Search Results (26)

Background/Objectives: Fibromyalgia syndrome (FMS) is a chronic pain condition in which executive function (EF) alterations have been reported, though strikingly, relationships between simple executive functions (EFs) (updating, inhibition, and mental flexibility) and high-order ones, such as planning and problem-solving, have not been addressed yet in this population. This research aimed to firstly explore how low-level EFs play a role in planning and problem-solving performances. Methods: Thirty FMS patients and thirty healthy participants completed a series of neuropsychological tests evaluating low- and high-order EFs. Clinical and emotional symptoms were assessed with self-report questionnaires, while pain and fatigue levels were measured with numerical scales. Importantly, specific drug restrictions were accounted for. Results: Patients scored lower in most neurocognitive tests, with statistical significance noted only for visuospatial working memory (WM) and two planning and problem-solving tests. Pain, fatigue, and sleep disturbances showed important effects on most of the cognitive outcomes. Multiple regression analyses reflected that planning and problem-solving were successfully and partially predicted by updating, inhibition, and mental flexibility (though differences emerged between tasks). Conclusions: Our study confirms the presence of cognitive impairments in FMS, especially in high-order EFs, supporting patients’ complaints. Clinical symptoms play a role in FMS dyscognition but do not explain it completely. For the first time, as far as the authors know, simple EF influences on planning and problem-solving tests have been described for FMS patients. These results might help in unraveling the dysexecutive profile in FMS to design more adjusted treatment options. Full article

Background and Objectives: During exam sessions, many students experience high levels of stress caused by the large volume of material to study, tight deadlines, and pressure to achieve top grades. This study aimed to examine the relationship between academic stress, sleep disturbances, and eating behaviors by using validated questionnaires administered to a student sample. As stress levels increased, the data revealed a higher frequency of insomnia symptoms and disordered eating, including behaviors such as compulsive eating and irregular meal patterns. Materials and Methods: This cross-sectional, correlational study was conducted on a convenience sample of 317 university students from various academic centers across Romania. Participants were recruited via online distribution of a self-administered questionnaire during a four-month period, including exam sessions. The survey included the Perceived Stress Scale (PSS), the Insomnia Severity Index (ISI), and the Eating Disorder Examination Questionnaire (EDE-Q), alongside additional items assessing perceived links between stress, sleep, and eating behaviors, and the use of medication. Data were analyzed using SPSS with Spearman correlations, t-tests, and linear regression. Results: Statistical analyses revealed significant and positive associations between perceived stress levels and insomnia, as indicated by Spearman’s correlation (p < 0.01). A similar significant correlation was identified between perceived stress and disordered eating behaviors among students. Specifically, the feeling of being overwhelmed by academic workload showed a strong positive correlation with a lack of control over eating behaviors (r = 0.568). Furthermore, linear regression analysis confirmed a significant predictive relationship between feeling overwhelmed and the tendency to eat excessively beyond initial intentions, with a standardized regression coefficient B = 0.581 (p < 0.001). A separate regression analysis focusing on exam-related stress and episodes of compulsive eating behavior demonstrated a comparable result (B = 0.573, p < 0.001), indicating a robust positive association. Additionally, independent samples t-tests demonstrated that students experiencing high levels of stress during the exam period reported significantly greater difficulties with sleep initiation and higher levels of disordered eating compared to their peers with lower stress levels. The difference in insomnia scores was highly significant (t = 11.516, p < 0.001), as was the difference in eating behavior scores (t = 10.931, p < 0.001). Conclusions: These findings underscore the need for emotional support services and effective stress management strategies, enabling students to navigate academic demands without compromising their mental or physical well-being. Full article

Background: Earthquake exposure has been linked with high rates of posttraumatic stress symptoms (PTSS) and comorbid conditions. Familial factors play critical roles in modulating these outcomes. This study examined youth trauma and parental influence following the twin earthquakes in Kefalonia, Greece, in 2014; Methods: A cross-sectional study was conducted with 502 adolescents (aged 11–18 years) and 474 parents from three regions categorized by proximity to the earthquake epicenter. Standardized self-report measures were administered. Data were analyzed using descriptive statistics, correlation analyses, and multiple hierarchical regression analyses to identify key predictors of adverse outcomes; Results: Among children, 5.2% exhibited probable PTSD, with girls reporting significantly higher symptom levels than boys. Higher earthquake exposure was associated with elevated PTSS and anxiety. In parents, 44.3% met criteria for probable PTSD, and those in the epicenter group reported significantly higher levels of stress, anxiety, and sleep disturbances. Earthquake exposure was identified as the strongest predictor of adverse outcomes, with parental psychopathology and diminished social support further contributing to increased symptom severity in children; Conclusions: The study demonstrates that both direct earthquake exposure and familial factors—particularly parental mental health and social support—play critical roles in shaping posttraumatic outcomes in youth, underscoring the need for integrated, family-centered mental health interventions in post-disaster settings. Full article

