1
|
Wen LY, Zhang L, Zhu LJ, Song JG, Wang AS, Tao YJ, Li HQ, Feng Y, Jin YL, Su H, Chang WW. Depression and suicidal ideation among Chinese college students during the COVID-19 pandemic: the mediating roles of chronotype and sleep quality. BMC Psychiatry 2024; 24:583. [PMID: 39192231 DOI: 10.1186/s12888-024-06027-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 08/20/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND This study was intended to investigate the correlation between depression and suicidal ideation among Chinese college students during the COVID-19 pandemic and the potential mediating roles of chronotype and sleep quality in this relationship . METHODS A sample of 4,768 college students was selected from four institutions in Anhui Province, China, and the study was conducted during the COVID-19 pandemic (November to December 2020) using a stratified, cluster, multi-stage sampling method. This study used the two-item Patient Health Questionnaire (PHQ-2) to assess depressive symptoms, the Morningness-Eveningness Questionnaire 19 (MEQ-19) to determine individual sleep chronotypes (i.e., morning or evening preference), and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Participants were asked about suicidal ideation. MPLUS 8.3 software was used to analyze the mediating effect of chronotype and sleep quality on the relationship between depression and suicidal ideation. RESULTS During the COVID-19 pandemic, the prevalence of suicidal ideation among Chinese college students was 5.4%. Depression was inversely correlated with chronotype (beta = - 0.346, P < 0.01) and positively correlated with sleep quality (beta = 0.846, P < 0.001), indicating that students experiencing depressive symptoms were more likely to have a later chronotype and poor sleep quality. A later chronotype (beta = - 0.019, P < 0.05) and poor sleep quality (beta = 0.066, P < 0.01) predicted suicidal ideation. Depression emerged as a direct and significant risk factor for suicidal ideation (effect value = 0.535, 95% confidence interval: 0.449 ~ 0.622). Chronotype and sleep quality were found to have potential mediating effects on the relationship between depression and suicidal ideation; however, the chain-mediating effect of chronotype and sleep quality was not statistically significant. CONCLUSIONS Our findings suggest that during the COVID-19 pandemic, depression can precipitate suicidal ideation through its influence on sleep chronotype and quality. These compelling findings highlight the urgency of early intervention strategies intended to mitigate suicidal thoughts, particularly among students exhibiting depressive symptoms, who experience disrupted sleep patterns and poor sleep quality.
Collapse
Affiliation(s)
- Li-Ying Wen
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Liu Zhang
- Department of Hospital Infection Management Office, Wuhu Hospital of Traditional Chinese Medicine, Wuhu, Anhui, 241000, China
| | - Li-Jun Zhu
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Jian-Gen Song
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - An-Shi Wang
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Yu-Jing Tao
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Hao-Qi Li
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Ying Feng
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Yue-Long Jin
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China.
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
| | - Wei-Wei Chang
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China.
| |
Collapse
|
2
|
Liu J, Hao Q, Li B, Zhang R, Luo G, Sun D. Prevalence and influencing factors of sleep disorders in medical students after the COVID-19 pandemic. BMC Psychiatry 2024; 24:538. [PMID: 39080631 PMCID: PMC11290009 DOI: 10.1186/s12888-024-05980-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The prevalence of sleep disorders among medical students was high during the COVID-19 pandemic. However, fewer studies have been conducted on sleep disorders among medical students after the COVID-19 pandemic. This study investigated the prevalence and factors influencing sleep disorders among Chinese medical students after COVID-19. METHODS A total of 1,194 Chinese medical students were included in this study from 9th to 12th July 2023. We used the Self-administered Chinese scale to collect the demographic characteristics. In addition, we used the Chinese versions of the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI) to assess subjects' depression, anxiety, and sleep disorders, respectively. The chi-square test and binary logistic regression were used to identify factors influencing sleep disorders. The receiver operating characteristic (ROC) curve was utilized to assess the predictive value of relevant variables for sleep disorders. RESULTS We found the prevalence of sleep disorders among medical students after COVID-19 was 82.3%. According to logistic regression results, medical students with depression were 1.151 times more likely to have sleep disorders than those without depression (OR = 1.151, 95% CI 1.114 to 1.188). Doctoral students were 1.908 times more likely to have sleep disorders than graduate and undergraduate students (OR = 1.908, 95% CI 1.264 to 2.880). CONCLUSION The prevalence of sleep disorders among medical students is high after COVID-19. In addition, high academic levels and depression are risk factors for sleep disorders. Therefore, medical colleges and administrators should pay more attention to sleep disorders in medical students after the COVID-19 pandemic. Regular assessment of sleep disorders and depression is essential.
Collapse
Affiliation(s)
- Jiao Liu
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Qingling Hao
- University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| | - Baozhu Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Ran Zhang
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Guoshuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China.
| | - Daliang Sun
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China.
| |
Collapse
|
3
|
Huang W, Wen X, Li Y, Luo C. Association of perceived stress and sleep quality among medical students: the mediating role of anxiety and depression symptoms during COVID-19. Front Psychiatry 2024; 15:1272486. [PMID: 38304285 PMCID: PMC10830648 DOI: 10.3389/fpsyt.2024.1272486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024] Open
Abstract
COVID-19 has intensified the influence on medical students by changing the lifestyle, online study and clinical practice which bring out series of stress, sleep disturbance and mental health problems. This cross-sectional study aim to explore the association between perceived stress and sleep quality among medical students and investigated whether anxiety and depression mediated this association during pandemic. A total of 1,021 medical students in two universities who were from Guangdong Province, China participated this study and from January to September 2020 through the online question are, with 28.80% reporting sleep disturbances. The medical students were finished various self-reported questionnaires, including the Perceived Stress Scale-10, Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder-7 Scale, and Patient Health Questionnaire-9, the study found positive correlations among sleep quality, perceived stress, anxiety, and depression. The data was analyzed with The Amos 26.0 system. Result demonstrated that perceived stress was associated with poor sleep quality. Anxiety and depression partially mediated the association between perceived stress and poor sleep quality, explaining 73.08% of the association. This study's structural equation model offers a useful framework for assessing mechanisms mediating associations between perceived stress and sleep quality. The findings emphases the importance of addressing psychological factors in high-pressure situations, which can exacerbate sleep disturbances among medical students. It is important to screen the level of stress, mental health problems and investigate the risk factors of sleep quality among medical students during emergency public health events.
Collapse
Affiliation(s)
- Wanmin Huang
- Guangzhou Panyu Central Hospital, Guangzhou, China
- School of Nursing, Jinan University, Guangzhou, China
| | - Xueke Wen
- School of Nursing, Jinan University, Guangzhou, China
| | - Yunjia Li
- School of Nursing, Jinan University, Guangzhou, China
| | - Chunliu Luo
- Medical Imaging Center, The First Affiliated Hospital, Jinan University, Guangzhou, Guandong, China
| |
Collapse
|