Association of Lifestyle Patterns With Depressive and Anxiety Symptoms Among Chinese Adolescents: A Mediating Effect of Mental Health Literacy

Abstract

Background: Adolescence represents a critical developmental period during which lifestyle behaviors exert a profound influence on psychological well-being. This study aimed to identify lifestyle patterns among Chinese adolescents and evaluate their associations with depressive and anxiety symptoms, while also examining the mediating role of mental health literacy (MHL). Methods: In this cross-sectional study, data were derived from the Guangdong Adolescents Mental Health Literacy Survey (GAMHLS) conducted between September and December 2023, which included 5759 adolescents. Latent class analysis (LCA) was employed to identify distinct lifestyle patterns based on seven lifestyle indicators. Multivariate logistic regression was used to assess associations between lifestyle patterns and symptoms of depression and anxiety. Structural equation modeling was applied to test the mediating effect of MHL. Results: LCA identified four lifestyle patterns: relatively healthy (57.2%), inactive/screen-dependent/myopic (9.5%), sleep-deprived/fatigued (22.9%), and multidimensional unhealthy (10.4%). Compared to the relatively healthy group, the multidimensional unhealthy group exhibited the highest risks of depression (OR = 13.472, 95% confidence interval [CI]: 8.860–20.485) and anxiety (OR = 9.300, 95% CI: 7.245–11.939). MHL significantly mediated the relationship between lifestyle patterns and both depressive and anxiety symptoms. Conclusion: Distinct lifestyle patterns are significantly associated with mental health symptoms among Chinese adolescents. MHL serves as a meaningful mediator in these relationships. Interventions should target clusters of lifestyle behaviors and incorporate strategies to enhance MHL for improved psychological outcomes.