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Environmental Health and Preventive Medicine

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01-12-2021 | Coronavirus | Research article

Associations between screen time, physical activity, and depressive symptoms during the 2019 coronavirus disease (COVID-19) outbreak among Chinese college students

Authors: Yi Zhang, Xiaoyan Wu, Shuman Tao, Shiyue Li, Le Ma, Yizhen Yu, Guilong Sun, Tingting Li, Fangbiao Tao

Published in: Environmental Health and Preventive Medicine | Issue 1/2021

Abstract

Background

The 2019 novel coronavirus disease (COVID-19) emerges in China, which spreads rapidly and becomes a public health emergency of international concern. Chinese government has promptly taken quarantine measures to block the transmission of the COVID-19, which may cause deleterious consequences on everyone’s behaviors and psychological health. Few studies have examined the associations between behavioral and mental health in different endemic areas. This study aimed to describe screen time (ST), physical activity (PA), and depressive symptoms, as well as their associations among Chinese college students according to different epidemic areas.

Methods

The study design is cross-sectional using online survey, from 4 to 12 February 2020, 14,789 college students accomplished this online study, participants who did not complete the questionnaire were excluded, and finally this study included 11,787 college students from China.

Results

The average age of participants was 20.51 ± 1.88 years. 57.1% of the college students were male. In total, 25.9% of college students reported depression symptoms. ST > 4 h/day was positively correlated with depressive symptoms (β = 0.48, 95%CI 0.37–0.59). COVID-19ST > 1 h/day was positively correlated with depressive symptoms (β = 0.54, 95%CI 0.43–0.65), compared with COVID-19ST ≤ 0.5 h/day. Compared with PA ≥ 3 day/week, PA < 3 day/week was positively associated with depression symptoms (β = 0.01, 95%CI 0.008–0.012). Compared with low ST and high PA, there was an interaction association between high ST and low PA on depression (β = 0.31, 95%CI 0.26–0.36). Compared with low COVID-19ST and high PA, there was an interaction association between high COVID-19ST and low PA on depression (β = 0.37, 95%CI 0.32–0.43). There were also current residence areas differences.

Conclusions

Our findings identified that high ST or low PA was positively associated with depressive symptoms independently, and there was also an interactive effect between ST and PA on depressive symptoms.

Hui DS, Azhar EI, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health-The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;93(91):264–6. https://doi.org/10.1016/j.ijid.2020.01.009.CrossRef

World Health Organization. Novel coronavirus (2019-nCoV) situation report-17[EB/ OL] [2020.2.6]. 2020. https://www.who.int/docs/defaultsource/coronaviruse/situation-reports/20200206-sitrep-17-ncov.pdf?sfvrsn=17f0dca_4.

Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med. 2020;27(2):taaa020. https://doi.org/10.1093/jtm/taaa020.CrossRefPubMed

Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912–20. https://doi.org/10.1016/S0140-6736(20)30460-8.CrossRefPubMedPubMedCentral

Qin F, Song YQ, Nassis GP, Zhao LN, Cui SQ, Lai LL, Wu ZZ, Xu MX, Qu CY, Dong YN, Wang ZW, Geng X, Zhao CC, Feng YW, Han ZN, Fan ZZ, Zhao JX. Prevalence of Insufficient physical activity, sedentary screen time and emotional well-Being during the early days of the 2019 Novel Coronavirus (COVID-19) outbreak in China: A national cross-sectional study (3/31/2020). Available at SSRN: https://ssrn.com/abstract=3566176 or doi:https://doi.org/10.2139/ssrn.3566176

Xiang M, Zhang Z, Kuwahara K. Impact of COVID-19 pandemic on children and adolescents' lifestyle behavior larger than expected. Prog Cardiovasc Dis. 2020a;63(4):531–2. https://doi.org/10.1016/j.pcad.2020.04.013.CrossRefPubMedPubMedCentral

Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of COVID-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study. Obesity. 2020;30. https://doi.org/10.1002/oby.22861.

