Prevalence of anxiety and depression symptom, and the demands for psychological knowledge and interventions in college students during COVID-19 epidemic: A large cross-sectional study

Medical students' perception of resilience and of an innovative curriculum-based resilience skills building course: A participant-focused qualitative analysis

BACKGROUND

Medicine is one of the most demanding academic fields with an extensive curriculum that entails plenty of potential stressors. There is sufficient evidence that medical students are more prone to psychological distress when compared to their peer group of other disciplines. Despite the established need to prioritize resilience skills building within the medical curriculum, very few medical programmes in the Middle East and North Africa region (MENA) proactively empower the students to help themselves in sustaining their mental health. The purpose of the current study is to explore the perception of medical students in Dubai, United Arab Emirates (UAE) regarding their understanding of, and personal experience with building resilience, and their engagement with the content of an innovative curriculum-based resilience skills building course, designed in alignment with the constructivism theory of education.

METHOD

The current study utilized a qualitative phenomenological research design. The curriculum-based resilience skills building course, that was investigated as part of this study, is offered at a medical school in Dubai, UAE. A total of 37 students submitted reflective essays about resilience building, in general, and the respective course, in specific. The collected data was inductively analysed following a six-step framework.

FINDINGS

The qualitative analysis generated three interlinked themes, namely: Awareness, Application, and Appraisal.

CONCLUSION

This study showed that integrating a resilience skills building course into medical curricula is likely to be positively appraised by the students, where it raises their level of awareness and likelihood of proactively applying the learned concepts in their daily lives. This is especially true when the course is anchored in constructivism experiential learning theory and designed to foster self-directed learning.

The relationships of preventive behaviors and psychological resilience with depression, anxiety, and stress among university students during the COVID-19 pandemic: A two-wave longitudinal study in Shandong Province, China

Introduction

Studies have shown that the psychological impact of the COVID-19 pandemic may lead to long-term health problems; therefore, more attention should be paid to the mental health of university students. This study aimed to explore the longitudinal effects of preventive behaviors and psychological resilience on the mental health of Chinese college students during COVID-19.

Methods

We recruited 2,948 university students from five universities in Shandong Province. We used a generalized estimating equation (GEE) model to estimate the impact of preventive behaviors and psychological resilience on mental health.

Results

In the follow-up survey, the prevalence of anxiety (44.8% at T1 vs 41.2% at T2) and stress (23.0% at T1 vs 19.6% at T2) decreased over time, whereas the prevalence of depression (35.2% at T1 vs 36.9% at T2) increased significantly (P < 0.001). Senior students were more likely to report depression (OR = 1.710, P < 0.001), anxiety (OR = 0.815, P = 0.019), and stress (OR = 1.385, P = 0.011). Among all majors, medical students were most likely to report depression (OR = 1.373, P = 0.021), anxiety (OR = 1.310, P = 0.040), and stress (OR = 1.775, P < 0.001). Students who wore a mask outside were less likely to report depression (OR = 0.761, P = 0.027) and anxiety (OR = 0.686, P = 0.002) compared to those who did not wear masks. Students who complied with the standard hand-washing technique were less likely to report depression (OR = 0.628, P < 0.001), anxiety (OR = 0.701, P < 0.001), and stress (OR = 0.638, P < 0.001). Students who maintained a distance of one meter in queues were less likely to report depression (OR = 0.668, P < 0.001), anxiety (OR = 0.634, P < 0.001), and stress (OR = 0.638, P < 0.001). Psychological resilience was a protective factor against depression (OR = 0.973, P < 0.001), anxiety (OR = 0.980, P < 0.001), and stress (OR = 0.976, P < 0.001).

Discussion

The prevalence of depression among university students increased at follow-up, while the prevalence of anxiety and stress decreased. Senior students and medical students are vulnerable groups. University students should continue to follow relevant preventive behaviors to protect their mental health. Improving psychological resilience may help maintain and promote university students' mental health.

Prevalence of depression, anxiety, stress and its relationship with knowledge about COVID-19 in medical and laboratory medicine students of Umm-Al-Qura University: a cross-sectional survey

Introduction

Coronavirus disease 2019 (COVID-19) pandemic has continued relentlessly for over one and half years now, causing a threat to life, fear of falling sick, helplessness, anxiety, depression and, pessimism about the future. There has been an increasing concern over student mental health in higher education. Our study was designed to measure current mental health status and its relationship with sociodemographic variables and level of knowledge about COVID-19 in Saudi Arabia.

Method

A cross-sectional survey was conducted among laboratory medicine students of Makkah city, Saudi Arabia from October, 2020 to January, 21. A semi-structured questionnaire was circulated through mail and What’s App. Data collected included sociodemographic details and level of knowledge towards the COVID-19 among the students. Depression anxiety and stress-21 item (DASS 21) was used to assess psychological status.

Result

Our study reported 51.4% depressive symptoms, 57.9% anxiety symptoms, and 48.5% stress in the study participants. History of being hospitalized with COVID-19 and ICU reported high anxiety (p = 0.0003) and depression scores (p = 0.04). Respiratory droplet as a mode of transmission revealed higher scores on anxiety subscale (p = 0.007), whereas surface contamination reported high score of stress (p = 0.004) and anxiety (p = 0.002). Knowing that COVID-19 can also clinically present with gastrointestinal symptoms was found to show high stress (p = 0.005) and anxiety (p = 0.01) scores than any other way of clinical presentation.

Conclusion

COVID-19 is likely to cause negative effect on the psychological health of students.

Experience of COVID-19 disease and fear of the SARS-CoV-2 virus among Polish students

Background

The SARS-CoV-2 virus pandemic has significantly affected individuals and entire societies. It has caused a number of adverse consequences for public health. It has contributed to lower average life expectancy and significantly reduced the sense of health security. It has affected not only physical but also mental health. COVID-19 infections have become so common in many countries, including Poland, that almost every member of society has either experienced it themselves or has a family member or friend who have been affected by the disease. The investigations undertaken in the article concern the fear of COVID-19 infection among Polish university students, determined by the experience of the disease -whether direct or among loved ones.

Methods

An online survey was conducted with 851 students. It took place between 1 and 15 March 2021, a year after detection of the first case of infection with the virus in Poland. The aim of the study was to find out about the relationship between the experience of COVID-19 disease (whether direct or among people close to the respondent) and fear of this disease among university students in Poland. The analysis used intergroup comparison tests (Mann-Whitney U Test and t-test).

Results

The results indicate that the level of fear of COVID-19 among Polish university students was low (M = 1.98; SD = .49), with women (M = 2.04; SD = .75) presenting statistically higher (t (620.46) = 3.05; p = .002) fear than men (M = 1.87; SD = .74). The situation of the respondent having had a close person fall ill with COVID-19 or die as a result of coronavirus infection was found to be significant for the level of experienced fear of COVID-19 in the studied group (t (469.46) = -2.98; p = .003).

Conclusions

The significantly higher level of fear in the group of young people who knew someone close with severe (fatal) COVID-19 disease indicates that psychological support may be more significant for such people than for individuals who have not experienced such a situation. A similar conclusion can be formulated taking into account the gender criterion, as the results make it possible to predict that women expect more support in a pandemic situation.

