Time spent on social media and depressive symptoms in university students: The mediating role of psychoactive substances.

BACKGROUND AND OBJECTIVES: Although some studies have related social media use and depressive symptoms, little is known about the role of psychoactive substance use in this relationship. Therefore, this study aimed to estimate the association between time spent on social media (TSSM) and depressive symptoms and to examine whether this relationship is mediated by psychoactive substances in students. METHODS: Our cross-sectional analysis included a sample of students from a university in a large city in southern Brazil. The TSSM and tobacco frequency of consumption were self-reported. Depressive symptoms were assessed with the Patient Health Questionnaire. Alcohol and illicit drug-related risks were assessed with the Alcohol, Smoking and Substance Involvement Screening Test. Hayes's PROCESS macro was used for mediation analyses, adjusted for age, sex, body mass index and physical activity. RESULTS: A total of 3161 students were included, of which, 69.0% reported moderate to severe depressive symptoms. The association between TSSM and depressive symptoms was statistically significant and partially mediated by tobacco consumption (indirect effect [IE] = 0.05; 95% CI: 0.02-0.08), alcohol-related risk (IE = 0.19; 95% CI: 0.14-0.25), and illicit drug-related risk (IE = 0.08; 95% CI: 0.05-0.12). CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Our data suggest a direct relationship between TSSM and depressive symptoms, with a partial mediation effect of psychoactive substance use. This study highlights the importance that public health initiatives aimed at preventing depressive problems in young adults should focus not only on TSSM, but also on controlling and reducing psychoactive substance use.

Adherence to the Mediterranean diet and depression, anxiety, and stress symptoms in Chilean university students: a cross-sectional study.

This study aims to determine the association of adherence to the Mediterranean diet and its food groups with depressive symptoms in Chilean university students. The study design was cross-sectional. A total of 934 first-year students at a Chilean public university completed a self-report questionnaire. To assess adherence to Mediterranean diet, an index validated in Chile (Chilean-MDI) was used, and depression, anxiety, and stress symptoms were assessed using the Depression Anxiety and Stress Scale (DASS-21). Logistic regression models were used to analyze the association of adherence to Mediterranean diet and its food groups with depression, anxiety, and stress symptoms adjusted for the main confounders. Students with moderate and high adherence to Mediterranean diet showed lower odds of depression [DASS-21 > 5, odds ratio (OR) = 0.64; 95% confidence interval (95%CI): 0.47-0.88] than those with low adherence to Mediterranean diet. The consumption of 1-2 servings/day of vegetables (OR = 0.63; 95%CI: 0.43-0.92), > 2 servings/week of nuts (OR = 0.41; 95%CI: 0.21-0.80), 1-2 servings/day of fruits (OR = 0.60; 95%CI: 0.42-0.85), 1-2 servings/week of fish and seafood (OR = 0.67; 95%CI: 0.48-0.94), and 1/2-3 units/week of avocado (OR = 0.67; 95%CI: 0.48-0.93) showed low odds of depressive symptoms. The consumption of whole grains and cereals (> 2 servings/day) (OR = 1.63; 95%CI: 1.02-2.61) showed the opposite association. Adherence to Mediterranean diet and consumption of fruits, vegetables, nuts, avocado, fish, and seafood are associated with a lower likelihood of depression in Chilean university students. New policies and educational strategies are recommended to improve diet quality and the mental health of the entire university community.

Is evening chronotype associated with higher alcohol consumption? A systematic review and meta-analysis.