Breast cancer is a major public health concern, and modifiable health behaviors such as sleep quality and physical activity may influence risk. This study examined the associations between self-reported sleep trouble, sleep duration, and physical activity with breast cancer incidence in a prospective longitudinal cohort of 10,305 females from Nova Scotia. Breast cancer cases were identified through record linkage to the Nova Scotia Cancer Registry. Multivariable logistic regression models were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs), accounting for sociodemographic factors, reproductive history, comorbidities, and other health behaviors. Frequent sleep trouble (“all of the time”) was significantly associated with increased odds of breast cancer (AOR = 2.41, 95% CI = 1.09–5.34, p = 0.03), while no significant associations were observed between sleep duration and breast cancer risk. High physical activity was significantly associated with a lower risk of breast cancer (AOR = 0.58, 95% CI = 0.39–0.86, p < 0.01). These findings suggest that frequent sleep disturbances may be associated with an increased risk of breast cancer, while high physical activity appears to be linked to a lower risk of breast cancer. Further research is needed to explore these relationships and their underlying mechanisms. Full article

Background: Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke maladaptive behaviors (e.g., compulsive buying, disordered eating, and an unhealthy lifestyle), resulting in adverse cardiometabolic events (e.g., hypertension and obesity), which may implicate the treatment of this complex condition. The diagnostic criteria for PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Including additional symptoms such as emotional numbing, sleep disturbance, and irritability strengthens the representation of the Impact of Event Scale-Revised (IES-R), suggesting that models with four, five, or six dimensions better capture its structure compared to the original three-dimensional model. Methods: Using a convenience sample of 58 Russian dental healthcare workers (HCWs: mean age = 44.1 ± 12.2 years, 82.8% females), this instrumental study examined the convergent, concurrent, and criterion validity of two IES-R structures: IES-R3 and IES-R6. Results: Exploratory factor analysis uncovered five factors, which explained 76.0% of the variance in the IES-R. Subscales of the IES-R3 and the IES-R6 expressed good internal consistency (coefficient alpha range = 0.69–0.88), high convergent validity (item total correlations r range = 0.39–0.81, and correlations with the IES-R’s total score r range = 0.62–0.92), excellent concurrent validity through strong correlations with the PTSD Symptom Scale-Self Report (PSS-SR: r range = 0.42–0.69), while their criterion validity was indicated by moderate-to-low correlations with high body mass index (BMI: r range = 0.12–0.39) and the diagnosis of hypertension (r range = 0.12–0.30). In the receiver-operating characteristic (ROC) curve analysis, all IES-R models were perfectly associated with the PSS-SR (all areas under the curve (AUCs) > 0.9, p values < 0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale were significantly associated with high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, were significantly associated with hypertension. In the two-step cluster analysis, five sets of all trauma variables (IES-R3/IES-R6, PSS-SR) classified the participants into two clusters according to their BMI (normal weight/low BMI vs. overweight/obese). Meanwhile, only the IES-R, PSS-SR, and IES-R3 dimensions successfully classified participants as having either normal blood pressure or hypertension. Participants in the overweight/obese and hypertensive clusters displayed considerably higher levels of most trauma symptoms. Input variables with the highest predictor importance in the cluster analysis were those variables expressing significant associations in correlations and ROC analyses. However, neither IES-R3 nor IES-R6 contributed to BMI or hypertension either directly or indirectly in the path analysis. Meanwhile, age significantly predicted both health conditions and current smoking. Irritability and numbing were the only IES-R dimensions that significantly contributed to current smoking. Conclusions: The findings emphasize the need for assessing the way through which various PTSD symptoms may implicate cardiometabolic dysfunctions and their risk factors (e.g., smoking and the intake of unhealthy foods) as well as the application of targeted dietary and exercise interventions to lower physical morbidity in PTSD patients. However, the internal and external validity of our tests may be questionable due to the low power of our sample size. Replicating the study in larger samples, which comprise different physical and mental conditions from heterogenous cultural contexts, is pivotal to validate the results (e.g., in specific groups, such as those with confirmed traumatic exposure and comorbid mood dysfunction). Full article

