Association between circadian rhythm disorder with depressive and anxiety symptoms of college students in Jinzhou City
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摘要:
目的 探讨大学生昼夜节律与抑郁、焦虑症状的关联，为有针对性的预防大学生抑郁、焦虑症状提供参考依据。 方法 采用方便抽样法，于2020年11—12月在锦州市3所大学抽取1 938名大学生，采用一般情况调查问卷、抑郁自评量表(SDS)、焦虑自评量表(SAS)及慕尼黑睡眠时型问卷(MCTQ)进行问卷调查，分析昼夜节律和抑郁、焦虑症状的关联。 结果 不同专业，不同吸烟、饮酒、体育锻炼情况的大学生抑郁症状检出率差异均有统计学意义(χ2值分别为46.80，5.88，5.76，12.23)，不同专业、吸烟情况、饮酒情况的大学生焦虑症状检出率差异均有统计学意义(χ2值分别为9.41，5.80，5.56)(P值均 < 0.05)。分层分析显示，不同睡眠时型抑郁症状在年龄21岁、女生、医学和非医学专业、二年级、城镇户籍地、体质量指数为正常、不吸烟、饮酒和不饮酒、参加体育锻炼大学生中差异均有统计学意义(χ2值分别为8.16，14.42，12.25，6.19，10.99，15.29，17.41，15.63，7.47，9.59，10.51，P值均 < 0.05)；不同睡眠时型焦虑症状在年龄21岁、不吸烟大学生中差异有统计学意义(χ2值分别为8.34，7.16，P值均 < 0.05)。Spearman秩相关显示，校正后的休息日睡眠中点(MSFsc)与抑郁、焦虑标准分呈正相关(rs值分别为0.10，0.09)，社会性时差与抑郁、焦虑标准分呈正相关(rs值分别为0.09，0.05)(P值均 < 0.05)。控制年龄、专业、吸烟、饮酒因素后，二分类Logistic回归显示，平均睡眠时长与抑郁症状呈负相关(OR=0.82)，每周失眠时间与抑郁症状呈正相关(OR=1.14)。早起型和中间型睡眠时型与抑郁症状呈负相关(OR值分别为0.66，0.57)；中间型睡眠时型与焦虑症状呈负相关(OR=0.65)。 结论 昼夜节律与抑郁、焦虑症状有关，其中平均睡眠时长、早起型和中间型睡眠时型与抑郁症状呈负相关，中间型睡眠时型与焦虑症状呈负相关。 Abstract:Objective To explore the association between circadian rhythm with depressive and anxiety symptoms of college students in Jinzhou City, to provide a theoretical basis for targeted depression and anxiety prevention among college students. Methods A total of 1 938 college students were selected by convenient sampling method from November to December 2020 for questionnaire survey. The relationship between circadian rhythm and depression and anxiety symptoms was analyzed by using questionnaire, survey including Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and Munich Chronotype Questionnaire (MCTQ). Results There were significant differences in the distribution of depressive symptoms in different majors, smoking, drinking and physical exercise (χ2=46.80, 5.88, 5.76, 12.23, P < 0.05). There were significant differences in the distribution of anxiety symptoms in different majors, smoking and drinking (χ2=9.41, 5.80, 5.56, P < 0.05). Stratified analysis showed that the depressive symptoms of different chronotype were statistically varied by age, gender, professional, grade, registered residence, body mass index, smoking, drinking, and sports(χ2=8.16, 14.42, 12.25, 6.19, 10.99, 15.29, 17.41, 15.63, 7.47, 9.59, 10.51, P < 0.05). The anxiety symptoms of different chronotype were statistically different in age (21 years) and smoking (no), (χ2=8.34, 7.16, P < 0.05). Spearman rank correlation showed that the corrected Mid-sleep on Free Days Corrected for Sleep Debt on Work Days (MSFsc) was positively correlated with the standard scores of depression and anxiety (rs=0.10, 0.09), and social jet lag was positively correlated with the standard scores of depression and anxiety (rs=0.09, 0.05)(P < 0.05). After controlling for age, major, smoking and drinking, binary Logistic regression showed that mean sleep length was inversely correlated with depressive symptoms (OR=0.82), and weekly insomnia frequency was positively correlated with depressive symptoms (OR=1.14).Early type and intermediate type of chronotypes were negatively correlated with depression (OR=0.66, 0.57). Intermediate type of chronotype was negatively correlated with anxiety symptoms (OR=0.65). Conclusion Circadian rhythm is related to depressive and anxiety symptoms, among which the average sleep length, early rise and intermediate sleep patterns are negatively related to depression symptoms, and intermediate sleep patterns and anxiety symptoms, suggesting that circadian rhythm disorder may affect depression and anxiety symptoms. -
Key words:
- Depression /
- Anxiety /
- Circadian rhythm /
- Regression analysis /
- Students
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表 1 不同人口统计学特征大学生抑郁焦虑症状检出率比较
Table 1. Comparison of detection rates of depression and anxiety symptoms among college students with different demographic characteristics
变量 选项 人数 抑郁 焦虑 变量 选项 人数 抑郁 焦虑 检出人数 χ2值 P值 检出人数 χ2值 P值 检出人数 χ2值 P值 检出人数 χ2值 P值 年龄/岁 18 214 80(37.4) 1.18 0.88 59(27.6) 2.70 0.61 五 111 42(37.8) 34(30.6) 19 387 146(37.7) 89(23.0) 户籍地 城镇 986 376(38.1) 0.89 0.34 257(26.1) 0.02 0.88 20 466 190(40.8) 124(26.6) 农村 952 383(40.2) 251(26.4) 21 407 159(39.1) 109(26.8) BMI 偏瘦 353 135(38.2) 4.30 0.23 91(25.8) 1.71 0.64 22~25 464 184(39.7) 127(27.4) 正常 1 158 439(37.9) 295(25.5) 性别 男 728 285(39.1) < 0.01 0.99 202(27.7) 1.42 0.23 过重 299 127(42.5) 84(28.1) 女 1 210 474(39.2) 306(25.3) 肥胖 128 58(45.3) 38(29.7) 专业 医学 1 040 334(32.1) 46.80 < 0.01 243(23.4) 9.41 < 0.01 吸烟 是 121 60(49.6) 5.88 0.02 43(35.5) 5.80 0.02 非医学 898 425(47.3) 265(29.5) 否 1 817 699(38.5) 465(25.6) 年级 一 470 174(37.0) 2.02 0.73 116(24.7) 1.86 0.76 饮酒 是 406 180(44.3) 5.76 0.02 125(30.8) 5.56 0.02 二 508 208(40.9) 133(26.2) 否 1 532 579(37.8) 383(25.0) 三 484 195(40.3) 126(26.0) 体育锻炼 参加 1 430 527(36.9) 12.23 < 0.01 362(25.3) 2.27 0.13 四 365 140(38.4) 99(27.1) 不参加 508 232(45.7) 146(28.7) 注：( )内数字为检出率/%。 
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表 2 不同睡眠时型大学生抑郁症状检出率比较
Table 2. Comparison of detection rates of chronotype depression symptoms among college students with different demographic characteristics
