Sleep perception impairment (SPI) characterized by subjective-objective discrepancies in sleep, is common among patients with depression. Its neurophysiological mechanisms remain unclear. This study investigated associations between polysomnography (PSG)-derived sleep macro- and micro-architecture features and SPI in depressed patients. We enrolled 63 adults (aged 18-65) with DSM-V major depressive disorder. The participants were divided into two groups: the SPI (n = 26) and non-SPI (n = 37). All underwent overnight PSG and completed clinical assessments. We analyzed sleep macro-architecture and EEG micro-architecture, including sleep temporal entropy (STE), reflecting fragmentation of sleep-stage transitions. Logistic and linear regression models assessed predictors of SPI, adjusting for demographics, clinical, and sleep-related covariates. Despite comparable objective sleep duration, SPI patients significantly underestimated their sleep duration based on their post-PSG subjective sleep time estimates, reported poorer subjective sleep quality, exhibited lower EEG total power (median 9.7 vs. 12.5 kµV²; p = 0.003), decreased interhemispheric EEG symmetry (0.50 vs. 0.51; p = 0.02), and elevated high-frequency relative to slow-wave EEG activity. Higher EEG total power (OR = 0.35 per 1000 µV² increase) and greater EEG symmetry (OR = 0.47 per 0.01 increase) independently predicted reduced odds of SPI in adjusted models. EEG-derived biomarkers (spectral power, symmetry, entropy) may differentiate sleep perception phenotypes in depression, offering potential targets for tailored clinical interventions.

Background:Major depressive disorder (MDD) in adolescents represents a significant global public health challenge. Moreover, metacognitive dysfunction plays a critical role in its onset, progression, and prognosis, but research on the metacognitive characteristics of Chinese adolescents with MDD remains highly limited. Methods:The study was conducted from January 2024 to January 2025 and employed a cross-sectional design with convenience sampling. The participants included 202 adolescents who were diagnosed with MDD, with a mean age of 15 years. All the subjects completed a self-administered general information questionnaire to collect demographic information. The Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Adverse Childhood Experience Questionnaire-Revised (ACE), Rumination Response Scale Chinese Version (RRS), and Metacognitive Questionnaire-30 (MCQ) were utilized to evaluate the psychological well-being of adolescents diagnosed with MDD. Results:Multiple linear regression analyses demonstrated the potential of the RRS total score, reflective pondering and household dysfunction as predictors of metacognitive deficits in adolescents diagnosed with MDD, with statistical significance at p < 0.05. Furthermore, the total ACE scores of adolescents diagnosed with MDD were significantly positively correlated with the MCQ (β = 0.189, p < 0.001) and RRS (β = 0.380, p < 0.001) scores. Additionally, the total RRS score was positively correlated with the MCQ score (β = 0.675, p < 0.001). Mediation analyses demonstrated that rumination mediated the association between adverse childhood experiences and metacognitive deficits, with a mediating effect value of 1.136 and a 95% confidence interval of [0.639, 1.635], explaining 57.32% of the total effect. Conclusion:Rumination mediates the relationship between adverse childhood experiences and metacognitive deficits in adolescents with MDD. Rumination, reflective pondering and household dysfunction in adolescents with MDD can predict metacognitive dysfunction to varying degrees. Our study highlights that interventions targeting rumination may be particularly effective in mitigating the negative impact of ACEs on metacognitive functioning in adolescents with MDD.