A broader understanding of whether and to what extent chronotype should be considered a risk factor for alcohol consumption is needed. The aim of this systematic review was to summarize the evidence on the association between evening chronotype and alcohol consumption. A systematic search of observational studies on this association was conducted in the PubMed, Scopus, Web of Science, Cochrane Library and PsycINFO databases up to April 30th, 2023. Random-effect models estimated the pooled odds ratio (OR) of alcohol consumption according to chronotype. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Quality Assessment tool for Observational Cohorts and Cross-sectional Studies from the National Heart, Lung and Blood Institute were followed. A total of 33 studies involving 28 207 individuals (age range: 18-93 years) were included in this review. Overall, most studies indicated a higher volume and frequency of alcohol consumption in evening-type individuals than in individuals with different chronotypes. Additionally, a meta-analysis including 13 studies showed that evening-type individuals were 41% more likely to consume alcohol than those with other chronotypes (OR = 1.41, 95% confidence interval: 1.16-1.66; I2 = 38.0%). Limitations of the present findings are the predominance of cross-sectional studies and varied definitions of alcohol consumption. The available evidence supports an association between the evening chronotype and alcohol consumption. The evening-type population, especially young adults, is a specific target for educational interventions for preventing or reducing alcohol consumption.PROSPERO number: CRD42022343778.

Relationship between free-time physical activity and sleep quality in Brazilian university students.

Poor sleep quality and low or no free-time physical activity (FTPA) practice are highly prevalent among university students, but the association between these conditions is still unclear. This cross-sectional study analyzed the relationship between FTPA and sleep quality. An online questionnaire was conducted with university students from a public university in southern Brazil in 2019. The weekly frequency of FTPA was self-reported, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and ANCOVA models were performed and adjusted for confounders. Among the 2,626 students analyzed, 52.2% did not practice the FTPA, and 75.6% had poor sleep quality (PSQI > 5). In the adjusted analysis, practicing FTPA 4-7 times/week was associated with poor sleep quality (odds ratio = 0.71; 95% confidence interval = 0.52, 0.97) compared with not practicing FTPA. In addition, those who practiced FTPA had significantly lower means of the global PSQI, subjective sleep quality and duration, sleep disturbances, and daytime dysfunction scores than those who did not practice FTPA. In conclusion, the FTPA may contribute to better sleep quality among university students.

Adherence to the Mediterranean diet and depression, anxiety, and stress symptoms in Chilean university students: a cross-sectional study / Adesão à dieta mediterrânea e sintomas de depressão, ansiedade e estresse em universitários chilenos: um estudo transversal / Adherencia a la dieta mediterránea y síntomas de depresión, ansiedad y estrés en universitarios chilenos: un estudio transversal

Abstract: This study aims to determine the association of adherence to the Mediterranean diet and its food groups with depressive symptoms in Chilean university students. The study design was cross-sectional. A total of 934 first-year students at a Chilean public university completed a self-report questionnaire. To assess adherence to Mediterranean diet, an index validated in Chile (Chilean-MDI) was used, and depression, anxiety, and stress symptoms were assessed using the Depression Anxiety and Stress Scale (DASS-21). Logistic regression models were used to analyze the association of adherence to Mediterranean diet and its food groups with depression, anxiety, and stress symptoms adjusted for the main confounders. Students with moderate and high adherence to Mediterranean diet showed lower odds of depression [DASS-21 > 5, odds ratio (OR) = 0.64; 95% confidence interval (95%CI): 0.47-0.88] than those with low adherence to Mediterranean diet. The consumption of 1-2 servings/day of vegetables (OR = 0.63; 95%CI: 0.43-0.92), > 2 servings/week of nuts (OR = 0.41; 95%CI: 0.21-0.80), 1-2 servings/day of fruits (OR = 0.60; 95%CI: 0.42-0.85), 1-2 servings/week of fish and seafood (OR = 0.67; 95%CI: 0.48-0.94), and 1/2-3 units/week of avocado (OR = 0.67; 95%CI: 0.48-0.93) showed low odds of depressive symptoms. The consumption of whole grains and cereals (> 2 servings/day) (OR = 1.63; 95%CI: 1.02-2.61) showed the opposite association. Adherence to Mediterranean diet and consumption of fruits, vegetables, nuts, avocado, fish, and seafood are associated with a lower likelihood of depression in Chilean university students. New policies and educational strategies are recommended to improve diet quality and the mental health of the entire university community.

