Associations of physical activity, screen time with depression, anxiety and sleep quality among Chinese college freshmen

Psychological education in higher education: Opportunities and challenges in the Internet+ era

In the context of "Internet+," the rapid development and integration of information technology in China have brought new opportunities and challenges to psychological education in higher education. Compared with traditional psychological education, the high information throughput and multichannel presentation of "Internet+" have altered students’ cognitive characteristics. Consequently, traditional psychological education methods are no longer suitable for the current environment, and education methods pose new challenges for higher education. New media technologies within the "Internet+" framework have played a crucial role in psychological education. Further research is needed to explore new applications for enhancing the quality of psychological education in higher education institutions. This paper reviews the current opportunities and challenges faced by psychological education in the context of "Internet+", and explores a mechanism-driven, collaborative, and efficient educational strategy that is responsive to new conditions.

Associations of objectively measured physical activity and sedentary behavior with sleep quality in college students

BACKGROUND

Sleep disorders are prevalent in college students and are often exacerbated by academic pressures. Accumulating evidence indicates that physical activity and sedentary behaviors exert divergent effects on sleep quality. This study aimed to investigate the associations of objectively measured physical activity and sedentary behavior with sleep quality in college students. The potential effects of substituting sedentary behavior with physical activity on sleep quality were also examined.

METHODS

This cross-sectional study included 349 college students (age range: 17-25 years; 57.6 % female) recruited from Shanghai, China. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sedentary behavior were objectively measured using wrist-worn accelerometers for 7 days. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. A single-factor model was used to examine independent associations, whereas an isotemporal substitution model (ISM) was used to estimate the effects of replacing sedentary behavior with physical activity on sleep quality.

RESULTS

Higher levels of LPA (B = -0.007, 95 % CI = -0.013 to -0.001, p < 0.05) and MVPA (B = -0.013, 95 % CI = -0.022 to -0.003, p < 0.05) were associated with better sleep quality. Conversely, sedentary time was negatively associated with sleep quality (B = 0.007, 95 % CI = 0.002 to 0.012, p < 0.05). In the ISM, replacing 30 min of sedentary behavior with an equivalent duration of MVPA was associated with improved sleep quality (B = -0.322, 95 % CI = -0.624 to -0.021, p < 0.05).

CONCLUSIONS

The findings indicated that physical activity was positively associated with sleep quality, whereas sedentary time was negatively associated with sleep quality in college students. Replacing sedentary behavior with an equivalent duration of MVPA positively affected sleep quality.

Psychological Distress Among Chinese Manufacturing Employees: Prevalence and a Symptom Network Analysis

The psychological distress among manufacturing workers is an increasingly important issue and has attracted extensive attention. However, the mental health of this subgroup of the Chinese population is underexplored. This study aimed to evaluate the prevalence of psychological distress in Chinese manufacturing employees and identify central symptoms, important bridge symptoms, and associations between symptoms using network analysis. The participants were 4934 employees recruited from a Chinese manufacturing company. The Maslach Burnout Inventory-General Survey (MBI-GS), the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS), and the Symptom Checklist 90 (SCL-90) were used to assess job burnout, anxiety, depression, compulsive symptom, somatization, psychoticism, paranoid, phobic, hostility, and interpersonal sensitivity, respectively. In total, 29.77%, 21.14%, and 26.53% of all participants experienced burnout, anxiety, and depression, respectively. Compared to normative data of the Chinese population, the seven symptoms of the SCL-90 among participants were significantly higher. The network analysis revealed that interpersonal sensitivity had the greatest strength and somatization had the greatest betweenness and closeness. Anxiety had the highest bridge expected influence. These results demonstrate that the mental health of Chinese manufacturing employees is a cause for concern. Interpersonal sensitivity and somatization emerged as the core symptoms, and anxiety was an important bridge symptom. Interventions aimed at these conditions may promote and enhance the overall mental health of Chinese manufacturing employees.

Physical activity and mobile phone addiction among Chinese college students: a chain mediation model of social anxiety and loneliness

Introduction

Mobile phone addiction is increasingly prevalent among college students and can lead to various physical, psychological, and social problems. This study aimed to investigate the relationship between physical activity and mobile phone addiction among Chinese college students and to examine the potential chain mediating effects of social anxiety and loneliness in this relationship.

Methods

A cross-sectional survey was conducted with 268 Chinese college students (62.7% male, mean age = 20.36 years, SD = 1.73) who completed standardized measures including the Physical Activity Rating Scale-3, Social Phobia Inventory, UCLA Loneliness Scale, and Mobile Phone Addiction Tendency Scale. Data were analyzed using Pearson's correlations and PROCESS macro for mediation analyses with bootstrapping.

Results

Physical activity had a significant negative effect on mobile phone addiction (β = -0.11, p < 0.05) with a total effect of β = -0.28 (p < 0.001). Social anxiety [β = -0.12, 95% CI (-0.18, -0.06)] and loneliness [β = -0.03, 95% CI (-0.06, -0.01)] independently mediated this relationship, while a significant chain mediation through both variables was also found [β = -0.02, 95% CI (-0.03, -0.01)], with all indirect effects accounting for 59.68% of the total effect.

Discussion

These findings extend previous research by identifying the psychological mechanisms through which physical activity protects against mobile phone addiction, providing new theoretical insights into the sequential pathway from physical activity to reduced addiction, and practical implications for developing targeted interventions that combine physical activity promotion with strategies to reduce social anxiety and loneliness among college students.

The association between sleep quality and anxiety symptoms: a cross-sectional study based on Tibetan university students at high altitude in China

Background

There have been more previous studies on sleep quality and anxiety symptoms among university students in plains areas. However, fewer studies have been conducted on Tibetan university students at high altitude. Analyzing the relationship between sleep quality and anxiety symptoms due to increased altitude may provide a reference for mental health promotion and intervention for Tibetan university students in high altitude areas.

Methods

Stratified whole cluster sampling was used. The pittsburgh sleep quality index (PSQI) scale was used to investigate the sleep quality of 4,777 university students at high altitude in China. The self-rating anxiety scale (SAS) was used to investigate anxiety symptoms. The chi-square test was used to compare the detection rates of anxiety symptoms among different groups, and logistic regression analysis was used to analyze the association between sleep quality and anxiety symptoms.

Results

The prevalence of anxiety symptoms among Tibetan university students at high altitude in China was 25.7%. The detection rate of anxiety symptoms among girls (28.4%) was higher than that of boys (22.1%), and the difference was statistically significant (χ 2 = 24.634, p < 0.001). The detection rates of anxiety symptoms among university students with sleep quality of "Good," "Medium" and "Poor" were 1.8, 4.8 and 39.2%, respectively, and the differences were statistically significant (χ 2 = 779.759, p < 0.001). Logistic regression analysis after adjusting for relevant covariates showed that the risk of anxiety symptoms was higher in the "Medium" (OR:3.479, 95%CI:1.946 ~ 6.221) and "Poor" (OR:44.817, 95%CI:29.175 ~ 68.847) groups, compared with the "Good" group. The same trend was observed in both men and women at the university level.

Conclusion

There is a close relationship between sleep quality and the occurrence of anxiety symptoms among Tibetan university students at high altitude in China. Improving sleep quality may have a positive effect on reducing the occurrence of anxiety symptoms among Tibetan university students at high altitude.

Sedentary behaviors negatively related to depressive symptoms in college students: The roles of type and duration of sedentary behaviors

OBJECTIVE

This study aimed to examine the associations of different types and duration with sedentary behaviors and depressive symptoms among college students.

METHODS

A cross-sectional study was conducted at a university in Shanghai, China, utilizing convenience sampling to recruit 3,190 participants (mean age 20.06 ± 1.23 years). Sedentary behaviors were self-reported using a structured questionnaire detailing the average daily time spent in different types of sedentary behaviors. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CESD-10). Linear regression models were conducted to analyze the associations between sedentary behaviors and depressive symptoms with adjustment for relevant covariates.

RESULTS

Recreational screen-based sedentary behaviors were significantly associated with higher depressive symptom scores on both weekdays (B = 0.523, 95 % CI= 0.409 to 0.637, p < 0.001) and weekends (B = 0.313, 95 % CI= 0.221 to 0.406, p < 0.001). Study-related sedentary behaviors showed no significant association on weekdays (p > 0.05), but were significantly associated with depressive symptoms on weekends (B = 0.084, 95 % CI= 0.017 to 0.151, p < 0.05). Other types of sedentary behaviors (e.g., commuting and eating) also showed a positive association with depression scores on both weekdays and weekends (p < 0.05). Longer durations of recreational screen-based and study-related sedentary behaviors were associated with higher depressive symptom scores (both p < 0.05).

CONCLUSION

The study suggests that the associations between sedentary behaviors and depressive symptoms vary by the type and context of sedentary behavior. Additionally, the duration of each sedentary behavior bout is a significant influencing factor.

Combined effect of the smartphone addiction and physical activity on the depressive symptoms in secondary school students: a cross sectional study in Shanghai, China

Objective

This study aims to investigate the prevalence of smartphone addiction, physical activity levels, and depressive symptoms among secondary school students, and to analyze the combined impact of smartphone addiction and physical activity on depressive symptoms.

Methods

A cluster sampling method was employed in two secondary schools in the Jing'an District of Shanghai, China. Univariate analysis was used to compare the prevalence of depressive symptoms across different demographic characteristics. Logistic regression was utilized to examine the associations between smartphone addiction, physical activity, and their combined effect on depressive symptoms.