Psychological Impact of COVID-19 on University Students in Bahrain

Background COVID-19 is an ongoing event that has affected millions worldwide financially, socially, and psychologically; university students have also felt the devastating impact. Therefore, assessing how students have been affected psychologically is important, which is explored in this study. Methods This cross-sectional study took place in two institutions in Bahrain between October and December 2021. A survey assembled from pre-validated questionnaires was sent through Google Forms after receiving ethics approval. Data were analyzed using network plot analysis and linear regression analysis. Results Out of 292 responses, the most common demographic observed were vaccinated Bahraini females living with families at a mean age of 21.21 (SD±3.447). The mean scores for the Generalized Anxiety Disorder Scale (GAD-7), Centered for Epidemiological Studies-Depression scale (CES-D), and Stigma Scale were 10.55 (SD ± 6.144), 18.75 (SD ± 9.147), and 25.40 (SD ± 3.428), respectively. The significant associations on ANOVA observed were stigma score and living status (p-value = 0.002), stigma, and alcohol consumption (p-value = <0.001). Statistically significant predictors of the outcomes in this study included gender for depressive symptoms (p-value = 0.013) and alcohol consumption for stigma (p-value = 0.017). Discussion The stigmatization of the pandemic may additionally influence sub-threshold depressive and anxiety-related symptoms in university students. Concluding from the results of this study, the psychological impact of the pandemic is significant among university students and needs to be addressed in institutions in Bahrain.

The influence of arts engagement on the mental health of isolated college students during the COVID-19 outbreak in China

Objectives

The COVID-19 pandemic significantly impacted the mental health of college students. This study aimed to investigate the buffering effect of arts engagement on anxiety and resilience in college students during the COVID-19 pandemic.

Study design

A cross-sectional study.

Methods

The data were collected via an online survey during a wave of SARS-CoV-2 infections in Shanghai (March 15 to April 15, 2022). In total, 2,453 college students throughout China reported general anxiety symptom levels (according to the GAD-7), resilience (according to the Connor-Davidson Resilience Scale), frequency of receptive arts engagement in the previous year, exposure to risk situations, and behavioral changes due to the pandemic.

Results

During the current stage of the pandemic, 43.7% of college students suffered from varying degrees of anxiety, and 2.6% showed severe anxiety. Gender and learning stage were not associated with anxiety. Hierarchical regression analysis showed that the decision to return to academic institution, the degree of exposure to COVID-19, and the frequency of accepting art participation and resilience could significantly predict the anxiety level of college students. Gender, study stage, behavioral changes arising from COVID-19, and exposure to COVID-19 significantly predict the resilience level of college students. There was an association between high frequency music activities, reading activities and low anxiety level (p < 0.001). There was an association between high frequency digital art, music activities, reading and high resilience (p < 0.01).

Conclusions

Arts engagement appears to help students cope with mental health problems and those at risk. Policymakers should encourage college students to participate in art activities, especially in the context of social distancing.

College students' sense of belonging in times of disruption: Prospective changes from before to during the COVID-19 pandemic

The current study examined whether college students' sense of belonging changed following the onset of the COVID-19 pandemic. Participants were 252 (66.7% female) first- and second-year college students at a large public university in the United States. It was hypothesized that students would report a decrease in their sense of belonging from before to during the pandemic. It was also hypothesized that female students and racial-ethnic minority students, respectively, would report steeper declines in their sense of belonging compared to their male peers and to their White, non-Hispanic peers. Repeated-measures data were analyzed using a multilevel modeling framework to test for mean differences in students' levels of belonging from pre-COVID to during-COVID periods. No direct change in students' sense of belonging was detected. Moderation results indicated that sense of belonging decreased significantly over time for racial-ethnic minority students but not for White, non-Hispanic students. The findings encourage higher education researchers and practitioners to consider the unique experiences of racial-ethnic minority college students during the COVID-19 pandemic and beyond.

Determination of the relationship between dietary inflammatory index and depression status in female students

Background: The relationship between diet, inflammation and mental health has been receiving increasing interest. However, limited data are available on the inflammatory role of diet in university students, among whom depression is commonly observed. Aim: The aim of our study is to investigate the relationship between dietary inflammatory index (DII) and depression among female students of nutrition and dietetics department, whom we assume to be conscious about health. Methods: DII scores were determined by averaging the 3-day dietary records. Depression status of the students was determined by using Beck Depression Inventory (BDI). Results: Our study was conducted with 122 female university students. The mean total BDI score of the students in the first tertile (more anti-inflammatory effect) was found significantly lower than those of the students in the second and third tertiles (p = 0.001). In addition, there were no significant difference between the depression scores of the students and their grade level (p = 0.114) and place of residence (p = 0.866). We found a positive association between DII and depressive symptoms (Model 1, B = 0.512, %95 CI: 0.236-0.789, p = 0.000). This relationship was also found when adjusting for age, weight, body mass index, smoking status, and presence of chronic disease (Model 2, B = 0.496, %95 CI: 0.217-0.776, p = 0.006; Model 3, B = 0.493, %95 CI: 0.210-0.777, p = 0.024. Conclusion: Supporting that the inflammatory burden of diet is associated with mental health, our findings are of significance for the development of anti-inflammatory nutritional approaches among students who are prone to depression.

Bouncing back from COVID-19: The role of resilience in depression, substance use, and loneliness in college students amidst the pandemic

Objective: To assess the influence of specific COVID-19 impacts on college student depression, loneliness, and alcohol and cannabis use, and to investigate if resilience moderates these relationships. Participants: Data were collected from students (N = 1849, 80.9% white, 66.6% female) at a midwestern university during the 2021 winter/spring semester. Methods: Data were gathered cross-sectionally through an online survey platform. COVID-19 impacts and resilience's relationships with mental health variables were analyzed with multiple regression analysis. Moderation analyses were conducted using PROCESS. Results: The COVID-19 impacts measured in this study were significantly related to student depression and cannabis use. Resilience moderated the association between COVID-19 impacts and (a) depression and (b) cannabis use. Conclusion: Resilience may mitigate the effect of pandemic-related impacts on depression and cannabis use in college students, but not loneliness and alcohol use. These findings hold important implications for further research and practice.

Psychological health, wellbeing and COVID-19: Comparing previously infected and non-infected South African employees

Most COVID-19 and work-related well-being research is centred around the adverse effects on employees' psychological well-being and is not focused on the work-related well-being of those infected by SARS-CoV-2. Furthermore, COVID-19 and work-related well-being research is generally aimed at healthcare workers. The current study focused on investigating the difference in the level of burnout, anxiety, depression and stress between previously infected and uninfected participants. This study used a cross-sectional survey design and non-probability quota sampling to collect data. A retrospective pre-post design was used to determine the difference between the level of burnout of the participants before and after infection. Working adults in South Africa were targeted and divided into those previously infected (n = 245) and those not yet infected with COVID-19 (n = 221). Participants completed questionnaires relating to burnout, depression, anxiety, and stress. A comparison of means revealed a significant increase in burnout after being infected. Infected participants had significantly higher burnout, anxiety, depression, and stress levels than their non-infected counterparts. Emotional exhaustion, withdrawal, and stress were the most prevalent psychological ill-health problems. The results of this study indicated that a SARS-CoV-2 infection has a detrimental impact on participants' psychological well-being and mental health compared to their own initially reported levels of burnout before infection, as well as compared to the levels of burnout, depression, anxiety and depression of the non-infected participants. Based on the findings, specific recommendations to industrial psychologists were made to manage the psychological impact of COVID-19 on employees.