Resumen: El objetivo de este estudio fue determinar la asociación entre la adherencia a la dieta mediterránea y sus grupos de alimentos y los síntomas depresivos en estudiantes universitarios chilenos. El diseño del estudio fue el transversal. Un total de 934 estudiantes de primer año de una universidad pública chilena completaron una encuesta de autoevaluación sobre la adherencia a la DM -utilizando un índice validado en Chile (IDM chileno)- y los síntomas de depresión, ansiedad y estrés, mediante el uso de la Escala de Depresión, Ansiedad y Estrés (DASS-21). Se utilizaron los modelos de regresión logística para analizar la asociación entre la adherencia a la dieta mediterránea y sus grupos alimenticios y los síntomas de depresión, ansiedad y estrés, ajustados por los principales factores de confusión. Los estudiantes con moderada o alta adherencia a la dieta mediterránea tenían menos probabilidades de presentar depresión [DASS-21 > 5, odds ratio (OR) = 0,64; intervalo de 95% de confianza (IC95%): 0,47-0,88] que aquellos con baja adherencia a la dieta mediterránea. Un consumo de 1-2 porciones por día de verduras (OR = 0,63; IC95%: 0,43-0,92), > 2 porciones por semana de nueces (OR = 0,41; IC95%: 0,21-0,80), 1-2 porciones por día de frutas (OR = 0,60; IC95%: 0,42-0,85), 1-2 porciones por semana de pescado y marisco (OR = 0,67; IC95%: 0,48-0,94) y 1/2-3 unidades por semana de aguacate (OR = 0,67; IC95%: 0,48-0,93) resultó en bajas probabilidades de síntomas depresivos. El consumo de cereales integrales (> 2 porciones por día) (OR = 1,63; IC95%: 1,02-2,61) tuvo una asociación opuesta. La adhesión a la dieta mediterránea y el consumo de frutas, verduras, nueces, aguacate, pescados y mariscos se asocian con una menor probabilidad de depresión en los estudiantes universitarios chilenos. Se sugiere la adopción de nuevas políticas y estrategias educativas para mejorar la calidad de la alimentación y promover la salud mental de toda la comunidad universitaria.

Resumo: O objetivo do estudo foi determinar a associação da adesão à dieta mediterrânea e seus grupos alimentares com sintomas depressivos em estudantes universitários chilenos. O desenho do estudo foi transversal. Um total de 934 estudantes do primeiro ano de uma universidade pública chilena responderam a uma pesquisa de autoavaliação para analisar a adesão à dieta mediterrânea - por meio de um índice validado no Chile (IDM-chileno) - e sintomas de depressão, ansiedade e estresse, utilizando a Escala de Depressão, Ansiedade e Estresse (DASS-21). Modelos de regressão logística foram utilizados para examinar a associação entre a adesão à dieta mediterrânea e seus grupos alimentares com sintomas de depressão, ansiedade e estresse, ajustados para os principais fatores de confusão. Estudantes com adesão moderada ou alta à dieta mediterrânea apresentaram chances menores de ter depressão [DASS-21 > 5, odds ratio (OR) = 0,64; intervalo de 95% de confiança (IC95%): 0,47-0,88] do que aqueles com baixa adesão à dieta mediterrânea. Um consumo de 1-2 porções por dia de verduras (OR = 0,63; IC95%: 0,43-0,92), > 2 porções por semana de nozes (OR = 0,41; IC95%: 0,21-0,80), 1-2 porções por dia de frutas (OR = 0,60; IC95%: 0,42-0,85), 1-2 porções por semana de peixes e frutos do mar (OR = 0,67; IC95%: 0,48-0,94) e 1/2-3 unidades por semana de abacate (OR = 0,67; IC95%: 0,48-0,93) resultou em chances baixas de sintomas depressivos. O consumo de cereais integrais (> 2 porções por dia) (OR = 1,63; IC95%: 1,02-2,61) resultou na associação oposta. A adesão à dieta mediterrânea e o consumo de frutas, verduras, nozes, abacate, peixes e frutos do mar estão associados a uma menor probabilidade de depressão em estudantes universitários chilenos. Recomendamos a adoção de novas políticas e estratégias educacionais para melhorar a qualidade da alimentação e promover a saúde mental de toda a comunidade universitária.