Results

A total of 1,316 respondents participated in the study, with reported prevalence rates of depressive symptoms (36.2%), smartphone addiction (19.2%), and insufficient physical activity (23.3%). Risk factors for depressive symptoms included being a non-only child (OR=1.421, 95% CI: 1.090-1.853, P=0.009), inadequate sleep duration (OR=2.722, 95% CI: 2.070-3.578, P<0.001) and smartphone addiction (OR=2.173, 95% CI: 1.621-2.913, P < 0.001). Adolescents with smartphone addiction were significantly more likely to report depressive symptoms compared to those without (OR=2.173, 95% CI: 1.621-2.913, P < 0.001). Joint analysis indicated that combined smartphone addiction and insufficient physical activity significantly increased the risk of depressive symptoms (OR=2.781, 95% CI: 1.627-4.753, P < 0.001).

Conclusion

The study identified a high prevalence of severe smartphone addiction, insufficient physical activity, and elevated rates of depressive symptoms among secondary school students. Smartphone addiction and inadequate physical activity were associated with increased likelihood of depressive symptoms. Moreover, higher levels of physical activity appeared to mitigate the adverse impact of smartphone addiction on depressive symptoms.

Prevalence and Influencing Factors of Severe Depression in Nurses During and After the COVID-19 Pandemic: A Large-Scale Multicenter Study

Background: During the COVID-19 epidemic, nurses are facing tremendous psychological pressure. However, there is a lack of research on severe depression and its related factors in nurses after COVID-19. This study aimed to compare the prevalence and explore the influencing factors of severe depression among Chinese nurses during and after the COVID-19 pandemic. Methods: This study recruited 937 frontline nurses during the outbreak and 784 frontline nurses who had participated in the initial recruitment after the pandemic. The self-rating depression scale (SDS), self-rating anxiety scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were used to assess subjects' depression, anxiety, and sleep disorders, respectively. Chi-square test, t-test, and binary logistic regression were used to identify factors influencing severe depression. Receiver operating characteristic (ROC) curves were used to assess the predictive value of severe depression-related variables. Results: The study found that the incidence of severe depression among nurses after the epidemic (4.9%) was significantly higher than that during the epidemic (1.7%). In addition, academic qualifications, health status, frequency of exercise per week, anxiety, and sleep disorders were associated with severe depression among nurses after the COVID-19 epidemic. ROC analyses showed that SAS scores and PSQI scores had good predictive value for nurses' severe depression after the pandemic. Conclusions: The prevalence of severe depression among nurses after COVID-19 is higher than that during COVID-19. Nurses continue to face severe psychological stress after the COVID-19 pandemic. Therefore, it is desperately needed for nurses to provide timely psychological support and establish a mental health support system after the COVID-19 epidemic.

Risk factors for anxiety, depression, stress, and their comorbidities among nurses: a prospective cohort from 2020 to 2022

BACKGROUND

Nurses are at the forefront of healthcare delivery during the COVID-19, placing them at an increased risk for mental health issues. This study aimed to identify the risk factors for anxiety, depression, stress, and their comorbidities among nurses during the 2020-2022 period.

METHODS

A prospective cohort of nurses in Zunyi City, China, was followed from 2020 to 2022. The Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Perceived Stress Scale (PSS) were used to assess anxiety, depression, and stress, respectively. A self-reported questionnaire was utilized to collect data on demographic characteristics, lifestyle habits, socioeconomic status, work-related factors, and medical history. The Healthy Eating Index (HEI) was calculated to evaluate diet quality. Univariate and multivariate logistic regression analyses were conducted to examine the associations between risk factors and mental health outcomes.

RESULTS

Among the 516 participating nurses, the incidence rates of new-onset anxiety, depression, and stress were 27.1%, 33.9%, and 39.9%, respectively. Frontline experience with infected patients, night shift work, longer working hours, and higher body mass index were consistently associated with increased risks of anxiety, depression, and stress, whereas a higher healthy eating index score was linked to reduced odds of these mental health outcomes. Notably, higher BMI (≥ 28: OR = 1.67, 95% CI: 1.12-2.16, p = 0.011), night shifts (> 1/week: OR = 5.12, 95% CI: 3.64-5.99, p < 0.001), longer working hours (> 40/week: OR = 1.99, 95% CI: 1.66-2.89, p < 0.001), and frontline experience (OR = 6.11, 95% CI: 4.52-8.88, p < 0.001) significantly increased comorbidity risk, while higher HEI (> 3: OR = 0.51, 95% CI: 0.36-0.70, p < 0.001) reduced the risk.

CONCLUSION

Our study highlights the considerable mental health burden among nurses during the 2020-2022 period and identifies key risk factors associated with anxiety, depression, stress, and their comorbidities. These findings underscore the importance of providing targeted interventions and support for nurses, including workload management, work-life balance promotion, and healthy lifestyle encouragement, to mitigate the negative consequences of identified risk factors and improve mental health outcomes.

Increased physical activity frequency in primary school adolescents is related to reduced risk of self-reported adverse mental health symptoms

Purpose

The sedentary lifestyle and mental health issues of primary school students are major public health issues in China and globally. Some studies have shown that regular physical activity is beneficial to health, but there are few epidemiological investigations on the relationship between physical activity and psychological problems. The purpose of this study is to explore the relationship between physical activity and mental health.

Materials and methods

We used data from our study, which was based on the Yanbian University School of Physical Education health survey of primary education, in which 822 elementary school students in grades 4-6 participated. Physical activity is evaluated through three questions (intensity, frequency, and duration), and mental health issues are evaluated through SPSS.

Results

In our study, 488 primary school students (200 males and 288 females) participated and completed self-reported data on physical activity and mental health variables. The findings revealed that a higher frequency of physical activity was significantly associated with decreased risks of various mental health symptoms. Specifically, students who reported a higher frequency of physical activity exhibited a lower risk of depressive symptoms (RR = 0.31, 95% CI = 0.14-0.71, p < 0.05), anxiety (RR = 0.35, 95% CI = 0.18-0.67, p < 0.05), low self-esteem (RR = 0.48, 95% CI = 0.26-0.90, p < 0.05), and life dissatisfaction (RR = 0.58, 95% CI = 0.35-0.96, p < 0.05). The risk of somatic complaints reporting was slightly lesser if the prevalence of physical activity reported at screening was higher (RR = 0.93, 95% CI = 0.50-1.76), although this result was not statistically significant (p > 0.05). These findings highlight the importance of regular physical activity in promoting mental health among primary school students.

Conclusion

Given the dose-response relationship between poor mental health and lack of physical activity, it is necessary to actively promote primary school students to participate more actively in physical activities.

Screen time and mental health in college students: Time in nature as a protective factor

Objective: To examine how time spent on handheld screens was related to internalizing mental health symptoms in college students and whether time spent in nature was associated with fewer mental health symptoms. Participants: Three hundred seventy-two college students (Mage = 19.47 ± 1.74, 63.8% female; 62.8% college freshman). Methods: College students completed questionnaires for research credit in their psychology courses. Results: Screen time significantly predicted higher anxiety, depression, and stress. Spending time outdoors ("green time") significantly predicted lower stress and depression, but not lower anxiety. Green time moderated the relationship, such that college students who spent less time outside (1SD below mean) had consistent rates of mental health symptoms across hours of screentime, but individuals who spent average/above average (mean, 1SD above mean) time outside had fewer mental health symptoms at lower levels of screentime. Conclusions: Promoting green time in students may be an effective way of improving stress and depression.

Bowel function, quality of life, and mental health of patients with high-grade intraepithelial neoplasia or T1 colorectal cancer after organ-preserving versus organ-resection surgeries: a cross-sectional study at a Chinese tertiary care center

BACKGROUND

This study aimed to determine the postoperative intestinal functioning, quality of life (QoL), and psychological well-being of patients treated either with organ-preserving surgery (OPS) or organ-resection surgery (ORS) for high-grade intraepithelial neoplasia (HIN) or T1 colorectal cancer (CRC).

METHODS

This cross-sectional study was conducted at a single tertiary care center. In total, 175 eligible individuals with T1 CRC or HIN were divided into the OPS (n = 103) or ORS (n = 72) group based on whether the relevant segment of the intestine was preserved or resected. Intestinal function was evaluated using low anterior resection syndrome (LARS) scores. QoL was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ)-C30 and EORTC-QLQ-CR29. Psychological status was evaluated using the Fear of Progression Questionnaire-Short Form and the Self-rating Anxiety and Depression scales. Propensity score matching (PSM) was used to minimize the influence of potential confounders.

RESULTS

Overall, 130 of 175 patients (74.29%) responded to the questionnaires; 56 and 74 were in the ORS and OPS groups, respectively. Thirty-five patient pairs were successfully matched through PSM. The mild and severe LARS rates were significantly higher in the ORS group than in the OPS group (P < 0.001). The EORTC-QLQ-C30 and EORTC-QLQ-CR29 scores revealed significantly better physical, role, and emotional functioning and an overall improved state of health (with multiple reduced symptom scores) in the OPS group than in the ORS group (P < 0.05). Significantly more patients were depressed in the ORS group than in the OPS group (P = 0.034), whereas anxiety or fear of disease progression did not differ significantly between the groups.

CONCLUSIONS

OPS for the treatment of HIN or T1 CRC was found to be more advantageous for patients in terms of improved intestinal function, QoL, and psychological status than was ORS.

The association of sedentary time with sleep disturbances among the US population, 2005 to 2014

BACKGROUND

Sleep problems increase the risk of premature illness and death. We evaluated the association between sedentary time and sleep disturbances.