睡眠时型 年龄/岁 性别 专业 年级 18 19 20 21 22~25 男 女 医学 非医学 一 二 三 四 五 早起型 14(29.2) 40(34.8) 48(42.1) 24(30.8) 22(32.8) 45(31.0) 103(37.2) 58(28.0) 90(41.9) 34(29.6) 62(41.9) 33(32.0) 17(36.2) 2(22.2) 中间型 15(29.4) 27(29.3) 38(32.8) 29(31.5) 24(35.3) 50(33.8) 83(30.6) 52(24.3) 81(39.5) 38(30.9) 35(29.7) 37(33.3) 22(36.1) 1(16.7) 晚起型 20(51.3) 33(44.6) 37(43.0) 46(48.9) 54(42.2) 77(42.8) 113(46.9) 83(39.3) 107(51.0) 35(41.2) 53(51.5) 44(46.3) 44(41.5) 14(43.8) χ2值 5.91 4.21 2.95 8.16 1.92 5.41 14.42 12.25 6.19 3.42 10.99 5.27 0.66 2.24 P值 0.05 0.12 0.23 0.02 0.38 0.07 < 0.01 < 0.01 0.05 0.18 < 0.01 0.07 0.72 0.37 睡眠时型 户籍地 BMI 吸烟 饮酒 体育锻炼 城镇 农村 偏瘦 正常 过重 肥胖 是 否 是 否 参加 不参加 早起型 74(35.7) 74(34.4) 27(34.2) 80(33.2) 27(37.5) 14(46.7) 9(52.9) 139(34.3) 26(37.7) 122(34.6) 107(32.6) 41(43.6) 中间型 54(27.1) 79(35.9) 30(37.5) 72(29.1) 24(36.4) 7(26.9) 8(36.4) 125(31.5) 32(35.6) 101(30.7) 96(30.4) 37(35.9) 晚起型 103(45.4) 87(44.8) 35(45.5) 113(46.5) 24(36.9) 18(50.0) 18(52.9) 172(44.4) 59(53.2) 131(42.3) 121(42.3) 69(51.1) χ2值 15.29 5.42 2.20 17.41 0.02 3.63 1.69 15.63 7.47 9.59 10.51 5.49 P值 < 0.01 0.07 0.33 < 0.01 0.99 0.16 0.43 < 0.01 0.02 0.01 0.01 0.06 注：()内数字为检出率/%。
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表 3 不同睡眠时型大学生焦虑症状检出率比较
Table 3. Comparison of detection rates of anxiety symptoms among college students with different demographic characteristics
睡眠时型 年龄/岁 性别 专业 年级 18 19 20 21 22~25 男 女 医学 非医学 一 二 三 四 五 早起型 7(14.6) 20(17.4) 32(28.1) 21(26.9) 13(19.4) 31(21.4) 62(22.4) 37(17.9) 56(26.0) 18(15.7) 39(26.4) 21(20.4) 12(25.5) 3(33.3) 中间型 10(19.6) 17(18.5) 25(21.6) 16(17.4) 15(22.1) 33(22.3) 50(18.5) 33(15.4) 50(24.4) 21(17.1) 27(22.9) 22(19.8) 12(19.7) 1(16.7) 晚起型 14(35.9) 16(21.6) 25(29.1) 34(36.2) 27(21.1) 54(30.0) 62(25.7) 51(24.2) 65(31.0) 23(27.1) 30(29.1) 26(27.4) 27(25.5) 10(31.3) χ2值 5.99 0.54 1.87 8.34 0.15 4.00 3.96 5.58 2.46 4.68 1.13 2.02 0.81 0.55 P值 0.05 0.76 0.39 0.02 0.93 0.14 0.14 0.06 0.29 0.10 0.57 0.37 0.67 0.80 睡眠时型 户籍地 BMI 吸烟 饮酒 体育锻炼 城镇 农村 偏瘦 正常 过重 肥胖 是 否 是 否 参加 不参加 早起型 45(21.7) 48(22.3) 15(19.0) 57(23.7) 14(19.4) 7(23.3) 6(35.3) 87(21.5) 16(23.2) 77(21.8) 69(21.0) 24(25.5) 中间型 34(17.1) 49(22.3) 20(25.0) 46(18.6) 11(16.7) 6(23.1) 6(27.3) 77(19.4) 21(23.3) 62(18.8) 61(19.3) 22(21.4) 晚起型 61(26.9) 55(28.4) 24(31.2) 65(26.7) 15(23.1) 12(33.3) 11(32.4) 105(27.1) 36(32.4) 80(25.8) 77(26.9) 39(28.9) χ2值 5.92 2.68 3.09 4.66 0.86 1.13 0.31 7.16 2.78 4.52 5.47 1.74 P值 0.05 0.26 0.21 0.10 0.65 0.57 0.86 0.03 0.25 0.10 0.07 0.42 注：()内数字为检出率/%。
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表 4 大学生不同睡眠时型和睡眠特征对抑郁焦虑症状影响的Logistic回归分析(n=1 262)
Table 4. Logistic regression analysis of different chronotype and sleep characteristics on depression and anxiety symptoms(n=1 262)
自变量 抑郁 焦虑 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 每天平均睡眠时长 -0.20 0.07 7.67 0.01 0.82(0.71~0.94) 每周失眠时间 0.13 0.04 10.72 < 0.01 1.14(1.05~1.23) 睡眠时型a 早起型 -0.41 0.15 7.97 0.01 0.66(0.50~0.88) -0.30 0.16 3.57 0.06 0.74(0.54~1.01) 中间型 -0.56 0.15 14.30 < 0.01 0.57(0.43~0.76) -0.43 0.17 6.84 0.01 0.65(0.47~0.90) 注：a参照组为晚起型。
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