ArticleBMC medical education2022
Association of depression symptoms and sleep quality with state-trait anxiety in medical university students in Anhui Province, China: a mediation analysis.
Article in BMC medical education, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed, 31 citations in OpenAlex.
- Impact of video quality in online learning on anxiety and motivation: a randomized controlled trial among medical students.BMC medical education · 2025Trial
- The associations between pre-sleep smartphone use, negative life events and depressive symptoms among Chinese undergraduate students.BMC public health · 2026Article
- Medical interns and health challenges: insights into physical inactivity, sleep disruption, and body metrics.Frontiers in health services · 2026Article
- Sleep Quality and Sex-Specific Physical Activity Benefits Predict Mental Health in Romanian Medical Students: A Cross-Sectional Analysis.Journal of clinical medicine · 2025Article
- Sleep quality by clinical training status among medical students and its associated factors: a cross-sectional study in Da Nang, Vietnam.Scientific reports · 2025Article
- Development and internal validation of a nomogram for sleep quality among Chinese medical students: a cross-sectional study.BMC public health · 2025Article
- Sleep quality and associated factors in Latin American medical students: a cross-sectional and multicenter study.BMC public health · 2025Article
- The association between sleep quality and anxiety symptoms: a cross-sectional study based on Tibetan university students at high altitude in China.Frontiers in psychology · 2025Article
- Associations between mobile phone involvement, BMI levels, and sleep quality among Chinese university students: evidence from a multi-regional large-scale survey.Frontiers in public health · 2025Article
- Innovative Analysis of the Interconnected Network Structure Between Anxiety and Sleep Quality Among College Students.Psychology research and behavior management · 2025Article
- Associations of perceived stress with depression in medical students: the mediating role of rumination and the moderating role of emotional intelligence.Frontiers in psychology · 2025Article
- Associations Between Sleep Duration, Sleep Quality, and Depressive Symptoms: Evidence from Medical Graduate Students in China.Nature and science of sleep · 2025Article
- Decomposition analysis of anxiety symptom differences between urban and rural Chinese university students: cross-sectional study.Frontiers in psychiatry · 2025Article
- Sleep-Related Disorders in Parkinson's Disease: Mechanisms, Diagnosis, and Therapeutic Approaches.CNS & neurological disorders drug targets · 2025Review
- Expressive suppression mediates the relationship between sleep quality and generalized anxiety symptomology.Scientific reports · 2024Article
- Stress events and stress symptoms in Chinese secondary school students: gender and academic year characteristics of the relationship.Frontiers in public health · 2024Article
- Psychological distress and sleep quality among Sri Lankan medical students during an economic crisis.PloS one · 2024Article
- Professional psychological qualities of Chinese medical students: theoretical models, questionnaire development, and relationship with mental health.Frontiers in psychology · 2024Article
- Chronotypes and their association with sleep quality among Chinese college students of Anhui Province: a cross-sectional study.BMJ open · 2023Article
- The Worldwide Prevalence of Sleep Problems Among Medical Students by Problem, Country, and COVID-19 Status: a Systematic Review, Meta-analysis, and Meta-regression of 109 Studies Involving 59427 Participants.Current sleep medicine reports · 2023Review
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Authors and funding
7 authors at 2 institutions in 1 country.
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Abstract
backgroundThe prevalence of depression symptoms among medical students is particularly high, and it has increased during the COVID-19 epidemic. Sleep quality and state-trait anxiety are risk factors for depression, but no study has yet investigated the mediating role of state-trait anxiety in the relationship between poor sleep quality and depression symptoms in medical students. This study aims to investigate the relationship among depression symptoms, sleep quality and state-trait anxiety in medical university students in Anhui Province.
methodsThis was a cross-sectional survey of 1227 students' online questionnaires collected from four medical universities in Anhui Province using a convenience sampling method. We measured respondents' sleep quality, state-trait anxiety, and depression symptoms using three scales: the Pittsburgh Sleep Quality Index (PSQI), the State-Trait Anxiety Inventory (STAI) and the Self-rating Depression Scale (SDS). We analysed the mediating role of STAI scores on the association between PSQI scores and SDS scores through the Sobel-Goodman Mediation Test while controlling for covariates. P < 0.05 was considered statistically significant.
resultsA total of 74.33% (912) and 41.40% (518) of the respondents reported suffering from poor sleep quality and depression symptoms. Sleep quality, state-trait anxiety, and depression symptoms were positively associated with each other (β = 0.381 ~ 0.775, P < 0.001). State-trait anxiety partially mediated the association between sleep quality and depression symptoms (Sobel test Z = 15.090, P < 0.001), and this mediating variable accounted for 83.79% of the association when adjusting for potential confounders. Subgroup analysis further revealed that STAI scores partially mediated the association between PSQI scores and SDS scores in females and rural students and fully mediated the association between PSQI scores and SDS scores in males and urban students.
conclusionsThis study found that sleep quality and state-trait anxiety have a significant predictive effect on depression symptoms. State-trait anxiety mediated the relationship between sleep quality and depression symptoms, with a more complex mechanism observed among rural and female medical students. Multiple pathways of intervention should be adopted, such as encouraging students to self-adjust, providing professional psychological intervention and timely monitoring, enriching extracurricular activities, and making changes in policies regarding long shifts and working hours.
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