METHODS

A cross-sectional analysis of the US nationally representative data of 21,414 adults (aged > = 18 years) from National Health and Nutrition Examination Survey (NHANES) (2005-2014) was performed. The data of sleep disturbances were assessed using NHANES questionnaire results, which included the question, "{Have you/has sp} ever been told by a doctor or other health professional that {you have/s/he has} a sleep disorder?". All participants were stratified by quartiles of sedentary behavior distribution, which was the explanatory variable (sedentary time quartile cut points: Q1, 0 < = Q1 < 3 h; Q2, 3 < = Q2 < 5 h; Q3, 5 < = Q3 < 8 h; Q4, 8 < = Q4 < 20 h). We used multivariable logistic regression and the restricted cubic splines (RCS) model to assess the relationship between sedentary time and sleep disturbances.

RESULTS

In the unadjusted multivariable logistic regression model (crude model), there was a demonstrated tendency for the odds of sleep disturbances to increase with the sedentary time (Q1 as reference, Q2: OR, 1.31 [95% CI 1.09-1.58] P = 0.005; Q3: OR, 1.62 [95% CI 1.39-1.88] P < 0.001; Q4: OR, 1.75 [95% CI 1.48-2.06] P < 0.001; P for trend < 0.001). In the adjusted model 4, adjustment for gender, age, marital type, education type, race, family poverty index ratio, waist circumference, recreational type, smoke status, drink status, diabetes mellitus status, cardiovascular disease status, sleep duration type, body mass index, the OR in Q2 subgroup didn't significantly increase (Q1 as reference. Q2: OR, 1.18 [95% CI 0.96-1.44] P = 0.1). However, the ORs in Q3 and Q4 (Q3: OR, 1.35 [95% CI 1.14-1.59] P < 0.001; Q4: OR, 1.45 [95% CI 1.21-1.75] P < 0.001) both revealed that the risk of sleep disturbances increased with increasing sedentary time, P for trend < 0.001. The unadjusted RCS model revealed that the risk of sleep disturbances increased non-linearly with increasing sedentary time for total participants (P for non-linearity < 0.001). After adjusting for all covariates, the RCS results revealed that the risk of sleep disturbances increased non-linearly with increasing sedentary time for total participants (P for non-linearity = 0.012).

CONCLUSIONS

This study suggested that the longer sedentary time was strongly associated with the sleep disturbances. The protective effect of recreational activities on sleep disturbance, has not been significantly demonstrated.

A longitudinal examination of the effect of physical exercise on the emotional states of college students: exploring the sense of coherence as a mediator through a cross-lagged panel analysis

Purpose

This longitudinal study aimed to investigate the causal relationship between physical exercise and emotional states among university students, focusing on the mediating role of sense of coherence.

Method

A total of 1,215 university students (aged 18-25 years) were recruited and completed questionnaires assessing physical activity (International Physical Activity Questionnaire-Short Form), emotional states (Positive and Negative Affect Schedule), and sense of coherence (Sense of Coherence Scale-13) at three time points over a three-month period. Preliminary analyses included independent samples t-tests, chi-square tests, and Pearson correlations. Cross-lagged panel mediation analysis was conducted using Mplus 8.3, with bootstrapping employed to test indirect effects.

Results

Results indicated that sense of coherence significantly predicted positive affect (β = 0.259-0.369, p < 0.001). Positive affect, in turn, predicted physical exercise (β = 0.083-0.182, p < 0.05), while negative affect also influenced physical exercise (β = -0.096-0.203, p < 0.05). Physical exercise indirectly influenced positive affect through sense of coherence (β = 0.037, p = 0.045), and positive affect indirectly influenced physical exercise through sense of coherence (β = 0.029, p = 0.028). Other indirect effects involving physical exercise, sense of coherence, and negative affect were non-significant.

Conclusion

This study underscores the importance of sense of coherence in promoting emotional well-being among university students and in the reciprocal relationship between physical exercise and positive emotional states. Findings suggest that interventions targeting sense of coherence may enhance the emotional benefits of physical exercise. Future research should explore other potential mediators and moderators of the relationship between physical exercise and emotions and examine the effectiveness of sense of coherence-based interventions on well-being in this population.

The relationship between locomotive syndrome and depression in young Chinese college students

OBJECTIVES

This study investigates the relationship between locomotive syndrome (LS) and mental disorder (depression) in young Chinese college students.

METHODS

Our study population (n = 165; mean age of 19.82 ±1.90 years) comprises college student residents at Tsinghua University in Beijing, China. Three screening methods were used to evaluate LS: 25-question Geriatric Locomotive Function Scale (GLFS-25), a two-step test, and a stand-up test. Depression was screened by the Chinese version of the Zung Self-Rating Depression Scale (ZSDS).

RESULTS

The prevalence of LS and depression was 20.1% and 30.9%, respectively. The LS group had lower grip strength and higher ZSDS scores than the non-LS group.

CONCLUSION

Young Chinese college students have a relatively high prevalence of LS, and LS and GLFS-25 scores were significantly related to depression. The present results suggest that management strategies for LS should consider depressive symptoms among young adults.

The Inflammatory State of Follicular Fluid Combined with Negative Emotion Indicators can Predict Pregnancy Outcomes in Patients with PCOS

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder syndrome with an incidence of 6% to 10% in women of reproductive age. Women with PCOS not only exhibit abnormal follicular development and fertility disorders, but also have a greater tendency to develop anxiety and depression. Our aim was to evaluate the ability of inflammatory factors in follicular fluid to predict embryonic developmental potential and pregnancy outcome and to construct a machine learning model that can predict IVF pregnancy outcomes based on indicators such as basic sex hormones, embryonic morphology, the follicular microenvironment, and negative emotion. In this study, inflammatory factors (CRP, IL-6, and TNF-α) in follicular fluid samples obtained from 225 PCOS and 225 non-PCOS women were detected via ELISA. For patients with PCOS, the levels of CRP and IL-6 in the follicular fluid in the pregnant group were significantly lower than those in the nonpregnant group. For non-patients with PCOS, only the level of IL-6 in the follicular fluid was significantly lower in the pregnant group than in the nonpregnant group. In addition, for both PCOS and non-patients with PCOS, compared with those in the pregnant group, patients in the nonpregnant group showed more pronounced signs of anxiety and depression. Finally, the factors that were significantly different between the two subgroups (pregnancy and nonpregnancy) of patients with or without PCOS were identified by an independent sample t test first and further analysed by multilayer perceptron (MLP) and random forest (RF) models to distinguish the two clinical pregnancy outcomes according to the classification function. The accuracy of the RF model in predicting pregnancy outcomes in patients with or without PCOS was 95.6% and 91.1%, respectively. The RF model is more suitable than the MLP model for predicting pregnancy outcomes in IVF patients. This study not only identified inflammatory factors that can affect embryonic development and assessed the anxiety and depression tendencies of PCOS patients, but also constructed an AI model that predict pregnancy outcomes through machine learning methods, which is a beneficial clinical tool.

Prevalence of major depressive disorder and its determinants among young married women and unmarried girls: Findings from the second round of UDAYA survey

INTRODUCTION

Depression is a prevalent and debilitating mental illness affecting young women worldwide. This study aimed to identify psychosocial determinants of major depressive disorder (MDD) among young women in Bihar and Uttar Pradesh, India.

METHODS

Data from "Understanding the Lives of Adolescents and Young Adults" (UDAYA) study (2018-19) for young women aged 12-23 years, both married and unmarried was used for this paper. MDD was evaluated using the Patient Health Questionnaire PHQ-9 with a cut-off score of ≤10. The determinants of MDD were identified through multilevel binary logistic regression analysis.

RESULTS

The prevalence of MDD was 13.6% (95% CL 12.2-15.2) and 5.1% (95% CL 4.2-6.1) for young married women and unmarried girls, respectively. Among the young married women, community-level variables like dowry-related humiliation (1.74, 95% CI 1.15-2.64), and sexual assaults (2.15, 95% CI 1.24-3.73) were significantly associated with MDD. For unmarried girls, reporting of family violence <10% of participants (0.45, 95% CI 0.24-0.85), family violence (≥10% of participants) % (0.35 95% CI 0.19-0.68) and interpartner violence (>25% of participants) (0.42; 95% CI 0.23-0.74) remain significant predictors of MDD. At individual level, for both the groups, age, participation in decision making (on education), social capital (currently attending school/educational course and number of friends), self-efficacy, telephonic harassment, and physical activity were associated with MDD. Wealth index, job seeking, participation in decision making (on health-seeking), parental interactions and physical abuse (for unmarried girls only) and education, reported last sexual intercourse, pressure from the in-laws' to conceive (for young married women only) were associated with MDD.

CONCLUSIONS

For young married women, community level targeted interventions should focus on the social ecology to foster a sense of safe community environment. For unmarried girls, additionally, interventions should aim to optimize their family environment for effective mental health outcomes.

Physical activity and sleep moderate the relationship between stress and screen time in college-aged adults

For undergraduate students, excessive screen time is associated with poorer mental health and greater perceived stress. Objective: The purpose of the present investigation was to determine the potential moderating influence of physical activity and sleep on the relationship between screen time and stress. Participants & Methods: A cross-sectional sample of 513 undergraduate students between Fall 2017 & Spring 2020 were given a questionnaire to assess perceived stress level, physical activity engagement, screen time, and sleep. Results: Stepwise hierarchical regression analyses identified that screen time, sleep, and the three-way interaction between screen time, sleep, and physical activity were associated with stress. Post-hoc decomposition revealed that higher levels of physical activity and sleep both mitigated the relationship between screen time and stress. Conclusions: Findings suggest that modifiable health behaviors such as physical activity and sleep may be important factors for managing the negative effects of screen time on stress in college-aged adults.

Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents

Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.

State of mental health, sleep status, and the interaction with health-related quality of life in HIV-infected Chinese patients during the COVID-19 pandemic

OBJECTIVE

To describe how mental health and sleep status influence the health-related quality of life (HRQOL) of people living with HIV/AIDS (PLWHA) during the novel coronavirus disease 2019 (COVID-19) pandemic, and to apply targeted interventions to improve the HRQOL.

METHODS

A web-based online questionnaire survey was administered. Descriptive analysis was used to depict the mental health and sleep status. Correlation analysis and the structural equation model (SEM) method were used to analyze the influence of mental health and sleep status on HRQOL in PLWHA.

RESULTS

After excluding 24 unqualified questionnaires, a total of 490 participants in this survey were included in the statistical analysis. Of the participants, 66.1% and 55.1% reported mild or worse symptoms of depression and anxiety, respectively. Overall, 70.0% had varying degrees of sleep problems. Correlation analysis showed that anxiety had the strongest correlation with sleep disturbances and sleep quality (R = 0.588 and 0.551, respectively), while depression had the strongest correlation with the HRQOL psychological and physical domains (R = - 0.759 and - 0.682, respectively). SEM analysis showed that depression, sleep quality, and psychological domains had the greatest item load on mental health, sleep status, and HRQOL (093, 0.82, and 0.89, respectively). Mental health had a more significant influence than sleep status on HRQOL, as indicated by factor loading (- 0.75 and - 0.15, respectively).

CONCLUSIONS

There were more severe mental health and sleep problems among PLWHA during the COVID-19 pandemic, thus, mental health intervention, especially to relieve depression symptoms, may be the most important approach to improve the HRQOL among PLWHA.

The Effect of Physical Activity on Sleep Quality Among Chinese College Students: The Chain Mediating Role of Stress and Smartphone Addiction During the COVID-19 Pandemic

Purpose

During the period of COVID-19 pandemic, the social restrictions and isolation exerted a significant impact on the sleep quality of Chinese college students. This study aims to delve into the influence of physical activity on the sleep quality of college students as well as the mediating roles of stress and smartphone addiction.

Materials and Methods

A cohort of 274 eligible college students (146 males and 128 females) were selected for the investigation. The International Physical Activity Questionnaire Short Form, Stress Perception Scale, Smartphone Addiction Scale, and Pittsburgh Sleep Quality Index were employed to assess the levels of physical activity, stress, smartphone addiction, and sleep quality among college students. For data analysis, descriptive statistics, correlation analysis, and chained mediation effect tests were performed sequentially.

Results

The findings revealed: (1) a significant negative correlation between physical activity and stress, smartphone addiction, and sleep quality among college students (r = -0.216, p < 0.001; r = -0.224, p < 0.001; r = -0.259, p < 0.001); (2) independent mediating roles of stress and smartphone addiction in the relationship between physical activity and sleep quality; and (3) chained mediating effects of stress and smartphone addiction in the association between physical activity and sleep quality.

Conclusion

This study deepens our comprehension of how physical activity augments the quality of slumber, concurrently emphasizing that mitigating stress levels and alleviating smartphone addiction constitute effective strategies for preventing sleep issues among college students.

Intake of dietary advanced glycation end products may be associated with depression and sleep quality in young adults

BACKGROUND

This study examined the relationship between dietary intake of advanced glycation end products (dAGEs) and depression and sleep quality in young adults.

METHODS

This study, which included 420 university students (F = 80.2 %; M = 19.8 %), is observational and cross-sectional. Dietary AGEs intakes of individuals were taken with a 24-h food consumption record system. Measuring the depression status of the participants was evaluated with the Beck Depression Inventory (BDI), and the assessment of their sleep quality was evaluated with the Pittsburg Sleep Quality Index (PSQI). Individuals' dAGEs intakes were divided into three equal groups (low, medium, and high). The energy was adjusted in all analyzes of dAGEs intake. Study data were analyzed with the SPSS (27.0 version) and GraphPad program (8.0 version).

RESULTS

The BDI and PSQI total score averages of individuals in the high dAGEs intake group were higher than the other groups, and this difference was statistically significant (p < 0.001). There is no significant difference between individuals' dAGEs intakes and energy and macronutrient intakes. Students' dAGEs intake was affected by BDI (β = 0.722, 95 % Cl = 0.639;0.811) and PSQI (β = 0.286, 95 % Cl = 0.179;0.431) scores (p < 0.001). This effect persisted even when various confounding factors were included (age, gender, smoking, body mass index, chronic disease) (p < 0.001).

LIMITATIONS

These data are cross-sectional, which limits the generalizability of results and establishing cause-effect relationships.

CONCLUSION

There may be an association between dAGEs intake and the development of depression and sleep quality in young adults. Clinical intervention studies using objective measurement methods should be conducted on this issue in the future.

Substitutions of physical activity and sedentary behavior with negative emotions and sex difference among college students

BACKGROUND

A growing number of studies have found that physical activity (PA) benefits mental health, and sedentary behavior (SB) increases the risk of psychological symptoms, but it remains unclear whether substituting the duration of different activities may affect the association, and whether sex difference exists among college students.

METHODS

A longitudinal survey was conducted in three colleges in Anhui province, China. A total of 8049 participants validly answered the questionnaire, which included demographic variables, PA, SB and negative emotions (depressive, anxiety, and stress symptoms).

RESULTS

Substituting 30 min per day of SB with equivalent walking was associated with lower scores of depressive symptoms. Stress symptoms were reduced when SB was substituted by moderate intensity PA (MPA) and walking. Substituting 30 min per day of MPA in place of walking and SB was associated with an amelioration of depressive and stress symptoms in females, and a reallocation of 30 min walking was associated with lower depressive and stress symptom scores when SB was replaced in males.

CONCLUSIONS

Replacing SB with walking and MPA ameliorates the depressive and stress symptoms in young adults. The results suggest a reallocation of time from SB or walking to MPA in females while from SB to walking in males may markedly reduce the depressive and stress symptoms in college population.

A prospective study of sleep status, anxiety, and depression levels of college students at a university in Shandong Province, China

Objective

To investigate the changes in sleep conditions, anxiety, and depression levels among college students before and after entering the university.

Methods

Utilizing a random sampling method, 692 new students from a college in Shandong province were selected in September 2019, and relevant indices were statistically analyzed in September 2021 following a comprehensive follow-up. Sleep status, anxiety, and depression levels were assessed using the Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7), respectively.

Results

Gender, passive smoking, exercise, intake of fruits, and intake of seafood were identified as significant influencing factors on college students' sleep status, anxiety, and depression levels (p < 0.05). A substantial difference was observed in the sleep quality of college students between the early enrollment stage and the follow-up stage (p < 0.05). Moreover, a significant positive correlation was found between PSQI scores and the levels of anxiety and depression (p < 0.05), cumulatively explaining approximately 10% of the variance in anxiety and depression levels.

Conclusion

The sleep quality of college students exhibited significant improvement after enrollment compared to the early enrollment period. Engaging in appropriate exercise and consuming fruits and seafood demonstrated a positive impact on sleep conditions, anxiety, and depression levels. These findings underscore the importance of fostering healthy lifestyle habits for promoting overall well-being among college students.

The comorbid network characteristics of anxiety and depressive symptoms among Chinese college freshmen

BACKGROUND

This study aimed to investigate the interplay between anxiety and depressive symptoms in Chinese college freshmen using the causal system perspective (CSP), which differs from the traditional common cause perspective (CCP) by providing an alternative explanation by attributing comorbidity to direct interactions among symptoms.

METHODS

A convenience sample of 2,082 Chinese college freshmen (39.51% male, Mage = 18.61) from a normal university completed the Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9). Network analysis was conducted and evaluated as to centrality, stability, node predictability, and bridging features. Moreover, the moderated network model (MNM) was utilized to detect the moderation effects of gender in the comorbidity network.

RESULTS

The network of anxiety and depressive symptoms exhibited stability, characterized by the core symptoms of "restlessness", "lack of energy", and "excessive worry about control", as well as the bridging symptoms of "fearfulness", "sad mood", and "irritability". Notably, the nodes representing "uncontrollable worry" and "difficulty in relaxation" demonstrated the highest predictive power. Gender did not exert any moderating effects on the anxiety and depressive symptom network.

CONCLUSION

These results reinforce that certain anxiety or depressive symptoms are more central than others, and thus play a more vital role in the comorbid network. These findings highlight underlying potential targeting symptoms to consider in future interventions.

Cross-sectional association between 24-hour movement guidelines and depressive symptoms in Chinese university students

Background

The world's first 24-h movement guidelines for adults were released on 15 October 2020 in Canada, though evidence of their associations with health indicators in young adults is sparse. This study aimed to report the prevalence of meeting the 24-h movement guidelines and associations with depressive symptoms in a sample of Chinese university students.

Methods

Cross-sectional data from 1,793 Chinese university students (mean age = 20.7 years, 63.6% female) were used. Sociodemographic information, movement behaviors (physical activity, sedentary behavior, and sleep duration), and depressive symptoms were collected using a self-reported questionnaire.

Results

The prevalence of meeting the 24-h movement guidelines was 27.8% in Chinese university students. Logistic regression results show that compared to those who met the 24-h movement guidelines, odds ratio (OR) for depressive symptoms in those who met fewer recommendations contained in the 24-h movement guidelines were significantly higher (OR for none = 3.4, 95% CI [2.1-5.5], p < 0.001; OR for one = 2.7, 95% CI [2.0-3.8], p < 0.001; OR for two = 1.5, 95% CI [1.1-2.1], p = 0.013).

