Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China

(1) Background: The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental health or effect...

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Veröffentlicht in:International journal of environmental research and public health 2020-05, Vol.17 (10), p.3722
Hauptverfasser: Zhang, Yao, Zhang, Haoyu, Ma, Xindong, Di, Qian
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creator Zhang, Yao
Zhang, Haoyu
Ma, Xindong
Di, Qian
description (1) Background: The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental health or effective mitigation strategies to improve mental health. (2) Purpose: The aim of this study was to assess the adverse impact of the COVID-19 outbreak on Chinese college students' mental health, understand the underlying mechanisms, and explore feasible mitigation strategies. (3) Methods: During the peak time of the COVID-19 outbreak in China, we conducted longitudinal surveys of sixty-six college students. Structured questionnaires collected information on demographics, physical activity, negative emotions, sleep quality, and aggressiveness level. A mixed-effect model was used to evaluate associations between variables, and the mediating effect of sleep quality was further explored. A generalized additive model was used to determine the dose-response relationships between the COVID-19 death count, physical activity, and negative emotions. (4) Results: The COVID-19 death count showed a direct negative impact on general sleep quality (β = 1.37, 95% confidence interval [95% CI]: 0.55, 2.19) and reduced aggressiveness (β = -6.57, 95% CI: -12.78, -0.36). In contrast, the COVID-19 death count imposed not a direct but an indirect impact on general negative emotions (indirect effect (IE) = 0.81, = 0.012), stress (IE = 0.40, < 0.001), and anxiety (IE = 0.27, = 0.004) with sleep quality as a mediator. Moreover, physical activity directly alleviated general negative emotions (β = -0.12, 95% CI: -0.22, -0.01), and the maximal mitigation effect occurred when weekly physical activity was about 2500 METs. (5) Conclusions: (a) The severity of the COVID-19 outbreak has an indirect effect on negative emotions by affecting sleep quality. (b) A possible mitigation strategy for improving mental health includes taking suitable amounts of daily physical activity and sleeping well.
doi_str_mv 10.3390/ijerph17103722
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Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental health or effective mitigation strategies to improve mental health. (2) Purpose: The aim of this study was to assess the adverse impact of the COVID-19 outbreak on Chinese college students' mental health, understand the underlying mechanisms, and explore feasible mitigation strategies. (3) Methods: During the peak time of the COVID-19 outbreak in China, we conducted longitudinal surveys of sixty-six college students. Structured questionnaires collected information on demographics, physical activity, negative emotions, sleep quality, and aggressiveness level. A mixed-effect model was used to evaluate associations between variables, and the mediating effect of sleep quality was further explored. A generalized additive model was used to determine the dose-response relationships between the COVID-19 death count, physical activity, and negative emotions. (4) Results: The COVID-19 death count showed a direct negative impact on general sleep quality (β = 1.37, 95% confidence interval [95% CI]: 0.55, 2.19) and reduced aggressiveness (β = -6.57, 95% CI: -12.78, -0.36). In contrast, the COVID-19 death count imposed not a direct but an indirect impact on general negative emotions (indirect effect (IE) = 0.81, = 0.012), stress (IE = 0.40, &lt; 0.001), and anxiety (IE = 0.27, = 0.004) with sleep quality as a mediator. Moreover, physical activity directly alleviated general negative emotions (β = -0.12, 95% CI: -0.22, -0.01), and the maximal mitigation effect occurred when weekly physical activity was about 2500 METs. (5) Conclusions: (a) The severity of the COVID-19 outbreak has an indirect effect on negative emotions by affecting sleep quality. (b) A possible mitigation strategy for improving mental health includes taking suitable amounts of daily physical activity and sleeping well.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph17103722</identifier><identifier>PMID: 32466163</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Adolescent ; Adult ; Aged ; Aggressive behavior ; Aggressiveness ; Anxiety ; Anxiety - epidemiology ; Betacoronavirus ; China - epidemiology ; College students ; Confidence intervals ; Coronavirus Infections - epidemiology ; Coronaviruses ; Correlation analysis ; COVID-19 ; Death ; Demography ; Disease transmission ; Dose-response effects ; Emotions ; Exercise ; Female ; Fragility ; Health problems ; Humans ; Longitudinal Studies ; Male ; Mental depression ; Mental disorders ; Mental Health ; Mental health care ; Metabolism ; Middle Aged ; Mortality ; Outbreaks ; Pandemics ; Physical activity ; Physical fitness ; Pneumonia, Viral - epidemiology ; Population ; Post traumatic stress disorder ; Public health ; Quality ; Questionnaires ; Respiratory diseases ; SARS-CoV-2 ; Sleep ; Students ; Surveys and Questionnaires ; Young Adult</subject><ispartof>International journal of environmental research and public health, 2020-05, Vol.17 (10), p.3722</ispartof><rights>(c) The COVID-19 outbreak has reduced people's aggressiveness, probably by making people realize the fragility and preciousness of life.