BackgroundInternet gaming disorder (IGD) has become increasingly prevalent among college students, while the prevalence of insomnia and social jet lag has also gradually increased in this population. Comorbidity among these conditions is common in young adults. Nevertheless, the internal correlational architecture underlying individual symptom indicators remains unclear. ObjectiveThis study aimed to investigate the central and bridge symptoms of IGD, social jet lag, and insomnia among college students; to explore the network structure and cross-symptom connectivity among them; and to provide evidence for targeted interventions for comorbid insomnia and IGD. MethodsThis cross-sectional study targeted a national sample of Chinese college students. A total of 1346 participants were included in this study, with a mean age of 19.35 (SD 1.35) years, including 668 (49.6%) male participants and 678 (50.4%) female participants. All participants completed a general information questionnaire, the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), the Munich Chronotype Questionnaire (MCTQ), and the Pittsburgh Sleep Quality Index (PSQI). Network analysis was used to investigate the network structure, identify central and bridge symptoms, quantify the correlation intensity between indicators, and assess network stability. Expected influence (EI) and bridge expected influence (BEI) were used to measure centrality. ResultsThree distinct variable clusters were extracted from the overall network: the insomnia factor cluster, the IGD symptom cluster, and social jet lag. The insomnia symptom “subjective sleep quality” (P1; strength=0.903) and the IGD symptom “loss” (I9; strength=2.463) were the most central nodes in the network, constituting the key indicators of this study. The bridge strength of all nodes ranged from 0.029 to 1.295. “Withdrawal” (I2) exhibited markedly higher bridge strength than all other nodes (1.295, 95% CI 1.162-1.428), followed by “social jet lag” (S1; 0.522, 95% CI 0.384-0.690) and “preoccupation” (I1; 0.519, 95% CI 0.364-0.718). As the key bridging symptom between the insomnia and IGD clusters, I2 had the strongest edge connection with “daytime dysfunction” (P7), with an edge weight of 0.329 (95% CI 0.246-0.450). Connections involving the social jet lag cluster (S1) were concentrated on “continue despite problems” (I6; 0.182, 95% CI 0.012-0.364), while the connections between the insomnia symptom cluster and S1 were all low. ConclusionsUnlike previous studies that focused on bivariate associations or single disorders, our findings reveal that I2 serves as the key bridging symptom connecting insomnia and IGD, while P1 and I9 are central nodes within their respective structural communities. These findings provide a novel perspective on the comorbidity of insomnia and IGD. In real-world practice, interventions targeting withdrawal symptoms should be prioritized, as they may alleviate comorbid symptoms simultaneously. The role of S1 was relatively limited, suggesting that managing circadian rhythm disruption may indirectly reduce the risk of IGD. These findings provide actionable symptom targets for prevention and treatment programs in university settings.

Abstract Introduction Sleep perception impairment (SPI) in depression refers to a marked discrepancy between subjective and objective sleep, similar to paradoxical insomnia. Many depressed patients report poor sleep despite normal polysomnography (PSG), yet the neurophysiological basis of this misperception remains unclear. We examined whether EEG microarchitecture features differentiate depressed patients with SPI from those without SPI. Methods We included 63 adults with major depressive disorder and insomnia symptoms who underwent overnight PSG. SPI was defined as underestimating sleep by ≥60 minutes compared with PSG-derived total sleep time. Based on this criterion, 26 participants were classified as SPI and 37 as non-SPI. Continuous EEG measures were extracted, including total spectral power (0.5–40 Hz, μV²), an interhemispheric symmetry index (ratio of NREM spindle-band power between hemispheres), and high-frequency spectral ratios (e.g., beta/delta, gamma/delta). Group differences were examined, and multivariable logistic regression evaluated EEG predictors of SPI. Linear regression assessed associations with the magnitude of subjective–objective sleep discrepancy. Results Objective sleep duration was comparable between groups (~7 hours), yet SPI participants perceived significantly shorter sleep. SPI patients showed lower total EEG power (9730 ± 2767 μV² vs 12482 ± 4179 μV², p = 0.003) and reduced EEG symmetry (0.50 vs 0.51, p = 0.02). High-frequency activity was elevated in SPI: the N2 beta/delta ratio was higher in SPI (0.34 vs 0.26, p = 0.02), with similar increases in gamma/delta ratio (p = 0.01). In adjusted logistic models, higher total EEG power predicted lower SPI likelihood (OR ≈ 0.35 per 1000 μV², p < 0.05). A 0.01 increase in symmetry index was similarly protective (OR ≈ 0.47, p < 0.05). Higher beta/delta ratio was associated with greater SPI odds (approximately two-fold per 0.1 increment). Linear regression showed that greater EEG power related to a smaller subjective-objective sleep gap (β = –34 min, p = 0.04). Conclusion Depressed patients with SPI demonstrate distinct EEG microarchitecture marked by reduced slow-wave amplitude, elevated fast-frequency activity, and subtle interhemispheric asymmetry. This objectively “lighter” sleep pattern supports a cortical hyperarousal mechanism underlying sleep misperception. Continuous EEG features—particularly total power, symmetry, and spectral ratios—may serve as promising biomarkers to identify SPI and inform targeted interventions. Support (if any)