Peluso MA, Guerra de Andrade LH. Physical activity and mental health: the association between exercise and mood. Clinics. 2005a;60(1):61–70. https://doi.org/10.1590/s1807-59322005000100012.CrossRefPubMed

Nagata JM, Abdel Magid HS, Pettee Gabriel K. Screen time for children and adolescents during the coronavirus disease 2019 pandemic. Obesity. 2020;28(9):1582–3. https://doi.org/10.1002/oby.22917.CrossRefPubMed

10.

LeBourgeois MK, Hale L, Chang AM, Akacem LD, Montgomery-Downs HE, Buxton OM. Digital media and sleep in childhood and adolescence. Pediatrics. 2017;140(Suppl 2):S92–6.CrossRefPubMed

11.

Twenge JM, Martin GN, Campbell WK. Decreases in psychological well-being among American adolescents after 2012 and links to screen time during the rise of smartphone technology. Emotion. 2018;18(6):765–80.CrossRefPubMed

12.

Wang CY, Pan RY, Wan XY, Tan YL, Xu LK, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17:1729. https://doi.org/10.3390/ijerph17051729.CrossRefPubMedCentral

13.

Zandifar A, Badrfam R. Iranian mental health during the COVID-19 epidemic. Asian J Psychiatr. 2020;51:101990. https://doi.org/10.1016/j.ajp.2020.101990.CrossRefPubMedPubMedCentral

14.

Xiao C. A novel approach of consultation on 2019 novel coronavirus (COVID-19)-related psychological and mental problems: structured letter therapy. Psychiatry Investig. 2020;17(2):175–6. https://doi.org/10.30773/pi.2020.0047.CrossRefPubMedPubMedCentral

15.

Xiang Y-T, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020b;7(3):228–9. https://doi.org/10.1016/S2215-0366(20)30046-8.CrossRefPubMedPubMedCentral

16.

Sund AM, Larsson B, Wichstrøm L. Role of physical and sedentary activities in the development of depressive symptoms in early adolescence. Soc Psychiatry Psychiatr Epidemiol. 2011;46(5):431–41. https://doi.org/10.1007/s00127-010-0208-0.CrossRefPubMed

17.

White K, Kendrick T, Yardley L. Change in self-esteem, self-efficacy and the mood dimensions of depression as potential mediators of the physical activity and depression relationship: exploring the temporal relation of change. Ment Health Phys Act. 2009;2:44–52. https://doi.org/10.1016/j.mhpa.2009.03.001.CrossRef

18.

Janssen I, Leblanc AG. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act. 2010;7:40. https://doi.org/10.1186/1479-5868-7-40.CrossRefPubMedPubMedCentral

19.

Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act. 2011a;8:98. https://doi.org/10.1186/1479-5868-8-98.CrossRefPubMedPubMedCentral

20.

Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act. 2011b;8:98. https://doi.org/10.1186/1479-5868-8-98.CrossRefPubMedPubMedCentral

21.

Capodaglio EM. Attività fisica, strumento di prevenzione e gestione delle malattie croniche [Physical activity, tool for the prevention and management of chronic diseases]. G Ital Med Lav Ergon. 2018;40(2):106–19.PubMed

22.

Cunningham C, O’Sullivan R, Caserotti P, Tully MA. Consequences of physical inactivity in older adults: A systematic review of reviews and meta-analyses. Scand J Med Sci Sports. 2020;30(5):816–27. https://doi.org/10.1111/sms.13616.CrossRefPubMed

23.

Sisson SB, Camhi SM, Church TS, Martin CK, Tudor-Locke C, Bouchard C, et al. Leisure time sedentary behavior, occupational/domestic physical activity, and metabolic syndrome in U.S. men and women. Metab Syndr Relat Disord. 2009;7(6):529–36. https://doi.org/10.1089/met.2009.0023.CrossRefPubMed

24.

Sloan RA, Sawada SS, Girdano D, Liu YT, Biddle SJ, Blair SN. Associations of sedentary behavior and physical activity with psychological distress: a cross-sectional study from Singapore. BMC Public Health. 2013;13:885. https://doi.org/10.1186/1471-2458-13-885.CrossRefPubMedPubMedCentral

25.

