Shuman Tao1, Xiaoyan Wu2, Shiyue Li3, Le Ma4, Yizhen Yu5, Guilong Sun6, Yi Zhang7, Tingting Li8, Fangbiao Tao9. 1. Department of Nephrology, The Second Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China. Electronic address: shumantao@126.com. 2. MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. Electronic address: xywu85@126.com. 3. School of Health Sciences, Wuhan University, Wuhan, 430071, Hubei, China. Electronic address: lsywhd@sina.com. 4. School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, China. Electronic address: male@mail.xjtu.edu.cn. 5. Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Hangkong Road 13, Wuhan, 430030, Hubei, China. Electronic address: yuyizhen650@163.com. 6. South-Central Minzu University, 182 Minyuan Road, Wuhan, 430074, Hubei, China. Electronic address: 2016022@mail.scuec.edu.cn. 7. MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. Electronic address: ZY18356056506@163.com. 8. MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. Electronic address: litingting199510@163.com. 9. MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. Electronic address: fbtao@ahmu.edu.cn.
Abstract
OBJECTIVE/ BACKGROUND: School closure and home quarantine has been implemented worldwide during the coronavirus disease 2019 (COVID-19) outbreak. The study aims to assess the associations of circadian rhythm abnormalities (CRA) during the COVID-19 outbreak with mental health in Chinese undergraduates. METHODS: A nationwide cross-sectional university-based survey was conducted from 4th February to 12th, 2020. Based on different geographical locations and purposive sampling approach, 19 universities from 16 provinces or municipalities in the mainland of China were selected. A total of 14,789 participants were recruited by using multistage stratified random sampling. The data of CRA were collected by self-reported questionnaires consist of four items involved rest-activity cycle, diet rhythm, wake up rhythm and sleep rhythm. The Patient Health Questionnaire and the Generalized Anxiety Disorder were applied to evaluate the symptoms of depression and anxiety. Chi-square test and ordinal logistic regression models were used to describe the distributions and associations of CRA and mental health. RESULTS: A total of 11,787 students [female: 6731(57.1%)] aged 15-26 years old (M = 20.45, SD = 1.76) were analyzed (response rate: 79.7%). The results showed the percentage of CRA were 17.5-28.7%. The prevalence of depression and anxiety were significantly higher in students with single CRA. Students who reported the coexistence of four CRA were more likely to be with the symptoms of depression (OR: 4.43, 95% CI: 3.91-5.03) and anxiety (OR: 3.11, 95% CI: 2.70-3.60). Dose-response relationships were found between multiple CRA and mental problems. CONCLUSION: Circadian rhythm abnormalities are positively associated with mental health among university studies. Mental health care is needed for college students during the COVID-19 epidemic period.
OBJECTIVE/ BACKGROUND: School closure and home quarantine has been implemented worldwide during the coronavirus disease 2019 (COVID-19) outbreak. The study aims to assess the associations of circadian rhythm abnormalities (CRA) during the COVID-19 outbreak with mental health in Chinese undergraduates. METHODS: A nationwide cross-sectional university-based survey was conducted from 4th February to 12th, 2020. Based on different geographical locations and purposive sampling approach, 19 universities from 16 provinces or municipalities in the mainland of China were selected. A total of 14,789 participants were recruited by using multistage stratified random sampling. The data of CRA were collected by self-reported questionnaires consist of four items involved rest-activity cycle, diet rhythm, wake up rhythm and sleep rhythm. The Patient Health Questionnaire and the Generalized Anxiety Disorder were applied to evaluate the symptoms of depression and anxiety. Chi-square test and ordinal logistic regression models were used to describe the distributions and associations of CRA and mental health. RESULTS: A total of 11,787 students [female: 6731(57.1%)] aged 15-26 years old (M = 20.45, SD = 1.76) were analyzed (response rate: 79.7%). The results showed the percentage of CRA were 17.5-28.7%. The prevalence of depression and anxiety were significantly higher in students with single CRA. Students who reported the coexistence of four CRA were more likely to be with the symptoms of depression (OR: 4.43, 95% CI: 3.91-5.03) and anxiety (OR: 3.11, 95% CI: 2.70-3.60). Dose-response relationships were found between multiple CRA and mental problems. CONCLUSION: Circadian rhythm abnormalities are positively associated with mental health among university studies. Mental health care is needed for college students during the COVID-19 epidemic period.