Prevalence and associated influential factors of mental health problems among Chinese college students during different stages of COVID-19 pandemic: A systematic review

This systematic review aims to take China as an example to determine the prevalence of mental health problems and associated influential factors of college students in different stages of the COVID-19 pandemic and provide a reference for effective intervention in the future. A systematic search was conducted on PubMed, Web of Science, Scopus, Science Direct, and Google scholar. A total of 30 articles were included. 1,477,923 Chinese college students were surveyed. In the early stage, the prevalence rates of depression, anxiety, stress, and PTSD ranged from 9.0% to 65.2%, 6.88%-41.1%, 8.53%-67.05%, and 2.7%-30.8%, respectively. Major risk factors were being a female, a medical student, isolation or quarantine, having family members or friends infected with COVID-19, and challenges of online learning. During the normalization stage, depression, anxiety, and insomnia prevalence rates ranged from 8.7% to 50.2%, 4.2%-34.6%, and 6.1%-35.0%, respectively. The main risk factors were self-quarantined after school reopening, regular taking temperature, and wearing face masks. The prevalence rates of mental health problems and associated influential factors unveiled in both stages showed that the students' mental health status was greatly affected. Therefore, a combination of efforts from the government, universities, and families or communities is highly needed to alleviate the mental health sufferings of students.

A protocol for a type 1 effectiveness-implementation randomized controlled trial of the WHO digital mental health intervention Step-by-Step to address depression among Chinese young adults in Macao (SAR), China

BACKGROUND

Among Chinese college students, the burden of depression is considerably high, affecting up to 30 % of the population. Despite this burden, few Chinese students seek mental health treatment. In addition, depression is highly comorbid with other mental health disorders, such as anxiety. Scalable, transdiagnostic, evidence-based interventions are needed for this population.

OBJECTIVE

The study will evaluate the effectiveness of a World Health Organization transdiagnostic digital mental health intervention, Step-by-Step, to reduce depressive and anxiety symptoms and improve well-being compared with enhanced care as usual and its implementation in a Chinese university community.

METHODS

A type 1 effectiveness-implementation two-arm, parallel, randomized controlled trial will be conducted. The two conditions are 1) the 5-session Step-by-Step program with minimal guidance by trained peer-helpers and 2) psychoeducational information on depression and anxiety and referrals to local community services. A total of 334 Chinese university students will be randomized with a 1:1 ratio to either of the two groups. Depression, anxiety, wellbeing, and client defined problems will be assessed at pre-intervention, post-intervention, and 3-month follow-up. Endline qualitative interviews and focus group discussions will be conducted to explore SbS implementation among service users, university staff, and stakeholders. Data will be analysed based on the intent-to-treat principle.

DISCUSSION

Step-by-Step is an innovative approach to address common mental health problems in populations with sufficient digital literacy. It is a promising intervention that can be embedded to scale mental health services within a university setting. It is anticipated that after successful evaluation of the program and its implementation in the type 1 hybrid design RCT study, Step-by-Step can be scaled and maintained as a low-intensity treatment in universities, and potentially extended to other populations within the Chinese community.

TRIAL REGISTRATION

ChiCTR2100050214.

COVID-19 e saúde mental

A pandemia de COVID-19 e as medidas de distanciamento social trouxeram implicações psicossociais para toda a comunidade universitária. Diante disso, o objetivo deste estudo é identificar fatores associados a sinais de ansiedade, depressão e estresse em uma comunidade universitária em regime de distanciamento social, durante a emergência sanitária. Por meio de estudo observacional de corte transversal com caráter quantitativo exploratório, realizado entre abril e maio de 2020, com uso da Escala de Depressão, Ansiedade e Estresse (DASS-21), foi obtida amostra on-line de 1.796 indivíduos. Os resultados de regressão quasi-Poisson demonstram que histórico de distúrbio mental, piora do estado emocional e dificuldades financeiras estão associados a altos escores dos três desfechos. Ainda, praticar atividade que proporciona bem-estar e possuir computador em casa estão associados negativamente a escores altos de depressão. Assim, mudanças do ensino presencial para o remoto podem ter implicações negativas na saúde mental de comunidades universitárias. 

Prevalence of anxiety and depression among Palestinian university students: a cross-sectional study during COVID-19 pandemic

Background

Anxiety and depression are more common among university students than in the general population. It is reported internationally that the COVID-19 pandemic increased the prevalence of anxiety and depression among students. This study aimed to measure the prevalence of anxiety and depression among university students in Palestine and to explore the association between anxiety and depression during the COVID-19 pandemic. A cross-sectional questionnaire-based descriptive study was carried out on university students. The Generalized Anxiety Disorder Scale (GAD-7) and the Center for Epidemiological Studies Depression (CES-D) scale were used to evaluate anxiety and depression, respectively. Chi-square was used to evaluate the risk factors associated with the levels of anxiety and depression. The association between anxiety and depression was evaluated using Pearson correlation.

Results

A total of 1049 students were enrolled in the study. The prevalence of depression among them was 55.8%, 26.4%, and 9.8% for severe, moderate, and mild depression, respectively. Depression symptoms were significantly variable based on students’ field and year of study, sleeping period, smoking, and food source. The prevalence of anxiety was 16.1%, 30.7%, and 36.1% for severe, moderate, and mild anxiety, respectively. Anxiety symptoms were significantly variable based on students’ gender, year of study, sleeping period, smoking, and place of residence. A strong positive correlation was observed between the CES-D and GAD-7 scores (R = 0.707).

Conclusion

Palestinian university students suffer from elevated levels of anxiety and depression during the COVID-19 pandemic. This necessitates the need for strategies by stakeholders to take immediate and appropriate interventions.

Psychological and physical health behavior deviations in students amidst the COVID-19 pandemic

Objective: This study sought to understand how the pandemic impacted mental and physical health behaviors in University students. Methods: Undergraduate and graduate students were asked to answer questions on depression, anxiety, stress, sleep quality, and physical activity "prior to" and "during" the shutdown. Results: 457/960 (47.6%) completed the entire survey. Paired samples t-tests showed significant change in mental and physical health behaviors over time. Hierarchical regression models indicated that negative experiences during the shutdown were associated with depression, anxiety, stress, and sleep quality (all p's < .001), but not time spent exercising or sedentary behavior. In addition, positive experiences during the shutdown acted as a buffer. Conclusion: The COVID-19 pandemic shutdown negatively impacted University students. Significant mental and physical health consequences were observed. These effects may linger long past the re-opening of society, and it may be prudent to prepare for additional demand on campus resources.

Prevalence and influencing factors of anxiety in medical students during the COVID-19 pandemic

Background and objective

The novel coronavirus disease (COVID-19) pandemic has caused a traumatic impact on the whole world in all aspects including physical health, economic condition, and mental health. Psychological problems are commonly neglected for their inconspicuous symptoms. Little is known about the medical students' psychological status during the COVID-19 pandemic. Our study aimed to investigate the prevalence and influencing factors of anxiety among medical students during the COVID-19 pandemic.

Methods

Two thousand and two medical students were investigated in this cross-sectional study. Zung's self-rating anxiety scale was used to evaluate their anxiety symptoms. A total of 1917 questionnaires were collected, and the response rate was 95.8%.

