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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Nov 19, 2025; 15(11): 111593
Published online Nov 19, 2025. doi: 10.5498/wjp.v15.i11.111593
Published online Nov 19, 2025. doi: 10.5498/wjp.v15.i11.111593
Chronotype as a risk factor for adolescent depression and anxiety: The mediating roles of sleep and social functioning
Xiao-Feng Zhao, Yu-Xiao Bi, Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Sa Xiao, Ming-Li Lou, Yu-Rong Xing, Department of International Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Wen-Li Zhu, Department of Psychiatry, The Fourth People’s Hospital of Wuhu, Wuhu 241002, Anhui Province, China
Co-corresponding authors: Wen-Li Zhu and Yu-Rong Xing.
Author contributions: Zhao XF and Bi YX contributed equally to the conception and design of the study and drafted the initial manuscript; Xiao S and Lou ML contributed to data collection; Xiao S contributed to assisting in study design and interpretation of findings; Lou ML contributed to data analysis; Zhu WL and Xing YR supervised the project, critically revised the manuscript, and contributed equally as co-corresponding authors. All authors read and approved the final manuscript.
Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of The First Affiliated Hospital of Zhengzhou University, No. 2024-KY-0528-001.
Informed consent statement: Written informed consent was obtained from all participants and their legal guardians after providing a detailed explanation of the study objectives, procedures, potential risks, and benefits. Participation was voluntary, and withdrawal was allowed at any stage without consequence.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Rong Xing, Department of International Medicine, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou 450000, Henan Province, China. fccxyr@zzu.edu.cn
Received: July 4, 2025
Revised: July 13, 2025
Accepted: August 25, 2025
Published online: November 19, 2025
Processing time: 123 Days and 18 Hours
Revised: July 13, 2025
Accepted: August 25, 2025
Published online: November 19, 2025
Processing time: 123 Days and 18 Hours
Core Tip
Core Tip: This cross-sectional observational study investigated the indirect pathways linking chronotype to adolescent mental health. Using validated measures in 381 adolescents, we found that the relationship between evening chronotype and higher levels of depression and anxiety was fully mediated by poor sleep quality and impaired social functioning. This is the first study to establish a chain mediation model incorporating both sleep and social factors, emphasizing the importance of targeting sleep hygiene and social adjustment in interventions for youth mental health.