Association between earphone use and anxiety symptoms among middle school students
FENG Jinmeng1,2, WANG Hao2, LI Na1,2, DAI Pinyuan2, ZHOU Xiaoyan2, ZHONG Jieming2
1. School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang 310053, China; 2. Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
Abstract：Objective To investigate the association between earphone use and anxiety symptoms among middle school students, so as to provide a basis for middle school students hearing health and psychological intervention. Methods From April to June 2022, a multi-stage stratified cluster sampling method was used to select middle school students from 30 counties (citues, districts) in Zhejiang Province as the survey subjects. A questionnaire survey was conducted to collect demographic information, self-reported health status, exercise frequency, and the frequency of continuous earphone use for ≥60 minutes in the past 7 days, with at least one instance of continuous headphone use ≥60 minutes defined as prolonged headphone use. Anxiety symptoms were evaluated using the Generalized Anxiety Disorder Scale. Multivariable logistic regression models were used to examine the association between earphone use and anxiety symptoms. Results A total of 26 486 middle school students were surveyed, with the mean age of (15.75±1.73) years. The sample included 13 659 boys (51.57%) and 12 827 girls (48.43%). There were 12 471 junior high school students (47.09%), 7 271 regular high school students (27.45%), and 6 744 vocational high school students (25.46%). In the past 7 days, 11 802 people (44.56%) had prolonged use of earphones. Anxiety symptoms were detected in 3 652 students, yielding a detection rate of 13.79%. Multivariable logistic regression analysis showed that after adjusting for factors such as demographic information, self-reported health status, and exercise frequency, compared with those who never use earphone for a long time in the past 7 days, the risk of anxiety symptoms increased by 33.7% (OR=1.337, 95%CI: 1.223-1.462), 77.5% (OR=1.775, 95%CI: 1.572-2.005), and 165.4% (OR=2.654, 95%CI: 2.329-3.025) for those who use earphone for a long time with a frequency of 1-2 times/week, 3-6 times/week, and ≥1 time/day, respectively. Interaction test results showed that the interaction between gender and the frequency of long-term earphone use in the past 7 days on anxiety symptoms was not statistically significant (Pfor interaction>0.05). Conclusion Long-term earphone use is positively statistically associated with the risk of anxiety symptoms among middle school students.
冯金梦, 王浩, 李娜, 戴品远, 周晓燕, 钟节鸣. 中学生耳机使用与焦虑症状的关系研究[J]. 预防医学, 2026, 38(7): 661-665.
FENG Jinmeng, WANG Hao, LI Na, DAI Pinyuan, ZHOU Xiaoyan, ZHONG Jieming. Association between earphone use and anxiety symptoms among middle school students. Preventive Medicine, 2026, 38(7): 661-665.
[1] 庄茂强,张迎修,李素云,等.山东省农村中小学生用耳行为及听力损伤影响因素分析[J].中国健康教育,2022,38(6):522-526. [2] Guo Z F,Ji W Q,Song P,et al.Global,regional,and national burden of hearing loss in children and adolescents,1990-2021:a systematic analysis from the Global Burden of Disease Study 2021[J/OL].BMC Public Health,2024,24[2026-06-26].https://doi.org/10.1186/s12889-024-20010-0. [3] 杨琪琪,郭猛,张志清.儿童、青少年焦虑与抑郁相关研究热点与趋势[J].中国临床药理学杂志,2024,40(15):2269-2272. [4] Polanczyk G V,Salum G A,Sugaya L S,et al.Annual research review:a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents[J].J Child Psychol Psychiatry,2015,56(3):345-365. [5] 汪妍,彭畅,程君菡,等.中国5省在校中学生自杀行为流行状况及其与抑郁、焦虑关联[J].中国公共卫生,2023,39(10):1225-1231. [6] Metts A V,Echiverri-Cohen A M,Yarrington J S,et al.Longitudinal associations among dimensional symptoms of depression and anxiety and first onset suicidal ideation in adolescents[J].Suicide Life Threat Behav,2023,53(3):457-469. [7] Choi J H,Park S S,Kim S Y.Associations of earphone use with tinnitus and anxiety/depression[J].Noise Health,2021,23(111):108-116. [8] 赵彬彬.小学生日间户外体力活动与口腔常见疾病的关联[J].中国学校卫生,2026,47(5):719-722,727. [9] 杨硕,刘冰,张宇婷,等.吉林省中小学生不良用耳行为及听力损伤相关因素分析[J].中国学校卫生,2025,46(2):215-218. [10] 丁宝莹,冯文雪,周沛臻,等.医务工作者正念水平在心理弹性与焦虑症状、抑郁症状间的中介效应[J].预防医学,2024,36(12):1040-1044. [11] 李晨,王勇,俞明芳,等.中学生抑郁焦虑症状与自杀意念或行为的关联分析[J].预防医学,2026,38(6):610-613. [12] 李通通,崔倩倩,张馨扬,等.太原市中学生视屏时间与焦虑抑郁症状及其共存的关联性[J].中国学校卫生,2025,46(7):980-984. [13] 赵海,王路,孙冰洁,等.北京市中学生抑郁焦虑现状及其与欺凌和暴力行为的关系[J].中国学校卫生,2024,45(7):1017-1020,1025. [14] 曾玲,张丽,任悄悄,等.2024年四川省中学生抑郁焦虑症状共患现状及其影响因素分析[J].预防医学情报杂志,2025,41(8):1031-1037. [15] 李霞,熊鹰,杨思维,等.重庆市中学生抑郁焦虑症状共存现状及影响因素分析[J].中国学校卫生,2025,46(10):1443-1448. [16] 卢秀娟,杜向东,李忻,等.贵州省中学生抑郁症状现况及其与耳机使用的关联研究[J].中国健康教育,2025,41(10):895-899,911. [17] Vogel I,van de Looij-Jansen P M,Mieloo C L,et al.Risky music listening,permanent tinnitus and depression,anxiety,thoughts about suicide and adverse general health[J/OL].PLoS One,2014,9(6)[2026-06-26].https://doi.org/10.1371/journal.pone.0098912. [18] 李凤芹,高磊,孙莹,等.大学生的生活行为与抑郁症状的关联分析[J].职业与健康,2025,41(4):526-531,536. [19] Liu Y L,Zhang L,Zong H,et al.The relationship between earphone use duration and depressive symptoms among Chinese college students:a threshold effect analysis[J/OL].Eur J Trauma Dissociation,2025,9(3)[2026-06-26].https://doi.org/10.1016/j.ejtd.2025.100568. [20] Thomas L,Kumar V V.Headphones on,world off:exploring music as a tool for mood regulation,mental focus,and learning among teenagers[J].Safer Communities,2026,25(2):177-193.