Results

There were 1735 (90.5%) complete and valid questionnaires. The average SAS standard score was 42.8 ± 11.0. The results indicated that the prevalence of anxiety in medical students was 25.9%. Less social support (OR = 1.4, 95%CI 1.2-1.7) is an independent risk factor of anxiety syndrome, while the female (OR = 0.6, 95%CI 0.5-0.8) is less likely to have anxiety syndrome.

Conclusion

The prevalence of anxiety in medical students is higher during the COVID-19 pandemic. Male students and students with less social support are more likely to have anxiety syndrome. Medical educators and students themselves should take serious steps to prevent, recognize and deal with the anxiety prevalence.

Perceived stress and depressive symptoms among Chinese college students: A moderated mediation model of biorhythm and ego resilience

Objective

To explore whether biological rhythm disturbance mediates the association between perceived stress and depressive symptoms and to investigate whether ego resilience moderates the mediation model.

Methods

A cross-sectional study was carried out using an online self-report questionnaire distributed to college students from September 2021 to October 2021. Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Severity (PSS-10), the Biological Rhythms Assessment in Neuropsychiatry (BRIAN), and Ego Resilience (ER-96) were used for investigation. SPSS 23 was used for data analyses. The significance of mediation was determined by the PROCESS macro using a bootstrap approach.

Results

Among the participants, 9.2% (N = 1,282) exhibited significant symptoms of depression. Perceived stress was positively associated with depressive symptoms, and biorhythm partially mediated this relationship. The direct and indirect effects were both moderated by ego resilience. Perceived stress had a greater impact on depressive symptoms and biorhythm for college students with lower ego resilience, and the impact of biorhythm on depressive symptoms was also stronger for those with lower ego resilience. Perceived stress had an impact on depressive symptoms directly and indirectly via the mediation of biorhythm.

Conclusion

Schools and educators should guide college students to identify stress correctly and provide effective suggestions to deal with it. Meanwhile, maintaining a stable biorhythm can protect college students from developing depressive symptoms. Students with low resilience should be given more attention and assistance.

Medical students' perceptions and performance in an online regional anatomy course during the Covid-19 pandemic

The present study evaluated the students' psychological well-being, experiences, performance, and perception of learning regional anatomy remotely. A regional anatomy remote learning curriculum was designed and learning materials were delivered virtually to 120 undergraduate medical students at Jinan University, China. All the students consented and voluntarily participated in this study by completing self-administered online questionnaires including the Zung's Self-Rating Anxiety and Depression Scales at the beginning and end of the learning session. A subset participated in focus group discussions. Most of the students (90.0%) positively evaluated the current distance learning model. More than 80% were satisfied with the content arrangement and coverage. Many students preferred virtual lectures (68.2%) and videos showing dissections (70.6%) during the distance learning sessions. However, writing laboratory reports and case-based learning were the least preferred modes of learning as they were only preferred by 23.2% and 14.1% of the students, respectively. There was no significant lockdown-related anxiety or depression reported by students using depression and anxiety scales as well as feedback from focus group discussions. The surveyed students' confidence scores in distance learning were significantly higher after 5 weeks than at the beginning of the session (3.05 ± 0.83 vs. 3.70 ± 0.71, P < 0.05). Furthermore, the present results showed no significant differences between the current group's academic performance in the unit tests as well as the final overall evaluation for different parts of the course compared to that of the previous year's cohort. The findings above were congruent with focus group discussion data that the use of the online teaching platform for regional anatomy significantly improved the students' confidence in virtual and self-directed learning and did not negatively affect their academic performance.

A study in University of Ruhuna for investigating prevalence, risk factors and remedies for psychiatric illnesses among students

There is no comprehensive study on the mental health of Sri Lankan undergraduate in higher education, as most existing studies have been done for medical students only. It is unknown how academic and environmental factors contribute for the prevalence of psychiatric illnesses. Further, there is no sufficient information on the student/university based remedies to reduce the psychological distress of students. This research is carried out to find the overall psychological distress, well-being, prevalence percentages of psychiatric illnesses, associated risk factors, and student/university remedies to overcome them. We use standard questionnaires to screen for psychiatric illnesses, and we analyze the responses for our own questionnaire using Binary logistic regression analysis to identify demographic factors, academic factors, and environmental factors causing each mental disorder. We use Pearson correlation coefficient to identify correlation between prevalence of each psychiatric illnesses. All 13 psychiatric illnesses were found with a moderate correlation among diseases having a mean prevalence percentage of 28 and a standard deviation of 14.36, despite the prevalence of well-being factors among students and only 8% are clinically diagnosed. 89% of the students were suffering from at least one psychiatric illness and 68% were found to be psychologically distressed. Sets of overall and individual demographic, academic, and environmental risk factors contributing for the prevalence of a psychiatric illness in general and in particular were identified respectively after a binary logistic regression analysis. 61% of the students don’t receive psychiatric help from the university and are using their own remedies. The universities must consider the environmental and academic risk factors associated with psychiatric illnesses and design curriculum, expand resources, and provide counseling services to reduce the impact of risk factors.

Prevalence and Correlates of Mental Health of University Students in Hong Kong: What Happened One Year After the Occurrence of COVID-19?

Purpose

In this study, we studied the prevalence and correlates of mental health problems (depression, anxiety, and stress) in Hong Kong university students after one year of the occurrence of COVID-19. We examined the relationships between mental health problems and socio-demographic factors (including age, gender, local/international students, living status, and economic strain), need satisfaction, and difficulties encountered.

Methods

A cross-sectional online survey involving 1,648 university students (Mean age = 20.09 years ± 1.37) was conducted. They responded to a questionnaire assessing their mental health (including the Depression, Anxiety, and Stress Scales—DASS), psychosocial resources, social support, need satisfaction, difficulties and challenges, and evaluation of services they received.

Results

Based on DASS cutoff scores, prevalence rates of moderate or above levels of depression, anxiety, and stress were 40.0, 50.7, and 22.2%, respectively. While age and gender were not related to the DASS measures, economic strain and living alone were positively related to negative emotional states based on the results of MANOVAs. Multiple regression and PROCESS analyses showed that need satisfaction and difficulties contributed to depression and anxiety, with stress as a mediating factor.

Conclusions

The proportions of students who experienced moderate and above levels of depression (40.0%), anxiety (50.7%), and stress (22.2%) indexed by DASS deserve attention. Living alone and experienced economic disadvantage are risk factors for negative emotional states. Need satisfaction and life challenges are related to negative emotional states. Need satisfaction and difficulties contributed to stress, which further influenced anxiety and depression.

Anxiety and psychological needs of high school students: COVID-19 period

The study aims to examine the relationship between anxiety and psychological needs of high school students during the COVID-19 pandemic period. The fact that the COVID-19 virus poses a threat to mental health as well as physical health, the effects of the pandemic period on the psychological needs and anxiety level of adolescents, especially in a critical developmental stage, and the scarcity of studies concerning adolescent mental health in this period, constituted the purpose of the current study. The quantitative (N = 502) and qualitative data (N = 29) of the study, in which triangulation design was used, were collected from high school students studying in the Southeast of Turkey. In the quantitative part of the research Multiple Linear Regression was implemented and content analysis was used in the qualitative part. The results indicate that love, belonging and power, which are subdimensions of basic psychological needs, are significant predictors of anxiety level. Additionally, it is seen that the need for freedom subdimension is the least predictive variable for the anxiety level. It is concluded that there are moderate negative and significant relationships between the general and subdimensions of basic psychological needs and the level of state anxiety. In this sense, it has been found that the level of anxiety tends to decrease as the level of the satisfaction of basic psychological needs increases. The results in the qualitative analysis part largely overlap with the results in the quantitative part. Suggestions based on the findings of the study are made to researchers.

