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Gao WJ, Hu Y, Ji JL, Liu XQ. Relationship between depression, smartphone addiction, and sleep among Chinese engineering students during the COVID-19 pandemic. World J Psychiatry 2023; 13:361-375. [PMID: 37383286 PMCID: PMC10294134 DOI: 10.5498/wjp.v13.i6.361] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/07/2023] [Accepted: 04/24/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND Existing research has demonstrated that depression is positively related to smartphone addiction, but the role of sleep has not been discussed thoroughly, especially among engineering undergraduates affected by the coronavirus disease 2019 pandemic.
AIM To evaluate sleep as a mediator of the association between smartphone addiction and depression among engineering undergraduates.
METHODS Using a multistage stratified random sampling method, a cross-sectional survey was conducted among 692 engineering undergraduates from a top engineering university in China, and data were collected by self-reported electronic questionnaires. The data included demographic characteristics, such as age, gender, the Smartphone Addiction Scale-Short Version (SAS-SV), the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index. Pearson correlation and multiple linear regression analyses were used to examine the association between smartphone addiction and depression, while structural equation models were established to evaluate the possible mediating role of sleep.
RESULTS Based on the cutoffs of the SAS-SV, the rate of smartphone addiction was 63.58 percent, with 56.21 percent for women and 65.68 percent for men, among 692 engineering students. The prevalence of depression among students was 14.16 percent, with 17.65 percent for women, and 13.18 percent for men. Smartphone addiction was positively correlated with depression, and sleep played a significant mediating effect between the two, accounting for 42.22 percent of the total effect. In addition, sleep latency, sleep disturbances, and daytime dysfunction significantly mediated the relationship between depression and smartphone addiction. The mediating effect of sleep latency was 0.014 [P < 0.01; 95% confidence interval (CI): 0.006-0.027], the mediating effect of sleep disturbances was 0.022 (P < 0.01; 95%CI: 0.011-0.040), and the mediating effect of daytime dysfunction was 0.040 (P < 0.01; 95%CI: 0.024-0.059). The influence of sleep latency, sleep disturbances, and daytime dysfunction accounted for 18.42%, 28.95%, and 52.63% of the total mediating effect, respectively.
CONCLUSION The results of the study suggest that reducing excessive smartphone use and improving sleep quality can help alleviate depression.
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Affiliation(s)
- Wen-Juan Gao
- Institute of Higher Education, Beihang University, Beijing 100191, China
- School of Public Administration, Beihang University, Beijing 100191, China
- Research Center for Beijing Higher Education Development, Beihang University, Beijing 100191, China
| | - Yan Hu
- Institute of Higher Education, Beihang University, Beijing 100191, China
- School of Public Administration, Beihang University, Beijing 100191, China
- Research Center for Beijing Higher Education Development, Beihang University, Beijing 100191, China
| | - Jun-Lin Ji
- Institute of Higher Education, Beihang University, Beijing 100191, China
- School of Public Administration, Beihang University, Beijing 100191, China
- Research Center for Beijing Higher Education Development, Beihang University, Beijing 100191, China
| | - Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
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2
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Ng HN, Boey KW. Efficacy of body-mind-spirit oriented psychosocial programme in promoting holistic well-being of students in late adolescence. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2021. [DOI: 10.1080/21507686.2021.1876114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Kam Weng Boey
- Research Unit on Love, Marriage and Family, School of Humanities and Languages, Caritas Institute of Higher Education, Hong Kong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
