Problematic mobile phone use (PMPU) is a risk factor for both adolescents’ sleep quality and mental health. It is important to examine the potential negative health effects of PMPU exposure. This study aims to evaluate PMPU and its association with mental health in Chinese college students. Furthermore, we investigated how sleep quality influences this association. In 2013, we collected data regarding participants’ PMPU, sleep quality, and mental health (psychopathological symptoms, anxiety, and depressive symptoms) by standardized questionnaires in 4747 college students. Multivariate logistic regression analysis was applied to assess independent effects and interactions of PMPU and sleep quality with mental health. PMPU and poor sleep quality were observed in 28.2% and 9.8% of participants, respectively. Adjusted logistic regression models suggested independent associations of PMPU and sleep quality with mental health (p < 0.001). Further regression analyses suggested a significant interaction between these measures (p < 0.001). The study highlights that poor sleep quality may play a more significant role in increasing the risk of mental health problems in students with PMPU than in those without PMPU.

Background: Comorbidity of psychiatric disorders such as depression and anxiety is very common among children and adolescents. Few studies have examined how comorbid anxiety and depression are associated with health risk behaviors (HRBs) in adolescents, which could inform preventative approaches for mental health. Objective: We evaluated the association between HRBs and comorbid anxiety and depression in a large adolescent cohort. Methods: We used data from 22,868 adolescents in the National Youth Cohort (China). Anxiety and depression symptoms were assessed using the 9-item Patient Health Questionnaire scale and the 7-item Generalized Anxiety Disorder scale, respectively. Comorbidity was determined by the coexistence of anxiety and depression. HRBs including poor diet, smoking, physical inactivity, and poor sleep, as well as the above HRB scores, were added to obtain the total HRB score (HRB risk index). Based on single and total HRB scores, we divided participants into low-, medium-, and high-risk groups. Potential confounders included gender, presence of siblings, regional economic level, educational status, self-rated health, parental education level, self-reported family income, number of friends, learning burden, and family history of psychosis. Correlation analysis was used to explore associations between single risk behaviors. Binary logistic regression estimated the association between HRBs and anxiety-depression comorbidity before and after adjusting for potential confounders. Results: The comorbidity rate of anxiety and depression among Chinese adolescents was 31.6% (7236/22,868). There was a statistically significant association between each HRB (P<.05), and HRBs were positively associated with comorbid anxiety and depression in the above population. For single HRBs, adolescents with poor diet, smoking, and poor sleep (medium-risk) were more prone to anxiety-depression comorbidity after adjusting for confounders compared to low-risk adolescents. However, adolescents with all high-risk HRBs were more likely to have comorbid anxiety and depression after adjusting for confounders (poor diet odds ratio [OR] 1.50, 95% CI 1.39-1.62; smoking OR 2.17, 95% CI 1.67-2.81; physical inactivity OR 1.16, 95% CI 1.06-1.28; poor sleep OR 1.84, 95% CI 1.70-2.01). Moreover, in both unadjusted (medium risk OR 1.79, 95% CI 1.56-2.05; high risk OR 3.09, 95% CI 2.72-3.52) and adjusted (medium risk OR 1.57, 95% CI 1.37-1.80; high risk OR 2.33, 95% CI 2.03-2.68) models, HRB risk index, like clustered HRBs, was positively associated with anxiety-depression comorbidity, and the strength of the association was stronger than for any single HRB. In addition, we found that compared to girls, the association between clustered HRBs and anxiety-depression comorbidity was stronger in boys after adjustment. Conclusions: We provide evidence that HRBs are related to comorbid anxiety and depression. Interventions that decrease HRBs may support mental health development in adolescence, with the potential to improve health and well-being through to adulthood.