ObjectiveAdolescent emotional issues have gained increasing global attention. The connection between Adverse Childhood Experiences (ACEs) and emotional issues in adolescents is well-established. However, the specific psychological pathways that explain this link are not yet fully understood. Our study aims to clarify the link between ACEs and depressive/anxious symptoms in a large Chinese adolescent cohort.MethodsWe conducted a cross-sectional analysis with 7,158 students from Shandong Province, China, using a stratified cluster sampling method. Participants completed a series of self-report scales: the Adverse Childhood Experiences Scale (ACE-R), the Perceived Stress Scale (PSS-10), the Self-hate Scale (SHS), and the Patient Health Questionnaire-4 (PHQ-4). To test our chain mediation hypothesis, we used correlation analyses and a bootstrap approach.ResultsFemale adolescents and those with poorer academic performance had higher scores on childhood adverse experiences, perceived stress, self-hate, and emotional symptoms (p < 0.05). High school students scored higher than middle school students in terms of childhood adverse experiences and self-hate (p < 0.05). Only children had higher scores on childhood adverse experiences compared to non-only children (p < 0.05). Perceived stress and self-hate serve as chain mediators in the relationship between childhood adverse experiences and depressive-anxiety symptoms in adolescents.DiscussionThis study expands the research on the relationship between adverse childhood experiences and depressive and anxious emotions in adolescence, providing new insights for reducing the negative impacts of depressive and anxious emotions in adolescents and promoting their mental health.

BACKGROUND: At present, insomnia, fatigue and mental health problems of researchers are increasingly prominent, and they are facing great perceived stress. However, there are relatively few studies on Chinese researchers, and the relationship between them is not clear. This study mainly explores the current status of insomnia and fatigue symptoms of Chinese researchers, and the relationship with perceived stress and anxiety symptoms. METHODS: A Total of 961 Chinese researchers participated in this nationwide cross-sectional survey. The Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Perceived Stress Scale (PSS) and Generalized Anxiety Disorder Scale (GAD-7) were used for evaluation. The count data were analyzed by chi-square analysis, the measurement data were analyzed by independent sample t test, and the chain mediation analysis was used to explore the relationship between insomnia, fatigue symptoms, perceived stress and anxiety symptoms. RESULTS: The prevalence of insomnia symptoms was 36.9% and The prevalence of fatigue symptoms was 68.7% among Chinese researchers. The multivariate covariance analysis showed that the scores of anxiety symptoms, perceived stress, and fatigue symptoms of the researchers with insomnia symptoms were higher than those of the researchers without insomnia symptoms (p<0.001). Insomnia and fatigue symptoms were related to lifestyle and exercise. Fatigue and anxiety symptoms played a chain mediating role between perceived stress and insomnia symptoms (Total indirect effect: 0.180(0.146,0.211), Direct effect: 0.036(-.0.001,0.079), Total effect: 0.216(0.190,0.242)). CONCLUSION: Insomnia and fatigue symptoms are serious among Chinese researchers. We should pay attention to the sleep and mental health problems of researchers, strengthen psychological intervention, and reduce their perceived stress level.

Purpose:Bruxism is relatively common among adolescents; however, the psychological factors affecting its occurrence remain unclear. This study explored the incidence of bruxism in adolescents, and the role of childhood trauma and perceived stress in the occurrence of bruxism. Patients and Methods:This was an online cross-sectional survey of 7794 adolescents aged 12-18 years, with 6780 adolescents meeting the inclusion criteria. We used the Adverse Childhood Experiences Questionnaire (ACEQ) to assess childhood trauma experiences, the Perceived Stress Scale (PSS) to evaluate stress in adolescents, and three items to assess bruxism. The chi-square test was used for demographic data and t-test was used for continuous variables. A mediation analysis was used to explore the mechanism of childhood trauma as it relates to bruxism. Results:Our research shows that about 21.6% of sampled adolescents had bruxism. Being in adolescents, childhood trauma, and high levels of perceived stress were risk factors for bruxism, and good academic performance was a protective factor against bruxism. Adolescents with bruxism had higher levels of childhood trauma and perceived stress. Perceived stress levels played a mediating role in the relationship between childhood trauma and the development of bruxism. Conclusion:Bruxism is common in adolescents, and its occurrence is related to childhood trauma and perceived stress levels. Childhood trauma mediates bruxism through perceived stress levels. Attention should be paid to the childhood trauma experiences and perceived stress levels of adolescents with bruxism, and timely interventions should be provided that are conducive to reducing the occurrence of bruxism.