Despite the rapidly emerging evidence on the contributions of physical activity to improving cancer-related health outcomes, adherence to physical activity among young adults with lymphoma remains suboptimal. Guided by self-determination theory (SDT), the Lymfit intervention (a 12-week individualized exercise program with bi-weekly kinesiologist support and an activity tracker) aimed to foster autonomous motivation toward physical activity. This pilot randomized controlled trial aimed to evaluate the feasibility, acceptability, and preliminary effects of Lymfit. Young adults (N = 26; mean age of 32.1 years) with lymphoma who were newly diagnosed and those up to six months after completing treatment were recruited and randomly assigned one-to-one to either the intervention group (n = 13) or a wait-list control group (n = 13). All a priori feasibility benchmarks were met, confirming the feasibility of the study in terms of recruitment uptake, retention, questionnaire completion, intervention fidelity, missing data, Fitbit wear adherence, and control group design. The intervention acceptability assessment showed high ratings, with eight out of ten items receiving >80% high ratings. At post-intervention, an analysis of covariance models showed a clinically significant increase in self-reported physical activity levels, psychological need satisfaction, and exercise motivation in the intervention group compared to controls. Lymfit also led to meaningful changes in six quality-of-life domains in the intervention group, including anxiety, depression, fatigue, sleep disturbance, social roles and activities, and pain interference. The findings support Lymfit as a promising means to meet psychological needs and increase the autonomous motivation for physical activity in this group. A fully powered efficacy trial is warranted to assess the validity of these findings. Full article

Introduction: Recent evidence reported mental health issues in university students such as anxiety and depressive symptoms and poor sleep quality. Decreased plasma brain-derived neurotrophic factor (BDNF) levels have been proposed as a biomarker of depressive symptoms, whereas cortisol levels are an index of energy mobilization and stress and have been linked to sleep quality. Given that salivary biomarkers represent an interesting new field of research, the aim of this cross-sectional study was to evaluate salivary BDNF and cortisol levels in university students to assess whether they have associations with psychological disturbances such as anxiety and depressive symptoms, sleep quality, and stress level. Methods: Salivary BDNF and cortisol levels were measured by specific immunoassays in 70 students whose mental health was also evaluated on the same day through the evaluation of anxiety and depression symptoms (Goldberg scale), sleep quality (Pittsburg Sleep Quality Index and Athens Insomnia Scale), and stress (self-perceived stress scale) and healthy lifestyle habits (alcohol consumption, smoking, regular exercise, and body mass index) were also measured. Multivariate regression analyses were performed in order to identify the strengths of associations between psychological alterations and the concentrations of BDNF, cortisol, and other variables. Results: Salivary BDNF levels were significantly higher in students with more depressive symptoms, whereas no significant differences were found for cortisol levels. When performing the binary logistic regression model, BDNF levels are included as a predictor variable for a high-depressive-symptoms burden (p < 0.05). Students with worse sleep quality on the Pittsburg Scale had higher cortisol levels (p < 0.05). The subdomains of sleep latency and sleep medication were those significantly associated with salivary cortisol levels in logistic regression analyses (OR = 15.150, p = 0.028). Sleep medication only appeared to be related to cortisol levels (OR = 185.142, p = 0.019). Perceived stress levels and anxiety symptoms were not associated with BDNF or cortisol levels. Conclusions: BDNF could play a key role in the pathophysiology of mood-related disorders, and elevation of its peripheral levels could contribute to protecting neurons from the development of mental illness. Higher salivary cortisol levels measured in the morning are accompanied by poorer sleep quality. More research is needed, focusing on salivary biomarkers of disorders related to depressive symptoms and poor sleep quality as a potential tool for the diagnosis and prevention of mental illness. Full article

