Prevalence and risk factors of depressive and anxiety symptoms and functional constipation among university students in Eastern China

Table 1 Sociodemographic and clinical characteristics of university students (n = 12721), n (%)

	Depression symptoms			Anxiety symptoms
	With (n = 2075)	Without (n = 10646)	P value	With (n = 3166)	Without (n = 9555)	P value
Sex			< 0.001			< 0.001
Male	878 (14.2)	5319 (85.8)		1312 (21.2)	4885 (78.8)
Female	1197 (18.3)	5327 (81.7)		1854 (28.4)	4670 (71.6)
Age (years), mean (SD)	19.68 (1.16)	19.62 (1.20)	0.033	19.62 (1.22)	19.63 (1.19)	0.802
Age group			0.010			0.191
17-19	785 (15.3)	4349 (84.7)		1309 (25.5)	3825 (74.5)
20-25	1290 (17.0)	6297 (83.0)		1857 (24.5)	5730 (75.5)
Height (m), mean (SD)	1.67 (0.08)	1.67 (0.08)	0.682	1.67 (0.08)	1.67 (0.08)	0.771
Weight (kg), mean (SD)	62.02 (10.85)	61.87 (10.56)	0.553	61.94 (10.68)	61.88 (10.58)	0.783
Body mass index (kg/m2)	22.08 (3.34)	22.03 (3.13)	0.563	22.05 (3.19)	22.04 (3.16)	0.933
Smoking			< 0.001			< 0.001
Yes	412 (27.1)	1106 (72.9)		592 (39.0)	926 (61.0)
No	1663 (14.8)	9540 (85.2)		2574 (23.0)	8629 (77.0)
Parental relationship			< 0.001			< 0.001
Harmony	942 (10.3)	8224 (89.7)		1668 (18.2)	7498 (81.8)
Moderate	909 (29.2)	2202 (70.8)		1255 (40.3)	1856 (59.7)
Conflict	224 (50.5)	220 (49.5)		243 (54.7)	201 (45.3)
Annual household income			< 0.001			< 0.001
Better	602 (11.4)	4684 (88.6)		988 (18.7)	4298 (81.3)
Good	875 (17.0)	4272 (83.0)		1367 (26.6)	3780 (73.4)
Fair	598 (26.1)	1690 (73.9)		811 (35.4)	1477 (64.6)
Functional constipation			< 0.001			0.002
Yes	596 (21.3)	2203 (78.7)		634 (22.7)	2165 (77.3)
No	1479 (14.9)	8443 (85.1)		2532 (25.5)	7390 (74.5)

Table 2 Percentage of students with various depressive and anxiety symptom severity levels (n = 12721)

	Depressive symptoms		Anxiety symptoms		Comorbid depression and anxiety symptoms
	n	%	n	%	n	%
Minimal	6986	54.9	8245	64.8	11025	86.7%
Mild	3660	28.8	3070	24.1	-	-
Moderate	1280	10.1	901	7.1	-	-
Moderately severe	524	4.1	-	-	-	-
Severe	271	2.1	505	4.0	-	-
Overall prevalence	2075	16.3	3166	24.9	1696	13.3

Table 3 Risk factor correlation with the prevalence of depressive and anxiety symptoms among students

	Depressive symptoms			Anxiety symptoms
	OR	95%CI	P value	OR	95%CI	P value
Sex
Male	1			1
Female	1.336	1.209-1.477	< 0.001	1.445	1.328-1.572	< 0.001
Age group (years)				-	-	-
17-19	1			-	-	-
20-25	1.066	0.963-1.180	0.220	-	-	-
Smoking
No	1			1
Yes	0.935	0.779-1.122	0.469	0.919	0.783-1.079	0.303
Parental relationship
Harmony	1			1
Moderate	3.340	2.934-3.802	< 0.001	2.651	2.367-2.969	< 0.001
Conflict	7.807	6.373-9.564	< 0.001	4.937	4.052-6.014	< 0.001
Annual household income
Better	1			1
Good	1.289	1.129-1.472	< 0.001	1.297	1.166-1.443	< 0.001
Fair	2.016	1.762-2.307	< 0.001	1.820	1.621-2.044
Functional constipation
No	1			1
Yes	1.811	1.617-2.029	< 0.001	0.931	0.839-1.033	0.180

OR: Odds ratio.

