were obtained in this research survey in total,the age range is 11.7-19.9 years old,average age was 15.618 years old.They are mainly female students（n=4372,50.4%）and residential students（n=4360,50.2%）.The main students’family location was urban（n=7150,82.4%）followed by towns（n=1175,13.5%）.Most of them are non—only child（n=5472,63.0%）and most of their parents’marital status are married,with a total of 3666（n=7970,91.8%）.Most of parents graduated from middle and high school only,54.6%and 53.8%respectively.2.Among 8682 people,the ULS-6 score range is 6-24 points,with an average score of 9.74±4.31(P₂₅=6,P₇₅=12).5840（67.3%）had no lonely symptoms,2236（25.7%）had mild lonely symptoms,and 606（7.0%）had severe lonely symptoms.3.Monofactor analysis showed significant differences in gender,age,grade,whether a boarding student,parental marital status,parental education,academic pressure,campus cohesion and social support among middle school students with varying degrees of loneliness（all P<0.05）;However,there was no significant difference between the location of the family and whether it was an only child.4.The analysis of ordinal logistic regression found that female（OR=0.61,95%CI:0.55-0.67,P<0.001）,whether a boarding student（OR=1.14,95%CI:1.01-1.28,P=0.036）,parent marital status（OR=0.70,95%CI:0.60-0.84,P<0.001）,father’s education level（middle school:OR=1.27,95%CI:1.03-1.56,P=0.027;College degree or above:OR=1.41,95%CI:1.12-1.77,P=0.003）,academic pressure（OR=1.26,95%CI:1.23-1.30,P<0.001）,campus cohesion（OR=1.10,95%CI:1.09-1.11,P<0.001）and social support（OR=0.84,95%CI:0.82 to 0.85,P<0.001）are related factors of loneliness.5.ULS-6 score score is 7(P₂₅=6,P₇₅=12)in non-depressive symptom group,15(P₂₅=11,P₇₅=18)in the depressive symptom group,there are significant differences between the two groups（P<O.001）.the risk of depressive symptoms in the mild loneliness group was 5.73 times that in the non loneliness group（OR=5.73,95%CI:4.95-6.64,P<0.001）,and the risk of depressive symptoms in the severe loneliness group was 25.36 times that in the non loneliness group（OR=25.36,95%CI:2.77-30.96,P<0.001）.Conclusion:First,The morbidity rate of loneliness was 32.7%,of which 25.7%had mild loneliness and 7.0%had severe loneliness.Second,female,a boarding student,father’s education level,academic pressure and campus cohesion are risk factor.Parent marital status and social support are protected factor.Third,Middle school students with more severe loneliness are more likely to have depressive symptoms,so reducing their loneliness can reduce their risk of depression.