Background: Depression is a debilitating disease with a high socioeconomic burden. Regular antidepressants usually require several weeks to ameliorate symptoms; however, numerous patients do not achieve remission. What is more, sleep disturbances are one of the most common residual symptoms. Ketamine is a novel antidepressant with rapid onset of action with a proven antisuicidal effect. Little is known about its impact on sleep–wake and circadian rhythm alterations. The aim of this systematic review is to research the impact ketamine has on sleep disturbances in depression. Methods: PubMed, Web of Science, and APA PsycINFO were searched for relevant studies on ketamine’s impact on sleep disturbances in depression. Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA2020 methodology was applied. The systematic review protocol was registered in the PROSPERO Registry (CRD42023387897). Results: Five studies were included in this review. Two studies reported significant improvement in sleep measured by MADRS (Montgomery–Åsberg Depression Rating Scale) and QIDS-SR16 (Quick Inventory of Depressive Symptomatology Self-Report (16-item)) scales after intravenous ketamine and intranasal esketamine administration. One case report showed mitigation of symptoms in PSQI (Pittsburgh Sleep Quality Index) and ISI (Insomnia Severity Index) during 3-month treatment with esketamine. In two studies, sleep was objectively measured by nocturnal EEG (electroencephalography) and showed a decrease in nocturnal wakefulness accompanied by an increase in slow wave (SWS) and rapid eye movement (REM) sleep. Conclusion: Ketamine reduces the severity of sleep insomnia in depression. Robust data are lacking. More research is needed. Full article

Background and Objectives: Remote patient monitoring (RPM) of vital signs and symptoms for lung transplant recipients (LTRs) has become increasingly relevant in many situations. Nevertheless, RPM research integrating multisensory home monitoring in LTRs is scarce. We developed a novel multisensory home monitoring device and tested it in the context of COVID-19 vaccinations. We hypothesize that multisensory RPM and smartphone-based questionnaire feedback on signs and symptoms will be well accepted among LTRs. To assess the usability and acceptability of a remote monitoring system consisting of wearable devices, including home spirometry and a smartphone-based questionnaire application for symptom and vital sign monitoring using wearable devices, during the first and second SARS-CoV-2 vaccination. Materials and Methods: Observational usability pilot study for six weeks of home monitoring with the COVIDA Desk for LTRs. During the first week after the vaccination, intensive monitoring was performed by recording data on physical activity, spirometry, temperature, pulse oximetry and self-reported symptoms, signs and additional measurements. During the subsequent days, the number of monitoring assessments was reduced. LTRs reported on their perceptions of the usability of the monitoring device through a purpose-designed questionnaire. Results: Ten LTRs planning to receive the first COVID-19 vaccinations were recruited. For the intensive monitoring study phase, LTRs recorded symptoms, signs and additional measurements. The most frequent adverse events reported were local pain, fatigue, sleep disturbance and headache. The duration of these symptoms was 5–8 days post-vaccination. Adherence to the main monitoring devices was high. LTRs rated usability as high. The majority were willing to continue monitoring. Conclusions: The COVIDA Desk showed favorable technical performance and was well accepted by the LTRs during the vaccination phase of the pandemic. The feasibility of the RPM system deployment was proven by the rapid recruitment uptake, technical performance (i.e., low number of errors), favorable user experience questionnaires and detailed individual user feedback. Full article

Sleep is negatively affected by environmental noise. In the present study, we investigated self-reported high sleep disturbances (being “highly sleep disturbed”—HSD) from road traffic (primary and secondary road networks), rail (train and tram) and air traffic noise in the LIFE-Adult cohort study in Leipzig, Germany. For this, we used exposure data from 2012 and outcome data of Wave 2 (collected during 2018–2021). HSD was determined and defined according to internationally standardized norms. The highest risk for transportation noise-related HSD was found for aircraft noise: the odds ratio (OR) was 19.66, 95% CI 11.47–33.71 per 10 dB increase in L_night. For road and rail traffic, similar risk estimates were observed (road: OR = 2.86, 95% CI 1.92–4.28; rail: OR = 2.67, 95% CI 2.03–3.50 per 10 dB L_night increase). Further, we compared our exposure-risk curves with the curves of the WHO environmental noise guidelines for the European region. The proportion of individuals with HSD for a given noise level was lower for rail traffic but higher for aircraft noise in the LIFE study than in the WHO curves. For road traffic, curves are not directly comparable because we also included the secondary road network. The results of our study add to the body of evidence for increased health risks by traffic noise. Moreover, the results indicate that aircraft noise is particularly harmful to health. We recommend reconsidering threshold values for nightly aircraft exposure. Full article