Conclusion

The prevalence of meeting the 24-h movement guidelines in Chinese university students was relatively low and should be enhanced through multiple strategies. Meeting the 24-h movement guidelines was associated with lower risk for depression in Chinese young adults. It is suggested that moving more, sitting less and sleeping well in this population may reduce the occurrence of depression.

Fairness and bias correction in machine learning for depression prediction across four study populations

A significant level of stigma and inequality exists in mental healthcare, especially in under-served populations. Inequalities are reflected in the data collected for scientific purposes. When not properly accounted for, machine learning (ML) models learned from data can reinforce these structural inequalities or biases. Here, we present a systematic study of bias in ML models designed to predict depression in four different case studies covering different countries and populations. We find that standard ML approaches regularly present biased behaviors. We also show that mitigation techniques, both standard and our own post-hoc method, can be effective in reducing the level of unfair bias. There is no one best ML model for depression prediction that provides equality of outcomes. This emphasizes the importance of analyzing fairness during model selection and transparent reporting about the impact of debiasing interventions. Finally, we also identify positive habits and open challenges that practitioners could follow to enhance fairness in their models.

The Associations of Physical Activity and Health-Risk Behaviors toward Depressive Symptoms among College Students: Gender and Obesity Disparities

Engaging in health-risk behaviors (HRBs) may be correlated with depressive symptoms among college students, but these relationships require more research. The purpose of this study was to examine the associations of physical activity levels (i.e., light [LPA] and moderate-vigorous [MVPA]) and HRBs (i.e., sedentary behavior [screen-based and non-screen-based behavior] and cigarette and e-cigarette tobacco use) with depressive symptoms in a sample of college students. Physical activity levels and HRBs were assessed through validated questionnaires. In total, 366 students participated (Mage = 22.59 ± 3.54; 60.1% female; 52.9% normal weight). E-cigarette use in males (β = 0.23, p < 0.05) and screen-based sedentary behavior in females (β = 0.14, p < 0.05) showed significant predictive utility toward depressive symptoms. In the overweight/obese group, screen-based sedentary behaviors (β = 0.19, p < 0.05) and e-cigarette use (β = 0.23, p < 0.01) showed significant predictive utility toward depressive symptoms. Females reported higher levels of depressive symptoms (Mfemale = 18.23 vs. Mmale = 14.81; η2 = 0.03) and less MVPA (Mmale = 52.83 vs. Mfemale = 41.09; η2 = 0.06) than males. Enhancing mental health by improving physical activity and eliminating HRBs should be tailored toward at-risk demographics.

Physical activity habits prevent psychological distress in female academic students: The multiple mediating role of physical and psychosocial parameters

Background

Psychological distress is recognised as the most common mental health difficulty in emerging adult (18-to-24-year-old) female academic students. This study aimed to test a novel model positing physical activity habits as a protective factor for psychological distress through the mediating role of physical and psychological parameters. Adherence to the Mediterranean diet and self-reported physical health status were included as physical parameters. Self-reported psychological health status and time spent on leisure activities were the psychological parameters considered.

Method

Data were collected between April and May 2021. Correlation analyses and a multiple mediation model were computed on 411 online questionnaires filled out by 18-to-24-year-old female students from the University of blind (Italy).

Results

The multiple indirect effects were significant (β = -0.088; p < 0.001). This means that physical activity habits reduce psychological distress through high adherence to the Mediterranean diet, a good self-assessment of one's physical and psychological health status, and more time spent on leisure activities outdoors, with friends, and with family members.

Conclusions

Results show that academic policies should be adopted so as to design physical activity programmes that may improve the students' healthy behaviours and social interactions, which, in turn, mitigate the detrimental effects of psychological distress.

Stress events and stress symptoms in Chinese secondary school students: gender and academic year characteristics of the relationship

Objective

To explore the relationship between stress events and stress symptoms and their gender and academic year characteristics in Chinese secondary school students.

Methods

4,995 secondary school students were investigated by the Adolescent Self-rating Life Events Checklist (ASLEC) and the Calgary Symptoms of Stress Inventory (C-SOSI).

Results

First, there were significant differences in all dimensions and total scores of stress events and stress symptoms between boys and girls in secondary school and between junior high school students and senior high school students. Second, the dimensions and total scores of stress events in secondary school students are positively correlated with the dimensions and total scores of stress symptoms. Third, the influence of punishment on the stress symptoms of secondary school boys is the most obvious, and the influence of punishment, adaption, relationship stress, and learning stress on the stress symptoms of secondary school girls is the most obvious. The influence of punishment on the stress symptoms of junior high school students is the most obvious, and the influence of punishment and relationship on the stress symptoms of senior high school students is the most obvious.

Conclusion

Stress events and stress symptoms of Chinese secondary school students have significant differences in gender and academic year. The same stress event has different influence mechanisms on the stress symptoms of Chinese secondary school students of different genders and different academic years.

Depression, anxiety, stress symptoms and their determinants among secondary students with vision impairment in rural Northwestern China during the COVID-19 pandemic

Objective

The measures implemented to control the spread of Coronavirus disease 2019 (COVID-19) could affect children's mental and vision health. Youth particularly from minority and socioeconomically disadvantaged backgrounds were more likely to be impacted by these measures. This study aimed to examine the mental health of children with vision impairment and associated factors in North-western China during the COVID-19 pandemic.

Methods

A cross-sectional study was conducted among 2,036 secondary school children living in Ningxia Hui Autonomous Region. Participants completed a survey on sociodemographic and lifestyle information and answered the Chinese version of the 21-item Depression Anxiety Stress Scales (DASS-21) questionnaire. Presenting visual acuity was measured by a trained enumerator. Multivariate logistic regression analysis was used to identify potential risk factors for mental health problems.

Results

Responses from 1,992 (97.8%) children were included in the analysis after excluding those with incomplete mental health outcome data. The prevalence of depression, anxiety and stress symptoms within the dataset were 28.9, 46.4, and 22.3%, respectively. The distribution of children with different stress levels differed significantly between those with and without vision impairment (p = 0.03). Multivariable logistic regression analyses revealed that depression symptoms decreased with higher parental education (OR, 0.76, 95% confidence intervals (CI):0.63-0.96), longer sleep duration (OR, 0.90, 95% CI: 0.81-0.97) and longer study time (OR, 0.82, 95% CI: 0.74-0.91), whereas they increased with higher recreational screen time (OR, 1.19, 95% CI: 1.08-1.32). Anxiety symptoms decreased with higher parental education (OR, 0.80, 95% CI: 0.66-0.96) and increased with higher recreational screen time (OR, 1.15, 95% CI: 1.04-1.27) and being a left-behind child (OR, 1.26, 95% CI: 1.04-1.54). In addition, stress symptoms decreased with longer sleep duration (OR, 0.92, 95%CI: 0.85-0.99) and increased with higher number of siblings (OR, 1.10, 95% CI: 1.01-1.19), higher recreational screen time (OR, 1.15, 95% CI: 1.04-1.28) and older age (OR,1.12, 95% CI: 1.004-1.24).

Conclusion

A considerable proportion of our sample experienced mental health problems during the pandemic. Healthcare planners in China should consider interventions such as reducing recreational screen time, ensuring sufficient sleep, and timely detection of mental health symptoms among socioeconomically disadvantaged groups.

Gender Differences Regarding Self-Perceived Physical and Mental Health in Spanish University Sports and Physical Therapy Students after Termination of the COVID-19 Lockdown Period

The COVID-19 pandemic was an unprecedented situation that raised concerns about the physical and mental health of adolescents. Several surveys demonstrated that post-lockdown, women reported more complaints and lower perceived quality of life compared to men. The aim of this study was to analyze gender differences in self-reported physical and mental health immediately after the second lock-down restrictions (July 2020 to December 2020) were suspended and physical exercise classes resumed after a break of several months. This was achieved using a comparative cross-sectional survey of over-18-year-old students from the faculties of Sports Science and Physical Therapy at the University of Cadiz (UCA) in Spain. Quality of life was assessed using two types of questionnaires. The first covered quality of nutrition (PREDIMED), and the second assessed emotional impact (SF12). Physical activity level was estimated using the International Physical Activity Questionnaire (IPAQ). Of the 166 participants in this study, about two-thirds were men. Men had a better perception of their overall health quality than women. In addition, men had significantly fewer limitations in performing activities of daily living than their female counterparts. In contrast, female university students had better coping strategies, that is, they were better able to handle the problems of daily life and did so with more composure, attention, and concentration. These findings highlight the differences in post-release recovery between men and women and can be used to develop programs to promote better living standards and services to reduce gender disparities, which can ultimately improve quality of life.

Relationship between mental health, sleep status and screen time among university students during the COVID-19 pandemic: a cross-sectional study

OBJECTIVE

On 20 July 2021, after the outbreak of COVID-19 at Nanjing Lukou International Airport, several universities started closed management and online teaching. This had a large impact on students' daily life and study, which may lead to mental health problems. The purpose of this study is to study the effect of screen time on mental health status of university students and the possible mediating effect of sleep status.

METHODS

This was a cross-sectional study. A web-based questionnaire survey was employed that included demographic characteristics, sleep status and mental health status (depression, anxiety and loneliness). The Pittsburgh Sleep Quality Index scale was used to assess sleep status, while the Centre for Epidemiologic Studies Depression (CES-D) scale, Generalised Anxiety Disorder-7 (GAD-7) scale and Emotional versus Social Loneliness Scale (ESLS) were used to assess depression, anxiety and loneliness, respectively. Linear and logistic regression models were developed and adjusted for confounding factors, and finally the mediating effects were tested using the Karlson-Holm-Breen method.

