Research reportActigraphic predictors of the depressive state in students with no psychiatric disorders
Introduction
Mild or moderate depressive state has been defined epidemiologically by several questionnaire surveys (Wells et al., 1989, Judd et al., 1997, Broadhead et al., 1990). The cutoff values for the scores in these questionnaires should be decided by the ethnicity or country based on the results of non-biased epidemiological studies.
Several studies have indicated an association between insomnia and the depressive state, and individuals with depressive symptoms have been reported to show lower levels of physical activity (Mendlowicz et al., 1999). The prevalence of depressive symptoms in Japan is about 4% at the workplace, and extremely high among university students (Iwata and Buka, 2002).
Depressive symptoms are generally reported subjectively, and the duration of sleep can be objectively measured using physiological methods, such as polysomnography or accelerometry (Rechstaffen and Kales, 1968, Acebo et al., 1999). In recent years, wrist actigraphy has been increasingly used to assess the status of sleep and activity in clinical patients and in the general population. There is evidence suggesting that wrist actigraphy can be used to study sleep patterns and psychomotor disturbances in cases of depression (Foster and Kupfer, 1975, Teicher, 1995). Wrist actigraphy has recently become less expensive (Tryon, 1991, Sadeh et al., 1995), and although it is sometimes intrusive, storage of data is relatively easy as compared with that during sleep polygraphy.
We hypothesized that actigraphy could be used to monitor mood disturbances based on the duration of sleep and physical activity levels. To test this hypothesis, we examined whether the depressive state was associated with actigraph-monitored daytime activity levels (DALs) and total sleep time (TST) in university students.
Section snippets
Study subjects
The students who attended the clinical practice course were recruited. Written informed consent was obtained from all the participants. The participants comprised of 105 individuals ranging in age from 22 to 31 years (mean age, 24.1 years (SD, 1.8); 74 men and 31 women), who had no psychiatric disorders.
Procedures
The subjects were continuously monitored for 4 days, except during heavy exercise and bathing, which affect the accelerator. Sleep and wakefulness data were acquired with an Actiwatch® (Mini
Data analysis
The objective of the statistical analysis was to check the association between the actigraphic parameters and the depressive state as assessed by the questionnaire survey, by determining the partial correlation coefficient after controlling for age. A stratified analysis by sex was also conducted. Furthermore, a multiple regression analysis was conducted to check the contribution of the depressive state, sex, age, and DAL to sleep.
Results
Our analysis results revealed that 24.3% of the students exhibited a mild depressive state and 12.6% of the students exhibited a moderate depressive state. Sex difference in the frequency of distribution could not be observed. There was no difference in this distribution of the severity of the depressive state between the sexes (Table 1). A significant association was noted between the CES-D and TST, but only in females (r = − 0.49, n = 28). There was no significant association between the TST and
Discussion
The results of this investigation suggest that the daytime activity level as assessed by wrist actigraphy cannot be used as an index of the depressive state even in university students. The present observation is not consistent with previous reports of the inverse association between daytime activity and the severity of the depressive state (Teicher, 1995). Other investigators have also reported significant inverse correlations between activity levels as assessed by activity monitors and the
Acknowledgements
This study was supported by the members in the Department of Hygiene and Public Health, Nippon Medical School, Japan.
References (20)
- et al.
Sleep disruption and mood changes associated with menopause
J. Psychosom. Res.
(1997) - et al.
Psychomotor retardation found in college students seeking counseling
Behav. Res. Ther.
(1995) - et al.
Race/ethnicity and depressive symptoms: a cross-cultural/ethnic comparison among university students in East Asia, North and South America
Soc. Sci. Med.
(2002) - et al.
Habituation of sleep to road traffic noise as determined by polysomnography and accelerometer
J. Sound Vib.
(2001) Psychomotor retardation: clinical, theoretical, and psychometric aspects
Psychiatr. Clin. North Am.
(1983)- et al.
Estimating sleep patterns with activity monitoring in children and adolescents: how many nights are necessary for reliable measures?
Sleep
(1999) - et al.
Depression, disability days, and days lost from work in a prospective epidemiologic survey
JAMA
(1990) - et al.
Psychomotor activity as a correlate of depression and sleep in acutely disturbed psychiatric inpatients
Am. J. Psychiatry
(1975) - et al.
The role and clinical significance of subsyndromal depressive symptoms (SSD) in unipolar major depressive disorder
J. Affect. Disord.
(1997) - et al.
Sleep continuity changes in depression
Dis. Nerv. Syst.
(1973)
Cited by (13)
Sleep duration and its association with sleepiness and depression in "ronin-sei" preparatory school students
2014, Asian Journal of PsychiatryCitation Excerpt :Although sleep duration in early adulthood averages 7–8.5 h per night, the duration in Japanese university students reported by Steptoe and associates (2006) was 6.2 h for men and 6.1 h for women. Students with short sleep duration are more likely to have depressive symptoms (O’Brien and Mindell, 2005; Kawada et al., 2007; Pasch et al., 2010). It has been reported that sleep loss in students increases the incidence of excessive daytime sleepiness and nodding in the classroom, and leads to low grades (Kelly et al., 2001; Ohida et al., 2004; Pallos et al., 2004; Bahammam et al., 2012; Dewald et al., 2010; Wolfson and Carskadon, 1998, 2003).
Depression in medical students: Cluster symptoms and management
2013, Journal of Affective DisordersCitation Excerpt :In addition ragging and low levels of social engagement have been identified as contributing to depressive symptoms (Castaldelli-Maia et al., 2012). Medical training itself has been shown to be a risk factor in production and maintenance of depressive symptoms (Ahaneku, 2000; Kawada et al., 2007; Jeon et al., 2009). Thus it is critical that, the medical schools area aware of these risks (Givens and Tjia, 2002) and provide suitable, direct, and fast interventions to help the students (Merritt et al., 2007).
Digital health tools for the passive monitoring of depression: a systematic review of methods
2022, npj Digital MedicineStudy of depression in university students in Pakistan
2020, Journal of the Pakistan Medical AssociationDepression, Acculturative Stress, and Social Connectedness among international university students in Japan: A statistical investigation
2019, Sustainability (Switzerland)