Evaluation of Expressive Arts Therapy on the Resilience of University Students in COVID-19: A Network Analysis Approach

As an alternative to traditional verbal counselling, expressive arts therapy has been shown to be an effective method of mental health care, particularly when dealing with stressful public interactions, such as those associated with COVID-19. However, few studies have been conducted to determine the efficacy of expressive arts therapy on the resilience of psychologically exposed university students during COVID-19. Furthermore, since network analysis appears to be a popular approach in psychological research, it has not been used in recent intervention studies for resilience. As a result, the current study utilized a network analysis approach to determine the efficacy of expressive arts therapy on the resilience of university students during the COVID-19 pandemic. A total of 263 students in a comprehensive university in China were selected for the therapy group between March and November 2021. In a pre-post design, students’ resilience was assessed using the Resiliency Scale for University Students (RSUS). The extended Bayesian information criteria (EBIC) and graphical LASSO were used to estimate and define paired resilience networks, and the strength, betweenness, and closeness indices were utilized to determine the centrality of the six facets of resilience. Additionally, we verified the stability and accuracy. It was discovered that significant differences appeared between the paired networks before and after expressive arts therapy. Facets of self-efficacy, self-acceptance and problem-solving in resilience were notably improved after the therapy, with the variable of emotional stability sustained at the mean level. Meanwhile, the network analysis has highlighted the central variable of self-efficacy in the pre-intervention and support from friends in the post-intervention. The connectivity among the components of problem solving, support from friends, and support from family was enhanced, with support from friends playing the role of hub nod in the following network. By utilizing a network analytic approach, expressive arts therapy can be more targeted in intervening in resilience mechanisms. As a proxy for efficacious problem-solving, intervention should be calibrated to the cultivation of social support networks, especially in the support from friends.

The Predictive Effects of Family and Individual Wellbeing on University Students' Online Learning During the COVID-19 Pandemic

The COVID-19 pandemic has significantly changed university students' life routines, such as prolonged stay at home and learning online without prior preparation. Identifying factors influencing student online learning has become a great concern of educators and researchers. The present study aimed to investigate whether family wellbeing (i.e., family support and conflict) would significantly predict university students' online learning effectiveness indicated by engagement and gains. The mediational role of individual wellbeing such as life satisfaction and sleep difficulties was also tested. This study collected data from 511 undergraduate students (Mean age = 20.04 ± 1.79 years, 64.8% female students) via an online survey. Structural equation modeling analysis revealed positive effects of family support on students' learning engagement and gains through the mediational effects of life satisfaction and sleep difficulties. In contrast to our expectation, family conflict during the pandemic also positively predicted students' learning gains, which, however, was not mediated by individual wellbeing. The findings add value to the existing literature by delineating the inter-relationships between family wellbeing, individual wellbeing, and online learning effectiveness. The study also sheds light on the unique meaning of family conflict, which needs further clarification in future studies.

Depression among young adults - risks and protective factors in the COVID-19 pandemic

Purpose

The present study aimed to assess the depression symptoms and predictors of depression in Polish young adults during online learning in the COVID-19 pandemic.

Methods

The online questionnaire, including the Kutcher Adolescent Depression Scale, was distributed to young Poles through school principals. The final sample consisted of 1,500 students between the ages of 18 and 23 attending secondary schools. Multivariable logistic regression assessed the relationships between sociodemographic factors, pandemic stressors, coping behaviours and depressive symptoms.

Results

56% of young Polish adults are experiencing significant depressive symptoms (95% CI: 1.82-13.96). Social isolation was recognized as the main stressor. Many significant predictors of depression were captured. Being female, living in the countryside, talking to parents, and participating in sports and hobbies are found to be protective factors. The following sociodemographic factors are important predictors of depression in young adults: being male, attending a secondary school, living in a large city. Experiencing stress due to pandemic and online learning is one of the risk factors for depression.

Conclusions

The majority of young Poles met the criteria for depressive disorders. The initial findings of the presented study not only highlight the need to address mental health consequences for young people during online learning, but also provide the grounds for the development of post-pandemic interventions.

Online education and the mental health of faculty during the COVID-19 pandemic in Japan

While the negative impact of the pandemic on students’ mental health has been studied around the world, very little is known about the mental health of faculty and staff. This research aims to examine mental health among Japanese faculty members who taught online courses during the COVID-19 pandemic. We recruited 537 university faculty members and assessed their mental health using the World Health Organization-Five Well-Being Index (WHO-5), both retrospectively (during the academic year before the onset of the pandemic) and during the pandemic. We also evaluated workload (number of online lectures taught and preparation time per class), difficulty in using information technology (IT) for online classes, and satisfaction with the university support service for online education. As a result, the WHO-5 score during the COVID-19 pandemic was significantly lower than before, and 33.5% of the faculty members were recognized as being at risk for mental illness during the COVID-19 pandemic. A binomial logistic regression analysis revealed two significant risk factors for mental illness—faculty members were more at risk for mental illness when they experienced difficulty in using IT for online classes, and were unsatisfied with the administrative support for online education. The deterioration of mental health during the COVID-19 was not predicted by workload, such as the number of online lectures and preparation time. These results suggest the importance of improving workplace support services, especially IT support, to prevent mental health deterioration among faculty teaching online.

Mental Health Among Medical Students During COVID-19: A Systematic Review and Meta-Analysis

Background

The mental health of medical students is an issue worthy of attention, especially during COVID-19. Many studies have shown that depression and anxiety are the main problems faced by medical students. To assess the pooled prevalence of depression and anxiety among medical students worldwide, we conducted this meta-analysis.

Methods

According to PRISMA, we used a computerized strategy to search studies in EMBASE, PubMed, PsycArticles, Web of Science, and China Biology Medicine disc. The pooled prevalence of depression and anxiety was calculated by a random-effects model. Heterogeneity was explored by subgroup analysis. Sensitivity analysis and publication bias were also carried out in this meta-analysis.

Results

Of 1316 studies, 41 studies were selected based on 36608 medical students. The pooled depression prevalence was 37.9% (95% CI: 30.7-45.4%), and pooled anxiety prevalence was 33.7% (95% CI: 26.8-41.1%). The prevalence of depression and anxiety among medical students varied by gender, country, and continent.

Conclusion

The data reported that the prevalence of depression and anxiety among medical students during COVID-19 was relatively higher than those of the general population and the healthcare workers. The impact of COVID-19 on medical students and how to protect the mental health of medical students are needed to determine through further research.

Systematic Review Registration

[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021274015], identifier [CRD42021274015].

