學業壓力與青少年抑鬱症狀及自傷行為的關係：一項在英格蘭開展的縱向前瞻性研究

The association between academic pressure and adolescent depressive symptoms and self-harm: a longitudinal, prospective study in England

—《柳葉刀·兒童與青少年健康》第10卷，第4期，2026年4月—

<The Lancet · Child & Adolescent Health> Volume 10, Issue 4, April 2026

【摘要】背景：學業壓力可能會增加青少年抑鬱和自傷的風險。然而，針對這種關聯的縱向研究尚屬匱乏，且現有研究存在局限性。本研究旨在探討從青少年時期至成年早期，個體感知的學業壓力水平與隨後出現的抑鬱症狀及自傷行為之間的關聯。我們的假設是：較高的學業壓力水平將與較嚴重的抑鬱症狀及較高的自傷風險相關聯。方法：在這項縱向研究中，我們使用了來自“埃文父母與子女縱向研究”（Avon Longitudinal Study of Parents and Children，英國埃文地區）的數據，該數據集涵蓋了出生於1991至1992年的青少年群體。本研究關注的主要暴露因素是15歲時測定的學業壓力，該指標通過一份“學校經歷問卷”中的相關條目進行測量（總分範圍：0–9分）。研究結局包括：在16至22歲期間的五個時間點，利用《簡版情緒與感受問卷》（Short Mood and Feelings Questionnaire）評估的抑鬱症狀（總分範圍：0–26分）；以及在16至24歲期間的四個時間點，通過自傷問卷評估的自傷行為。數據分析採用多重插補後的樣本數據，運用多層模型進行統計建模：針對抑鬱症狀採用線性模型，針對自傷行為（指過去一年內的自傷情況）採用Logistic模型；分析過程分別在調整協變量之前和之後進行。結果：本研究共納入了4714名青少年（其中女性2725名 [57.8%]，男性1989名 [42.2%]）。在經過全面協變量調整的模型中，15歲時的學業壓力每增加1分，其隨後出現的抑鬱症狀評分便相應增加0.43分（95%置信區間 [CI]：0.36–0.51）。這種關聯在16歲時評估抑鬱症狀時表現得最為顯著（增加0.53分；95% CI：0.42–0.64），但在22歲時進行評估時，這種關聯依然存在（增加0.35分；95% CI：0.23–0.47）。關於自傷行為，在經過全面協變量調整的模型中，學業壓力每增加1分，發生自傷行為的幾率（Odds）便增加8%（調整後的優勢比 [Odds Ratio] 為1.08；95% CI：1.01–1.16），且這種關聯強度隨時間推移未見顯著變化。解讀：我們的研究結果支持這一假設：學業壓力是青少年抑鬱症狀，乃至可能出現的自傷行為的一個潛在的可干預風險因素。針對減輕學業壓力的干預措施可予以開發並進行評估。

[Summary] Background: Academic pressure could increase the risk of adolescent depression and self-harm. However, there are few longitudinal studies of this association, and those that exist have limitations. We aimed to investigate associations between perceived levels of academic pressure and subsequent depressive symptoms and self-harm from adolescence to early adulthood. Our hypothesis was that higher levels of academic pressure would be associated with higher levels of depressive symptoms and self-harm. Methods: In this longitudinal study, we used data from the Avon Longitudinal Study of Parents and Children (Avon, UK) that includes adolescents born in 1991–92. Our primary exposure of interest was academic pressure measured at age 15 years, using items from a school experiences questionnaire (total scores 0–9). Outcomes were depressive symptoms assessed with the Short Mood and Feelings Questionnaire at five timepoints between age 16 years and 22 years (total scores 0–26), and a self-harm questionnaire at four timepoints between age 16 years and 24 years. Analyses were linear (depressive symptoms) and logistic (self-harm in the previous year) multilevel models in samples with multiply imputed data, before and after adjustments. Findings: We included 4714 adolescents (2725 [57·8%] female, 1989 [42·2%] male). In fully adjusted models, a 1-point increase in academic pressure at age 15 years was associated with a 0·43 (95% CI 0·36–0·51) point increase in depressive symptoms. This association was largest when depressive symptoms were assessed at age 16 years (0·53, 0·42–0·64), but remained at age 22 years (0·35, 0·23–0·47). For self-harm, in fully adjusted models, each 1-point increase in academic pressure was associated with 8% higher odds of self-harm (adjusted odds ratio 1·08, 1·01–1·16), with no differences over time. Interpretation: Our findings support the hypothesis that academic pressure is a potential modifiable risk factor for adolescent depressive symptoms, and possibly self-harm. Interventions to reduce academic pressure could be developed and evaluated.

論文原文：Xuchen Guo, Marie A E Mueller, Jessica M Armitage, et al. (2026). The association between academic pressure and adolescent depressive symptoms and self-harm: a longitudinal, prospective study in England. The Lancet • Child & Adolescent Health, Volume 10, Issue 4, Pages 265-272. April 2026.

https://doi.org/10.1016/S2352-4642(25)00342-6

（翻譯兼責任編輯：MARY）

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