Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China.
Department of Hospital Infection Management Office, Wuhu Hospital of Traditional Chinese Medicine, Wuhu, Anhui, 241000, China.
BMC Psychiatry. 2024 Aug 27;24(1):583. doi: 10.1186/s12888-024-06027-0.
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 .
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.
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.
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.
本研究旨在探讨新冠肺炎疫情期间中国大学生抑郁与自杀意念的相关性，以及时型和睡眠质量在两者关系中的潜在中介作用。
采用分层、整群、多阶段抽样方法，从安徽省四所高校选取了 4768 名大学生作为样本，于新冠肺炎疫情期间（2020 年 11 月至 12 月）进行了这项研究。本研究采用 PHQ-2 中的两个条目评估抑郁症状，MEQ-19 评估个体睡眠时型（即晨型或晚型偏好），PSQI 评估睡眠质量。调查了自杀意念。采用 MPLUS 8.3 软件分析时型和睡眠质量对抑郁与自杀意念关系的中介作用。
在新冠肺炎疫情期间，中国大学生自杀意念的发生率为 5.4%。抑郁与时型呈负相关（β=-0.346，P<0.01），与睡眠质量呈正相关（β=0.846，P<0.001），表明有抑郁症状的学生更可能有时型晚和睡眠质量差。时型晚（β=-0.019，P<0.05）和睡眠质量差（β=0.066，P<0.01）预测自杀意念。抑郁是自杀意念的直接且显著的危险因素（效应值=0.535，95%置信区间：0.449~0.622）。时型和睡眠质量对抑郁与自杀意念之间的关系具有潜在的中介作用；然而，时型和睡眠质量的链式中介作用不具有统计学意义。
本研究结果表明，在新冠肺炎疫情期间，抑郁可能通过影响睡眠时型和质量导致自杀意念。这些引人注目的发现强调了实施早期干预策略的紧迫性，旨在减轻特别是有抑郁症状、睡眠模式紊乱和睡眠质量差的学生的自杀想法。