[Depression, anxiety and stress in college students before and during the first three months of COVID-19 lockdown]

Introduction: Different psychological symptoms of distress as well as drinking motives have been associated with alcohol use in college students. The COVID-19 lockdown [aislamiento social, preventivo y obligatorio (ASPO)] reduced movement to a minimum, impacting college students' mental health and generating changes in several behaviours, including alcohol use.Objectives: To examine the association between symptoms of anxiety, depression and stress, drinking motives and alcohol use in two groups of Argentinian college students, before and during the first three months of lockdown. In addition, it was examined whether drinking motives mediate the relationship between psychological distress and alcohol use.Methods: Two samples of college students, one before the lockdown (n=125; mean age, 23.87 ± 3.27 years; 73.6% women) and another during the lockdown (n=174; 24.32 ± 3.64 years; 78.2% women) completed an online survey.Results: Alcohol use, as well as social and enhancement motives, decreased in college students during lockdown. The associations between psychological distress and drinking motives with alcohol use were more consistent in the group during lockdown compared with the group after lockdown. At a multivariate level, coping motives explained an increased frequency of alcohol consumption in college students during lockdown.Conclusions: It is necessary to pay special attention to the mental health of college students who have experienced changes in their routines as a result of the restrictions implemented during the pandemic.

A Cross-sectional Study of the Mental Health Symptoms of Latin American, US Hispanic, and Spanish College Students Amid the COVID-19 Pandemic

Young adults and racial/ethnic minorities report the worst mental health outcomes during the COVID19 pandemic, according to the Center for Disease Control (2020). The objectives of this study were (1) to identify common mental health symptoms among Latin American, US Hispanic, and Spanish college students, and (2) to identify clinical features predictive of higher post-traumatic stress symptoms (PTSS) among this population. The study sample included 1,113 college students from the USA, Mexico, Chile, Ecuador, and Spain who completed an online survey containing demographic questions and mental health screeners. Findings revealed higher scores of depression, suicidality, and PTSS compared to pre-pandemic levels and current scores by non-Spanish speaking college students; however, less than 5% of participants endorsed clinical levels of anxiety. After controlling for demographic profiles and sociocultural values, clinical symptoms of depression, loneliness, perceived stress, anxiety, and coping strategies explained 62% of the PTSS variance. Age, history of mental illness, perceived social support, and familism were not significant predictors. This sample of college students revealed higher mental health symptoms during the COVID-19 pandemic. The high prevalence of PTSS highlights the need to develop pragmatic, cost-effective, and culturally sensitive prevention and intervention strategies to mitigate these symptoms. Implications for college administrators and clinicians are discussed.

Finding Silver Linings: A Mixed Methods Analysis of COVID-19's Challenges and Opportunities for College Students' Functioning and Outlook

This study examines the impact of the COVID-19 pandemic on college students' lives. A mixed methods approach, analyzing open- and closed-ended questions about challenges and opportunities, reveals numerous ways in which the pandemic has impacted students in general and differentially by gender, sexual orientation, race/ethnicity, and family income. Cisgender male and heterosexual students generally reported less of a mental health impact from the pandemic. Gender and sexual minorities, and low- to middle-income students, also noted some effects of the pandemic more often than their peers. Finally, thematic analysis revealed that where students found challenges, they also found opportunities within the broad categories of Lifestyle and Routines, Academic/Professional, Health, Interpersonal, and Societal impacts, evidencing heterogeneity and resilience in finding silver linings despite the challenging pandemic. This research has implications for equitably deploying and tailoring university and mental health resources both during and beyond the pandemic to improve student well-being and success.

The Psychological, Academic, and Economic Impact of COVID-19 on College Students in the Epicenter of the Pandemic

Initial research has indicated that college students have experienced numerous stressors as a result of the pandemic. The current investigation enrolled the largest and most diverse sample of college students to date (N = 4714) from universities in New York (NY) and New Jersey (NJ), the epicenter of the North American pandemic in Spring 2020. We described the impact on the psychological, academic, and financial health of college students who were initially most affected and examined racial/ethnic group differences. Results indicated that students' mental health was severely affected and that students of color were disproportionately affected by academic, financial, and COVID-related stressors. Worry about COVID-19 infection, stressful living conditions, lower grades, and loneliness emerged as correlates of deteriorating mental health. COVID-19's mental health impact on college students is alarming and highlights the need for public health interventions at the university level.

Factors affecting the adoption of health-promoting behaviours in patients with polycystic ovary syndrome: a cross-sectional study

OBJECTIVE

This study aimed to investigate health-promoting lifestyle status and associated risk factors in patients with polycystic ovary syndrome (PCOS).

DESIGN

Cross-sectional study.

SETTING

This study was conducted at a tertiary hospital in Guizhou, China from December 2020 to June 2021.

PARTICIPANTS

A total of 366 participants (18-45 years) diagnosed with PCOS were recruited from the outpatient departments.

MEASURES

Sociodemographic characteristics were collected, and health-promoting behaviours were measured using the Health-Promoting Lifestyle Profile scale. Anxiety status was measured using the Zung's Self-Rating Anxiety Scale, depression status using the Zung's Self-Rating Depression Scale and self-efficacy using the Managing Chronic Disease 6-Item Scale. Multiple stepwise linear regression was conducted to assess the risk factors associated with the health-promoting behaviours of the study participants.

RESULTS

The participants had a poor health-promoting behaviours (88.54±17.44). The highest score in all dimensions was spiritual growth (16.68±4.98), while physical activity (12.71±2.68) was the lowest. Multiple regression analysis revealed that the main factors influencing the development and maintenance of health-promoting behaviours among participants were education (B=10.788, p<0.001), depression (B=-0.377, p<0.001), anxiety (B=-0.333, p<0.001) and self-efficacy (B=0.938, p=0.002). The model showed 74.40% variance shared between the dependent and independent variables (R²=74.40, F=264.633, p<0.001).

CONCLUSION

Health-promoting behaviours are minimal among patients with PCOS, and improving negative emotions and enhancing behavioural awareness and self-efficacy are necessary to increase the adoption of health-promoting behaviours among patients with PCOS.

TRIAL REGISTRATION NUMBER

ChiCTR2000034572.

COVID-19-Related Knowledge and Anxiety Response among Physical Education Teachers during Practical In-Person Lessons: Effects of Potential Moderators

The COVID-19 pandemic has resulted in heightened anxiety levels among teachers, especially regarding PE teachers who are required to engage students in practical in-person or contact teaching lessons. Previous research showed that these levels of anxiety among PE teachers appeared to be explained by the interplay between COVID-19 knowledge, workplace safety perception, and educational qualification. This study assessed the relationship between COVID-19-related knowledge and anxiety response among PE teachers during such practical lessons while moderating the effects of workplace safety perception and educational qualification within the relationship. The study conveniently recruited 160 PE teachers to solicit responses through both online and printed questionnaires. Using correlation and linear regression analyses, the study revealed a significant negative relationship between COVID-19-related knowledge and anxiety response among PE teachers. The educational qualification of PE teachers did not significantly moderate the association between COVID-19-related knowledge and anxiety response. Workplace safety perception significantly moderated the association between COVID-19-related knowledge and anxiety response among PE teachers. The findings remind educational authorities about the essence of creating a positive and safe working environment conducive to academic work. Achieving this goal requires the provision of adequate COVID-19 management logistics (e.g., personal protective equipment, hand sanitizers) by educational authorities for PE teachers to maintain safety practices and optimal learning conditions.