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 by the authors. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-406ec2b03a706cff17e6e4cdbfd4d8ed05d8622e0c6f6c66b71a268be3398d7d3</citedby><cites>FETCH-LOGICAL-c484t-406ec2b03a706cff17e6e4cdbfd4d8ed05d8622e0c6f6c66b71a268be3398d7d3</cites><orcidid>0000-0002-1584-4770 ; 0000-0002-4261-4639 ; 0000-0003-0614-2176 ; 0000-0002-6473-7015</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277113/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277113/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32466163$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Yao</creatorcontrib><creatorcontrib>Zhang, Haoyu</creatorcontrib><creatorcontrib>Ma, Xindong</creatorcontrib><creatorcontrib>Di, Qian</creatorcontrib><title>Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China</title><title>International journal of environmental research and public health</title><addtitle>Int J Environ Res Public Health</addtitle><description>(1) Background: The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental health or effective mitigation strategies to improve mental health. (2) Purpose: The aim of this study was to assess the adverse impact of the COVID-19 outbreak on Chinese college students' mental health, understand the underlying mechanisms, and explore feasible mitigation strategies. (3) Methods: During the peak time of the COVID-19 outbreak in China, we conducted longitudinal surveys of sixty-six college students. Structured questionnaires collected information on demographics, physical activity, negative emotions, sleep quality, and aggressiveness level. A mixed-effect model was used to evaluate associations between variables, and the mediating effect of sleep quality was further explored. A generalized additive model was used to determine the dose-response relationships between the COVID-19 death count, physical activity, and negative emotions. (4) Results: The COVID-19 death count showed a direct negative impact on general sleep quality (β = 1.37, 95% confidence interval [95% CI]: 0.55, 2.19) and reduced aggressiveness (β = -6.57, 95% CI: -12.78, -0.36). In contrast, the COVID-19 death count imposed not a direct but an indirect impact on general negative emotions (indirect effect (IE) = 0.81, = 0.012), stress (IE = 0.40, &lt; 0.001), and anxiety (IE = 0.27, = 0.004) with sleep quality as a mediator. Moreover, physical activity directly alleviated general negative emotions (β = -0.12, 95% CI: -0.22, -0.01), and the maximal mitigation effect occurred when weekly physical activity was about 2500 METs. (5) Conclusions: (a) The severity of the COVID-19 outbreak has an indirect effect on negative emotions by affecting sleep quality. (b) A possible mitigation strategy for improving mental health includes taking suitable amounts of daily physical activity and sleeping well.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aggressive behavior</subject><subject>Aggressiveness</subject><subject>Anxiety</subject><subject>Anxiety - epidemiology</subject><subject>Betacoronavirus</subject><subject>China - epidemiology</subject><subject>College students</subject><subject>Confidence intervals</subject><subject>Coronavirus Infections - epidemiology</subject><subject>Coronaviruses</subject><subject>Correlation analysis</subject><subject>COVID-19</subject><subject>Death</subject><subject>Demography</subject><subject>Disease transmission</subject><subject>Dose-response effects</subject><subject>Emotions</subject><subject>Exercise</subject><subject>Female</subject><subject>Fragility</subject><subject>Health problems</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental Health</subject><subject>Mental health care</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Outbreaks</subject><subject>Pandemics</subject><subject>Physical activity</subject><subject>Physical fitness</subject><subject>Pneumonia, Viral - epidemiology</subject><subject>Population</subject><subject>Post traumatic stress disorder</subject><subject>Public health</subject><subject>Quality</subject><subject>Questionnaires</subject><subject>Respiratory diseases</subject><subject>SARS-CoV-2</subject><subject>Sleep</subject><subject>Students</subject><subject>Surveys and Questionnaires</subject><subject>Young