Clustered Health Risk Behaviors with Comorbid Symptoms of Anxiety and Depression in Young Adults: Moderating Role of Inflammatory Cytokines.

Background: People with multiple health risk behaviors (HRBs) are at higher risk for psychological problems, and vice versa. However, the mechanisms underlying this association remain unknown.Method: We collected questionnaire and blood sample data from 2 universities in Anhui and Jiangxi Provinces. Demographic information, HRBs and blood samples were collected at baseline. Depression/anxiety symptoms were collected using questionnaires at follow-up. Latent class analysis was used to explore clustered HRBs pattern, and logistic regression analysis was used to examine the association between clustered HRBs quantity, pattern and anxiety-depression symptoms comorbidity. The Mplus software was used to analyze the moderating effects of inflammatory cytokines.Results: Compared to the HRB low-risk group, the substance dependence group (OR: 1.89, 95%CI: 1.11-3.21) and sedentary group (OR: 2.98, 95%CI: 1.48-6.02) had a higher risk of anxiety-depression comorbid symptoms. Compared to participants with no clustered HRBs, participants with 2 HRBs (OR: 2.16 95%CI: 1.17-4.00) and >3 HRBs (OR: 3.55, 95%CI: 1.68-7.48) were more likely to suffer from comorbid symptoms of anxiety and depression. Moreover, IL-6, IL-1 beta, IL-10 had negative moderating effects between clustered HRBs pattern and comorbid symptoms of anxiety and depression. Limitations: Recall bias may exist for anxiety / depression symptoms, and cannot exclude unmeasured confounders or the effect of residual confounding.Conclusions: This study finds clustered HRBs have a significant impact on mental health among young adults, and inflammatory cytokine evidence supports a negative moderating effect on the relationship. Interventions that decrease clustered HRBs may support mental health development in adolescence.