RESULTS

Finally, 1070 valid questionnaires were included. Among these, 604 (56.45%) indicated depressive symptoms (CES-D score ≥16) and 902 (84.30%) indicated anxiety symptoms (GAD-7 score ≥10). The mean ESLS score (for loneliness) was 26.51±6.64. The relationship between screen time and depressive symptoms (OR 1.118, 95% CI 1.072 to 1.166) and anxiety symptoms (OR 1.079, 95% CI 1.023 to 1.138) remained significant after adjusting for confounding factors. Meanwhile, sleep status plays an intermediary role in screen time and mental health status (depression and anxiety) and accounts for 13.73% and 19.68% of the total effects, respectively. We did not find a significant association between screen time and loneliness.

CONCLUSION

During the outbreak of COVID-19, screen time is inevitably prolonged among university students. There is a relationship between mental health and screen time, and sleep status plays a mediating role.

Sleep quality as a mediator of the relationship between screen time and negative emotions among Chinese college freshmen

College freshmen are special populations facing great challenges in adapting to the brand new environment, and their lifestyle and emotional states are worthy of attention. Especially during the COVID-19 pandemic, their screen time and prevalence of negative emotions were significantly increased, but few studies have focused on such situation of college freshmen and illustrated relevant mechanisms. Thus, based on a sample of Chinese college freshmen during the COVID-19 pandemic, the current study aimed to investigate the association between their screen time and negative emotions (depression, anxiety and stress), and further explore the mediating effects of sleep quality. Data from 2,014 college freshmen was analyzed. The screen time was self-reported by participants using predesigned questionnaires. The Pittsburgh Sleep Quality Index (PSQI) and Chinese Version of Depression Anxiety and Stress Scale-21 (DASS-21) were used to assess sleep quality and emotional states, respectively. The mediation analysis was conducted to examine the meditation effect. Results indicated that participants with negative emotions tended to have longer daily screen time and worse sleep quality, sleep quality partially mediated the association between screen time and negative emotions.The critical role of sleep quality and related intervention measures should be recognized and implemented.

The effect of yoga classes on the mental health of female college students

BACKGROUND

Mental health problems have become prominent among college students. The purpose of this study was to to explore the influence of yoga course on female college students' mental health.

METHODS

Three hundred fifty-four female college students enrolled in Anhui University of Traditional Chinese Medicine in 2020 or 2021 were selected and divided into three groups according to whether they took PE courses and the content of PE courses: No physical education group (control group) (N.=131), aerobics group (N.=120), and yoga group (N.=103), questionnaire survey was conducted before, at the middle (8 weeks), and at the end of the course. The patient health questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Connor- Davidson resilience scale (CD-RISC) were used to evaluate the mental health status of female college students at different time points.

RESULTS

The demographic characteristics of the three groups showed no significant differences. Repeated measures Analysis of Variance showed that there were time main effect, group and time interaction effect and group main effect in patients' health questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Connor- Davidson resilience scale (CD-RISC) among the three groups before and after practice. Patient health score: The score of PHQ-9 and GAD-7 in yoga group at 16 weeks, at 8 weeks, before practice (P<0.05), and the scores of yoga group at 8 weeks and 16 weeks were lower than those of control group and aerobics group (P< 0.05). For CD-RISC: the score of yoga group at16 weeks, 8 weeks, before practice (P<0.05), and the scores at 8 and 16 weeks were higher than those of aerobics group and control group (P<0.05); There was no significant difference before and after exercise between the control group and the aerobics group (P< 0.05).

CONCLUSIONS

The teaching of yoga course can enhance the level of psychological resilience, improve depression and anxiety, promote mental health, and improve subjective well-being and improve the quality of college life.

The effects of body dissatisfaction, sleep duration, and exercise habits on the mental health of university students in southern China during COVID-19

Following the outbreak of COVID-19 at the end of 2019, universities around the world adopted a closed management model and various restrictive measures intended to reduce human contact and control the spread of the disease. Such measures have had a profound impact on university students, with a marked increase in depression-related psychological disorders. However, little is known about the specific status and factors influencing the impact of the pandemic on student mental health. Addressing this gap, this study examines the body dissatisfaction, physical activity, and sleep of university students during the pandemic, and uses their levels of depression to provide a theoretical basis for the development of mental health interventions for university students in the post-epidemic era. To achieve this, a total of 1,258 university students were randomly recruited for this cross-sectional study. Collected data included respondents' anthropometric measurements, body dissatisfaction levels, dietary habits, sleep status, physical activity levels, and depression levels. The overall detection rate of depression was 25.4%, with higher levels of depression among women. Multiple regression analysis showed that the PSQI score (β = 1.768, P < 0.01) and physical activity scores (β = -0.048, P < 0.01) were significant predictors of depression in men, while the PSQI score (β = 1.743, P < 0.01) and body dissatisfaction scores (β = 0.917, P < 0.01) were significant predictors of depression in women. Mental health problems were prevalent among university students during the COVID-19 pandemic. Results indicate the possibility of alleviating depression among university students by improving their body dissatisfaction, physical activity, and sleep. However, as this study was limited to Ganzhou City, it is challenging to extrapolate the findings to other populations. As this was a cross-sectional study, a causal relationship between depression levels and lifestyle habits cannot be determined.

Gender-Based Analysis of the Association Between Mental Health, Sleep Quality, Aggression, and Physical Activity Among University Students During the COVID-19 Outbreak

COVID-19 has spread throughout the world, resulting in significant morbidity, mortality, and negative psychological effects among general population. However, university students are particularly vulnerable in terms of mental health. The present study evaluated the association between mental health, quality of sleep, aggression, and physical activity in university students in Mexico after 1 year of dealing with the COVID-19 pandemic in Mexico, including a gender-sensitive analysis. Participants (935 university students) completed an online questionnaire which collected information regarding demographic data, psychological distress (IES-R scale), depression, anxiety, and stress (DASS-21), aggressiveness Buss-Perry Aggressive Questionnaire, sleep quality (PSQI) and physical activity (IPAQ-S). Findings showed that female students showed significantly higher scores in psychological distress, anxiety, stress scores and sleep quality, as compared to male students. By contrast, male students showed significantly higher scores on aggressiveness than female students. In addition, on physical activity, females performed significantly higher MET-min/week on moderate and high levels. Finally, liner regression model accounted for approximately 73.5% of the variance in DASS-21 scores, with the body mass index, IES-R, Pittsburgh Sleep Quality Index, and IPAQ subscales, emerging as significant individual (positive) predictors. Therefore, the pandemic affected female and male students differently. Female students reported more psychological distress, anxiety, and stress while male students reported higher aggressiveness. The differences observed may be due to physiological differences, the response to stress, and differences in sensitivity to life events.

Interactive effects of sleep and physical activity on depression among rural university students in China

Background

Decreased sleep quality and physical activity among university students have become important concerns, while depressive symptoms are on the rise, especially in rural areas. Previous studies have confirmed the association between sleep quality and physical activity and depressive symptoms, but the effect of their interaction on depressive symptoms has been less studied. For this reason, the present study analyzed the interaction between sleep quality and physical activity on depressive symptoms to provide reference and assistance for mental health promotion and intervention for university students in rural areas of China.

Methods

In this study, we investigated sleep quality, physical activity, and depressive symptoms in 11,423 university students in rural areas of China. The association of sleep quality and physical activity with depressive symptoms was analyzed by using univariate analysis and logistic regression analysis. And further analyzed the association between the interaction effect of sleep quality and physical activity and depressive symptoms.

Results

The proportion of university students with depressive symptoms in rural China was 33.3%, with a higher proportion of girls students (36.7%) having depressive symptoms than boys students (28.8%). Logistic regression analysis of the interaction between sleep quality and physical activity and depressive symptoms in university students showed that university students with poor sleep quality and MVPA>60 min/d (OR = 4.40,95% CI: 3.75-5.05) had the highest risk of depressive symptoms (p < 0.001). University students with moderate sleep quality and MVPA of 30-60 min/d (OR = 1.18, 95% CI: 0.75-1.61) had the lowest risk of depressive symptoms (p < 0.001). Moreover, there was no gender difference in this result.

Conclusion

The prevalence of depressive symptoms was higher among university students in rural areas of China. There was an interaction between sleep quality and MVPA on depressive symptoms, maintaining a good quality of sleep and an appropriate length of MVPA has a contributory effect on mental health, and the same trend was found for both boys and girls students. It is recommended that university students in rural areas of China should first maintain proper sleep quality while maintaining 30-60 min of MVPA per day, which may reduce the risk of depressive symptoms.

Factors Associated with Sedentary Behavior and Physical Activity Among People Living in Saudi Arabia - A Cross-Sectional Study

Background

A poor physical activity and sedentary behavior is common among individuals which can be detrimental to one's health. Furthermore, sedentary behavior is associated with metabolic disorders. Therefore, this study explored factors associated with sedentary behavior and physical activity among individuals in capital region of Saudi Arabia.

Methods

A cross-sectional web-based study was conducted over a period of 3 months in 2023 using prevalidated questionnaires, which address the sedentary behavior and physical activity and its factors. This study included among individuals aged from 19 to 50 years, living in Riyadh. Factors associated with outcome variables were identified using multiple linear regression analysis in SPSS.

