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How Positive Interpersonal Relationships Release Medical Students’ Anxiety and
Depression? The Mediating Effect of Sleep and the Moderating Role of Academic
Stress

Y. Xiong, C. Qiu, S. Ren, and J. Lu 3
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1
2
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1 West China School of Nursing, Sichuan University, China, West China School of Medicine, Sichuan
3
University (West China Hospital), China, and College of Computer Science, Sichuan University, China

Background: Interpersonal relationships play a crucial role in the mental health of medical students,
highlighting the importance of effective communication and interpersonal skills in their professional
growth.

Objective: This study aims to examine the interconnected pathways linking interpersonal relationships
and mental health in medical students, while delving into the mediating and moderating roles of sleep
quality and academic stress.

Methods: A cross-sectional survey was conducted among 2334 undergraduate medical students from
seven universities in Southwest China. The research employed an electronic questionnaire to collect
self-assessment data on participants’ interpersonal relationships, academic stress, sleep quality, and
mental health status, utilizing tools such as the General Information Questionnaire, Pittsburgh Sleep Quality
Index Scale (PSQI), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS). Controlling for
confounding variables such as gender, age, study year, physical condition and household economics,
the statistics were then tested using the PROCESS macro (Model 14) of SPSS version 26.0 for moderated
mediation model analysis.

Results: (1)Both interpersonal distress and sleep disturbance were positively correlated with
anxiety/depression(β=0.118***;β=0.503***/β=0.206***;β=0.419***). (2)Sleep quality positively mediated
the effect of interpersonal relationship on anxiety/depression, with an intermediate effect value of
1.197/1.154, representing 47%/30% of the total effect. (3) Academic stress positively moderated the latter
part of the mediation pathway and positively predicted undergraduates’ anxiety/depression status
(β=0,079***/β=0.069***). Note.***p＜0.001.

Conclusion: The current study showed that enhancing interpersonal relationships can benefit
undergraduate medical students’ mental health through improving sleep quality. Academic stress
played an interactive role of amplifying the effect of sleep disturbance on mental well-being. Thus,
it strongly recommended medical students to optimize interpersonal relationships, improve sleep
quality, and manage academic stress, aiming to benefit their psycho-spiritual well-being.

Poster Presentation Abstracts
Keywords: medical students, interpersonal relationships, anxiety, depression, sleep quality

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Correspondence: Chen Qiu, West China School of Medicine, Sichuan University (West China Hospital), China
E-mail: cqiu@scu.edu.cn

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