Background
Materials and methods
Participants and procedure
Measures
Confounding factors
Mental health problems
Exposure variables
Teacher–student relationship
Peer relationship
Data analysis
Results
Mental health problems and sociodemographic characteristics of the participants
Demographic characteristics | N | Prevalence (%) | p-value | OR (95% CI) |
---|---|---|---|---|
Gender | ||||
Female | 5250 | 37.3 | – | 1 |
Male | 4881 | 34.7 | 0.006 | 0.893 (0.823–0.968) |
Age | < 0.001a | |||
13 | 2308 | 23.6 | – | 1 |
14 | 2251 | 38.2 | < 0.001 | 2.000 (1.759–2.274) |
15 | 1663 | 38.9 | < 0.001 | 2.060 (1.795–2.364) |
16 | 1631 | 41.3 | < 0.001 | 2.278 (1.985–2.614) |
17 | 1120 | 37.5 | < 0.001 | 1.941 (1.663–2.265) |
18 | 1158 | 43.4 | < 0.001 | 2.484 (2.137–2.888) |
Being only child | ||||
No | 4547 | 38.0 | – | 1 |
Yes | 5584 | 34.4 | < 0.001 | 0.854 (0.787–0.927) |
Household registration | ||||
Rural | 5353 | 38.3 | – | 1 |
Urban | 4778 | 33.4 | < 0.001 | 0.809 (0.746–0.878) |
Family economic status | ||||
Good | 1514 | 33.4 | – | 1 |
Middle | 7111 | 34.1 | 0.597 | 1.032 (0.918–1.161) |
Poor | 1506 | 47.5 | < 0.001 | 1.805 (1.559–2.092) |
The prevalence of mental health problems
Dimensions | Normal | Mild | Moderate to severe |
---|---|---|---|
SOM | 8004 (79.0) | 1586 (15.7) | 541 (5.3) |
O–C | 5748 (56.7) | 3093 (30.6) | 1290 (12.7) |
I-S | 6514 (64.3) | 2598 (25.6) | 1019 (10.1) |
DEP | 7205 (71.1) | 2099 (20.7) | 827 (8.2) |
ANX | 7099 (70.1) | 2117 (20.9) | 915 (9.0) |
HOS | 6875 (67.9) | 2200 (21.7) | 1056 (10.4) |
PHOB | 7411 (73.2) | 1859 (18.3) | 861 (8.5) |
PAR | 6957 (68.7) | 2286 (22.6) | 888 (8.7) |
PSY | 7607 (75.0) | 1822 (18.0) | 702 (7.0) |
Total score | 6482 (64.0) | – | – |
The association between school interpersonal relationships and mental health problems
Variables | SOM | O–C | I-S | DEP | ANX | HOS | PHOB | PAR | PSY | Total score |
---|---|---|---|---|---|---|---|---|---|---|
Teacher–student relationship | ||||||||||
Intimacy | ||||||||||
Good (2357) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Middle (5203) | 1.306 (1.152–1.482) | 1.661 (1.499–1.840) | 1.593 (1.430–1.776) | 1.564 (1.392–1.756) | 1.453 (1.298–1.628) | 1.437 (1.287–1.604) | 1.330 (1.184–1.493) | 1.551 (1.386–1.736) | 1.508 (1.334–1.705) | 1.616 (1.450–1.801) |
Poor (2571) | 1.523 (1.324–1.753) | 2.375 (2.114–2.667) | 2.363 (2.094–2.666) | 2.130 (1.874–2.421) | 1.999 (1.763–2.266) | 1.999 (1.768–2.259) | 1.735 (1.525–1.973) | 2.187 (1.931–2.478) | 2.146 (1.876–2.454) | 2.440 (2.162–2.752) |
Satisfaction | ||||||||||
Good (2301) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Middle (4171) | 1.199 (1.050–1.369) | 1.300 (1.170–1.445) | 1.365 (1.220–1.526) | 1.318 (1.169–1.487) | 1.244 (1.107–1.398) | 1.151 (1.027–1.289) | 1.185 (1.050–1.336) | 1.251 (1.114–1.405) | 1.307 (1.151–1.486) | 1.365 (1.220–1.526) |
Poor (3659) | 1.602 (1.404–1.828) | 1.791 (1.609–1.993) | 1.982 (1.771–2.219) | 1.956 (1.735–2.204) | 1.693 (1.506–1.903) | 1.667 (1.488–1.867) | 1.595 (1.414–1.800) | 1.898 (1.690–2.131) | 2.026 (1.786–2.300) | 2.054 (1.836–2.299) |
Support | ||||||||||
Good (1785) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Middle (5230) | 1.611 (1.385–1.875) | 1.845 (1.644–2.070) | 1.819 (1.607–2.059) | 1.883 (1.643–2.158) | 1.768 (1.550–2.016) | 1.632 (1.439–1.851) | 1.516 (1.326–1.732) | 1.903 (1.666–2.172) | 1.755 (1.517–2.030) | 1.901 (1.678–2.153) |
Poor (3116) | 2.345 (2.004–2.744) | 2.265 (2.003–2.562) | 2.599 (2.280–2.963) | 2.689 (2.332–3.101) | 2.378 (2.071–2.731) | 2.216 (1.940–2.531) | 2.111 (1.835–2.429) | 2.869 (2.497–3.296) | 2.882 (2.480–3.350) | 2.730 (2.393–3.113) |
Conflict | ||||||||||
