Mediating Effect of Sleep Disorder Between Low Mental Health Literacy and Depressive Symptoms Among Medical Students: The Roles of Gender and Grade

Jie Hu; Jun Wang; Danlin Li; Xuexue Huang; Yanni Xue; Liyuan Jia; Zhixian Zhang; Yuhui Wan; Xianbing Song; Rui Wang; Jun Fang; Yehuan Sun; Shichen Zhang

doi:10.3389/fpsyt.2022.818295

Mediating Effect of Sleep Disorder Between Low Mental Health Literacy and Depressive Symptoms Among Medical Students: The Roles of Gender and Grade

Front Psychiatry. 2022 Feb 3:13:818295. doi: 10.3389/fpsyt.2022.818295. eCollection 2022.

Authors

Jie Hu¹, Jun Wang², Danlin Li¹, Xuexue Huang¹, Yanni Xue¹, Liyuan Jia¹, Zhixian Zhang¹, Yuhui Wan^{1

3}, Xianbing Song⁴, Rui Wang⁵, Jun Fang^{2

3

6}, Yehuan Sun⁷, Shichen Zhang^{8

1

3}

Affiliations

¹ Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
² School of Public Health, Anhui Medical University, Hefei, China.
³ MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China.
⁴ Department of Human Anatomy, Histology and Embryology, Anhui Medical College, Hefei, China.
⁵ Information Technology Office, Anqing Medical College, Anqing, China.
⁶ Faculty of Pharmaceutical Science, Sojo University, Kumamoto, Japan.
⁷ Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
⁸ School of Public Health and Health Management, Anhui Medical College, Hefei, China.

Abstract

Objective: In this study, we aimed to disentangle the mediating effect of sleep disorder between mental health literacy (MHL) and depressive symptoms in Chinese medical students, especially focusing on the impact of gender and grade.

Methods: Pooled longitudinal data of 5,504 medical students was collected between November 2019 and June 2020 to assess the MHL, sleep disorder and mental health of medical students in Anhui province, China. Mediation analyses were tested by using bootstrapping procedures.

Results: Sleep disorder were negatively correlated with adequate MHL, but positively correlated with depressive symptoms. The relationships between MHL and depressive symptoms were mediated by sleep disorder in total samples and the indirect effect accounted for 13.59% of the total effect. However, the ratio was 20.82% in female students, whereas no mediating effect was found in the male students. Moreover, the ratio was found higher in freshmen (15.11%) than that in sophomores (11.56%).

Conclusion: Improving the sleep disorder by enhancing MHL is an effective way to reduce depressive symptoms in Chinese medical students. Further investigations elaborately considered by using more gender-balanced population with higher grade and lower level of education.

Keywords: depressive symptoms; gender; grade; medical students; mental health literacy; sleep disorder.