The prevalence of morning type (MT), neutral type (NT), and evening type (ET) among male prisoners was 47.2%, 46.7%, and 6.1%, respectively.
Being an evening type is significantly associated with younger age and higher levels of and depression.
The risk of depression is nearly three times higher for evening types compared to morning types.
Insomnia partially mediates the relationship between and depression.
The direct effect of chronotype on depression is significant, accounting for 50.51% of the total effect.
Simplified
BACKGROUND: This study aimed to estimate the prevalence of among male prisoners in China and to examine the relationship between chronotype, , and in this population.
METHODS: A total of 1609 male inmates participated in this cross-sectional study by completing the Morning and Evening Questionnaire-5 (MEQ-5), Insomnia Severity Index (ISI), and Patient Health Questionnaire-9 (PHQ-9). Age, time served, insomnia, and depressive symptoms were compared across chronotypes. Binary logistic stepwise regression was used to analyze factors influencing depression. Additionally, a simple mediation model incorporating MEQ-5, ISI, and PHQ-9 was analyzed, with age controlled as a covariate.
RESULTS: The prevalence of morning type (MT), neutral type (NT), and evening type (ET) was 47.2%, 46.7%, and 6.1%, respectively. Being an ET was significantly associated with younger age and increased symptoms of insomnia and depression (P < 0.05). The relative risk of depression was 2.970-fold higher (95% CI, 1.724 to 5.116; P < 0.001) for ET compared to MT. Mediation analysis revealed that insomnia partially mediated the relationship between chronotype and depression, while the direct effect of chronotype on depression was also significant (accounting for 50.51% of the total effect).
CONCLUSIONS: The prevalence of ET is relatively low among male prisoners. Resetting ET tendencies may reduce depressive symptoms in this population.
Key numbers
2.970×
Relative Risk of Depression Increase
Risk of depression for evening types compared to morning types.
6.1%
Prevalence of Evening
Proportion of male prisoners classified as evening type.
41.8%
Incidence of Clinically Significant Depression
Percentage of evening types reporting significant .
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Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki. The study received approval from the Ethics Committee of the Second Affiliated Hospital of Xinxiang Medical College (Ethics No: XYEFYLL-(keyan)-2020-23-2). Clinical trial number: not applicable. All study participants signed a written informed consent form. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Conflict of interest: All authors declared no conflict of interest.
