Pathways linking loneliness and depressive symptoms among Chinese adolescents: The mediating role of sleep disturbance.

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY Journal of affective disorders Pub Date : 2024-11-04 DOI:10.1016/j.jad.2024.11.006

Huiyu Cheng, Wanting Hu, Shengyu Luo, Xiangyu Feng, Zijie Chen, Xiangyue Yu, Huijun Li, Xiuqiong Feng, Weiqing Chen, Vivian Yawei Guo

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Abstract

Background: Despite growing evidence linking loneliness and depressive symptoms, the underlying pathways remain unclear. This study aims to assess the impact of loneliness on depressive symptoms among Chinese adolescents and investigate the potential mediating role of sleep disturbance.

Methods: A cross-sectional study was conducted between November and December 2021. Loneliness, depressive symptoms, and sleep disturbance were assessed using the UCLA Loneliness Scale, the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index questionnaire, respectively. Baron and Kenny's causal steps method and the Karlson-Holm-Breen method were applied to explore the mediating role of sleep disturbance. Subgroup analysis by gender was also conducted.

Results: A total of 6838 adolescents were included, with 52.2 % boys and a mean age of 14.5 (SD = 1.6) years. Approximately 15.8 % of the adolescents reported depressive symptoms. Loneliness was positively associated with depressive symptoms after controlling for covariates (OR = 1.34, 95%CI = 1.31-1.36). After incorporating sleep disturbance into the model, the association was still significant (OR = 1.28, 95%CI = 1.25-1.31). Sleep disturbance partially mediated this association, contributing to 18.89 % of the total effects. The associations and mediation effects were consistent across both genders, with no moderating effect of gender observed.

Limitations: The cross-sectional design limits the ability to establish causality.

Conclusion: Loneliness was significantly associated with depressive symptoms in Chinese adolescents and this association was partially mediated by sleep disturbance. Interventions aimed at reducing loneliness and improving sleep quality may help lower the risk of depressive symptoms in Chinese adolescents, regardless of genders. Nevertheless, further randomized controlled trials are needed to confirm these findings.

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中国青少年孤独感与抑郁症状之间的联系途径：睡眠障碍的中介作用

背景：尽管越来越多的证据表明孤独感与抑郁症状有关，但其背后的途径仍不清楚。本研究旨在评估孤独感对中国青少年抑郁症状的影响，并探讨睡眠障碍的潜在中介作用：方法：2021年11月至12月期间进行了一项横断面研究。孤独感、抑郁症状和睡眠障碍分别通过加州大学洛杉矶分校孤独感量表、9项患者健康问卷和匹兹堡睡眠质量指数问卷进行评估。巴伦和肯尼的因果步骤法以及卡尔森-霍尔姆-布林法被用来探讨睡眠障碍的中介作用。研究还按性别进行了分组分析：共纳入了 6838 名青少年，其中男生占 52.2%，平均年龄为 14.5 岁（SD = 1.6）。约 15.8% 的青少年报告了抑郁症状。在控制协变量后，孤独感与抑郁症状呈正相关（OR = 1.34，95%CI = 1.31-1.36）。在将睡眠障碍纳入模型后，这种关联仍然显著（OR = 1.28，95%CI = 1.25-1.31）。睡眠障碍对这一关联起到了部分中介作用，占总效应的 18.89%。两性之间的关联和中介效应是一致的，没有观察到性别的调节效应：局限性：横断面设计限制了确定因果关系的能力：结论：孤独感与中国青少年的抑郁症状有明显的关联，这种关联部分受睡眠障碍的影响。旨在减少孤独感和改善睡眠质量的干预措施可能有助于降低中国青少年（无论性别）出现抑郁症状的风险。不过，还需要进一步的随机对照试验来证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.