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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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 |
format | Article |
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= 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.</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,
< 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 & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of environmental research and public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Yao</au><au>Zhang, Haoyu</au><au>Ma, Xindong</au><au>Di, Qian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China</atitle><jtitle>International journal of environmental research and public health</jtitle><addtitle>Int J Environ Res Public Health</addtitle><date>2020-05-25</date><risdate>2020</risdate><volume>17</volume><issue>10</issue><spage>3722</spage><pages>3722-</pages><issn>1660-4601</issn><issn>1661-7827</issn><eissn>1660-4601</eissn><abstract>(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.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>32466163</pmid><doi>10.3390/ijerph17103722</doi><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><oa>free_for_read</oa></addata></record> |
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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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