锦州市大学生昼夜节律紊乱与抑郁焦虑症状关联

Association between circadian rhythm disorder with depressive and anxiety symptoms of college students in Jinzhou City

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(χ^(2)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(χ^(2)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(χ^(2)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(χ^(2)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(r_(s)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(r_(s)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。

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(χ~2=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(χ~2=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(χ~2=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),(χ~2=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(r_(s)=0.10,0.09),and social jet lag was positively correlated with the standard scores of depression and anxiety(r_(s)=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.