Background: High prevalence and strong relationships among suicidal ideation, Internet gaming disorder (IGD), insomnia, and depression have been reported for adolescents worldwide, but the mechanism underlying these psychological problems remains unclear. This cross-sectional study explored the mediating effect of insomnia and depression on the association between IGD and suicidal ideation. Methods: Participants were 1066 adolescents (median age = 13.0 years) with Internet games exposure in the previous 12 months from junior high schools in Shanghai, China. Questionnaire measures of suicidal ideation, IGD, insomnia, depressive symptoms, and background characteristics were obtained. Path analysis was conducted to test the multiple mediating roles of insomnia and depression. Results: Suicidal ideation, IGD, insomnia, and depression prevalence was 27.2, 13.6, 9.2, and 17.0%, respectively. A serial multiple mediation model was generated. The mediation effect of insomnia and depression on the pathway from IGD to suicidal ideation was 45.5% (direct effect: standardized estimate [Std. estimate] = 0.186; total indirect effect: Std. estimate = 0.155). The association between IGD and depression was partially mediated by insomnia (direct effect: Std. estimate = 0.211; indirect effect: Std. estimate = 0.135). The proposed model fit the data well. Conclusions: Insomnia and depression may serially mediate the association between IGD and suicidal ideation. IGD was positively associated with insomnia, then with depression, which in turn positively contributed to suicidal ideation. We suggest greater monitoring of Internet use and prevention of insomnia and depression to mitigate the risk of suicidal ideation among Chinese adolescents.

The use of social network sites (SNSs) is inevitable in daily life. Everyone is likely to be addicted to SNSs, especially medical students. This study is aimed to assess the degree of SNS addiction and its relation to psychosocial factors such as depression, loneliness and unmet interpersonal needs among Chinese medical students. The cross-section survey was conducted from March to May in 2018 in Shanghai Jiao Tong University School of Medicine. Of the total 1067 participants, 33.18% had an SNS addiction, 87.7% of the participants used SNSs every day during last month and 53.42% of the participants used SNSs for at least an hour per day during the last week. SNS addiction is positively related with depression both directly and indirectly. The mediating roles of loneliness and unmet interpersonal needs on the relationship between SNS addiction and depression are significant. For the well-being of medical students, efforts should be taken to prevent them from becoming addicted to SNSs.

Background: Sexual compulsivity (SC) and its relationship with unprotected intercourse (UI) have long been an intriguing topic, but its existential meaning in the management of public health or, more precisely, sexually transmitted infections (STIs) has rarely been studied to date. This study examines whether SC plays a role in UI among sexually active STI patients. Method: A cross-sectional study was conducted in two sexual transmitted disease (STD) clinicals of Shanghai Skin Diseases Hospital in Shanghai. Totally 664 sexually active STI patients were included. Results: The ages of the 664 participants ranged from 18 to 76 years, with 58.73% between 26 and 40 years old. 449 (191 male and 258 female) reported had UI during the past 6 months. Although the only statistically significant difference (p < 0.01) was in relation to UI with a casual sexual partner, the difference between male/female and regular/casual sexual partners remained evident. Conclusions: SC is evidently a potential predictor of UI with a casual sexual partner in male STI patients, while the use of condoms is more likely to be affected by other factors. In addition to general sexual education, counseling interventions should be provided by health institutions, and specific intervention methods targeting gender and sexual partners should be considered.