Hamer M, Stamatakis E, Mishra GD. Television- and screen-based activity and mental well-being in adults. Am J Prev Med. 2010;38(4):375–80. https://doi.org/10.1016/j.amepre.2009.12.030.CrossRefPubMed

26.

Tremblay MS, Warburton DE, Janssen I, Paterson DH, Latimer AE, Rhodes RE, et al. New Canadian physical activity guidelines. Appl Physiol Nutr Metab. 2011c;36(1):36–46; 47-58. https://doi.org/10.1139/H11-009.CrossRefPubMed

27.

Wu XY, Tao SM, Zhang YK, Zhang SC, Tao FB. Low physical activity and high screen time can increase the risks of mental health problems and poor sleep quality among Chinese college students. PLoS One. 2015;10(3):e0119607. https://doi.org/10.1371/journal.pone.0119607.CrossRefPubMedPubMedCentral

28.

Janssen I, Katzmarzyk PT, Boyce WF, Vereecken C, Mulvihill C, Roberts C, et al. Health behaviour in school-aged children obesity working group. Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns. Obes Rev. 2005;6(2):123–32. https://doi.org/10.1111/j.1467-789X.2005.00176.x.CrossRefPubMed

29.

Martin A, Rief W, Klaiberg A, Braehler E. Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiatry. 2006;28(1):71–7. https://doi.org/10.1016/j.genhosppsych.2005.07.003.CrossRefPubMed

30.

Beard C, Hsu KJ, Rifkin LS, Busch AB, Björgvinsson T. Validation of the PHQ-9 in a psychiatric sample. J Affect Disord. 2016;193:267–73. https://doi.org/10.1016/j.jad.2015.12.075.CrossRefPubMed

31.

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13. https://doi.org/10.1046/j.1525-1497.2001.016009606.x.CrossRefPubMedPubMedCentral

32.

Wu X, Tao S, Zhang Y, et al. Geographic distribution of mental health problems among chinese college students during COVID-19 pandemic: cross-sectional, Online Survey Study [published online ahead of print, 2021 J Med Internet Res 2021;https://doi.org/10.2196/23126.

33.

Ni MY, Yang L, Leung C, Li N, Yao XI, Wang Y, et al. Mental health, risk factors, and social media use during the COVID-19 epidemic and cordon sanitaire among the community and health professionals in Wuhan, China: cross-sectional survey. JMIR Mental Health. 2020;7(5):e19009. https://doi.org/10.2196/19009.CrossRefPubMedPubMedCentral

34.

Main A, Zhou Q, Ma Y, Luecken LJ, Liu X. Relations of SARS-related stressors and coping to Chinese college students' psychological adjustment during the 2003 Beijing SARS epidemic. J Couns Psychol. 2011;58(3):410–23. https://doi.org/10.1037/a0023632.CrossRefPubMed

35.

Ghrouz AK.; Noohu MM.’ Dilshad MM.; Warren SD.; Ba Hammam AS.; Pandi-Perumal SR. Physical activity and sleep quality in relation to mental health among college students. Sleep Breath, 2019. 23(2), 627-634. doi: https://doi.org/10.1007/s11325-019-01780-zCrossRefPubMed

36.

Talevi D, Socci V, Carai M, Carnaghi G, Faleri S, Trebbi E, et al. Mental health outcomes of the CoViD-19 pandemic. Riv Psichiatr. 2020;55(3):137–44. https://doi.org/10.1708/3382.33569.CrossRefPubMed

37.

Feng Q, Zhang QL, Du Y, Ye YL, He QQ. Associations of physical activity, screen time with depression, anxiety and sleep quality among Chinese college freshmen. PLoS One. 2014;9(6):e100914. Published 2014 Jun 25. https://doi.org/10.1371/journal.pone.0100914.CrossRefPubMedPubMedCentral

38.

Hrafnkelsdottir SM, Brychta RJ, Rognvaldsdottir V, Gestsdottir S, Chen KY, Johannsson E, et al. Less screen time and more frequent vigorous physical activity is associated with lower risk of reporting negative mental health symptoms among Icelandic adolescents. PLoS One. 2018;13(4):e0196286. https://doi.org/10.1371/journal.pone.0196286.CrossRefPubMedPubMedCentral

39.

Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211–24. https://doi.org/10.1016/S2215-0366(18)30511-X Erratum in: Lancet Psychiatry. 2019; 6(4):e11. PMID: 30792114.CrossRefPubMed

40.

Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206–12. https://doi.org/10.3201/eid1007.030703.CrossRefPubMedPubMedCentral

41.

Sprang G, Silman M. Posttraumatic stress disorder in parents and youth after health-related disasters. Disaster Med Public Health Prep. 2013;7(1):105–10. https://doi.org/10.1017/dmp.2013.22.CrossRefPubMed

42.

Maisonnette S, Morato S, Brandão ML. Role of resocialization and of 5-HT1A receptor activation on the anxiogenic effects induced by isolation in the elevated plus-maze test. Physiol Behav. 1993 Oct;54(4):753–8. https://doi.org/10.1016/0031-9384(93)90087-v.CrossRefPubMed

43.

Morley BJ, Worsham E. The effects of prolonged handling, scopolamine, and physostigmine on the activity of isolated and socially reared rats. Physiol Psychol. 1978;6:83–8.CrossRef

44.

Ikemoto S, Panksepp J. The effects of early social isolation on the motivation for social play in juvenile rats. Dev Psychobiol. 1992;25:261–74. https://doi.org/10.1002/dev.420250404.CrossRefPubMed

45.

McCool BA, Chappell AM. Early social isolation in male Long-Evans rats alters both appetitive and consummatory behaviors expressed during operant ethanol self-administration. Alcohol Clin Exp Res. 2009;33(2):273–82. https://doi.org/10.1111/j.1530-0277.2008.00830.x.CrossRefPubMed

46.

Orben A, Tomova L, Blakemore SJ. The effects of social deprivation on adolescent development and mental health. Lancet Child Adolesc Health. 2020;4(8):634–40. https://doi.org/10.1016/S2352-4642(20)30186-3.CrossRefPubMedPubMedCentral

47.

Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci Rep. 2018;8(1):2861. https://doi.org/10.1038/s41598-018-21243-x.CrossRefPubMedPubMedCentral

48.

Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatr. 2020;33(2):e100213. https://doi.org/10.1136/gpsych-2020-100213 Erratum in: Gen Psychiatr. 2020 Apr 27;33(2):e100213corr1.CrossRefPubMedPubMedCentral

49.

Lissak G. Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study. Environ Res. 2018;164:149–57. https://doi.org/10.1016/j.envres.2018.01.015.CrossRefPubMed

50.

Twenge JM, Campbell WK. Associations between screen time and lower psychological well-being among children and adolescents: evidence from a population-based study. Prev Med Rep. 2018;12:271–83. https://doi.org/10.1016/j.pmedr.2018.10.003.CrossRefPubMedPubMedCentral

51.

Chao M, Xue D, Liu T, Yang H, Hall BJ. Media use and acute psychological outcomes during COVID-19 outbreak in China. J Anxiety Disord. 2020;74:102248. https://doi.org/10.1016/j.janxdis.2020.102248.CrossRefPubMedPubMedCentral

52.

Resnyansky L. Social media, disaster studies, and human communication. IEEE Technol Soc Mag. 2014;33(1):54–65. https://doi.org/10.1109/MTS.2014.2301857.CrossRef

53.

Holman EA, Garfin DR, Silver RC. Media’s role in broadcasting acute stress following the Boston Marathon bombings. Proc Natl Acad Sci U S A. 2014;111(1):93–8. https://doi.org/10.1073/pnas.1316265110.CrossRefPubMed

54.

Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S, et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020;14(5):779–88. https://doi.org/10.1016/j.dsx.2020.05.035.CrossRefPubMedPubMedCentral

55.

Liu M, Ming Q, Yi J, Wang X, Yao S. Screen time on school days and risks for psychiatric symptoms and self-harm in mainland Chinese adolescents. Front Psychol. 2016;7:574. https://doi.org/10.3389/fpsyg.2016.00574.CrossRefPubMedPubMedCentral

56.

