Disrupted Rhythms of Life, Work and Entertainment Behaviours and Their Associations with Mental Health Problems under the Stress of COVID-19 Epidemic: A Survey in 5854 Chinese People with Different Backgrounds
Authors: Yang Min , He Ping , Xu Xiaoming , Wang Jing , Wang Yanjun , Liu Kaijun , Wen Liangzhi , Xiao Xiao , He Yuqing , Tang Wen , Zhao Rong , Cao Yan , Chen Linlin , Wei Yanling , Lan Chunhui , Wang Xingwei , Wang Bin , Wang Wo , Zhao Mingming , Zhao Mei , Lin Hui , Yue Ruihua , Deng Mingming , Deng Tianwei , Kuang Li , Chen Dongfeng 
Published: May 2020

Abstract
BACKGROUND and OBJECTIVE The rhythms of life, work and entertainment behaviours are considered as the external behavioural manifestations of biological rhythm.To evaluate the distinctive disrupted rhythms of behaviours and their associations with mental health problems in people with different backgrounds under the stress of COVID-19 epidemic.SUBJECTS AND METHODS A cross-sectional study was conducted from 10-17 March 2020 under the stress of COVID-19 epidemic.A structured e-questionnaire containing general information,rhythm scale(subscale1 for life-work rhythms and subscale2 for entertainment rhythm) and Zung's self-rating depression and anxiety scale(SDS and SAS) were filled and the data were analysed.RESULTS Overall 5854 participants were included.Significant differences were found in rhythm, SDS and SAS scores among people with different backgrounds (all P<0.05). Subjects with female gender and poor health status were mostly suffered from disrupted rhythms of life- work-entertainment behaviours, combined with depression and anxiety. Nurses and subjects being divorced or with chronic disease with psychosomatic diseases were mostly suffered from disrupted rhythms of life-work behaviours, combined with depression and anxiety. Subjects with aged 26-30 years, or annual income of 50,000-100,000CY were mostly suffered from disrupted rhythms of life-work combined with depression. Subjects with income over 300,000CY were mostly suffered from disrupted rhythm of entertainment combined with anxiety.The prevalence rates of depression and anxiety in people with the high-scores of rhythm disruption increased by 34.50% and 47.16%, respectively, compared with those with low-scores.People with the high-scores of rhythm disruption had higher SDS and SAS scores, compared to those with low scores (all P<0.001). The independent related factors of disrupted rhythms included gender,age,marital status, health status,annual income and chronic diseases with psychosomatic diseases using logistic regression.The disrupted rhythms of life and work behaviours was positively correlated with both SDS and SAS scores.CONCLUSIONS The disrupted rhythms of life, work and entertainment behaviours were closely associated with mental health problems.The disrupted rhythms of behaviours are frequent and fluxible,triggering more severe mental health problems under the stress of COVID-19 epidemic.The physicians should be aware of their importance when evaluating their interviewees or patients’ mental health and achieving maximization of therapeutic efficacy by integrating the intervention of circadian rhythm and its behaviour.