In China, unmarried female migrants are vulnerable to sexual and reproductive health risks. One effective protection strategy is promoting consistent condom use (CCU). We conducted a cross-sectional study to apply the information-motivation-behavioral skills (IMB) model and modified it by addition of psychological and personal factors to examine the related factors of CCU and provide suggestions for intervention among unmarried female migrants. Of all 903 eligible participants, only 13.8% of participants reported CCU in the past six months. Both the IMB model and the modified IMB model provided acceptable fit to the data. In both models, information had no direct or indirect influence on CCU (p > 0.05). However, behavioral skills had a positive effect on CCU (β = 0.344, p < 0.001 and β = 0.330, p < 0.001). Moreover, motivation contributed to CCU indirectly by affecting behavioral skills (β = 0.800, p < 0.001) and had no direct influence (p > 0.05). In the modified model, psychological and personality factors influenced CCU directly (β = − 0.100, p = 0.005). Our results highlight the importance of conducting CCU promotion among unmarried female migrants. Future intervention strategies should focus on both the traditional IMB model constructs and the added psychological and personality factors.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Electronic health literacy (eHL) has been increasingly associated with health-related quality of life (HRQoL). However, the underlying mechanisms, especially in the general population, remain insufficiently explored. Objective: This study aimed to investigate the mediating role of health self-management behaviors (HSMB) in the relationship between eHL and HRQoL. Methods: A cross-sectional study was conducted in Shanghai, China, from October to December 2022. Participants were recruited via convenience sampling from seven community health service centers. Data were collected through an online survey platform Wenjuanxing. Validated scales, including the eHealth Literacy Scale, the Adults Health Self-Management Skill Rating Scale, and the 12-item Short Form Health Survey were utilized to measure eHL, HSMB, and HRQoL, respectively. The HRQoL was summarized into the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Correlation analysis, multivariate linear regression with stepwise backward selection, and mediation analysis were performed to explore the relationships among eHL, HSMB, PCS, and MCS, with adjustments for sociodemographic and health-related covariates. Results: Among the 2,364 participants recruited from urban, peri-urban, and rural areas, eHL scores varied significantly by demographic characteristics. Positive correlations between eHL, HSMB, PCS and MCS were observed, with Spearman correlation coefficients ranging from 0.24 to 0.46 (P<.001). Multivariate analysis showed that eHL was significantly positively associated with PCS (RC=0.14, 95% CI = 0.09-0.18, P<.001) and MCS (RC=0.23, 95% CI = 0.17-0.28, P<.001). Mediation analysis indicated that eHL had a significant direct (PCS: βc = 0.18, 95% CI = 0.13-0.23, P<.001; MCS: βc = 0.32, 95% CI = 0.25-0.38, P<.001) and an indirect effect on HRQoL through HSMB (PCS: βc’ = 0.11, 95% CI = 0.09-0.14, P<.001; MCS: βc’ = 0.14, 95% CI = 0.10-0.17, P<.001). Conclusions: This study demonstrated a positive association between eHL and HRQoL, with HSMB acting as a partial mediator among the general population in Shanghai. Targeted interventions should be implemented to improve eHL and HSMB.

Background The prevalence of depression in sexually transmitted infections (STIs) patients is much higher than general public. However, studies focusing on comprehensive psychosocial effects on depression among STIs patients are limited. This study aimed to examine association of multiple psychosocial syndemic conditions with depression among STIs patients in Shanghai, China. Methods We conducted a cross-sectional study and recruited 910 STIs patients from Shanghai Skin Disease Hospital. Participants self-reported their demographics and themselves completed the scales of depression, self-esteem, loneliness, social support, entrapment, defeat and interpersonal needs. Logistic regressions were performed to detect the possible contributing psychosocial factors for depression and to verify the syndemic conditions of psychosocial problems. Results Of the STIs patient sample, the prevalence of depression was 17.9%. Multivariable analysis showed low-level self-esteem (odds ratio [ORm]: 2.18, 95% CI [1.19–4.00]) and social support (ORm: 2.18, 95% CI [1.37–3.46]), high-level entrapment (ORm: 6.31, 95% CI [3.75–10.62]) and defeat (ORm: 2.60, 95% CI [1.51–4.48]) increased the risk of depression. Psychosocial syndemic conditions magnified effect in fusing depression (adjusted odds ratio [AOR]: 11.94, 95% CI [7.70–18.53]). Participants with more than 4 psychosocial problems were about 22 times more likely to have depression (AOR: 22.12, 95% CI [13.19–37.09]). Conclusions The psychosocial problems syndemic magnifying the risk of depression was confirmed and psychosocial interventions to prevent depression is needed among STIs patients.