The current study examines the mediating roles of self-efficacy and sleep disturbance and the moderating role of gender in the association between the duration of youth/parent communication on depression and anxiety during the COVID-19 isolation period in China. We used the self-designed demographic variable questionnaire, General Self-Efficacy Scale, the Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, and the Self-Rating Anxiety Scale with 1,772 youths aged 15–24 from 26 provinces in China during the COVID-19 lockdown. We performed demographic variable analysis, correlation analysis, mediation analysis, and moderated analysis. The duration of daily communication with parents was significantly positively correlated with self-efficacy and significantly negatively correlated with sleep disturbance, depression, and anxiety. The chain mediation analysis revealed that the duration of communication with parents directly affected depression and anxiety. Self-efficacy, sleep disturbance, and self-efficacy sleep disturbance had significant mediating and chain-mediating effects on the duration of communication with parents, depression, and anxiety. The interactions between sleep disturbance and gender (B = 0.35, 95% CI 0.06 to 0.64, p = .02 < .05) were significant. The duration of parent/youth communication directly affected depression and anxiety and indirectly affected depression and anxiety via the chain-mediating effect of self-efficacy and sleep disturbance. Gender moderates the relationships between sleep disturbance and depression.

Objectives: To investigate the association between combined healthy lifestyle factors and risk of depressive symptoms. Methods: We conducted a cross-sectional study from April to October 2021,including 5,027 Chinese adults from the general population.A healthy lifestyle score was constructed by assigning 1 point to each healthy lifestyle factor, including active physical activity, non-smoking, no or moderate alcohol consumption, and healthy diet. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusting for confounding variables. Results: Each additional healthy lifestyle factor was associated with a 29% lower risk of having depressive symptoms (OR (95% CI): 0.71 (0.66-0.77)). Compared with individuals with 0-2 healthy lifestyle factors, individuals with four healthy lifestyle factors had a 55% reduced risk of depressive symptoms (0.45 (0.38-0.54)). After stratification by age, the significant inverse association with healthy lifestyle score was stronger in individuals aged younger than 45 years old. Besides, the significant negative association between healthy lifestyle score and depressive symptoms remained the same for different severity of depressive symptoms. Conclusions: Our study indicated that adherence to healthy lifestyle factors was associated with a reduced risk of depressive symptoms among Chinese adults, especially among individuals aged younger than 45 years old. These findings warrant further verification in interventional studies.

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