BackgroundThe development of executive function in adolescents is influenced by many environmental factors. Previous studies have found that perceived stress is closely related to executive function， whereas its role in the mediation of executive function remains poorly studied.ObjectiveTo explore the role of negative affect and self-hate in mediating the relationship between perceived stress and executive function in adolescents， so as to assist the improvement of executive function in adolescents.MethodsQuestionnaires were administered to 7 734 adolescents from five junior and five senior high schools in Rizhao city， Shandong province from 1 to 30 May 2022. Data were collected using a self-made questionnaire， and adolescents were assessed using Perceived Stress Scale （PSS）， Behavior Rating Inventory of Executive Function-Self Report Version （BRIEF-SR）， Patient Health Questionnaire （PHQ-4） and Self-Hate Scale （SHS）. Spearman correlation analysis was conducted to examine the correlation between variables. A Bootstrap method was chosen to examine the mediation effect of self-hate and negative affect on the relationship between perceived stress and executive function in adolescents.ResultsA total of 7 012 （90.66%） valid questionnaires were retrieved. BRIEF-SR score was positively correlated with PSS， PHQ-4 and SHS scores （r=0.564， 0.653， 0.597， P<0.01）. PSS score was positively correlated with PHQ-4 and SHS scores （r=0.615， 0.531， P<0.01）. PHQ-4 score was positively correlated with SHS score （r=0.566， P<0.01）. The value of mediation effect of perceived stress on executive function was 0.574 （95% CI： 0.555~0.594）. Self-hate （indirect effect value of 0.160， 95% CI： 0.145~0.175） and negative affect （indirect effect value of 0.143， 95% CI： 0.129~0.158）， separately from each other， mediated the relationship between perceived stress and executive function， and a chained mediation effect of self-hate and negative affect was also documented （indirect effect value of 0.065， 95% CI： 0.058~0.073）， accounting for 27.87%， 24.91% and 11.32% of the total effect， respectively.ConclusionThe perceived stress of adolescents may be a influencing factor of the executive function. Additionally， perceived stress can either directly affect executive function or indirectly through the separate or chained mediation via negative affect and self-hate.

The Nightmare Disorder Index Questionnaire (NDI) was developed to measure the impact of nightmares. The purpose of this study was to investigate the psychometric properties of NDI among Chinese adolescents. This study investigated the validity and internal consistency of the Nightmare Disorder Index Chinese (NDI-CV) among 6014 Chinese adolescents who completed the NDI-CV, Nightmare Distress Questionnaire-Chinese Version (NDQ-CV), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Chinese Adolescent Daytime Sleepiness Scale (CADSS), Generalized Anxiety Disorder-7 Questionnaire (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). In addition, we investigated the test-retest reliability of the NDI-CV among 423 adolescents who completed a retest of the NDI-CV after a 2-week interval. Finally, NDI-CV demonstrated good psychometric properties in a sample of Chinese adolescents (Cronbach's α coefficient of 0.876), and the 95% confidence interval for the 2-week retest correlation coefficient was 0.675-0.977 (p < 0.001).

