Exploring the interconnections of anxiety, depression, sleep problems and health-promoting lifestyles among Chinese university students: a comprehensive network approach

探索中国大学生焦虑、抑郁、睡眠问题和健康生活方式之间的相互联系:综合网络方法

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作者:Changqing Sun, Zhengqi Zhu, Peijia Zhang, Lianke Wang, Qiang Zhang, Yuanli Guo, Lina Guo, Yang Li, Panpan Wang, Bo Hu, Mengting Liu, Jingyi Duan, Yiwen Wang, Ziqi Wang, Ying Qin

Background

Anxiety, depression, and sleep problems are prevalent comorbid mental disorders among university students. The World Health Organization (WHO) emphasized a mental health promotion

Conclusion

Targeting core and bridge symptoms with timely and appropriate interventions can alleviate anxiety, depression, and sleep problems in this population. Moreover, promoting physical activity, fostering spiritual growth, and managing stress are likely to significantly enhance the overall mental health of university students.

Methods

A total of 3,896 qualified university students participated in this study. Anxiety, depression, sleep problems, and HPLs were assessed using the GAD-7, PHQ-9, PSQI, and HPLP-II scales. A Gaussian Graphical Model was used to construct the networks. The Network Comparison Test was applied to determine whether the associations between HPLs and comorbid symptoms vary by gender, educational level, family sibling, and mental health status.

Results

Low energy (PHQ4) had the highest strength centrality, followed by Daytime dysfunction (PSQI7) and Trouble relaxing (GAD4). Five bridge symptoms were identified: Daytime dysfunction (PSQI7), Self-harm even suicide (PHQ9), Sad mood (PHQ2), Low energy (PHQ4), and Feeling afraid (GAD7). Regarding protective HPLs, Physical activity, Spiritual growth, and Stress management generally emerged as the top three central mental health-promoting behaviors.

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