Study objective: Long COVID patients can experience high levels of impairment in their cognitive function and mental health. Using a parallel randomized control trial, we evaluated the effectiveness of a neuro-meditation program to reduce cognitive impairment in patients with long COVID. Methods: A total of 34 patients with long COVID were randomized to an intervention group (G-Int; n = 17) or a control group (G-Con; n = 17) and 15 healthy participants were constitutive of a normative group (G-Nor). The intervention consisted of ten 30-min sessions of Rebalance^® over a period of five weeks. Each session included sound therapy and coach-guided meditation associated with light stimulations (i.e., chromotherapy). Primary outcomes were performance on five computerized cognitive tasks (choice response time, pattern comparison, Simon, pursuit rotor task, and Corsi block-tapping task), mental and physical fatigue (Chalder fatigue scale), perceived stress (perceived stress scale) and mood (profiles of mood states). Secondary outcomes were anxiety and depressive symptoms (hospital anxiety and depression scale), muscular pain, joint pain, and headaches using visual analog scales (VAS) as well as sleep quality (Spiegel sleep questionnaire). Assessments were conducted at baseline and at 1–2 and 7–8 days of follow-up. Results: Compared to healthy subjects, long COVID patients showed significant differences at baseline on all the self-report questionnaires, and a Rebalance^® program improved all the subjective reports, as well as cognitive performances, especially on reaction time-based tasks. In particular, only the G-Int group revealed shortened reaction times in the choice reaction time (RT_baseline = 593 ± 121 ms vs. RT_post2 = 521 ± 86 ms, p < 0.001), Simon (RT_baseline = 539 ± 123 ms vs. RT_post2 = 494 ± 134 ms, p < 0.01), and pattern comparison tasks (RT_baseline = 1244 ± 315 ms vs. RT_post2 = 1079 ± 213 ms, p < 0.001). Conclusions) Initial evidence suggests that neuro-meditation reduces cognitive impairment and improves physical and mental fatigue, muscle and joint pain, symptoms of depression and anxiety, mood disturbances as well as sleep quality. The Rebalance^® program hence constitutes a promising non-pharmacological intervention for the treatment of long-term psychological/cognitive outcomes of COVID-19. Full article

During the COVID-19 pandemic, an increase in poor mental health among Asian Indians was observed in the United States. However, the leading predictors of poor mental health during the COVID-19 pandemic in Asian Indians remained unknown. A cross-sectional online survey was administered to self-identified Asian Indians aged 18 and older (N = 289). Survey collected information on demographic and socio-economic characteristics and the COVID-19 burden. Two novel machine learning techniques-eXtreme Gradient Boosting and Shapley Additive exPlanations (SHAP) were used to identify the leading predictors and explain their associations with poor mental health. A majority of the study participants were female (65.1%), below 50 years of age (73.3%), and had income ≥ $75,000 (81.0%). The six leading predictors of poor mental health among Asian Indians were sleep disturbance, age, general health, income, wearing a mask, and self-reported discrimination. SHAP plots indicated that higher age, wearing a mask, and maintaining social distancing all the time were negatively associated with poor mental health while having sleep disturbance and imputed income levels were positively associated with poor mental health. The model performance metrics indicated high accuracy (0.77), precision (0.78), F1 score (0.77), recall (0.77), and AUROC (0.87). Nearly one in two adults reported poor mental health, and one in five reported sleep disturbance. Findings from our study suggest a paradoxical relationship between income and poor mental health; further studies are needed to confirm our study findings. Sleep disturbance and perceived discrimination can be targeted through tailored intervention to reduce the risk of poor mental health in Asian Indians. Full article

Sleep disturbance has an enormous impact on college students. Poor sleep is associated with low academic achievement, psychological distress and high health risk behaviors. College students with various mental health problems (e.g., anxiety and depression) are particularly at risk for sleep problems. The aim of the present study was to examine the impact of a wide range of internalizing/externalizing psychological problems on sleep disturbance. A total of 2134 Chinese college students (60.2% men) with mental health problems were selected as participants after completing the self-reported Chinese college student mental health screening scale. A web-based survey was used to assess a wide variety of internalizing/externalizing psychological problems and sleep disturbance. The results showed that hostility, somatic symptoms and obsessive-compulsive symptoms (OCS) were significantly associated with sleep disturbance. Somatic symptoms played a mediating role in the relationship between hostility and sleep disturbance. Moreover, the mediating effect was moderated by OCS, and a significant difference in the mediating effects was observed between low OCS and high OCS groups. Overall, our research findings indicate that a high level of OCS exacerbates the adverse effects of somatic symptoms on sleep disturbance, and suggests that assessment and improvement of hostility, somatic symptoms and OCS should be considered in facilitating better sleep among college students with mental health problems. Full article