Table 4 Gender-stratified analysis of risk factors for depressive and anxiety symptoms

Risk factor	Depressive symptoms					Anxiety symptoms
	Male (n = 6197)		Female (n = 6524)		P value for interaction1 (n = 12721)	Male (n = 6197)		Female (n = 6524)		P value for interaction1 (n = 12721)
	OR	95%CI	OR	95%CI		OR	95%CI	OR	95%CI
Age group (years)					< 0.001					< 0.001
17–19	1		1			1		1
20–25	1.048	0.898–1.223	1.079	0.942–1.236		0.865	0.760–0.985	0.915	0.817–1.025
Smoking					0.016					0.056
No	1		1			1		1
Yes	1.369	1.060–1.769	0.839	0.649–1.085		1.245	0.994–1.558	0.944	0.752–1.185
Parental relationship					< 0.001					< 0.001
Harmony	1		1			1		1
Moderate	2.817	2.321–3.418	3.886	3.262–4.628		2.561	2.167–3.027	2.790	2.389–3.258
Conflict	7.661	5.694–10.309	8.009	6.059–10.586		5.946	4.466–7.917	4.262	3.250–5.589
Annual household income					< 0.001					< 0.001
Better	1		1			1		1
Good	1.483	1.214–1.811	1.183	0.990–1.415		1.317	1.122–1.546	1.285	1.113–1.483
Fair	2.712	2.207–3.332	1.619	1.352–1.938		2.048	1.715–2.445	1.678	1.439–1.958
Functional constipation					< 0.001					0.061
No	1		1			1		1
Yes	1.628	1.372–1.930	1.954	1.676–2.278		0.861	0.736–1.007	0.985	0.857–1.133

¹P value for interaction between gender and risk factors.

OR: Odds ratio.

Table 5 Population attributable risk proportions of risk factors for depressive and anxiety symptoms and functional constipation

Risk factor	Overall PARP (95%CI)	Male PARP (95%CI)	Female PARP (95%CI)	P for interaction1
Depressive symptoms
Parental relationship				< 0.001
Moderate vs harmonious	22.3 (19.7–4.8)	20.5 (17.6–23.4)	23.9 (21.1–26.6)
Conflicted vs harmonious	16.3 (14.1–8.4)	15.6 (13.2–18.1)	16.4 (13.9–18.9)
Annual household income				< 0.001
Good vs better	7.8 (5.3–10.2)	10.6 (7.2–13.9)	5.0 (2.4–7.6)
Fair vs better	22.7 (19.1–6.2)	27.3 (22.9–31.6)	18.2 (14.4–21.9)
FC (yes vs no)	15.1 (11.9–8.2)	12.1 (8.2–16.0)	17.4 (13.0–21.7)	< 0.001
Smoking (yes vs no)	1.2 (0.0–3.0)	4.1 (0.7–7.4)	−1.8 (−4.1 to 0.5)	0.016
Anxiety symptoms
Parental relationship				< 0.001
Moderate vs harmonious	19.7 (17.4–2.0)	19.9 (17.2–22.6)	19.6 (17.0–22.1)
Conflicted vs harmonious	13.8 (11.8–5.7)	15.2 (12.8–17.5)	12.4 (10.2–14.6)
Annual household income				< 0.001
Good vs better	9.3 (6.2–12.4)	9.5 (5.8–13.1)	9.2 (5.2–13.1)
Fair vs better	18.4 (15.2–1.5)	21.6 (17.5–25.6)	15.9 (12.3–19.4)
FC (yes vs no)	–1.5 (–4.1 to 1.0)	–2.7 (–5.9 to 0.4)	–0.3 (–3.6 to 2.9)	0.061
Smoking (yes vs no)	0.8 (–0.5–2.1)	3.5 (0.1–6.8)	–0.9 (–3.4 to 1.5)	0.056
FC
Depressive symptoms (yes vs no)	11.7 (9.2–14.1)	9.7 (6.5–12.8)	13.2 (10.0–16.3)	< 0.001
Anxiety symptoms (yes vs no)	−1.7 (–4.3 to 0.9)	–3.1 (–6.3 to 0.1)	–0.5 (–3.8 to 2.9)	0.061

¹P value for interaction between gender and risk factors.

FC: Functional constipation; PARP: Population attributable risk proportion.