Association Of Mental Health Literacy And Physical Activity With Symptoms Of Depressive And Anxiety In College Students

Objective We aimed to clarify the prevalence characteristics of anxiety and depressive symptoms in college students,and to examine the associations between mental health literacy and physical activity with anxiety and depressive symptoms in Chinese college students.Methods A cluster sampling method was conducted from May to June 2020.A total of 7512 students were recruited for questionnaire survey from two junior colleges in Hefei and Anqing city in Anhui Province,China,and the weighted number was changed to 7527 by gender.The Adolescent Mental Health Literacy Assessment Questionnaire(AMHLAQ),the Physical Activity Rank Scale-3(PARS-3),the Center for Epidemiologic Studies-Depression(CES-D)and the Self-Rating Anxiety Scale(SAS)were used to evaluate the level of MHL,physical activity,depressive and anxiety symptoms,respectively.T-test,chi-square test and variance analysis were used to compare the differences of MHL,physical activity,depression and anxiety symptoms between different groups.Analyses were conducted with logistic regression models.Statistical significance was set at P < 0.05.Results Before unweighting,Of the 7 512 students,the mean age was(19.7±1.1)years old,1 904 were males(25.3%)and 5 608 were females(74.7%).After weighted,of the 7 527 students,the mean age was(19.7±1.2)years old,3 770 were males(50.1%)and 3 757 were females(49.9%).The overall AMHLAQ scores for all participants 5were 82.62±13.58.The total rate of mental health literacy revealed statistically significant differences by gender,grade,only children,self-reported family economy,cigarette use,and alcohol use(P < 0.05 for each).The prevalence of physical activity was 31.5%(2 374/7 527).Meanwhile,the total rate of physical activity revealed statistically significant differences by gender,registered residence,only children,parental education level,self-reported family economy,cigarette use,and alcohol use(P < 0.01 for each).The prevalence of low,medium and high levels of physical activity were 73.8%(5 559/7 527),15.7%(1 182/7 527)and 10.4%(786/7 527),respectively.In addition,the total rate of physical activity rank revealed statistically significant differences by gender,grade,registered residence,only children,parental education level,self-reported family economy,cigarette use,and alcohol use(P <0.01 for each).Moreover,16.4%(1 235/7 527)and 8.6%(649/7 527)students detected depressive symptoms,anxiety symptoms.Statistically significant differences were also found in the total rate of depressive and anxiety symptoms by gender,grade,parental education level,self-reported family economy,cigarette use,and alcohol use(P < 0.05 for each).Insufficient physical activity was significantly associated with depressive symptoms(OR=1.359,95%CI 1.184～1.561)and anxiety symptoms(OR=1.492,95%CI: 1.237～1.799).Inadequate mental health literacy was significantly associated with depressive symptoms(OR=3.089,95%CI: 2.607～3.662)and anxiety symptoms(OR=3.675,95%CI: 2.861～4.721).Low physical activity rank(OR=1.438,95%CI: 1.151～1.798)was significantly related with depressive symptoms but not anxiety symptoms.Meanwhile,the interaction of mental health literacy and physical activity had significant effects on depressive symptoms(OR=2.333,95%CI:1.793～2.827)and anxiety symptoms(OR=2.934,95%CI: 2.197～3.919).The interaction of mental health literacy and physical activity rank had significant effects on depressive symptoms(OR=2.938,95%CI: 2.421～3.565)and anxiety symptoms(OR=3.650,95%CI: 2.722～4.894).In addition,the students who had inadequate mental health literacy and insufficient physical activity had the highest risks of depressive symptoms(OR = 5.049,95% CI: 3.649～6.987)and anxiety symptoms(OR= 5.270,95% CI: 3.338～8.321).Conclusion These finding indicated that Chinese college students having insufficient physical activity and inadequate mental health literacy are at risk of exhibiting anxiety and depressive symptoms.Early intervention programs for college students with mental health problems should be considered to enhance their mental health literacy and to increase their physical activities.