Qu Diyang, Lin Junkang, Wu Zhijun, Cai Tongtong, Yan Jingyan, Aku Yisheng, Liu Chang, Zu Yuxin, Xi Yingjun, Chen Runsen, An Jing
Vanke School of Public Health, Tsinghua University, Beijing, China.
Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), Beijing, China.
J Affect Disord. 2025 Oct 15;387:119451. doi: 10.1016/j.jad.2025.119451. Epub 2025 May 19.
Grounded in the 24-Hour Activity Cycle framework, this study aimed to quantify dose-response thresholds for seven daily behaviors-sleep, napping, low to high intensity physical activity, sedentary time, and screen time-and to evaluate their associations with mental health problems and self-injurious thoughts or behaviors in Chinese adolescents.
Between 2022 and 2023, data were collected from 33,397 Chinese students to examine lifestyle patterns and mental health. Adjusted logistic regression estimated associations between behavioral categories and four mental-health outcomes, and generalized additive models captured dose-response relationships.
Compared with non-nappers, adolescents who napped 60-90 min daily had 16 % lower odds of suicidal risk (OR 0.84; 95 % CI 0.73-0.97) and other outcomes, while moderate-intensity exercise on at least one to two days per week was associated with up to 31 % reduction in odds across all mental health outcomes. Conversely, sleep under 7 h, daily sedentary time equal or over 7 h, and screen time exceeding 4 h were linked to higher risk of adverse outcomes. Generalized Additive Models revealed significant nonlinear dose-response relationships and identified a threshold lifestyle profile for all four mental health outcomes. This profile includes more than 40 minutes of napping per day, a sleep duration ranging from a minimum optimal value of 7.5 hours to a maximum of 10.5 hours per day, at least two days per week of moderate exercise, and no more than 4.4 hours of screen time per day.
These results provide evidence for school-based programs aimed at fostering healthier daily routines, ultimately promoting the mental health and resilience of children and adolescents.
本研究基于24小时活动周期框架，旨在量化七种日常行为（睡眠、午睡、低强度至高强度体育活动、久坐时间和屏幕使用时间）的剂量反应阈值，并评估它们与中国青少年心理健康问题以及自我伤害想法或行为之间的关联。
在2022年至2023年期间，收集了33397名中国学生的数据，以研究生活方式模式和心理健康状况。调整后的逻辑回归估计了行为类别与四种心理健康结果之间的关联，广义相加模型则捕捉了剂量反应关系。
与不午睡的青少年相比，每天午睡60至90分钟的青少年自杀风险及其他结果的几率低16%（比值比0.84；95%置信区间0.73 - 0.97），而每周至少有一到两天进行中等强度运动与所有心理健康结果的几率降低高达31%相关。相反，睡眠不足7小时、每日久坐时间等于或超过7小时以及屏幕使用时间超过4小时与不良后果的较高风险相关。广义相加模型揭示了显著的非线性剂量反应关系，并确定了所有四种心理健康结果的阈值生活方式特征。该特征包括每天午睡超过40分钟、睡眠时间从每天最少最佳值7.5小时到最多10.5小时不等、每周至少两天进行中等强度运动以及每天屏幕使用时间不超过4.4小时。
这些结果为旨在培养更健康日常习惯的校本项目提供了证据，最终促进儿童和青少年的心理健康及恢复力。