Objective:To explore the mediating role of self-hating in the influence of adverse childhood experiences on adolescents' negative emotions.Methods:A questionnaire method was used to collect demographic variables, and 7 012 valid questionnaires were obtained from adolescents by applying the revised adverse childhood experiences questionnaire, patient health questionnaire-4, and self-hate scale from May 1 to May 30, 2022, in five high schools(90 classes) and five junior high schools(60 classes) in Rizhao city, Shandong province, China. Data entry and analysis were performed by SPSS 22.0 software.Mann-Whitney U test was used for the comparison between demographic variables and other variables, and the correlations between variables were expressed by Spearman correlation coefficient. AMOS 23.0 software was applied for testing the mediating and moderating effects of variables. Results:(1)There were significant positive correlations between adverse childhood experiences(0(2)) and negative emotion(3(10))( r=0.459, P<0.01), self-hating(2(4))( r=0.427, P<0.01). There were significant positive correlations between self-hating and negative emotion( r=0.566, P<0.01). (2) Self-hating played a mediating role between adverse childhood experience and adolescent negative emotion, and the mediating effect was 0.299, accounted for 61.27% of the total effect.(3) The mediating pathway of self-hated was moderated by gender, with girls' adverse childhood experiences( Bsimple=2.428, t=39.585, P<0.05) predicting self-hating more than boys( Bsimple=1.641, t=25.355, P<0.05). Conclusion:Adverse childhood experiences can predict adolescents' negative emotions, and self-disgusting can also affect adolescents' negative emotions.Gender plays a moderating role in the mediating pathway.

背景 重性抑郁障碍(major depressive disorder,MDD)是一种病因和病理生理复杂的常见精神疾病,其分子机制尚未完全阐明,目前一些研究结果 提示脂质代谢与MDD的发生、发展可能存在一定关系.目的 探讨成年人MDD与血脂之间的相关性.方法 回顾性分析2019年2月-2020年9月入住北京回龙观医院的138例MDD患者,另选健康对照86例,常规采静脉血通过酶法检测血脂等生化指标.结果 与对照组比较,MDD组载脂蛋白A1(apolipoprotein A1,ApoA1)水平明显低于对照组[(1.39±0.34)g/L vs(1.71±0.31)g/L,P=0.000],高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)水平高于对照组[(1.40±0.38)mmol/L vs(1.31±0.28)mmol/L,P=0.008].单因素分析结果 表明体质量指数(body mass index,BMI)、吸烟史、受教育年限和ApoA1水平均与MDD具有显著相关性(P均<0.05).多元logistic回归分析显示中等水平[(1.47±0.09)g/L]和高水平[(1.92±0.27)g/L]ApoA1相比低水平[(1.14±0.11)g/L]ApoA1发生MDD的风险均降低0.99倍(OR=0.01,95％CI:0.00～0.07,P<0.0001);调整相关危险因素后结果 没有明显改变,中等水平和高水平ApoA1仍然比低水平ApoA1发生MDD的风险分别降低0.94倍和0.89倍(OR=0.06,95％CI:0.01～0.42,P=0.0048;OR=0.11,95％CI:0.02～0.80,P=0.0288);HDL-C水平在MDD的发生风险中无统计学意义(P>0.05).结论 MDD患者血清ApoA1水平明显低于对照组,ApoA1有可能是MDD的独立危险因素,进一步的结论 尚需更多的研究证实.

Background Although professional identity is a strong predictor of career choice, only a few studies have reported on medical students' career attitude during a public health emergency. This study investigates the changes in medical students' professional identity and career attitude during the COVID-19 pandemic, evaluates their mental health and social support system under stress, and explores the relationship between their career attitude and other factors. Methods An online survey of 6,226 Chinese medical students was conducted to collect information on demographics, professional identity, and career attitude. The collected data were assessed using the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Social Support Rating Scale. Results The results revealed that most (80.8%) of the participants did not change their career attitude and the professional identity of most participants strengthened, and they preferred to participate on the frontline during the COVID-19 pandemic. The prevalence of depression and anxiety among medical students was 22.86% and 35.43%. Low social support, depressive symptoms, male gender, and higher grades were factors that negatively affected career attitude. Conclusions After the outbreak of the pandemic, it was necessary to conduct diversified professional identity research to support medical students, especially those with low social support and depressive symptoms.