Lachlan KA, Spence PR, Seeger M. Terrorist attacks and uncertainty reduction: Media use after September 11. Behav Sci Terror Polit Aggression. 2009;1(2):101–10. https://doi.org/10.1080/19434470902771683.CrossRef

57.

Burke M, Marlow C, Lento T. Social network activity and social wellbeing. CHI’10: Proceedings of the SIGCHI conference on human factors in computing systems. Atlanta: ACM Press; 2010. p. 1909–12.

58.

O'Donovan G, Blazevich AJ, Boreham C, Cooper AR, Crank H, Ekelund U, et al. The ABC of physical activity for health: a consensus statement from the British Association of Sport and Exercise Sciences. J Sports Sci. 2010;28(6):573–91. https://doi.org/10.1080/02640411003671212.CrossRefPubMed

59.

Crisafulli A, Pagliaro P. Physical activity/inactivity and COVID-19. Eur J Prev Cardiol. 2020;18:2047487320927597. https://doi.org/10.1177/2047487320927597.CrossRef

60.

Rocha SF, Marocolo M, Corrêa EN, Morato GS, da Mota GR. Physical activity helps to control music performance anxiety. Med Probl Perform Art. 2014;29(2):111–2. https://doi.org/10.21091/mppa.2014.2022.CrossRefPubMed

61.

Adams TB, Moore MT, Dye J. The relationship between physical activity and mental health in a national sample of college females. Women Health. 2007;45(1):69–85. https://doi.org/10.1300/J013v45n01_05.CrossRefPubMed

62.

Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: Special focus in older people. Prog Cardiovasc Dis. 2020;63(3):386–8. https://doi.org/10.1016/j.pcad.2020.03.009.CrossRefPubMedPubMedCentral

63.

Lippi G, Henry BM, Sanchis-Gomar F. Physical inactivity and cardiovascular disease at the time of coronavirus disease 2019 (COVID-19). Eur J Prev Cardiol. 2020;27(9):906–8. https://doi.org/10.1177/2047487320916823.CrossRefPubMedPubMedCentral

64.

Rothon C, Edwards P, Bhui K, Viner RM, Taylor S, Stansfeld SA. Physical activity and depressive symptoms in adolescents: a prospective study. BMC Med. 2010;8:32. https://doi.org/10.1186/1741-7015-8-32.CrossRefPubMedPubMedCentral

65.

Cao H, Qian Q, Weng T, Yuan C, Sun Y, Wang H, et al. Screen time, physical activity and mental health among urban adolescents in China. Prev Med. 2011;53(4-5):316–20. https://doi.org/10.1016/j.ypmed.2011.09.002.CrossRefPubMed

66.

Kremer P, Elshaug C, Leslie E, Toumbourou JW, Patton GC, Williams J. Physical activity, leisure-time screen use and depression among children and young adolescents. J Sci Med Sport. 2014;17(2):183–7. https://doi.org/10.1016/j.jsams.2013.03.012.CrossRefPubMed

67.

Trinh L, Wong B, Faulkner GE. The independent and interactive associations of screen time and physical activity on mental health, school connectedness and academic achievement among a population-based sample of youth. J Can Acad Child Adolesc Psychiatry. 2015;24(1):17–24.PubMedPubMedCentral

68.

Vallance JK, Winkler EA, Gardiner PA, Healy GN, Lynch BM, Owen N. Associations of objectively-assessed physical activity and sedentary time with depression: NHANES (2005-2006). Prev Med. 2011;53(4-5):284–8. https://doi.org/10.1016/j.ypmed.2011.07.013.CrossRefPubMed

69.

Teychenne M, Ball K, Salmon J. Physical activity and likelihood of depression in adults: a review. Prev Med. 2008;46(5):397–411. https://doi.org/10.1016/j.ypmed.2008.01.009.CrossRefPubMed

70.

Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm (Vienna). 2009;116(6):777–84. https://doi.org/10.1007/s00702-008-0092-x.CrossRef

71.

Dunn AL, Trivedi MH, O'Neal HA. Physical activity dose-response effects on outcomes of depression and anxiety. Med Sci Sports Exerc. 2001;33(6 Suppl):S587–610. https://doi.org/10.1097/00005768-200106001-00027.CrossRefPubMed

72.

