Objective:This research focuses on the factors,critical symptoms,and comorbid indications of anxiety and depression among Hebei's primary and secondary students under the"Double Reduction"policy.It aims to guide the creation of prevention and intervention strategies for these disorders in this group.Methods:The study employed a demographic questionnaire,PHQ-9,and GAD-7 to survey 4,413 students from 48 schools across six districts in Hebei Province.Results:Anxiety and depression had prevalence rates of 13.7％and 10.4％,respectively,while the co-morbidity rate stood at 6.3％.The binary logistic regression analysis revealed that female gender,residing in dormito-ries,high academic pressure,experience of bullying,and sleep disturbances(P＜0.05)were shared risk factors for both anxiety and depressive symptoms.Specific to anxiety,factors such as attending middle school and being an only child were identified(P＜0.01),whereas for depression,living in urban areas,being from a two-parent family,spending over two hours daily on the internet,and maladjustment to school life were significant(P＜0.05).Within the symptom network,GAD4"struggling to relax,"PHQ6"feeling down about oneself or disappointing others,"and PHQ1"loss of interest"were projected to be highly influential(Z-scores of 1.09,1.06,and 1.05 respectively).Symptoms serving as potential bridges conveying elevated risk included PHQ9"harboring negative thoughts,"PHQ1"loss of interest,"and GAD7"anticipation of terrible events"(Z-scores of 0.54,0.53,and 0.46 respectively).Conclusion:In the context of the"Double Reduction"policy,the prevalence of anxiety and depression symptoms in Hebei Province is lower compared to previous research findings,yet further reduction is required.Shared risk factors for both conditions include being female,residing in dormitories,experiencing significant academic stress,victimiza-tion from bullying,and sleeplessness,while specific risk factors for anxiety include being a junior high school student and an only child,and for depression include living in urban areas,coming from a two-parent household,spending in excess of two hours per day online,and struggling to adjust to the school environment.Within the network analysis of these symptoms,GAD4,PHQ6,and PHQ1 emerges as central nodes,and PHQ9,PHQ1,and GAD7 are identified as significant bridge symptoms that may confer a heightened risk of psychopathology transmission.
Anxiety-depressive symptomBinary logistic regression analysisNetwork analysesPrimary and middle school studentsDouble reduction
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