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Wang S, Wang H, Shi X, Wu F, Lv L, Hu M, Sun W, Wu L, Zhou H. A case of Melkersson-Rosenthal syndrome with endocrine disorders: Extraordinary efficiency of hydroxychloroquine and mechanism hypothesis. Eur J Neurol 2020; 28:928-933. [PMID: 33270950 DOI: 10.1111/ene.14615] [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: 07/17/2020] [Revised: 09/17/2020] [Accepted: 10/22/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Melkersson-Rosenthal syndrome (MRS) is a rare neuro-mucocutaneous disease. In addition to the traditional clinical triad, there is also a diversity of clinical signs, and it may be related to other systemic diseases. METHODS In the present study, we report a case of MRS with endocrine disorders that exhibits extraordinary therapeutic efficiency by using hydroxychloroquine (HCQ), explore whether there is an internal connection between MRS and endocrine disorders, and discuss the mechanism of the therapeutic efficiency of using HCQ. The hypothesis proposed for the first time is that MRS may essentially be a systemic granulomatous disease. RESULTS The physical examination revealed orofacial swelling and fissured tongue. The histopathologic examination showed epithelioid granulomas. Combined with the other examination, this case was diagnosed as incomplete MRS. HCQ and local drugs were introduced. The patient achieved clinical recovery and psychological cure by the 18-week follow-up, and the 1-year follow-up found no reactivation of MRS. Moreover, the levels of cortisol and adrenocorticotropic were within normal ranges. CONCLUSIONS After the drug therapy was targeted at granuloma, not only did all of the symptoms related to MRS disappear, but the endocrine system also returned to normal. It is speculated that the endocrine disorder in this patient may be related to MRS. We further propose the first-time hypothesis that MRS may essentially be a systemic granulomatous disease. It provides a new medication method with high-level efficiency.
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Affiliation(s)
- Shimeng Wang
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Hongmei Wang
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.,Mianyang Stomatological Hospital, Mianyang, China
| | - Xueke Shi
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Fanglong Wu
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Ling Lv
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Mingjia Hu
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Wanxin Sun
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Lanyan Wu
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hongmei Zhou
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
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4
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Ng SM, Lo HHM, Yeung A, Young D, Fung MHY, Wang AM. Study Protocol of Brief Daily Body-Mind-Spirit Practice for Sustainable Emotional Capacity and Work Engagement for Community Mental Health Workers: A Multi-Site Randomized Controlled Trial. Front Psychol 2020; 11:1482. [PMID: 32670170 PMCID: PMC7332841 DOI: 10.3389/fpsyg.2020.01482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/03/2020] [Indexed: 01/14/2023] Open
Abstract
Background Given the emotional demanding nature of social services, we developed a brief daily body-mind-spirit (BMS) program and successfully piloted it with workers at elderly services. The proposed study focuses on community mental health workers who are often under chronic stress and vulnerable to burnout. Methods The study aims to evaluate the program for fostering sustainable emotional capacity and work engagement for community mental health workers. A multi-site randomized controlled trial design is adopted. All the 24 the Integrated Community Centre for Mental Wellness (ICCMW of Hong Kong will be approached to join this program. Assuming conservatively, 60% ICCWM (14 centers) will respond and participate. At each site, a pair of intervention and control groups will be run. The targeted total sample size is 224. To investigate the course of changes in burnout and engagement, each group will last 6 months, including 3-month intervention and 3-month follow-up. Measures will be taken at monthly intervals. Discussion In light of literature and the pilot trial’s findings, participants in the Brief Daily BMS intervention group are expected to have a reduced burnout level and a narrowing of range in work engagement during the 3 months intervention. And within the 3 months post-intervention period, a rebound of burnout level and a widening of range in work engagement are expected to be observed in the same group of participants. Hopefully, this study will contribute to the deeper understanding of burnout and work engagement, and shed light on sustainable intervention for emotionally demanding workplaces. Clinical Trial Registration The trial has been registered in the Clinical Trials Centre of the University of Hong Kong. HKUCTR-2763 Registered 27 December 2019 – Retrospectively registered, http://www.hkuctr.com/Study/Show/eb930d24e2c647afb7a922055163f24b.