Wicke T, Silver RC. A community responds to collective trauma: An ecological analysis of the James Byrd murder in Jasper, Texas. Am J Community Psychol. 2009;44(3-4):233–48. https://doi.org/10.1007/s10464-009-9262-8.CrossRefPubMedPubMedCentral

73.

Janssen I. Estimating whether replacing time in active outdoor play and sedentary video games with active video games influences youth’s mental health. J Adolesc Health. 2016;59(5):517–22.CrossRefPubMed

74.

75.

Wu X, Tao S, Rutayisire E, Chen Y, Huang K, Tao F. The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China. Eur Child Adolesc Psychiatry. 2017;26:541–8.CrossRefPubMed

76.

Oswald TK, Rumbold AR, Kedzior S, Moore VM. Psychological impacts of “screen time” and “green time” for children and adolescents: a systematic scoping review. PLoS One. 2020;15(9):e0237725.CrossRefPubMedPubMedCentral

77.

Marques A, Calmeiro L, Loureiro N, Frasquilho D, de Matos MG. Health complaints among adolescents: Associations with more screen-based behaviours and less physical activity. J Adolesc. 2015;44:150–7.CrossRefPubMed

78.

Bélanger M, Gallant F, Doré I, O'Loughlin JL, Sylvestre MP, Abi Nader P, et al. Physical activity mediates the relationship between outdoor time and mental health. Prev Med Rep. 2019;16:101006.CrossRefPubMedPubMedCentral

79.

de Graaff AM, Cuijpers P, Acarturk C, Bryant R, Burchert S, Fuhr DC, et al. Effectiveness of a peer-refugee delivered psychological intervention to reduce psychological distress among adult Syrian refugees in the Netherlands: study protocol. Eur J Psychotraumatol. 2020;11(1):1694347–10.1080/20008198.2019.1694347.CrossRefPubMedPubMedCentral

80.

Zhou X. Psychological crisis interventions in Sichuan Province during the 2019 novel coronavirus outbreak. Psychiatry Res. 2020;286:112895. https://doi.org/10.1016/j.psychres.2020.112895.CrossRefPubMedPubMedCentral

81.

Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):300–2. https://doi.org/10.1016/S2215-0366(20)30073-0.CrossRefPubMedPubMedCentral

82.

Peluso MA, Guerra de Andrade LH. Physical activity and mental health: the association between exercise and mood. Clinics. 2005b;60(1):61–70. https://doi.org/10.1590/s1807-59322005000100012.CrossRefPubMed

83.

Hammami A, Harrabi B, Mohr M, Krustrup P. Physical activity and coronavirus disease 2019 (COVID-19): specific recommendations for home-based physical training. Manag Sport Leis. 2020:1–6. https://doi.org/10.1080/23750472.2020.1757494.

84.

Hinkley T, Brown H, Carson V, Teychenne M. Cross sectional associations of screen time and outdoor play with social skills in preschool children. PLoS One. 2018;13(4):e0193700.CrossRefPubMedPubMedCentral

85.

Zhang X, Li M, Guo L, Zhu Y. Mental health and its influencing factors among left-behind children in South China: a cross-sectional study. BMC Public Health. 2019;19(1):1725.CrossRefPubMedPubMedCentral

Title: Associations between screen time, physical activity, and depressive symptoms during the 2019 coronavirus disease (COVID-19) outbreak among Chinese college students
Authors: Yi Zhang
Xiaoyan Wu
Shuman Tao
Shiyue Li
Le Ma
Yizhen Yu
Guilong Sun
Tingting Li
Fangbiao Tao
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Coronavirus
Mood Disorders
Affective Disorder
COVID-19
Published in: Environmental Health and Preventive Medicine / Issue 1/2021
Print ISSN: 1342-078X
Electronic ISSN: 1347-4715
DOI: https://doi.org/10.1186/s12199-021-01025-0

At a glance: The STEP trials

Springer Medicine

Associations between screen time, physical activity, and depressive symptoms during the 2019 coronavirus disease (COVID-19) outbreak among Chinese college students

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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