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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.
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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.
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Üzer A, Uran C, Yılmaz E, Şahin ŞN, Ersin MK, Yılmaz RH, Çıkla A. The relationship between chronotype, psychological pain, problematic social media use, and suicidality among university students in Turkey. Chronobiol Int 2024; 41:504-512. [PMID: 38373906 DOI: 10.1080/07420528.2024.2320226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/13/2024] [Indexed: 02/21/2024]
Abstract
Chronotype has been extensively linked to various psychological outcomes, including suicide, which significantly impacts the mortality rate among young adults worldwide. Research on the extent of these links is still ongoing. This cross-sectional study aimed to explore the complex relationships between chronotype, internet addiction, problematic social media use (PSMU), psychological pain, and suicidality in a student population. A total of 571 Turkish students (65.3% female, mean age 20.3 ± 1.63 years) completed the following scales: the Suicide Probability Scale (SPS), the Mee-Bunney Psychological Pain Assessment Scale (MBPPAS), the Social Media Disorder Scale (SMDS), the Internet Addiction Test (IAT), the Morningness - Eveningness Questionnaire (MEQ), and the Hospital Anxiety and Depression Scale (HADS). The results showed that the relationship between chronotype and suicidality was partially mediated by SMDS and MBPPAS but not by anxiety, depression, or IAT. These findings suggest that psychological pain and PSMU may be important factors that contribute to suicidality in evening-type individuals. These findings have significant implications for the development of interventions aimed at reducing suicidality among evening-type individuals. By addressing the underlying factors of psychological pain and PSMU, it may be possible to mitigate the increased risk of suicidality among this population.
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Affiliation(s)
- Ahmet Üzer
- Faculty of Medicine, Department of Psychiatry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ceren Uran
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Elif Yılmaz
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Şeima Nur Şahin
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Muhammet Kaan Ersin
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Rohat Hasret Yılmaz
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ayça Çıkla
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Ceylan B, Kocoglu-Tanyer D, Sacikara Z, Sultan Dengiz K. The relationship between chronotype and food addiction: Serial mediation of social jetlag and psychological pain. Chronobiol Int 2024; 41:485-494. [PMID: 38353208 DOI: 10.1080/07420528.2024.2315220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/01/2024] [Indexed: 02/21/2024]
Abstract
This study evaluates how food addiction is related to chronotype, social jetlag, and psychological pain. Of the participants (n = 1,035 university students), 16.6% had a morning chronotype, 25.1% had an evening chronotype, and 25.1% were clinically addicted to eating. The mean sleep durations for participants were 7.41 ± 2.18 h and 8.95 ± 3.0 h on weekdays and weekends, respectively. The mean misalignment time for social jetlag was 1.45 ± 1.5 h. Food addiction, psychological pain, and social jetlag levels were high among participants with the evening chronotype. The risk factors for food addiction included being female, having an evening chronotype, and having high body mass index levels and psychological pain. The total indirect effect of psychological pain and social jetlag on the relationship between chronotype and food addiction was 20.6%. However, the social jetlag effect is relatively minor compared to psychological pain. The significant conclusions of this study are as follows. Clinical food addiction is prevalent among students, and a strong direct correlation between chronotype and food addiction was observed. The study emphasizes the importance of being aware of chronotype and mental status in establishing a healthy diet and lifestyle.
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Affiliation(s)
- Burcu Ceylan
- Faculty of Health Sciences, Nursing Department, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | | | - Zeynep Sacikara
- Faculty of Nursing, Public Health Department, Necmettin Erbakan University, Konya, Turkey
| | - Kubra Sultan Dengiz
- Faculty of Nursing, Public Health Department, Necmettin Erbakan University, Konya, Turkey
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Magnani L, Aguglia A, Alexander J, Maiorano A, Richard-Lepouriel H, Iancau SP, Amerio A, Parise A, Serafini G, Amore M, Nguyen KD, Costanza A. Evening Chronotype and Suicide: Exploring Neuroinflammation and Psychopathological Dimensions as Possible Bridging Factors-A Narrative Review. Brain Sci 2023; 14:30. [PMID: 38248245 PMCID: PMC10813318 DOI: 10.3390/brainsci14010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
A chronotype is generally defined as the variability of the phase angle of entrainment, while the latter reflects the relationship between the timing of a certain rhythm (e.g., the sleep-wake cycle) and the timing of an external temporal cue. Individuals can be placed on a spectrum from "morning types" (M types) to "evening types" (E types). E-chronotype has been proposed as a transdiagnostic risk factor for psychiatric conditions, and it has been associated with psychopathological dimensions. Eveningness seems to be correlated with both suicidal ideation (SI) and suicidal behavior (SB) through several possible mediating factors. Immunological alterations have also been linked to later chronotypes and SI/SB. This narrative review aims to summarize the evidence supporting the possible association between chronotypes and suicide and the eventual mediating role of neuroinflammation and several psychopathological dimensions. A search of the literature (2003-2023) was conducted using various databases: PUBMED, EMBASE, Scopus, UpToDate, PsycINFO, and Cochrane Library. English-language articles were collected and screened for eligibility. Despite the apparent absence of a direct correlation between E-chronotype and suicidality, E-chronotype promotes a chain of effects that could be involved in an increased risk of SB, in which with neuroinflammation possibly plays an intriguing role and some psychopathological dimensions may stand out.
