The association between reproductive health awareness and co-occurring symptoms of anxiety and depression among adolescents.
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OBJECTIVE: To address the rising incidence of anxiety-depression co-occurring symptoms among adolescents, our analysis focused on the correlation between awareness of reproductive health and these mental health conditions. METHODS: A total of 1399 adolescents, with a mean age of 15.16 ± 1.85 years, were recruited from middle school between April and May 2024. Anxiety and depression status were assessed with Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Reproductive health awareness was assessed by a self-administered questionnaire with two parts: adolescent health awareness and HPV vaccine awareness. Logistic regression was used to explore the associations between reproductive health awareness and anxiety-depression co-occurring symptoms. Network analysis was further applied. Gender-based network comparison tests were conducted. RESULT: The co-occurring symptoms rate was 47.9 %. Adolescents who perceived higher personal relevance to cervical cancer (OR = 0.78, 95 %CI = 0.60-0.997), had greater awareness of it (OR = 0.74, 95 %CI = 0.58-0.94), and were more willing to receive the HPV vaccine (OR = 0.72, 95 %CI = 0.54-0.96), exhibited lower risk. Gender comparison revealed significant differences in network structure (M = 0.402, P = 0.010) and global strength (male strength = 29.16, female strength = 26.97, P < 0.05), with male networks showing higher density and shorter path length, and female networks demonstrating greater transitivity. CONCLUSION: The prevalence rate of anxiety-depression co-occurring symptoms among adolescents is high, and reproductive health awareness, especially awareness of HPV factors, may be related to these conditions. Significant gender differences in network structure suggest the need for gender-tailored interventions.