Chronotype as a risk factor for adolescent depression and anxiety: The mediating roles of sleep and social functioning

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BACKGROUND: Adolescents with an evening chronotype are at higher risk for mental health problems, such as depression and anxiety. However, the mechanisms underlying this relationship are not well understood. Sleep disturbances and impaired social functioning may mediate this association. AIM: To examine the mediating roles of sleep quality and social functioning in the relationship between chronotype and mental health in adolescents. METHODS: A cross-sectional survey was conducted among 381 adolescents (mean age 14.3 years; 61.9% male) using the Morningness-Eveningness Questionnaire, Hamilton Depression Rating Scale, Hamilton Anxiety Scale, Pittsburgh Sleep Quality Index, and Social Disability Screening Schedule. Descriptive statistics, Pearson correlation analyses, and chain mediation analysis using the bootstrap method were performed. RESULTS: Chronotype was significantly associated with both depression and anxiety. Sleep quality and social functioning significantly mediated these relationships. The indirect effect on depression was -0.52, accounting for 69.3% of the total effect. For anxiety, the indirect effect was -0.39, accounting for 79.3%. No significant direct effect of chronotype on depression or anxiety was found after accounting for the mediators. CONCLUSION: Sleep quality and social functioning mediate the association between chronotype and adolescent mental health. These findings highlight the importance of addressing sleep disturbances and social functioning impairments in interventions aimed at improving mental well-being among adolescents with evening chronotypes.

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