Previous studies have shown a high prevalence of sleep disturbances in tinnitus patients. However, no study has yet evaluated subjective sleep satisfaction. The present study aimed to investigate associations of self-reported sleep satisfaction with sociodemographic factors, tinnitus-related distress, depression, and self-reported quality of life. This is a retrospective analysis of 2344 outpatients with tinnitus presenting at a tertiary German tinnitus clinic from 2010 to 2020. Patients who filled in five questionnaires (Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Major Depression Inventory (MDI), Tinnitus Sample Case History Questionnaire (TSCHQ), and the World Health Organization Quality of Life Brief Version (WHOQOL-Bref)) were included. Based on the question about sleep satisfaction in the WHOQOL-Bref, group classification into (I) sleep-satisfied, (II) neither satisfied or dissatisfied, and (III) sleep-dissatisfied patients was performed. Associations between sleep satisfaction and quality of life, depression, tinnitus distress, and tinnitus characteristics were analyzed by group differences and a multinomial regression model with elastic net penalization. A total of 42.38% of patients were satisfied or very satisfied with sleep, whereas 40.91% of patients were dissatisfied or very dissatisfied with sleep. The remaining patients reported being neither satisfied nor dissatisfied with sleep. Sleep-dissatisfied patients were significantly more burdened in questionnaires on depressive symptoms (MDI), tinnitus distress (TQ, THI), and quality of life (WHOQOL-Bref). In addition, they suffered significantly more often from comorbidities such as headache, neck pain, or temporomandibular joint disorder (TMJ). The elastic net regression based on sum scores of THI, TQ, MDI, the four domains of WHOQOL-Bref, as well as all individual questions from the TSCHQ was able to classify patients satisfied with their sleep with an accuracy of 79%, 87.8% sensitivity, and 70.4% specificity. The model could not identify patients indifferent with the quality of their sleep (neither satisfied nor dissatisfied) (sensitivity: 0%; specificity: 100%). The accuracy of the model to predict patients dissatisfied with their sleep was 80.7%, with 83% sensitivity and 78.4% specificity. Poor physical and mental health (Domain I/II WHOQOL-Bref) as well as tinnitus distress were the strongest predictors of sleep dissatisfaction. Conversely, for sleep satisfaction, good physical and mental health as well as low tinnitus distress were the strongest predictors. The division into sleep-satisfied and sleep-dissatisfied tinnitus patients allows a very good discrimination regarding disease burden as indicated by depression, tinnitus distress, quality of life, and pain-related comorbidities. Physical and mental health as well as tinnitus distress seem to be strongly related to sleep satisfaction underscoring the concept of “tinnitus” versus “tinnitus disorder”, but also the importance of sleep satisfaction as a global health indicator. Moreover, these data indicate the relevance of addressing sleep disorders in the therapeutic management of chronic tinnitus patients. Full article

Anxiety is a common disorder among college students, especially those with obesity. Obesity contributes to metabolic disorders and disturbs the neural functions, further leading to anxiety. In this cross-sectional study, we aimed to determine the association between obesity and anxiety among college students and identified the potential factors for obesity-associated anxiety. We evaluated the intervention effects of calorie restriction on anxiety. Self-reported questionnaires were distributed to 1381 college students from January to March in 2021. Anxiety was measured by the State-Trait Anxiety Inventory (STAI). Participants were classified into anxiety and non-anxiety groups according to their STAI scores. Chi-squared test and logistic regression were used to analyze the potential factors. We found that 383 college students exhibited anxiety, accounting for 30.1% among all included college students, which was higher than the global average. The association between anxiety and obesity was observed among college students (p = 0.009), especially in males (p = 0.007). We identified that pre-obesity (p = 0.012), unhealthy calorie intake (p = 0.001), dieting (p = 0.003) and high academic year (p = 0.006) as the risk factors for anxiety and found that the long sleep duration was a protective factor for anxiety (p < 0.001). We found that more obese students showed an improvement of anxiety than the underweight students after calorie restriction (p < 0.001). Collectively, our findings suggest that obesity-associated anxiety is prevalent among the college students and could be alleviated by moderate calorie restriction. It is necessary for students to receive anxiety management in their college life. Additionally, the proper calorie restriction should be promoted to help students protect against obesity and obesity-associated anxiety. Full article