. 2024 Jul 1:356:597-603.

doi: 10.1016/j.jad.2024.03.022. Epub 2024 Mar 12.

Prevalence and network analysis of internet addiction, depression and their associations with sleep quality among commercial airline pilots: A national survey in China

He-Li Sun¹, Pan Chen², Qinge Zhang³, Tong Leong Si⁴, Yan-Zhang Li⁵, Han-Yu Zhu⁶, Erliang Zhang⁷, Minzhi Chen⁸, Jie Zhang⁹, Zhaohui Su¹⁰, Teris Cheung¹¹, Gabor S Ungvari¹², Todd Jackson¹³, Yu-Tao Xiang¹⁴, Mi Xiang¹⁵

Affiliations

¹ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR; Centre for Cognitive and Brain Sciences, University of Macau, Macao, SAR. Electronic address: yc27604@um.edu.mo.
² Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR; Centre for Cognitive and Brain Sciences, University of Macau, Macao, SAR. Electronic address: yc17609@um.edu.mo.
³ Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
⁴ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR. Electronic address: mc24763@connect.um.edu.mo.
⁵ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR. Electronic address: mc34524@um.edu.mo.
⁶ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR. Electronic address: mc34515@um.edu.mo.
⁷ School of Public Health, Shanghai Jiao Tong University, Shanghai, China. Electronic address: zhang_99@sjtu.edu.cn.
⁸ School of Public Health, Shanghai Jiao Tong University, Shanghai, China. Electronic address: tauriel@sjtu.edu.cn.
⁹ School of Public Health, Shanghai Jiao Tong University, Shanghai, China. Electronic address: zj0906@sjtu.edu.cn.
¹⁰ School of Public Health, Southeast University, Nanjing, China. Electronic address: szh@utexas.edu.
¹¹ School of Nursing, Hong Kong Polytechnic University, Hong Kong, SAR. Electronic address: teris.cheung@polyu.edu.hk.
¹² Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia.
¹³ Department of Psychology, University of Macau, Macao, SAR. Electronic address: toddjackson@um.edu.mo.
¹⁴ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR; Centre for Cognitive and Brain Sciences, University of Macau, Macao, SAR. Electronic address: xyutly@gmail.com.
¹⁵ School of Public Health, Shanghai Jiao Tong University, Shanghai, China; Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya & School of Public Health, Shanghai, China. Electronic address: xiang-sjtu@hotmail.com.

PMID: 38484881
DOI: 10.1016/j.jad.2024.03.022

Prevalence and network analysis of internet addiction, depression and their associations with sleep quality among commercial airline pilots: A national survey in China

He-Li Sun et al. J Affect Disord. 2024.

. 2024 Jul 1:356:597-603.

doi: 10.1016/j.jad.2024.03.022. Epub 2024 Mar 12.

Authors

Affiliations

¹ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR; Centre for Cognitive and Brain Sciences, University of Macau, Macao, SAR. Electronic address: yc27604@um.edu.mo.
² Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR; Centre for Cognitive and Brain Sciences, University of Macau, Macao, SAR. Electronic address: yc17609@um.edu.mo.
³ Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
⁴ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR. Electronic address: mc24763@connect.um.edu.mo.
⁵ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR. Electronic address: mc34524@um.edu.mo.
⁶ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR. Electronic address: mc34515@um.edu.mo.
⁷ School of Public Health, Shanghai Jiao Tong University, Shanghai, China. Electronic address: zhang_99@sjtu.edu.cn.
⁸ School of Public Health, Shanghai Jiao Tong University, Shanghai, China. Electronic address: tauriel@sjtu.edu.cn.
⁹ School of Public Health, Shanghai Jiao Tong University, Shanghai, China. Electronic address: zj0906@sjtu.edu.cn.
¹⁰ School of Public Health, Southeast University, Nanjing, China. Electronic address: szh@utexas.edu.
¹¹ School of Nursing, Hong Kong Polytechnic University, Hong Kong, SAR. Electronic address: teris.cheung@polyu.edu.hk.
¹² Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia.
¹³ Department of Psychology, University of Macau, Macao, SAR. Electronic address: toddjackson@um.edu.mo.
¹⁴ Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR; Centre for Cognitive and Brain Sciences, University of Macau, Macao, SAR. Electronic address: xyutly@gmail.com.
¹⁵ School of Public Health, Shanghai Jiao Tong University, Shanghai, China; Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya & School of Public Health, Shanghai, China. Electronic address: xiang-sjtu@hotmail.com.

PMID: 38484881
DOI: 10.1016/j.jad.2024.03.022

Abstract

Objective: Airline pilots are members of a unique occupational group that is often confronted with sleep routine disruptions, yet relatively few studies have examined their mental health status. This study assessed the prevalence and network structure of internet addiction, depression and sleep quality problems in commercial airline pilots.

Method: A total of 7055 airline pilots were included in analyses. Internet addiction and depression were measured with the Internet Addiction Test (IAT) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The network model was constructed based on an Ising model and its association with sleep quality was evaluated using a flow procedure.

Results: Internet addiction, depression and sleep quality were common among airline pilots. The prevalence of internet addiction was 8.0 % (95 % CI: 7.3-8.6 %), while the rates of depression and poor sleep quality were 23.3 % (95 % CI: 22.3-24.2 %) and 33.0 % (95 % CI: 31.9-34.1 %), respectively. In the depression and internet addiction network model, "Fatigue" (PHQ4; Expected Influence (EI): 2.04) and "Depressed/moody/nervous only while being offline" (IAT20; EI: 1.76) were most central symptoms while "Fatigue" (PHQ4; Bridge EI: 1.30) was also the most important bridge symptom. The flow network model of sleep quality with internet addiction and depression showed that "Appetite" (PHQ5) had the strongest positive association with poor sleep quality.

Conclusion: Internet addiction, depression and sleep quality were common among airline pilots and warrant regular screening and timely treatment. Strategies to improve sleep hygiene may be useful in preventing onsets or exacerbations in depression and internet addiction among airline pilots.

Keywords: Airline pilots; Depression; Internet addiction; Network analysis; Sleep quality.

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Conflict of interest statement

Declaration of competing interest The authors have no conflicts of interest to declare. Financial disclosure This project is funded by (1) the National Natural Science Foundation of China (No.: 71804110), (2) Shanghai Science and Technology Development Funds (No.: 21QA1405300) and (3) Science Foundation of Ministry of Education of China (No.: 22YJAZH116) and the University of Macau (MYRG2019-00066-FHS; MYRG2022-00187-FHS).

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Prevalence and network analysis of internet addiction, depression and their associations with sleep quality among commercial airline pilots: A national survey in China

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Prevalence and network analysis of internet addiction, depression and their associations with sleep quality among commercial airline pilots: A national survey in China

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