Association between mental health and executive dysfunction and the moderating effect of urban–rural subpopulation in general adolescents from Shangrao, China: a population-based cross-sectional study
Huan Wang,
Qi Jiang,
Scott Rozelle,
Fan Jiang,
Yunting Zhang,
M K Singh,
Sarah-Eve Dill,
Qingmin Lin,
Cody Abbey,
Guanghai Wang,
Jinkui Lu,
Xinshu She
Affiliations
Huan Wang
3 Department of Medical Administration, Southwest Hospital, Army Medical University, Chongqing, China
Qi Jiang
Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
Scott Rozelle
Stanford Center on China`s Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
Fan Jiang
5 Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai, China
Yunting Zhang
Child Health Advocacy Institute, Department of Developmental and Behavioral Pediatrics, National Children`s Medical Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
M K Singh
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
Sarah-Eve Dill
Stanford Center on China`s Economy and Institutions, Freeman Spogli Institute for International Studies & Stanford Institute for Economic Policy Research, Stanford University, Stanford, California, USA
Qingmin Lin
Pediatric Translational Medicine Institution, Shanghai Children`s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Cody Abbey
Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
Guanghai Wang
Pediatric Translational Medicine Institution, Shanghai Children`s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Jinkui Lu
Department of Physical Education, Shangrao Normal University, Shangrao, China
Xinshu She
Stanford University School of Medicine, Stanford, California, USA
Objectives To examine the association between mental health and executive dysfunction in general adolescents, and to identify whether home residence and school location would moderate that association.Design A population-based cross-sectional study.Setting A subsample of the Shanghai Children’s Health, Education, and Lifestyle Evaluation-Adolescents project. 16 sampled schools in Shangrao city located in downstream Yangtze River in southeast China (December 2018).Participants 1895 adolescents (48.8% male) which were divided into three subpopulations: (A) adolescents who have urban hukou (ie, household registration in China) and attend urban schools (UU, n=292); (B) adolescents who have rural hukou and attend urban schools (RU, n=819) and (C) adolescents who have rural hukou and attend rural schools (RR, n=784).Measures The Depression Anxiety and Stress Scale-21 was used to assess adolescent mental health symptoms, and the Behaviour Rating Inventory of Executive Function (parent form) was applied to measure adolescent executive dysfunction in nature setting.Results Mental health symptoms were common (depression: 25.2%, anxiety: 53.0%, stress: 19.7%) in our sample, and the prevalence rates were lower among UU adolescents than those among the RR and RU, with intersubgroup differences in screen exposure time explaining most of the variance. We found the three types of symptoms were strongly associated with executive dysfunction in general adolescents. We also observed a marginal moderating effect of urban–rural subgroup on the associations: UU adolescents with depression (OR 6.74, 95% CI 3.75 to 12.12) and anxiety (OR 5.56, 95% CI 1.86 to 16.66) had a higher executive dysfunction risk when compared with RR youths with depression (OR 1.93, 95% CI 0.91 to 4.12) and anxiety (OR 1.80, 95% CI 1.39 to 2.33), respectively.Conclusions Rural adolescents experienced more mental health symptoms, whereas urban individuals with mental health problems had a higher executive dysfunction risk.