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Affiliation(s)
- Luca Magnani
- Department of Psychiatry, San Maurizio Hospital, 39100 Bolzano, Italy;
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Jacques Alexander
- Department of Psychiatry, Geneva University Hospital (HUG), 1205 Geneva, Switzerland; (J.A.); (A.M.)
| | - Alessandra Maiorano
- Department of Psychiatry, Geneva University Hospital (HUG), 1205 Geneva, Switzerland; (J.A.); (A.M.)
| | - Hélène Richard-Lepouriel
- Department of Psychiatry, Mood Disorder Unit, Psychiatric Specialties Service, Geneva University Hospital (HUG), 1205 Geneva, Switzerland;
| | - Sidonia Paula Iancau
- Residence School in Psychiatry, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, 00185 Rome, Italy;
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Alberto Parise
- Geriatric-Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy;
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Khoa D. Nguyen
- Chinese University of Hong Kong, Hong Kong SAR, China;
- Tranquis Therapeutics, Palo Alto, CA 94303, USA
| | - Alessandra Costanza
- Department of Psychiatry, Geneva University Hospital (HUG), 1205 Geneva, Switzerland; (J.A.); (A.M.)
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), 6900 Lugano, Switzerland
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), 1205 Geneva, Switzerland
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Zarogoulidis P, Petridis D, Kosmidis C, Sapalidis K, Nena L, Matthaios D, Porpodis K, Kakavelas P, Steiropoulos P. Immunotherapy and Chemotherapy Versus Sleep Disturbances for NSCLC Patients. Curr Oncol 2023; 30:1999-2006. [PMID: 36826116 PMCID: PMC9955782 DOI: 10.3390/curroncol30020155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION Cancer patients are known to experience sleep disturbances that differ between disease stages and treatments. Regarding lung cancer patients and immunotherapy, information on their sleep disturbances has been recently acquired, but no comparison has been made between different treatment modalities. PATIENTS AND METHODS We recruited 98 non-small cell lung cancer patients; 49 had programmed death-ligand 1 expression of ≥50% and received immunotherapy as first-line treatment and 49 had programmed death-ligand 1 expression in the range from 0-49 and received chemotherapy as first-line treatment. All patients were stage IV, but with no bone metastasis. Sleep disturbances were recorded through polysomnography and sleep questionnaires. RESULTS For immunotherapy patients with PD-L1 expression ≥ 50%, the disease response was rapid and the sleep disturbances decreased rapidly. On the other hand, for chemotherapy patients, the sleep disturbances remained for all those patients that had partial response and stable disease. It was noticed that chemotherapy drugs induce severe adverse effects. DISCUSSION In our study, it was observed that patients with complete response had reduced sleep disturbances in the case of immunotherapy patients. However, sleep disturbances continued for several patients in the chemotherapy group due to the adverse effects of chemotherapy drugs. IN CONCLUSION Immunotherapy drugs on their own do not induce sleep disturbances and, through treatment response, alleviate sleep disturbances in lung cancer patients.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department, General Clinic Euromedica Private Hospital, 851 05 Thessaloniki, Greece
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6977-2719-74
| | - Dimitrios Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, 574 00 Thessaloniki, Greece
| | - Christoforos Kosmidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Surgery Department, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Lila Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| | | | - Konstantinos Porpodis
- Pulmoanry Department, G. Papanikolaou General Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Paschalis Kakavelas
- Intensive Care Unit (ICU), General Clinic Euromedica, 153 43 Thessaloniki, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
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