Influencing Factors on College Students' Willingness to Spread Internet Public Opinion: Analysis Based on COVID-19 Data in China

Following COVID-19 outbreak, Internet public opinion has tended to proliferate. From a theoretical perspective, however, the spread law of Internet public opinion in major epidemic prevention and control may provide optimization strategies on how best to channel Internet public opinion. Specifically, this article aims at exploring key factors affecting our theoretical understanding on the spread of Internet public opinion on a major epidemic situation amongst college students. A questionnaire survey on college students was conducted via online research data collection platform located in Changsha, China, amassing three hundred and nineteen valid questionnaires. Smart PLS was applied to verify a theoretical model vis-à-vis the reliability and validity of the measuring instrument. Results show that adult attachment and social motivation have significant positive influences on the consciousness of social participation. Evidently, adult attachment, emotional orientation and risk perception also have significant positive influences on emotional motivation. Emotional motivation plays a mediating role in the relationship between affective disposition and dissemination willingness. Additionally, social motivation, consciousness of social participation and emotional motivation significantly influence one's dissemination willingness in a positive way. The consciousness of social participation plays a mediating role in the relationship between social motivation and dissemination willingness. Social motivation plays a moderating role in the relationship between risk perception and dissemination willingness. Altogether, theoretical rationalization to enhance understanding and guide the initiation and spread of Internet public opinion of major public health emergencies accurately has now been provided by this work.

Psychological impact during COVID-19 pandemic: A web-based cross-sectional study among students studying at College of Science and Technology (CST), Phuentsholing, Bhutan

The unprecedented experience of national lockdowns and uncertainty of academic career due to the COVID-19 pandemic has multifaceted impacts on mental health among university students worldwide. This study determined its impact on depression and anxiety level, and associated risk factors among engineering students studying at College of Science and Technology (CST), Phuentsholing, Bhutan during the first lockdown in the country. Self-reported depression and anxiety levels were assessed using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) respectively. Data was collected using an e-questionnaire link generated in Google form and the link was shared with students via the student’s official email group. A total of 278 students (response rate, 26.9%) completed the questionnaire. The majority of respondents were male (69.8%) and were aged from 18 to 30 (Mean: 21.7 ±SD 2.07) years. The prevalence of self-reported moderate to severe depression and anxiety were 44.2% (95% CI, 38.5–49.6) and 27.3% (95% CI, 22.3–32.4) respectively. Participants having their family members as frontline workers reported a significantly higher level of anxiety (χ2 = 4.85, p = 0.028). In multivariable logistic regression analysis, students who were academically lagging showed a higher risk of depression (AOR = 5.36, 95% CI = 2.86–10.04) and anxiety (AOR = 3.83, 95%CI = 1.86–7.88) as compared to students who were not academically behind. A high percentage of depression and anxiety was reported by students of CST during the COVID-19 pandemic. Findings from the study highlight the importance of adopting appropriate online-based teaching and learning methods to ensure timely academic and professional achievements. Moreover, the relevant stakeholders should put health system strategies in place to provide psychological support to university students during the COVID-19 pandemic.

Newly Food-Insecure College Students in Appalachia During the COVID-19 Pandemic

OBJECTIVE

This study investigated if the coronavirus disease (COVID-19) pandemic influenced college student food insecurity and factors that might contribute to a student becoming newly food insecure.

DESIGN

A convenience sample was assessed using a cross-sectional survey.

SETTING

Online.

PARTICIPANTS

College students (n = 2,018) enrolled at a land-grant institution in Appalachia.

MAIN OUTCOME MEASURE(S)

Food insecurity was assessed using the Hunger Vital Sign with reference before COVID-19 and since COVID-19. Demographic and pandemic-specific questions and their associations with food insecurity status were assessed.

ANALYSIS

Students were categorized as food secure (food secure before and since COVID-19 or food insecure in the year before COVID-19 but not food insecure since COVID-19), consistently food insecure (food insecure before and since COVID-19), and newly food insecure (food secure before but food insecure since COVID-19). Multivariate logistic regression was used to investigate the relationship between new food insecurity and contributing factors.

RESULTS

Of respondents, 68.4% were food secure, 16.5% were consistently food insecure, and 15.1% were newly food insecure. Loss of employment, increased grocery expenditure, anxiety, and a perceived threat posed by COVID-19 were significant indicators of students being newly food insecure.

CONCLUSIONS AND IMPLICATIONS

More students were facing food insecurity as a result of the COVID-19 pandemic. Continued advocacy for sustainable solutions to college food insecurity is needed.

Climate change anxiety and mental health: Environmental activism as buffer

A growing body of research has documented the phenomenon of climate change anxiety (CCA), defined broadly as negative cognitive, emotional, and behavioral responses associated with concerns about climate change. A recently validated scale of CCA indicated two subscales: cognitive emotional impairment and functional impairment (Clayton & Karazsia, 2020). However, there are few empirical studies on CCA to date and little evidence regarding whether CCA is associated with psychiatric symptoms, including symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD), and whether engaging in individual and collective action to address climate change could buffer such relationships. This mixed methods study draws on data collected from a sample of emerging adult students (ages 18-35) in the United States (N = 284) to address these gaps. Results indicated that both CCA subscales were significantly associated with GAD symptoms, while only the Functional Impairment subscale was associated with higher MDD symptoms. Moreover, engaging in collective action, but not individual action, significantly attenuated the association between CCA cognitive emotional impairment and MDD symptoms. Responses to open-ended questions asking about participants' worries and actions related to climate change indicated the severity of their worries and, for some, a perception of the insignificance of their actions relative to the enormity of climate change. These results further the field's understanding of CCA, both in general and specifically among emerging adults, and suggest the importance of creating opportunities for collective action to build sense of agency in addressing climate change.

Sleepless in Solitude-Insomnia Symptoms Severity and Psychopathological Symptoms among University Students during the COVID-19 Pandemic in Poland

Since 25 March 2020, all schools, colleges, and universities in Poland have indefinitely closed and, where possible, have activated distance learning because of the COVID-19 pandemic. Considering that the undergraduate years are usually characterized by a high prevalence of emotional disorders and sleep problems, it can be expected that the current situation may have a remarkable impact on the student population. This study aimed to investigate the occurrence of sleep problems among Polish university students as well as the relationship of insomnia symptoms severity with psychopathological symptoms, posttraumatic stress disorder (PTSD) symptoms, and behavioral factors, such as substance use, changes in the amount of sleep, and the level of physical activity during the COVID-19 pandemic. Data were collected from 1111 Polish university students via an online survey conducted between IV and VI 2020. The survey included demographic variables, the level of psychopathological symptoms (General Health Questionnaire, GHQ-28), insomnia (Insomnia Severity Index, ISI), and symptoms of posttraumatic stress (Impact of Events Scale-Revised, IES-R). The results showed that over half of the studied group of students had some form of sleep disturbances during the period of data collection, with moderate-to-severe insomnia symptoms noted in 21.6%. At the same time, the majority of the sample declared they slept more during the pandemic. A significant positive correlation was observed between the severity of insomnia symptoms and PTSD symptoms, as well as GHQ scores, increased substance use, and decreased physical activity. An additional association between the presence of dreams related to the event and insomnia symptoms as well as GHQ scores has been found. The results suggest that sleep problems may be prevalent among university students during the pandemic. Moreover, although the symptoms of insomnia, as well as the severity of sleep disturbance, significantly correlated with all the investigated variables, the direction of those associations remains to be established.

