COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents

Abstract Background Mental health problems were certainly widespread during the COVID-19 pandemic. The study aimed to examine the associations between clustering patterns of health risk behaviors (HRBs) and anxiety-depression comorbidity among Chinese adolescents, and further explore the moderating...

Full description

Saved in:
Bibliographic Details
Main Authors: Shuman Tao, Yang Qu, Yi Zhang, Hong Gan, Xingyue Mou, Panfeng Zhou, Fangbiao Tao, Xiaoyan Wu
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Psychology
Subjects:
Online Access:https://doi.org/10.1186/s40359-025-02937-0
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850136885922365440
author Shuman Tao
Yang Qu
Yi Zhang
Hong Gan
Xingyue Mou
Panfeng Zhou
Fangbiao Tao
Xiaoyan Wu
author_facet Shuman Tao
Yang Qu
Yi Zhang
Hong Gan
Xingyue Mou
Panfeng Zhou
Fangbiao Tao
Xiaoyan Wu
author_sort Shuman Tao
collection DOAJ
description Abstract Background Mental health problems were certainly widespread during the COVID-19 pandemic. The study aimed to examine the associations between clustering patterns of health risk behaviors (HRBs) and anxiety-depression comorbidity among Chinese adolescents, and further explore the moderating role of COVID-19 risk perception level in the associations. Methods A cross-sectional school-based study was conducted between April and May 2022 in Anhui Province, China. A self-administrated questionnaire was used to assess HRBs, anxiety-depression comorbidity, and COVID-19 risk perception. Latent Class Analysis was used to identify the clustering patterns of HRBs. The multinomial logistics regression models were used to explore the associations between clustering patterns of HRBs and anxiety-depression comorbidity. Furthermore, hierarchical multiple regression was used to analyze the moderating effect of COVID-19 risk perception level on the associations between the two. Results A total of 3 782 participants were analyzed. The prevalence of anxiety-depression comorbidity was 27.4%. HRBs clustering was grouped as category 1 (low-risk, 39.5%, n = 1 492), category 2 (unhealthy dietary patterns, 13.1%, n = 496), and category 3 (sleep insufficiency, 47.4%, n = 1 794). Unhealthy dietary patterns (OR = 2.10, 95%CI: 1.64–2.66) and sleep insufficiency (OR = 1.39, 95%CI: 1.17–1.66) were positively associated with anxiety-depression comorbidity. There was a positive moderating effect of COVID-19 risk perception on the relationships between clustering patterns of HRBs and anxiety-depression comorbidity (P<0.05). Conclusion COVID-19 risk perception enhances the positive association between clustering patterns of HRBs and anxiety-depression comorbidity symptoms in adolescents. Multidimensional risk factors should be warranted in the intervention programs for mental health among Chinese adolescents.
format Article
id doaj-art-37e642d4f50d455fa8c8a3d1e8fa6aac
institution OA Journals
issn 2050-7283
language English
publishDate 2025-06-01
publisher BMC
record_format Article
series BMC Psychology
spelling doaj-art-37e642d4f50d455fa8c8a3d1e8fa6aac2025-08-20T02:31:00ZengBMCBMC Psychology2050-72832025-06-011311910.1186/s40359-025-02937-0COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescentsShuman Tao0Yang Qu1Yi Zhang2Hong Gan3Xingyue Mou4Panfeng Zhou5Fangbiao Tao6Xiaoyan Wu7Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityMOE Key Laboratory of Population Health Across Life Cycle, Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical UniversityMOE Key Laboratory of Population Health Across Life Cycle, Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical UniversityAbstract Background Mental health problems were certainly widespread during the COVID-19 pandemic. The study aimed to examine the associations between clustering patterns of health risk behaviors (HRBs) and anxiety-depression comorbidity among Chinese adolescents, and further explore the moderating role of COVID-19 risk perception level in the associations. Methods A cross-sectional school-based study was conducted between April and May 2022 in Anhui Province, China. A self-administrated questionnaire was used to assess HRBs, anxiety-depression comorbidity, and COVID-19 risk perception. Latent Class Analysis was used to identify the clustering patterns of HRBs. The multinomial logistics regression models were used to explore the associations between clustering patterns of HRBs and anxiety-depression comorbidity. Furthermore, hierarchical multiple regression was used to analyze the moderating effect of COVID-19 risk perception level on the associations between the two. Results A total of 3 782 participants were analyzed. The prevalence of anxiety-depression comorbidity was 27.4%. HRBs clustering was grouped as category 1 (low-risk, 39.5%, n = 1 492), category 2 (unhealthy dietary patterns, 13.1%, n = 496), and category 3 (sleep insufficiency, 47.4%, n = 1 794). Unhealthy dietary patterns (OR = 2.10, 95%CI: 1.64–2.66) and sleep insufficiency (OR = 1.39, 95%CI: 1.17–1.66) were positively associated with anxiety-depression comorbidity. There was a positive moderating effect of COVID-19 risk perception on the relationships between clustering patterns of HRBs and anxiety-depression comorbidity (P<0.05). Conclusion COVID-19 risk perception enhances the positive association between clustering patterns of HRBs and anxiety-depression comorbidity symptoms in adolescents. Multidimensional risk factors should be warranted in the intervention programs for mental health among Chinese adolescents.https://doi.org/10.1186/s40359-025-02937-0Anxiety-depressionComorbidityAdolescentsCOVID-19Health riskBehaviors risk
spellingShingle Shuman Tao
Yang Qu
Yi Zhang
Hong Gan
Xingyue Mou
Panfeng Zhou
Fangbiao Tao
Xiaoyan Wu
COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents
BMC Psychology
Anxiety-depression
Comorbidity
Adolescents
COVID-19
Health risk
Behaviors risk
title COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents
title_full COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents
title_fullStr COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents
title_full_unstemmed COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents
title_short COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents
title_sort covid 19 risk perception moderates the relationships between health risk behaviors clustering and anxiety depression comorbidity in adolescents
topic Anxiety-depression
Comorbidity
Adolescents
COVID-19
Health risk
Behaviors risk
url https://doi.org/10.1186/s40359-025-02937-0
work_keys_str_mv AT shumantao covid19riskperceptionmoderatestherelationshipsbetweenhealthriskbehaviorsclusteringandanxietydepressioncomorbidityinadolescents
AT yangqu covid19riskperceptionmoderatestherelationshipsbetweenhealthriskbehaviorsclusteringandanxietydepressioncomorbidityinadolescents
AT yizhang covid19riskperceptionmoderatestherelationshipsbetweenhealthriskbehaviorsclusteringandanxietydepressioncomorbidityinadolescents
AT honggan covid19riskperceptionmoderatestherelationshipsbetweenhealthriskbehaviorsclusteringandanxietydepressioncomorbidityinadolescents
AT xingyuemou covid19riskperceptionmoderatestherelationshipsbetweenhealthriskbehaviorsclusteringandanxietydepressioncomorbidityinadolescents
AT panfengzhou covid19riskperceptionmoderatestherelationshipsbetweenhealthriskbehaviorsclusteringandanxietydepressioncomorbidityinadolescents
AT fangbiaotao covid19riskperceptionmoderatestherelationshipsbetweenhealthriskbehaviorsclusteringandanxietydepressioncomorbidityinadolescents
AT xiaoyanwu covid19riskperceptionmoderatestherelationshipsbetweenhealthriskbehaviorsclusteringandanxietydepressioncomorbidityinadolescents