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Affiliation(s)
- S M Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Herman H M Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Albert Yeung
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Daniel Young
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Melody H Y Fung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Amenda M Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
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5
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Ng SM, Leng LL, Xie QW, Chan JSM, Chan CHY, So KF, Li A, Po KKT, Yuen LP, Ku KS, Choi AWM, Chouliara Z, Cheung ACY, Chan CLW, Emery C. Trust as a mediator in the relationship between childhood sexual abuse and IL-6 level in adulthood. PLoS One 2020; 15:e0232932. [PMID: 32413063 PMCID: PMC7228092 DOI: 10.1371/journal.pone.0232932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/25/2020] [Indexed: 12/20/2022] Open
Abstract
Childhood sexual abuse (CSA) has been shown to predict the coupling of depression and inflammation in adulthood. Trust within intimate relationships, a core element in marital relations, has been shown to predict positive physical and mental health outcomes, but the mediating role of trust in partners in the association between CSA and inflammation in adulthood requires further study. The present study aimed to examine the impact of CSA on inflammatory biomarkers (IL-6 and IL-1β) in adults with depression and the mediating role of trust. A cross-sectional survey data set of adults presenting with mood and sleep disturbance was used in the analysis. CSA demonstrated a significant negative correlation with IL-6 level (r = -0.28, p<0. 01) in adults with clinically significant depression, while trust showed a significant positive correlation with IL-6 level (r = 0.36, p < .01). Sobel test and bootstrapping revealed a significant mediating role for trust between CSA and IL-6 level. CSA and trust in partners were revealed to have significant associations with IL-6 level in adulthood. Counterintuitively, the directions of association were not those expected. Trust played a mediating role between CSA and adulthood levels of IL-6. Plausible explanations for these counterintuitive findings are discussed.
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Affiliation(s)
- Siu-Man Ng
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Ling-Li Leng
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Qian Wen Xie
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Jessie S. M. Chan
- Laboratory of Neuropsychology, The University of Hong Kong, sai wan, Hong Kong
- Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, sai wan, Hong Kong
| | - Celia H. Y. Chan
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Kwok Fai So
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, Guangdong, China
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, sai wan, Hong Kong
- State Key Laboratory of Brain and Cognitive Science, The University of Hong Kong, sai wan, Hong Kong
| | - Ang Li
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, Guangdong, China
| | - Kevin K. T. Po
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, sai wan, Hong Kong
| | - L. P. Yuen
- International Association for Health and Yangsheng, sai wan, Hong Kong
| | - Kam-Shing Ku
- District Elderly Community Service, Haven of Hope Haven of Hope Christian Service, sai wan, Hong Kong
| | - Anna W. M. Choi
- Department of Social and Behavioral Sciences, City University of Hong Kong, sai wan, Hong Kong
| | - Zoë Chouliara
- Division of Mental Health and Counselling, Abertay University, Dundee, United kingdom
| | - Amos C. Y. Cheung
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Cecilia L. W. Chan
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Clifton Emery
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
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6
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Ji X, Ivers H, Savard J, LeBlanc M, Morin CM. Residual symptoms after natural remission of insomnia: associations with relapse over 4 years. Sleep 2020; 42:5514570. [PMID: 31192349 DOI: 10.1093/sleep/zsz122] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/05/2019] [Indexed: 12/29/2022] Open
Abstract