ObjectiveTo discuss the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia.MethodsA total of 47 patients with depression in remission in Beijing Huilongguan Hospital were enrolled. Insomnia Severity Index （ISI） and the sleep efficiency calculated by the first four items of Pittsburgh Sleep Quality Index （PSQI） were defined as insomnia. Among the selected patients， 22 subjects were classified into insomnia group， and 25 subjects in non-insomnia group. The objective sleep status of all subjects was evaluated by polysomnography （PSG）， and the cognitive function was evaluated with the Repeatable Battery for Assessment of Neuropsychological Status （RBANS）. A regression model was established to explore the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia.ResultsThere was statistically significant difference in immediate memory factor scores of RBANS between depression patients in remission with and without insomnia （t=-2.102， P<0.05）. The sleep efficiency （Z=-2.113， P<0.05）， the proportion of N3 sleep stage （Z=-3.175， P<0.01） and the duration of N3 sleep stage （Z=-3.196， P<0.01） in insomnia group were all lower than those in non-insomnia group， and the nocturnal awakening （Z=-2.058， P<0.01）， the proportion of N1 sleep stage （Z=-2.399， P<0.05） and the duration of N1 sleep stage （Z=-2.463， P<0.05） were higher than those of the insomnia group. Within insomnia group， the increased proportion of REM sleep was correlated with the improvement of attention function （β=0.953， 95% CI： 0.123~2.038， P<0.05）， and the increase of nocturnal awakening was correlated with the decline of delayed memory （β=-0.173， 95% CI： -0.325~-0.024， P<0.05）.ConclusionObjective sleep is associated with cognitive impairment in remission depression patients with insomnia， the proportion of REM sleep has a positive impact on attention function， and frequent nocturnal awakening at night has a negative impact on delayed memory.

Background: The coronavirus disease−2019 (COVID-19) pandemic has halted in-person medical education worldwide. Limited studies have reported on the mental health status of medical students during this public health emergency. This study aimed to explore the association of personal virus exposure, regional epidemic condition, and social support with medical students' depressive and anxiety symptoms during the COVID-19 outbreak in China. Methods: In February 2020, 5,982 medical students (60.0% females, Meanage = 21.7 years, Medianage = 22 years) completed an online survey consisting of demographics, personal virus exposure, the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Social Support Rating Scale. Results: The prevalence rates of mild to severe depressive symptoms and anxiety symptoms were 35.2 and 22.8%, respectively. Multivariate linear regression showed that students with low- or medium-level social support had a higher risk of experiencing depressive or anxiety symptoms than those with high-level social support. COVID-19 exposure was positively associated with mild to severe depressive or anxiety symptoms. Respondents living in provinces with 500–1,000 confirmed COVID-19 cases had an increased risk of experiencing mild to severe depressive symptoms compared with those living in provinces with <100 cases. Other related factors were gender and years of training. Conclusions: Some medical students suffered from a poor psychological status during the COVID-19 outbreak. Low social support was a stronger factor related to poor mental status compared with COVID-19 exposure or the provincial epidemic condition. Thus, we suggest that colleges or universities provide social support and mental health screening.

Coronavirus disease-2019 (COVID-19) pandemic has seriously threatened the global public health security and caused a series of mental health problem. Current research focuses mainly on mental health status and related factors in the COVID-19 pandemic among Chinese university students. Data from 11133 participants was obtained through an online survey. The Patient Health Question-9 (PHQ-9) was used to assess depressive symptoms, the Social Support Rate Scale (SSRS) was used to assess social support. We also used 7-item Generalized Anxiety Disorder Scale (GAD-7) to assess anxiety symptoms. Totally, 37.0% of the subjects were experiencing depressive symptoms, 24.9% anxiety symptoms, 20.9% comorbid depressive and anxiety symptoms, and 7.3% suicidal ideation. Multivariable logistic regression analysis revealed an increased presence of mental health problems in female students, graduate students, and those with personal COVID-19 exposure. Awareness of COVID-19, living with family were protective factors that reduced anxiety and depression symptoms. In addition, male, personal COVID-19 exposure, depressive and anxiety symptoms were risk factors for suicidal ideation. Social support, COVID-19 preventive and control measures, prediction of COVID-19 trends, living with family and graduate students are protective factors for reducing suicidal ideation.

Self-control is very important for the adaptation among adolescents. It is associated with depression and tendencies of eating disorders. This study aimed to investigate the relationship between the two and the mediating role of self-control for adolescents. In total, 1,231 adolescents (11-18 years) participated in this study. Self-control, depression, and tendencies of eating disorders were evaluated using the Dual-Mode of Self-Control Scale (DMSC-S), 11-item Kutcher Adolescent Depression Scale (KADS-11), and Eating Attitudes Test (EAT-26). The correlations among these factors were analyzed using mediating effect models. Girls had higher scores on the both subscales (impulse system and control system) of DMSC-S (P < 0.001). Those between 15-18 years had higher scores on impulse system than those between 11-14 years (P < 0.001). A significant mediating effect (12.8%) of the impulse system was observed between depression and tendencies of eating disorders in adolescents.