Low (2908) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Middle (4991) | 2.113 (1.852–2.412) | 2.129 (1.932–2.346) | 2.174 (1.959–2.412) | 2.378 (2.115–2.673) | 2.318 (2.070–2.597) | 2.271 (2.034–2.535) | 1.840 (1.641–2.062) | 2.584 (2.305–2.896) | 2.642 (2.324–3.004) | 2.370 (2.133–2.633) |
High (2232) | 3.620 (3.133–4.183) | 2.537 (2.262–2.846) | 2.991 (2.652–3.374) | 4.023 (3.530–4.585) | 3.503 (3.082–3.983) | 3.521 (3.107–3.990) | 2.757 (2.424–3.136) | 4.078 (3.586–4.637) | 4.536 (3.940–5.221) | 3.359 (2.975–3.793) |
Peer relationship | ||||||||||
Social-emotional | ||||||||||
Good (2423) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Middle (4648) | 1.395 (1.229–1.584) | 1.418 (1.281–1.569) | 1.635 (1.467–1.822) | 1.516 (1.351–1.702) | 1.485 (1.327–1.663) | 1.699 (1.518–1.901) | 1.386 (1.234–1.558) | 1.514 (1.353–1.693) | 1.512 (1.338–1.708) | 1.582 (1.420–1.761) |
Poor (3060) | 1.451 (1.267–1.663) | 1.696 (1.521–1.892) | 2.024 (1.803–2.272) | 1.841 (1.629–2.081) | 1.694 (1.502–1.911) | 2.004 (1.778–2.259) | 1.581 (1.396–1.789) | 1.844 (1.637–2.077) | 1.805 (1.587–2.054) | 1.945 (1.734–2.182) |
Communicative interaction | ||||||||||
Good (2107) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Middle (5335) | 1.395 (1.221–1.595) | 1.555 (1.399–1.729) | 1.875 (1.671–2.105) | 1.626 (1.438–1.838) | 1.747 (1.547–1.972) | 1.534 (1.367–1.721) | 1.408 (1.248–1.589) | 1.621 (1.440–1.826) | 1.705 (1.495–1.945) | 1.793 (1.600–2.009) |
Poor (2689) | 1.723 (1.490–1.993) | 2.092 (1.859–2.354) | 2.659 (2.343–3.017) | 2.353 (2.061–2.688) | 2.223 (1.948–2.537) | 1.847 (1.627–2.097) | 1.605 (1.405–1.834) | 2.385 (2.096–2.715) | 2.414 (2.096–2.781) | 2.338 (2.063–2.649) |
Interpersonal harmony | ||||||||||
Good (2417) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Middle (4712) | 1.555 (1.362–1.774) | 1.608 (1.451–1.782) | 1.890 (1.689–2.115) | 1.842 (1.630–2.081) | 1.813 (1.612–2.040) | 1.618 (1.444–1.812) | 1.621 (1.436–1.829) | 1.669 (1.486–1.874) | 1.703 (1.498–1.935) | 1.893 (1.693–2.117) |
Poor (3002) | 1.991 (1.732–2.288) | 2.199 (1.967–2.457) | 3.021 (2.681–3.404) | 2.906 (2.558–3.302) | 2.359 (2.082–2.672) | 2.327 (2.064–2.624) | 2.151 (1.894–2.444) | 2.562 (2.268–2.895) | 2.641 (2.312–3.016) | 2.788 (2.477–3.140) |
Multivariable logistic regression analysis on mental health problems with school interpersonal relationships
Variables | Model 1 | Model 2 | ||
---|---|---|---|---|
p | OR (95% CI) | p | OR (95% CI) | |
Teacher–student relationship | ||||
Intimacy | ||||
Good | – | 1 | – | 1 |
Middle | 0.096 | 1.112 (0.981–1.259) | < 0.001 | 1.490 (1.334–1.664) |
Poor | < 0.001 | 1.414 (1.219–1.639) | < 0.001 | 2.175 (1.922–2.460) |
Satisfaction | ||||
Good | – | 1 | – | 1 |
Middle | 0.429 | 1.051 (0.929–1.190) | < 0.001 | 1.299 (1.159–1.456) |
Poor | 0.004 | 1.225 (1.067–1.405) | < 0.001 | 1.919 (1.711–2.152) |
Support | ||||
Good | – | 1 | – | 1 |
Middle | 0.064 | 1.142 (0.992–1.314) | < 0.001 | 1.680 (1.479–1.908) |
Poor | 0.139 | 1.131 (0.961–1.331) | < 0.001 | 2.395 (2.093–2.740) |
Conflict | ||||
Low | – | 1 | – | 1 |
Middle | < 0.001 | 1.892 (1.692–2.116) | < 0.001 | 2.254 (2.024–2.510) |
High | < 0.001 | 2.757 (2.415–3.148) | < 0.001 | 3.246 (2.863–3.680) |
Peer relationship | ||||
Social-emotional | ||||
Good | – | 1 | – | 1 |
Middle | 0.517 | 0.956 (0.835–1.095) | < 0.001 | 1.493 (1.338–1.666) |
Poor | 0.065 | 0.859 (0.731–1.009) | < 0.001 | 1.841 (1.636–2.071) |
Communicative interaction | ||||
Good | – | 1 | – | 1 |
Middle | 0.005 | 1.227 (1.063–1.415) | < 0.001 | 1.682 (1.498–1.889) |
Poor | 0.059 | 1.185 (0.994–1.414) | < 0.001 | 2.127 (1.871–2.418) |
Interpersonal harmony | ||||
Good | – | 1 | – | 1 |
Middle | < 0.001 | 1.462 (1.268–1.687) | < 0.001 | 1.788 (1.596–2.004) |
Poor | < 0.001 | 1.926 (1.618–2.293) | < 0.001 | 2.644 (2.339–2.988) |