Objective: To study the characteristics and risk factors of psychological and behavioral problems of children and adolescents of different ages and genders in long-term home-schooling during the coronavirus disease-2019 pandemic. Further, to provide scientific basis for more targeted psychological intervention and coping strategies in the future. Methods: A cross-sectional survey using an online questionnaire was conducted on students aged 6-16 years old in five representative cities of North (Beijing), East (Shanghai), West (Chongqing), South (Guangzhou) and Middle (Wuhan) in China. In this study, the social behavior and psychological abnormalities which was defined as the positive of any dimension were investigated in multiple dimensions during long-term home-schooling. The influencing factors of psycho-behavioral problems were analyzed by Logistic regression, and the confounding factors were corrected with graded multivariable adjustment. Results: A total of 6 906 valid questionnaires were collected including 3 592 boys and 3 314 girls, of whom 3 626 were children (6-11 years old) and 3 280 were adolescents (12-16 years old). The positive detection rate of psychosocial-behavioral problems were 13.0% (900/6 906) totally, 9.6% (344/3 592) in boys and 16.8% (556/3 314) in girls respectively, and 7.3%(142/1 946) in boys aged 6-11, 14.0%(235/1 680) in girls aged 6-11, 12.3%(202/1 646) in boys aged 12-16, 19.6%(321/1 634) in girls aged 12-16 respectively. There were significant differences between the psychological problems group and the non-psychological problems group in gender, parent-offspring conflict, number of close friends, family income change, sedentary time, homework time, screen exposure time, physical activity, dietary problems (χ²=78.851, 285.264, 52.839, 26.284, 22.778, 11.024, 10.688, 36.814, 70.982, all P<0.01). The most common symptoms in boys aged 6-11 years were compulsive activity, schizoid and depression, in girls aged 6-11 years were schizoid/compulsive activity, hyperactivity and social withdrawal, in boys aged 12-16 years were hyperactivity, compulsive activity and aggressive behavior, and in girls aged 12-16 years were schizoid, anxiety/compulsive activity and depression/withdrawal, respectively. After graded multivariable adjustment, besides the common risk factors, homework time and online study time were the risk factors of 6-11 years old groups [boys OR(95%CI): 1.750 (1.32-2.32), 1.214(1.00-1.47), girls: 1.579(1.25-1.99), 1.222(1.05-1.42), all P<0.05], videogames time were the risk factors of 12-16 years old groups [ boys: 2.237 (1.60-3.13), girls: 1.272 (1.00-1.61), all P<0.05]. Conclusions: Some children and adolescents may have psychological and behavioral problems during long-term home-schooling. The psychological and behavioral manifestations differed in age and gender subgroups, which deserve special attention in each subgroups. Schools, families and specialists should actively provide precise psychological support and comprehensive intervention strategies according to special features and risk factors.
目的： 研究新型冠状病毒肺炎（COVID-19）大流行期间长期居家学习的不同年龄和性别儿童青少年的心理行为问题特点及影响因素，为今后进行更有针对性的心理干预和社会支持提供科学依据。 方法： 横断面研究。采用网络问卷调查的方式，对我国的地理区域北部（北京）、东部（上海）、西部（重庆）、南部（广州）和中部（武汉）的5个不同地域的代表性城市中6~16岁儿童和青少年在长期居家学习期间的社会行为和心理问题进行多维度调查，以任一维度阳性作为存在心理行为问题，采用Logistic 回归分析心理行为问题的危险因素，并对混杂因素进行逐级校正。 结果： 共收到有效问卷6 906份。其中男3 592人、女3 314人，6~11岁组3 626人，12~16岁组3 280人。心理行为问题的总阳性检出率为13.0%（900/6 906），男童为9.6%（344/3 592）、女童为16.8%（556/3 314）；其中6~11岁组男童为7.3%（142/1 946）、女童为14.0%（235/1 680）；12~16岁组男童为12.3%（202/1 646）、女童为19.6%（321/1 634）。心理行为问题阳性组在性别、亲子冲突、好朋友数量、家庭收入变化、久坐时间、家庭作业时间、屏幕暴露时间、体育活动时间、饮食问题（χ²=78.851、285.264、52.839、26.284、22.778、11.024、10.688、36.814、70.982，均P<0.001）等方面与阴性组间存在明显差异。不同年龄和性别儿童与青少年组心理行为问题表现不同，6~11岁男孩为强迫性、分裂样和抑郁；6~11岁女孩为分裂强迫、多动和社交退缩；12~16岁男孩为多动、强迫性和攻击性；12~16岁女孩为分裂样、焦虑强迫和抑郁退缩。多因素校正及分析发现，不同年龄组除了共性的风险因素外，作业时间、网课时间是6~11岁组的危险因素［男童OR（95%CI）分别为 1.750（1.32~2.32）、1.214（1.00~1.47），女童OR（95%CI）分别为 1.579（1.25~1.99）、1.222（1.05~1.42），P均<0.05］，电子游戏时间是12~16岁组的危险因素［男童OR（95%CI）为2.237（1.60~3.13），女童OR（95%CI）为1.272（1.00~1.61），P均<0.05］。 结论： 长期居家学习期间部分儿童青少年可能会产生心理行为问题，不同年龄和性别组的异常表现和影响因素并不完全相同。学校、家庭和专科医生应针对不同年龄性别特点和相应的风险因素积极给予更精准的心理支持和综合干预策略。.