Background: The coronavirus disease-2019 (COVID-19) pandemic is a serious threat to global public health, including a wide range of metal health problems. Current research focuses mainly on mental health status and related factors among Chinese university students during the COVID-19 pandemic.Methods: Data from 11133 participants was obtained through an online survey of university students in mainland China. Depressive and anxiety symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9), and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively.Results: In total, 37.0% of the subjects were experiencing depressive symptoms, 24.9% anxiety symptoms, 20.9% comorbid depressive and anxiety symptoms, and 7.3% suicidal ideation. Multivariable logistic regression analysis revealed an increased presence of mental health problems in female students, graduate students, and those with personal COVID-19 exposure. Living with family and awareness of COVID-19 were protective factors against depressive and anxiety symptoms. In addition, male, depressive and anxiety symptoms were risk factors for suicidal ideation. Living with family, graduate students, prevention and control measures and projections of COVID-19 trends were protective factors against suicidal ideation.Conclusions: The findings underlined that the mental health of university students should be monitored, and provided important information for healthcare planning during the COVID-19 pandemic.

Purpose: The coronavirus disease 2019 (COVID-19) outbreak impacts physical and mental health. The purpose of this study was to explore the association between the levels of social support and mental health among Chinese adolescents during the outbreak. Methods: A total of 7,202 adolescents aged 14-18 years completed online survceys from March 8 to 15, 2020, in China. Researchers assessed the associations between depression symptoms (Patient Health Questionnaire-9), anxiety symptoms (Chinese version of the 7-item Generalized Anxiety Disorder scale), and social support (Social Support Rate Scale). Results: COVID-19 exposure was associated with a higher prevalence of depression symptoms (odds ratio [OR] = 1.38, 95% confidence interval [CI]: 1.14-1.66) and anxiety symptoms (OR = 1.26, 95% CI: 1.04-1.52). Only 24.6% of adolescents reported high levels of social support. Most adolescents (70%) reported medium levels of support, and 5.4% reported low support. Low support was associated with higher prevalence of depression (OR = 4.24, 95% CI: 3.38-5.33) and anxiety symptoms (OR = 3.18, 95% CI: 2.54-3.98), while controlling for gender, grade, living situation, and COVID-19 exposure; similarly, medium support was associated with higher prevalence of depression (OR = 2.79, 95% CI: 2.48-3.15) and anxiety (OR = 2.19, 95% CI: 1.94-2.48) symptoms. Conclusions: This study indicates there is a higher prevalence of mental health problems among adolescents with medium and low levels of social support in China during the outbreak of COVID-19. (C) 2020 Society for Adolescent Health and Medicine. All rights reserved.

目的 探讨青少年认知灵活性、抑郁对进食态度的影响,为完善进食障碍的早期识别与干预提供参考依据.方法 采用一般资料问卷、Kutcher青少年抑郁量表11项版(Kutcher Adolescent Depression Scale 11-item,KADS-11)、认知灵活性量表(Cognitive Flexibility Inventory,CFI)和进食态度问卷(Eating Attitude Test-26,EAT-26)对日照市1 231名学生进行测评,采用独立样本t检验、非参数检验、Spearman相关分析和Logistic回归分析进行分析.结果 不同性别和有无抑郁青少年之间的EAT-26总分差异均有统计学意义(P值均＜0.01).有无进食障碍症状青少年之间的CFI总分、灵活控制性因子评分与KADS-11总分差异均有统计学意义(P值均＜0.01).青少年EAT-26总分与CFI总分(r=-0.19)及灵活控制性评分(r=-0.23)呈负相关,与KADS-11总分呈正相关(r=0.23)(P值均＜0.01).女生(OR=2.40,95％CI=1.87～3.23)、抑郁症状(OR=1.76,95％CI=1.35 ～2.29)和灵活控制性差(OR=1.94,95％CI=1.48～ 2.54)与进食障碍症状正向相关.结论 女性、抑郁症状、灵活控制能力较差更易发生进食障碍,需要加以关注.