Associations of Circadian Rhythm Abnormalities Caused by Home Quarantine During the COVID-19 Outbreak and Mental Health in Chinese Undergraduates: Evidence from a Nationwide School-Based Survey

Abstract

Background: School closure and home quarantine has been implemented worldwide during the coronavirus disease 2019 (COVID-19) outbreak. The study aims to assess the associations of circadian rhythm abnormalities caused by home quarantine during the COVID-19 outbreak and mental health in Chinese undergraduates. Methods: A nationwide school-based survey was conducted in a total of 11787 university students from 16 provinces or municipalities of China. The data of circadian rhythm were collected by self-reported questionnaires consist of 4 items involved rest-activity cycle, diet rhythm, wake up rhythm and sleep rhythm. The Patient Health Questionnaire and the Generalized Anxiety Disorder were applied to evaluate the symptoms of depression and anxiety. Chi-square test and ordinal logistic regression models were used to describe the distributions and associations of circadian rhythm abnormalities and mental health. Findings: A total of 11 787 students [female: 6731(57.1%)] aged 15-26 years old (M=20.45, SD=1.76) were analyzed. The results showed the percentage of abnormal circadian rhythm were 17.5-28.7%. The prevalence of depression and anxiety were significantly higher in students with single circadian rhythm abnormality. Students who reported the coexistence of four circadian rhythm abnormalities were more likely to be with depression (OR: 4.43, 95% CI: 3.91–5.03) and anxiety (OR: 3.11, 95% CI: 2.70–3.60). Dose-response relationships were found between multiple circadian rhythm abnormalities and mental problems. Interpretation: Circadian rhythm abnormalities caused by home quarantine has a detrimental effect on mental health among university studies. Mental health care is needed for college students during the COVID-19 epidemic period. Funding Statement: The study is funded by Anhui Medical University Emergency Key Research Project for Novel Coronavirus Pneumonia (YJGG202001) Declaration of Interests: The authors declare there are no competing interests. Ethics Approval Statement: The study protocol was approved by the Ethics Committee of Anhui Medical University. Electronic informed consents were obtained from all participants before completing the survey