Objective　To explore the relationship between family function, school life satisfaction and their interaction with depression and anxiety among youth in school.

Methods　A multi-stage stratified sampling approach was employed to recruit in-school youth in a city in western Guangdong from August to October 2023 as study participants. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were utilized to assess the risk levels of depression and anxiety, respectively. School life satisfaction was evaluated via the School Life Satisfaction Rating Questionnaire, while family function was measured using the Family APGAR Index. A binary Logistic regression model was constructed to examine the associations of family function and school life satisfaction with depression and anxiety. Additionally, the epiR package in R software was applied to calculate the multiplicative and additive interactions between these two factors.

Results　A total of 29,426 youth in school aged 15-24 years old were investigated. The detection rates of depression and anxiety in this population were 20.24% and 11.40%, respectively. The binary Logistic regression results showed that after adjusting for confounding factors such as age, gender and education level, compared with those with severely dysfunctional family, moderately family functioning [OR=0.40, 95%CI (0.36, 0.44)], good family functioning [OR=0.24, 95%CI (0.22, 0.27)] were negatively correlated with depression level. Compared with those dissatisfied with school life, those satisfaction with school life [OR= 0.60, 95%CI (0.56, 0.64)] was negatively correlated with depression. The same trend was observed for anxiety. Family functioning and satisfaction with school life had synergistic and multiplicative interactive effects on depression. Taking those with severely dysfunctional family and dissatisfaction with school life as the reference, the detection rates of depression in school youth in the group with moderately family functioning or well-functioning family, and good satisfaction with school life were lower, with OR values of 0.28[95%CI (0.25, 0.32)], 0.16[95%CI (0.14, 0.18)], respectively, and a similar downward trend was observed for anxiety indicators.

Conclusion　Establishing a collaborative intervention pathway involving both family and school may help reduce the risk of depression and anxiety among youth, offering a feasible approach to promote adolescent mental health.

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