Results

Of the 833 study participants, 569 (68.3%) and most were males aged between years 31-35 years old. Only 20.6% (n=172) of the activities that induced high levels of breathing or heart rate were vigorous-intensity activities among the respondents. The average number of sitting hours per day was 6.74 (SD=1.577). The regression model's findings showed a significant correlation between mean sitting time and education level (p=0.008), occupation (p=0.001), monthly income (p=0.029), and kind and status of physical activity (p=0.002). Similar to this, there was a significant correlation between age group (p=0.040) and physical activity status (p=0.001) and the amount of time spent engaging in vigorous-intensity activities at work on an average day.

Conclusion

The findings of this study confirmed that Saudi adults living in the Riyadh region spent a significant amount of time sedentary, and the most common factors associated with sedentary behavior were education, employment, monthly income, physical activity status, type of physical activity, and reasons for not practicing physical activity. The findings of this study can be used by healthcare providers and those associated with policymaking to improve health outcomes in healthcare settings.

Patterns of sedentary behaviour in adults with acute insomnia derived from actigraphy data

BACKGROUND

Sleep disorders, such as insomnia, have been associated with extended periods of inactive, sedentary behaviour. Many factors contribute to insomnia, including stress, irregular sleep patterns, mental health issues, inadequate sleeping schedules, diseases, neurological disorders and prescription medications.

OBJECTIVES

Identification of the patterns of sedentary time and its duration in adults with acute insomnia and healthy controls to determine the statistically significant sedentary bouts; comparison of the sedentary behaviour patterns in acute insomnia adults with healthy controls.

METHODS

We investigate the daytime actigraphy data and identify temporal patterns of inactivity among adults with acute insomnia and healthy adults. Seven days of actigraphy data were utilised to calculate sedentary time and bouts of variable duration based on a threshold of activity counts (<100 counts per minute). Statistical analysis was applied to investigate sedentary bouts and total sedentary time during weekdays and weekend. A logistic regression model has been used to determine the significance of sedentary bouts.

RESULTS

We found that individuals with acute insomnia accumulate a significant amount of their sedentary time in medium (6-30 minutes and 31-60 minutes) and longer (more than 60 minutes) duration bouts in comparison to healthy adults. Furthermore, a low p value for total sedentary time (2.54 ⋅ 10-4) association with acute insomnia supports the finding that acute insomnia individuals are significantly more engaged in sedentary activities compared to healthy controls. Also, as shown by the weekend vs weekday analysis, the physical and sedentary activity patterns of acute insomnia adults demonstrate higher variability during the weekdays in comparison to the weekend.

CONCLUSION

The results of the present study demonstrate that adults with acute insomnia spend more time in low-intensity daily physical activities compared to healthy adults.

Non-suicidal self-injury and suicidal ideation among Chinese college students of childhood emotional abuse: associations with rumination, experiential avoidance, and depression

Background

Prior studies have proved the relationships between childhood emotional abuse (CEA) histories and suicidal thoughts or behaviors in adulthood, however, how emotion regulation strategies work as the mediating mechanism is necessary to be investigated. This study aimed to further verify the impacts of rumination, experiential avoidance (EA) and depression on the associations between CEA and non-suicidal self-injury (NSSI) and suicidal ideation (SI) on a sample of Chinese college students.

Methods

The Childhood Emotional Abuse Questionnaire, the Non-Suicidal Self-Injury Questionnaire, the Symptom Checklist, the Ruminative Response Scale, the Acceptance and Action Questionnaire-II and the Zung Self-Rating Depression Scale were completed by 1,317 college students.

Results

The rates of NSSI and SI of students with CEA experiences were 31.70 and 7.90% respectively, both higher than those without such experiences. The mediating roles of rumination, EA and depression between CEA and NSSI and SI were significant (p < 0.01).

Conclusion

The current study shed light on the linking roles of rumination, EA and depression in the relations between CEA and NSSI and SI. It is suggested that developing adaptive emotion-regulating strategies may be helpful to the intervention of suicidal thoughts or behaviors among individuals with CEA experiences.

Physical activity and depression of Chinese college students: chain mediating role of rumination and anxiety

Objective

To explore the relationship between physical activity and depression among college students, as well as the mediating role of rumination and anxiety.

Methods

A total of 1,292 Chinese college students were investigated by physical activity questionnaire, rumination scale, self-rating anxiety scale (SAS), and depression scale.

Results

(1) There was a significant negative correlation between physical activity and depression (r = -0.399, p < 0.01), and the direct path of physical activity on depression was significant (β = -0.399, t = -13.374, p < 0.01). (2) Physical activity negatively predicted rumination (β = -0.322, t = -10.440, p < 0.01) and anxiety (β = -0.222, t = -7.089, p < 0.01). Rumination positively predicted anxiety (β = 0.283, t = 9.017, p < 0.01) and depression (β = 0.267, t = 9.046, p < 0.01). Anxiety positively predicted depression (β = 0.262, t = 8.902, p < 0.01). (3) Rumination and anxiety play a significant mediating role between physical activity and depression. The mediating effect involves three paths: physical activity → rumination → depression (the mediating effect value: -0.076); physical activity → anxiety → depression (the mediating effect value: -0.052). Physical activity → rumination → anxiety → depression (the mediating effect value: -0.021).

Conclusion

(1) Physical activity can negatively predict the rumination, anxiety, and depression of college students, which means physical activity can reduce rumination, anxiety, and depression of college students. (2) Physical activity can not only directly affect the depression of college students, but also indirectly affect depression through the independent intermediary role of rumination and anxiety, and the chain mediation of rumination and anxiety.

Mitigation role of physical exercise participation in the relationship between blood cadmium and sleep disturbance: a cross-sectional study

The neurotoxicity of heavy metals received increasingly attention in recent years. Sleeping is regulated and coordinated by nervous system, however, the health hazard of heavy metal like cadmium (Cd) exposure on sleep health remained unknown. Rescue strategies like physical exercise (PE) has emerged to mitigate such influence. An epidemiological design with cross-sectional data from National Health and Nutrition Examination Survey 2007-2010 was applied. The relationship between three blood heavy metals [cadmium (Cd), lead (Pb), mercury (Hg)] and sleep disturbance was analyzed. A total of 8,751 participants were finally included in and the weighted participants were 330,239,463. Weighted quantile sum (WQS) regression indicated that mixed blood metals were positively related to risk of sleep disturbance and the mixture effect of exposure to heavy metals was mainly attributable to Cd (89.1%). Weighted logistic regression showed a significant positive association between the highest quartile of blood Cd and sleep disturbance [(OR (95% CI)): 1.191 (1.014,1.400), p = 0.036] in the fully adjusted model, while no association was found under Pb and Hg exposure. In the association between Q3 and Q4 level of blood Cd and sleep disturbance, moderate-to-vigorous physical exercise group had lower risks than none and low exercise group. In the restricted cubic spline model, it was also verified that higher PE participation was associated with the lowest incidence of sleep disturbance with the increment in Cd concentration. Our study suggested that both policy makers and the public should minimize heavy metal exposure. Moreover, conducting moderate to vigorous physical exercise is a protecting factor to mitigate Cd's influence on sleep health.

Mental health and cognitive function among medical students after the COVID-19 pandemic in China

Background

Chinese people experienced a nationwide coronavirus disease 2019 (COVID-19) pandemic after the adjustment of epidemic response policies from December 2022 to January 2023. This study aims to explore the prevalence of mental and cognitive symptoms and their associated factors among medical students after the COVID-19 pandemic.

Methods

A cross-sectional study was conducted between February 27th and March 8th, 2023. The symptoms of anxiety, depression, insomnia, post-traumatic stress disorder (PTSD), and cognitive function among medical students were examined using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Athens Insomnia Scale (AIS), the Impact of Event Scale-6 (IES-6), and the Perceived Deficits Questionnaire-Depression-5 (PDQ-D-5). Data on demographic information was also collected. Statistical analyses were conducted to describe the prevalence and explore the associated factors of mental and cognitive symptoms.

Results

Among 947 participants, the proportion of students experiencing anxiety, depression, insomnia, and PTSD symptoms was 37.8, 39.3, 28.3, and 29.5%, respectively. The self-reported COVID-19 infection rate was 72.2%. Higher grades, childhood, and current rural residence were identified as potential risk factors for mental and cognitive symptoms. Gender, age, average monthly household income, and COVID-19 diagnosis were not associated with mental and cognitive symptoms among medical students.

Conclusion

Our findings revealed a high prevalence of mental and cognitive symptoms among Chinese medical students after the COVID-19 pandemic. Special attention should be paid to the mental health of higher-grade students and those residing in rural areas.

Association of screen time and physical activity with health-related quality of life in college students

OBJECTIVE

To determine the association between screen time and physical activity with quality of life among Chilean university students.

METHODS

Cross-sectional and analytical study conducted on 726 first-year university students who replied three questionnaires: Youth Risk Behavior Survey, WHO Quality of Life-BREF scale, and the International Physical Activity Questionnaire.

RESULTS

There were differences in overall quality of life (p < .001) and level of satisfaction in health (p < .01) according to screen exposure time. These results follow a linear trend for all the quality of life domains (p < .01), and they indicate that there is an inverse association between screen time and quality of life.

CONCLUSION

There is an inverse association between screen time and quality of life in university students. Students with a longer screen exposure time showed a lower quality of life, specifically in the domains of social relationships and psychological health, regardless of sex, physical activity, or socioeconomic level.

Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus

BACKGROUND

Continuous glucose monitoring (CGM)-derived time in range (TIR) is closely associated with micro- and macrovascular complications in type 2 diabetes mellitus (T2DM). This study was performed to investigate the relationship between key CGM-derived metrics and specific cognitive domains in patients with T2DM.