The Association Between Alcohol-Related Problems and Sleep Quality and Duration Among College Students: a Multicountry Pooled Analysis.

Alcohol consumption and sleep disorders are both prevalent and relevant problems among college students, but the relationship between these conditions is unclear. This study aimed to analyze the association between alcohol-related problems and sleep in first-year college students from Brazil, Chile, and Spain. Cross-sectional analyses were performed with data from three independent studies with first-year college students from each country. The risk of alcohol-related problems (RARP) and sleep quality and duration were self-reported using mixed methods. Pooled odds ratios (p-OR) and 95% confidence intervals (95% CI) of suboptimal sleep quality and of short (< 7 h) and long (> 8 h) sleep duration were estimated according to RARP adjusting for the main confounders. Of the 1830 students included (31.2% Brazilian, 42.2% Chilean, and 26.6% Spanish), 61.6% were female, and the mean age was 20.0 ± 3.6 years. Overall, 25.0% and 9.9% of the students were classified as intermediate and high RARP, respectively. In the combined results for the three countries, intermediate-to-high RARP was associated with a higher likelihood of suboptimal sleep quality (p-OR: 1.24; 95% CI: 1.00 to 1.52; I2 heterogeneity statistics: 43.0%), regardless of sociodemographic and lifestyle covariates and of self-rated health. The frequency of alcohol consumption was not associated with sleep quality or sleep duration. In this multicountry pooled analysis, first-year college students at risk of alcohol-related problems were more likely to report worse sleep quality. The coexistence of alcohol-related problems and sleep disorders could potentiate its adverse health effects among these young adults. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-022-00763-8.

Associação entre o consumo de café e de medicamentos psicoativos e a qualidade do sono de estudantes universitários

Introdução: o sono pode ser alterado com o uso de psicofármacos e consumo de café, dessa forma este estudo teve a finalidade de analisar a qualidade do sono dos estudantes universitários e sua relação com o consumo dessas substâncias, realizou-se um estudo transversal com universitários com 18 anos ou mais. Métodos: A coleta de dados ocorreu por meio de um questionário online entre abril e junho de 2019. A variável dependente foi a qualidade de sono e as variáveis independentes foram o consumo de medicamentos psicoativos e consumo elevado de café. Para as análises de associação foi utilizada a regressão de poisson com variância robusta, com cálculo da razão de prevalência (RP) e intervalo de confiança à 95 % (IC 95 %). Resultados: dentre os estudantes avaliados (N=2721), a prevalência de má qualidade do sono foi de 75,6 %. O consumo de medicamentos psicoativos e consumo elevado de café foi de 11,2 % e 14,1 %, respectivamente. A má qualidade de sono demonstrou maior prevalência em estudantes que utilizam medicamentos psicoativos (RP 1,11; IC 95 % 1,06-1,16), consomem elevada quantidade de café (RP 1,06; IC 95 % 1,01-1,11), ou utilizam uma das duas substâncias (RP 1,10; IC 95 % 1,06-1,15). Conclusão: o presente estudo demonstrou haver associação entre má qualidade do sono e uso de psicoativos e maior consumo de café em universitários, o que atrelado à elevada prevalência de má qualidade do sono em universitários demostra a importância do manejo adequado do uso destes produtos, bem como ações de prevenção e resolução de distúrbios do sono.

SUMMARY Introduction: sleep can be altered with the use of psychotropic drugs and coffee consumption, so this study aimed to analyze the quality of sleep of university students and its relationship with the consumption of these substances, a cross-sectional study was carried out with university students aged 18 years or over. Methods: Data collection took place through an online questionnaire between April and June 2019. The dependent variable was sleeping quality and the independent variables were consumption of psychoactive medications and high consumption of coffee. For the association analyses, Poisson regression with robust variance was used, with calculation of the prevalence ratio (PR) and confidence interval at 95 % (95 % CI). Results: among the evaluated students (N=2721), the prevalence of poor sleep quality was 75.6 %. The consumption of psychoactive drugs and high consumption of coffee was 11.2 % and 14.1 %, respectively. Poor sleep quality was more prevalent in students who use psycho-active medications (PR 1.11; 95 % CI 1.06 to 1.16), consuming a high amount of coffee (PR 1.06; 95 % CI 1.01- 1.11), or use one of the two substances (RP 1.10; 95 % CI 1.06-1.15). Conclusion: the present study showed an association between poor sleep quality and the use of psychoactive drugs and higher coffee consumption in college students, which, together with the high prevalence of poor sleep quality in college students, demonstrates the importance of proper management of the use of these products, as well as actions to prevent and resolve sleep disorders.