STUDY OBJECTIVES Chronic insomnia tends to "wax and wane" over lifetime. The presence of residual insomnia symptoms is common, especially among naturally remitted individuals. This study aims to examine the features of these residual symptoms and their potential association with future relapse. METHODS A population-based data set on the natural history of insomnia was used for this secondary analysis. Residual insomnia symptoms were investigated in those who had insomnia symptoms/syndrome at baseline and achieved full remission (according to predetermined diagnostic algorithm) within the following 1 year. Cox regressions were used to determine the hazard ratio (HR) of each residual symptom for predicting relapse in the next 4 years. The nature and severity of residual symptoms were examined with an extended version of the Insomnia Severity Index (ISI), which incorporates additional items on sleep quality and specific sleep-related daytime impairments (on daytime fatigue, cognitive functioning, mood, interpersonal relationship, and daily activities). In addition, the presence of depressive symptoms and medical conditions were controlled for in investigating risks of insomnia relapse. RESULTS A total of 434 participants were included in this study (age ranges from 18 to 94; 65.9% female); 248 of them had relapsed within 4 years. The response rate ranged from 78% to 83%. The most frequently reported residual symptoms with at least moderate severity (ISI items ≥2 on 0-4 ISI item scale) were poor "Quality of sleep" (39.2 %), followed by "difficulty maintaining sleep" (DMS; 27%). The most common residual daytime impairments related to insomnia were fatigue (24.7 %), mood disturbances (23%) and cognitive disturbances (22.6%). After controlling for baseline insomnia and depression severity and concurrent physical diseases, impairments of cognition (HR = 1.46), poor quality of sleep (HR = 1.43), disturbed mood (HR = 1.39), being female (HR = 1.36), DMS (HR = 1.35), and fatigue (HR = 1.24) were significantly associated with insomnia relapse in the next 4 years. Moreover, residual poor sleep quality and daytime insomnia symptoms were independent of DMS in predicting relapse. Subgroup regressions according to sex showed that for male participants, residual cognition impairments (HR = 1.98) was the most significant predictors of future relapse, whereas residual DMS (HR = 1.46) significantly predicted relapse for women only. CONCLUSION A wide range of residual symptoms exists in individuals with naturally remitted insomnia. Notably, residual DMS is the most common residual nighttime symptom and the only nighttime symptom associated with insomnia relapse. Additionally, perceived poor sleep quality and cognitive, mood, and somatic impairments attributed to sleep disturbances are also related to future relapse. Attention to these residual symptoms when initiating insomnia treatment is warranted to minimize future relapse.
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Affiliation(s)
- Xiaowen Ji
- School of Psychology, Université Laval, Quebec City, QC, Canada.,Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Quebec City, QC, Canada
| | - Hans Ivers
- School of Psychology, Université Laval, Quebec City, QC, Canada.,Centre de recherche du CHU de Quebec, Université Laval, Quebec City, QC, Canada.,Cancer Research Center, Université Laval, Quebec City, QC, Canada
| | - Josée Savard
- School of Psychology, Université Laval, Quebec City, QC, Canada.,Centre de recherche du CHU de Quebec, Université Laval, Quebec City, QC, Canada.,Cancer Research Center, Université Laval, Quebec City, QC, Canada
| | - Mélanie LeBlanc
- School of Psychology, Université Laval, Quebec City, QC, Canada.,Centre de recherche du CHU de Quebec, Université Laval, Quebec City, QC, Canada
| | - Charles M Morin
- School of Psychology, Université Laval, Quebec City, QC, Canada.,Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Quebec City, QC, Canada
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7
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Comparing primary insomnia to the insomnia occurring in major depression and general anxiety disorder. Psychiatry Res 2019; 282:112514. [PMID: 31474379 DOI: 10.1016/j.psychres.2019.112514] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 12/16/2022]
Abstract
Apart from possibly distinguishing the different clinical causes of insomnia, this article explores the subjective and objective sleep differences amongst primary insomnia, major depression with insomnia and general anxiety disorder with insomnia. Subjective sleep and objective sleep of the participants were evaluated by using the Pittsburgh sleep quality index and polysomnography, respectively. We found that major depression with insomnia exhibited higher daytime dysfunction than primary insomnia; showed significantly higher values of rapid eye movement (REM) periods, time of REM sleep and percentage of REM stage; and presented lower percentage of non-rapid eye movement stage compared with primary insomnia and general anxiety disorder with insomnia (p < 0.05). General anxiety disorder with insomnia showed lower awakening number (AN) than primary insomnia, and other objective and subjective sleep values of general anxiety disorder with insomnia and primary insomnia showed no significant difference (p > 0.05). Our findings showed that major depression with insomnia increased active REM sleep and severe daytime function, which could alert clinicians to the risk of depression. Major depression with insomnia and primary insomnia may be categorically different. However, general anxiety disorder with insomnia and primary insomnia might be a continuum of a disease rather than be categorically distinct.
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