METHODS

Outpatients with T2DM who were otherwise healthy were recruited for this study. A battery of neuropsychological tests was performed to evaluate cognitive function, including memory, executive functioning, visuospatial ability, attention, and language. Participants wore a blinded flash continuous glucose monitoring (FGM) system for 72 h. The key FGM-derived metrics were calculated, including TIR, time below range (TBR), time above range (TAR), glucose coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE). Furthermore, the glycemia risk index (GRI) was also calculated by the GRI formula. Binary logistic regression was used to assess risk factors for TBR, and we further analysed the associations between neuropsychological test results and key FGM-derived metrics with multiple linear regressions.

RESULTS

A total of 96 outpatients with T2DM were recruited for this study, with 45.8% experiencing hypoglycemia (TBR^{< 3.9 mmol/L}). Spearman analysis results revealed that a higher TBR^{< 3.9 mmol/L} was correlated with worse performance on the Trail Making Test A (TMTA), Clock Drawing Test (CDT), and cued recall scores (P < 0.05). Logistic regression analysis results indicated that the TMTA (OR = 1.010, P = 0.036) and CDT (OR = 0.429, P = 0.016) scores were significant factors influencing the occurrence of TBR^{< 3.9 mmol/L}. Multiple linear regressions further demonstrated that TBR^{< 3.9 mmol/L} (β = -0.214, P = 0.033), TAR^{> 13.9 mmol/L} (β = -0.216, P = 0.030) and TAR^{10.1-13.9 mmol/L} (β = 0.206, P = 0.042) were significantly correlated with cued recall scores after adjusting for confounding factors. However, TIR, GRI, CV and MAGE showed no significant correlation with the results of neuropsychological tests (P > 0.05).

CONCLUSIONS

A higher TBR^{< 3.9 mmol/L} and TAR^{> 13.9 mmol/L} were associated with worse cognitive functions (memory, visuospatial ability, and executive functioning). Conversely, a higher TAR of 10.1-13.9 mmol/L was associated with better memory performance in memory tasks.

The prevalence of post-traumatic stress disorder in college students by continents and national income during the COVID-19 pandemic: a meta-analysis

Introduction

The present study aimed to provide a more accurate representation of post-traumatic stress disorder (PTSD) in college students during COVID-19 by performing meta-analyses by continents, national income, and study majors, and comparing the results with estimated pooled prevalence.

Methods

Based on the guideline of PRISMA, literature was searched in PubMed, Web of Science, and Embase. The prevalence of PTSD was estimated through a random model based on the different continents and levels of national income, as well as study majors, and compared with the pooled prevalence of PTSD among college students.

Results

Totally 381 articles were retrieved from electronic databases and 38 articles were included in the present meta-analysis. The results showed that the pooled prevalence of college students' PTSD was 25% (95% CI: 21-28%). Prevalence estimates of PTSD among college students were statistically significant (p < 0.00001) when stratified with geographical regions, income levels, and study majors. In comparison with the pooled prevalence of PTSD (25%), subgroups of Africa and Europe, lower-middle-income countries, and medical college students possessed higher prevalence estimates.

Discussion

The findings of the study showed that the prevalence of PTSD in college students worldwide during COVID-19 was relatively high and varied in different continents and countries with different income levels. Therefore, healthcare providers should pay attention to the psychologically healthy condition of college students during COVID-19.

A comparison of the effects of remote coaching HIIT training and combined exercise training on the physical and mental health of university students

Aim

To compare the differences in the effects of based on remote coached high intensity interval training and combined exercise training on the physical and mental health of university students.

Method

Sixty university students were recruited from Shandong Normal University and randomly divided into HIIT group (n = 30) and AR group (n = 30), with the HIIT group using high-intensity interval training intervention and the AR group using combined exercise (aerobic combined with resistance) training intervention for 8 weeks. Mental health indicators, fitness indicators and body composition indicators were measured at the beginning and end of the intervention.

Results

After 8 weeks, among the mental health indicators, the results of the Symptom Self-Rating Scale (SCL-90) test showed a significant improvement in the HIIT group in terms of total score, somatization, obsessive-compulsive, interpersonal sensitivity, depression, hostility, and psychoticism (p < 0.05); the AR group showed significant improvements in psychoticism (P < 0.05). There were no significant differences between the two groups. The results of the Pittsburgh Sleep Quality Index scale (PSQI) showed a significant difference in sleep efficiency in the HIIT group with an inverse improvement in scores; the AR group showed no significant improvement in each test item. The results of the between-group covariance showed significant differences in sleep efficiency and hypnotic drugs in the HIIT group (p < 0.05). Among the fitness indicators, the HIIT group showed significant improvements in maximum oxygen uptake, grip strength and flexibility (P < 0.05); the AR group showed significant improvements in back muscle strength and flexibility (P < 0.05). The results of the between-group covariance showed significant improvements in maximum oxygen uptake in the HIIT group (P < 0.01). Regarding body composition indicators, there was a significant improvement in Body weight, BMI, Body fat percentage and Waist-to-hip ratio in both the HIIT and AR groups (P < 0.01). There were no significant differences between the two groups.

Conclusion

HIIT and combined exercise training based on remote coaching had some improvement on fitness level and body composition of university students, HIIT was more advantageous in improving aerobic endurance, and HIIT based on remote coaching may have better effect than combined exercise in mental health.

Trial registration

Chinese Clinical Trial Register, ChiECRCT20220149. Registered on 16 May 2022.

Mediating effect of mindfulness level on the relationship between marital quality and postpartum depression among primiparas

BACKGROUND

Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery. Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.

AIM

To investigate the correlations among mindfulness, marital quality, anxiety, and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.

METHODS

A cross-sectional study was conducted. The self-administered questionnaire was submitted online through smartphones. The levels of mindfulness, anxiety, depression, and marital quality were respectively investigated by the mindful attention awareness scale (MAAS), the self-rating anxiety scale (SAS), the self-rating depression scale (SDS), and the marriage perception scale (MPS) in these enrolled Han and Tujia primiparas.

RESULTS

No statistical significance was observed in the prevalence of postpartum anxiety and depression, nor scores of MAAS and MPS-Total in different regions or ethnicities (P > 0.05). However, MPS-Marital interaction (P < 0.05), MPS-Family relationship (MPS-FR) (P < 0.01), and MPS-Marital conflict (MPS-MC) (P < 0.01) scores of urban primiparas were higher than those of rural primiparas. The MPS-MC score of Han primiparas was higher than that of Tujia primiparas (P < 0.05). Negative correlations were observed between MAAS and SAS (r = -0.457, P < 0.01), and MAAS and SDS (r = -0.439, P < 0.01). SAS has revealed a highly positive correlation with SDS (r = 0.720, P < 0.01) and a weak negative correlation with MPS (r = -0.200, P < 0.05). Besides, a weak negative correlation was observed between MAAS and MPS-MC (r = -0.184, P < 0.05), and a weak positive correlation was noticed between SAS and MPS-MC (r = -0.225, P < 0.01). Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety (P < 0.05, 95%CI: -0.384 to 0.033), MPS-MC and postpartum anxiety (P < 0.01, 95%CI: 0.027-0.193), MPS-FR and postpartum depression (P < 0.05, 95%CI: -0.365 to 0.031), and MPS-MC and postpartum depression (P < 0.01, 95%CI: 0.022-0.206).

CONCLUSION

Mindfulness demonstrates negative correlations with marital conflict, postpartum anxiety and depression, and it may have cross-ethnic and trans-regional characteristics. Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study, it demonstrates a full mediation effect on the relationships between family relationships, marital conflict, and postpartum anxiety and depression.

Mediating effect of mindfulness level on the relationship between marital quality and postpartum depression among primiparas

BACKGROUND

Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery. Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.

AIM

To investigate the correlations among mindfulness, marital quality, anxiety, and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.

METHODS

A cross-sectional study was conducted. The self-administered questionnaire was submitted online through smartphones. The levels of mindfulness, anxiety, depression, and marital quality were respectively investigated by the mindful attention awareness scale (MAAS), the self-rating anxiety scale (SAS), the self-rating depression scale (SDS), and the marriage perception scale (MPS) in these enrolled Han and Tujia primiparas.

RESULTS

No statistical significance was observed in the prevalence of postpartum anxiety and depression, nor scores of MAAS and MPS-Total in different regions or ethnicities (P > 0.05). However, MPS-Marital interaction (P < 0.05), MPS-Family relationship (MPS-FR) (P < 0.01), and MPS-Marital conflict (MPS-MC) (P < 0.01) scores of urban primiparas were higher than those of rural primiparas. The MPS-MC score of Han primiparas was higher than that of Tujia primiparas (P < 0.05). Negative correlations were observed between MAAS and SAS (r = -0.457, P < 0.01), and MAAS and SDS (r = -0.439, P < 0.01). SAS has revealed a highly positive correlation with SDS (r = 0.720, P < 0.01) and a weak negative correlation with MPS (r = -0.200, P < 0.05). Besides, a weak negative correlation was observed between MAAS and MPS-MC (r = -0.184, P < 0.05), and a weak positive correlation was noticed between SAS and MPS-MC (r = -0.225, P < 0.01). Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety (P < 0.05, 95%CI: -0.384 to 0.033), MPS-MC and postpartum anxiety (P < 0.01, 95%CI: 0.027-0.193), MPS-FR and postpartum depression (P < 0.05, 95%CI: -0.365 to 0.031), and MPS-MC and postpartum depression (P < 0.01, 95%CI: 0.022-0.206).

CONCLUSION

Mindfulness demonstrates negative correlations with marital conflict, postpartum anxiety and depression, and it may have cross-ethnic and trans-regional characteristics. Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study, it demonstrates a full mediation effect on the relationships between family relationships, marital conflict, and postpartum anxiety and depression.