Purpose: Sleep insufficiency and circadian rhythm disturbances in college students have become prominent. Current findings show that sleep insufficiency is closely related to inflammation. Studies on the correlation between chronotype and inflammatory factors are still lacking. Therefore, this research intended to examine the relationships between sleep duration, chronotype and inflammatory cytokines in young adults, and to estimate the correlation between chronotype and inflammatory cytokines stratified by sleep duration. Patients and Methods: We conducted a cross-sectional study in April and May 2019. Participants were recruited from two colleges located in central China. The Pittsburgh Sleep Quality Index (PSQI) and the Morning and Evening Questionnaire-5 (MEQ-5) were administered to assess sleep duration and chronotype. Sleep duration less than 7 hours was defined as insufficient sleep. Fasting venous blood was collected to measure plasma levels of inflammatory markers including IL-1β, IL-6, TNF-α and IL-10. Results: A total of 723 participants were included in this study, with a mean age of 18.68 years (standard deviation=0.99). After adjusting for confounding factors, the results of generalized linear model showed that sleep insufficiency was positively correlated with IL-1β, TNF-α and IL-10; and evening-types (E-types) were positively associated with the levels of IL-1β and IL-6 (p< 0.05). Compared to the control group (sleep sufficiency and M-types), there were positive interaction effects of sleep insufficiency and neutral-types (N-types) on the levels of IL-1β, IL-6, TNF-α and IL-10 (p< 0.05). The hierarchical regression model showed that N-types and E-types were positively correlated to the levels of IL-1β, IL-6, TNF-α and IL-10 among college students with sleep insufficiency (p< 0.05). Conclusion: The levels of inflammatory markers were higher among college students with sleep insufficiency and E-types. N-types and E-types were positively correlated with IL-1β, IL-6, TNF-α and IL-10 among college students with sleep insufficiency.

The increase rates of cesarean section (CS) occurred at the same period as the dramatic increase of childhood overweight/obesity. In China, cesarean section rates have exponentially increased in the last 20 years and they now exceed World Health Organization (WHO) recommendation. Such high rates demand an understanding to the long-term consequences on child health. We aim to examine the association between CS and risk of overweight and obesity among preschool children. We recruited 9103 children from 35 kindergartens in 4 cities located in East China. Children anthropometric measurements were taken in person by trained personnel. The mode of delivery was classified as vaginal or CS, in sub-analyses we divided cesarean delivery into elective or non-elective. The mode of delivery and other parental information were self-reported by parents. Multivariate logistic regression analysis was used to examine the associations. In our cross-sectional study of 8900 preschool children aged 3–6 years, 67.3 % were born via CS, of whom 15.7 % were obese. Cesarean delivery was significantly associated with the risk of overweight [OR 1.24; (95 % CI 1.07–1.44); p = 0.003], and the risk of obesity [OR 1.29; (95 % CI 1.13–1.49); p < 0.001] in preschool children. After adjusted for child characteristics, parental factors and family income, the odd of overweight was 1.35 and of obesity was 1.25 in children delivered by elective CS. The associations between CS and overweight/obesity in preschool children are influenced by potential confounders. Both children delivered by elective or non-elective CS are at increased risk of overweight/obesity. Potential consequences of CS on the health of the children should be discussed among both health care professionals and childbearing women.

Background: Insufficient physical activity (IPA) and mobile phone dependence are common coexisting behaviors among college students. However, the impact of the synergies between the two behaviors on depression has yet to be validated. Therefore, this study evaluated independent and interactive associations of problematic mobile phone use (PMPU) and IPA with depression symptoms and increased depressive symptoms among Chinese college students. Methods: In total, 2134 college students participated in this follow-up study, which was conducted between June 2014 (wave 1) and December 2014 (wave 2) at Anhui Medical University. The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use and the Center for Epidemiologic Studies Depression Scale were used to assess PMPU and depression symptoms, respectively. Physical activity (PA) was assessed with a reliable question from the Youth Risk Behavior Survey. Joint effects of PMPU and PA were calculated, and increased depressive symptoms were assessed. We used multivariable-adjusted odds ratios (OR) with 95% confidence intervals (CI) to evaluate associations between depression symptoms and PMPU, IPA, and the PMPU/IPA joint effect, estimated by binary logistic regression models. Results: PMPU and high PMPU/IPA joint effect scores were significantly associated with depression symptoms in waves 1 (OR 7.36, 95% CI: 5.09, 10.66) and 2 (OR 3.74, 95% CI: 2.56, 5.48). IPA was significantly associated with depression symptoms in wave 1 (OR 1.40, 95% CI: 1.09, 1.79) but not wave 2 (OR 1.24, 95% CI: 0.95, 1.62). PMPU and high PMPU/IPA joint effect scores were also significantly associated with increased depressive symptoms (OR 2.36, 95% CI: 1.55, 3.60). Conclusions: These results suggest that PMPU is an important factor for depression in college students, and IPA may be a synergistic factor.