Adult</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkUtv1DAUhSMEoqWwZYkssWGT4hd2hgVSFQZaaapW4rGNHPs68Sixp7aD6J_gN-NOS9Wy8pHv53Ov76mq1wQfM7bC790W4m4kkmAmKX1SHRIhcM0FJk8f6IPqRUpbjFnDxep5dcAoF4IIdlj9OQef1YROQU15RJcx9BPMCZklOj-gPAJqL36efa7JCl0qb2B2OqEi9qVzl92gsgsera0FnRMKFq1_Q9QuwUd0gjbBDy4vxvnS5FsR1zdEG6YJBthflP4JOY_asTAvq2dWTQle3Z1H1Y8v6-_tab25-HrWnmxqzRuea44FaNpjpiQW2loiQQDXpreGmwYM_mAaQSlgLazQQvSSKCqaHsrOGiMNO6o-3fruln4Go8sQUU3dLrpZxesuKNc9rng3dkP41UkqJSGsGLy7M4jhaoGUu9klDdOkPIQldZTjhmJOV7ygb_9Dt2GJZR97SkrJhaSFOr6ldAwpRbD3wxDc3UTdPY66PHjz8Av3-L9s2V-TTKcF</recordid><startdate>20200525</startdate><enddate>20200525</enddate><creator>Zhang, Yao</creator><creator>Zhang, Haoyu</creator><creator>Ma, Xindong</creator><creator>Di, Qian</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1584-4770</orcidid><orcidid>https://orcid.org/0000-0002-4261-4639</orcidid><orcidid>https://orcid.org/0000-0003-0614-2176</orcidid><orcidid>https://orcid.org/0000-0002-6473-7015</orcidid></search><sort><creationdate>20200525</creationdate><title>Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China</title><author>Zhang, Yao ; Zhang, Haoyu ; Ma, Xindong ; Di, Qian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-406ec2b03a706cff17e6e4cdbfd4d8ed05d8622e0c6f6c66b71a268be3398d7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aggressive behavior</topic><topic>Aggressiveness</topic><topic>Anxiety</topic><topic>Anxiety - epidemiology</topic><topic>Betacoronavirus</topic><topic>China - epidemiology</topic><topic>College students</topic><topic>Confidence intervals</topic><topic>Coronavirus Infections - epidemiology</topic><topic>Coronaviruses</topic><topic>Correlation analysis</topic><topic>COVID-19</topic><topic>Death</topic><topic>Demography</topic><topic>Disease transmission</topic><topic>Dose-response effects</topic><topic>Emotions</topic><topic>Exercise</topic><topic>Female</topic><topic>Fragility</topic><topic>Health problems</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Mental Health</topic><topic>Mental health care</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Outbreaks</topic><topic>Pandemics</topic><topic>Physical activity</topic><topic>Physical fitness</topic><topic>Pneumonia, Viral - epidemiology</topic><topic>Population</topic><topic>Post traumatic stress disorder</topic><topic>Public health</topic><topic>Quality</topic><topic>Questionnaires</topic><topic>Respiratory diseases</topic><topic>SARS-CoV-2</topic><topic>Sleep</topic><topic>Students</topic><topic>Surveys and Questionnaires</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Yao</creatorcontrib><creatorcontrib>Zhang, Haoyu</creatorcontrib><creatorcontrib>Ma, Xindong</creatorcontrib><creatorcontrib>Di, Qian</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; 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Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental health or effective mitigation strategies to improve mental health. (2) Purpose: The aim of this study was to assess the adverse impact of the COVID-19 outbreak on Chinese college students' mental health, understand the underlying mechanisms, and explore feasible mitigation strategies. (3) Methods: During the peak time of the COVID-19 outbreak in China, we conducted longitudinal surveys of sixty-six college students. Structured questionnaires collected information on demographics, physical activity, negative emotions, sleep quality, and aggressiveness level. A mixed-effect model was used to evaluate associations between variables, and the mediating effect of sleep quality was further explored. A generalized additive model was used to determine the dose-response relationships between the COVID-19 death count, physical activity, and negative emotions. (4) Results: The COVID-19 death count showed a direct negative impact on general sleep quality (β = 1.37, 95% confidence interval [95% CI]: 0.55, 2.19) and reduced aggressiveness (β = -6.57, 95% CI: -12.78, -0.36). In contrast, the COVID-19 death count imposed not a direct but an indirect impact on general negative emotions (indirect effect (IE) = 0.81, = 0.012), stress (IE = 0.40, &lt; 0.001), and anxiety (IE = 0.27, = 0.004) with sleep quality as a mediator. Moreover, physical activity directly alleviated general negative emotions (β = -0.12, 95% CI: -0.22, -0.01), and the maximal mitigation effect occurred when weekly physical activity was about 2500 METs. (5) Conclusions: (a) The severity of the COVID-19 outbreak has an indirect effect on negative emotions by affecting sleep quality. 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subjects Adolescent
Adult
Aged
Aggressive behavior
Aggressiveness
Anxiety
Anxiety - epidemiology
Betacoronavirus
China - epidemiology
College students
Confidence intervals
Coronavirus Infections - epidemiology
Coronaviruses
Correlation analysis
COVID-19
Death
Demography
Disease transmission
Dose-response effects
Emotions
Exercise
Female
Fragility
Health problems
Humans
Longitudinal Studies
Male
Mental depression
Mental disorders
Mental Health
Mental health care
Metabolism
Middle Aged
Mortality
Outbreaks
Pandemics
Physical activity
Physical fitness
Pneumonia, Viral - epidemiology
Population
Post traumatic stress disorder
Public health
Quality
Questionnaires
Respiratory diseases
SARS-CoV-2
Sleep
Students
Surveys and Questionnaires
Young Adult
title Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China
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