Introducción: el sueño se puede alterar con el uso de psicofármacos y el consumo de café, por lo que este estudio tuvo como objetivo analizar la calidad del sueño de los estudiantes universitarios y su relación con el consumo de estas sustancias, se realizó un estudio transversal con estudiantes universitarios de 18 años o más. Métodos: La recolección de datos se realizó a través de un cuestionario en línea entre abril y junio de 2019. La variable dependiente fue la calidad del sueño y las variables independientes fueron el consumo de medicamentos psicoactivos y el alto consumo de café. Para los análisis de asociación se utilizó la regresión de Poisson con varianza robusta, con cálculo de la razón de prevalencia (RP) y el intervalo de confianza al 95 % (IC 95 %). Resultados: entre los estudiantes evaluados (N = 2721), la prevalencia de mala calidad del sueño fue del 75,6 %. El consumo de psicofármacos y alto consumo de café fue de 11,2 % y 14,1 %, respectivamente. La mala calidad del sueño fue más prevalente en los estudiantes que usan medicamentos psicoactivos (PR 1,11; IC del 95 %: 1,06 a 1,16), que consumen una gran cantidad de café (RP 1,06; IC del 95 %: 1,01 a 1,11) o consumen una de las dos sustancias (RP 1,10; IC 95 % 1,06-1,15). Conclusión: el presente estudio mostró una asociación entre la mala calidad del sueño y el uso de psicofármacos y un mayor consumo de café en estudiantes universitarios, lo que, junto con la alta prevalencia de mala calidad del sueño en estudiantes universitarios, demuestra la importancia de un adecuado manejo del uso. de estos productos, así como acciones para prevenir y resolver los trastornos del sueño.

A Estratégia de Saúde da Família e as internações por condições sensíveis à atenção primária no Paraná: série temporal, 2007-2016 / Family health strategy and hospitalizations due to primary health care sensitive conditions in Paraná: a time series study, 2007-2016

Propõe-se com o presente estudo, descrever a evolução das ações da atenção primária em saúde e correlacioná-las às hospitalizações por condições sensíveis a esse nível de atenção. Trata-se de um estudo ecológico, retrospectivo e analítico, a partir de dados secundários. Foram objetos de estudo a abrangência populacional das eSF, PACS e número de NASF, além das internações por condições sensíveis a atenção primária, no Paraná e suas cinco maiores cidades. Utilizou-se o modelo de correlação de Pearson, a fim de investigar a relação entre as variáveis. Observou-se tendência crescente na abrangência das eSF em todos os locais do estudo. Houve decréscimo importante no número de ICSAP no período estudado, bem como correlação estatística negativa com o a ampliação da cobertura das ações da APS no estado do Paraná. (AU)

This study proposed to describe the evolution of actions in primary health care, and to correlate them with hospitalizations due to sensitive conditions. It is an ecological, retrospective and analytical study, based on secondary data. The objects of study are the population coverage by Family Health teams (eSF), Health Community Agents Program (PACS), and number of Family Health Support Centers (NASF), as well as hospitalizations for primary care sensitive conditions, in the five largest cities in the state of Paraná. Pearson's correlation model was used to investigate a possible correlation between the variables. There was an increase in the coverage of eSF in all of the cities of the study. There was a significant decrease in the number of Primary Health Care Sensitive Conditions (ICSAP) during the period studied, as well as a negative statistical correlation with the increase in the coverage of Primary Health Care actions in the state of Paraná. (AU)