Subjective mental well-being among higher education students in Finland during the first wave of COVID-19

Aims:

Increased mental health problems during the COVID-19 pandemic have become a major concern among young adults. Our aim was to understand which COVID-19-related questions predicted mental well-being during the outbreak.

Methods:

Two cross-sectional datasets were used. The primary dataset was collected in May 2020 (n = 1001), during the initial COVID-19 outbreak, and the secondary in April 2019 (n = 10866), before the pandemic. Mental well-being was assessed with the Short Warwick–Edinburgh Mental Well-Being Scale. Relationships between mental well-being and COVID-19-related questions were investigated with lasso regression. As an exploratory analysis, two-way ANOVAs were used to compare mental well-being before and during the outbreak.

Results:

Higher levels of mental well-being were associated with lower levels of academic stress and COVID-19-related worry, along with a higher satisfaction with the procedures and information provided by the higher education institutions and the government. COVID-19-related symptoms and infections did not have an impact on students’ mental well-being during the outbreak. Small to moderate effect sizes across the time points were detected, indicating an overall decrease in mental well-being across age and gender during the outbreak.

Conclusions:

COVID-19 had an impact on higher education students’ mental well-being. Higher education institutes may play a crucial role in protecting their students’ well-being during uncertain times.

Depression, COVID-19 Anxiety, Subjective Well-being, and Academic Performance in University Students With COVID-19-Infected Relatives: A Network Analysis

This study aimed to examine the relationship between anxiety, depression, subjective well-being, and academic performance in Peruvian university health science students with COVID-19-infected relatives. Eight hundred two university students aged 17-54 years (Mean 21.83; SD = 5.31); 658 females (82%) and 144 males (18%); who completed the Patient Health Questionnaire-2, Coronavirus Anxiety Scale, Subjective Well-being Scale (SWB), and Self-reporting of Academic Performance participated. A partial unregularized network was estimated using the ggmModSelect function. Expected influence (EI) values were calculated to identify the central nodes and a two-tailed permutation test for the difference between the two groups (COVID-19 infected and uninfected). The results reveal that a depression and well-being node (PHQ1-SWB3) presents the highest relationship. The most central nodes belonged to COVID-19 anxiety, and there are no global differences between the comparison networks; but at the local level, there are connections in the network of COVID-19-infected students that are not in the group that did not present this diagnosis. It is concluded that anxious-depressive symptomatology and its relationship with well-being and evaluation of academic performance should be considered in order to understand the impact that COVID-19 had on health sciences students.

International students challenges during the COVID-19 pandemic in a university in the United States: A focus group study

Research suggests that the COVID-19 pandemic has deeply impacted college students. However, very few studies have attended to the specific plight of  international students . The purpose of this study was to document challenges international students may have encountered while studying in the United States during the pandemic. Focus groups (N = 4; 13 students total) were conducted with students who were ≥ 18 years of age, enrolled at least part-time, on an F1 visa, and non-resident alien, who did not have parents/guardians living in the United States and were able to read and write in English. Focus groups lasted 1.5-2 h in duration and followed a standardized script. These sessions were audio-recorded and professionally transcribed. Two researchers performed qualitative content analysis. Six themes emerged from the analysis and included residency challenges, lifestyle changes, coping, negative affect, social support, and university structure. It appears that the challenges associated with residency and lifestyle directly impacted students' negative affect. However, the remaining themes moderated this relationship. These findings highlight the role universities can play in providing relief to international students during these challenging times and suggest areas for improving their experiences.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-022-02776-x.

Return to classes impact on mental health of university students during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic and the necessary social isolation and distancing measures - that were adopted to prevent spreading the virus, including the suspension of university classes - negatively impacted the mental health of young adults. The aim of the current study was to investigate whether returning to online classes, even not presential, during the social isolation of the COVID-19 pandemic, affected the mental health of university students.

METHODS

Forty students (10 men and 30 women) (age, 22.3 ± 3.8 years; body mass, 62.5 ± 17.8 kg; height, 165.6 ± 8.7 cm) from undergraduate health courses participated in the study. The students answered a self-administered questionnaire designed to gather personal and quarantine information as well as information about the frequency of depression (PHQ-9) and anxiety (GAD-7) symptoms. The questionnaire was answered before and after the return to online classes.

RESULTS

There was a significantly lower frequency of depression symptoms after the return to online classes (Z = -2.27; p = 0.02). However, there was no difference in anxiety symptoms before and after returning to online classes (Z = -0.51; p = 0.61).

CONCLUSIONS

Return to online classes positively impacted the mental health (decrease of frequency of depression symptoms) of university students. Future studies are needed to observe whether the changes observed after returning to school are maintained over time.

Sleep disturbance and anxiety symptom among public during the second wave of COVID-19 in Beijing: A web-based cross-sectional survey

PURPOSE

The global coronavirus disease 2019 (COVID-19) epidemic has significantly impacted people's lives. This study aimed to examine the influence of the unexpected second wave of COVID-19 on sleep quality and anxiety of Chinese residents in Beijing in June 2020, compared with the initial outbreak at the beginning of 2020, and to investigate the associated factors.

METHODS

Using a web-based cross-sectional survey, we collected data from 1,511 participants. assessed with demographic information, sleep quality and anxiety symptoms. The participants were asked to compare their recent sleep and sleep during the first outbreak. The Zung's Self-rating Anxiety Scale (SAS) was used to assess their current insomnia severity. Multivariable logistic regression models were used to analyze the association between COVID-19 epidemic and risk of sleep disturbance and anxiety symptom.

RESULTS

The overall prevalence of sleep disturbance and anxiety symptoms were 50.8% and 15.3% respectively. People had significantly shorter sleep duration during the second wave of COVID-19(7.3 ± 1.3) h than the first outbreak (7.5 ± 1.4)h (p < 0.001). During the second outbreak, people were less concerned about infection and more concerned about financial stress and occupational inferference. Beijing residents did not have significant differences in sleep disturbance and anxiety compared with other regions, nor were occupations and nucleic acid testing associated risk factors. Home quarantine, health administrators, history of insomnia and anxiety-depression were significantly associated with sleep disturbance. Female gender, home quarantine, history of insomnia and anxiety-depression were significantly associated with anxiety.

CONCLUSION

High prevalence of sleep disturbance and depression symptom was common during the second wave of COVID-19 crisis in Beijing. Home quarantine and previous history of insomnia and anxiety-depressive risk factors were associated with sleep disturbance and anxiety. Female gender was impacting predictor of anxiety. We need continuous assessment of the sleep quality and anxiety symptoms of this epidemic.

The Role of General and Study-Related Intraindividual Factors on Academic Learning Outcomes under COVID-19: A Cross-Sectional and Longitudinal Analysis

Little is known about the intraindividual dispositional factors related to cognitive, behavioral, and emotional academic learning outcomes under COVID-19. This study investigated (i) the associations of intraindividual factors, some related to studying (motivation to learn, self-regulated learning, and study resilience), others more general (soft skills, intolerance of uncertainty) with three situational academic learning outcomes (general distress, online self-regulated learning, study-related emotions), and (ii) the effect of time, intraindividual factors, online self-regulated learning, and study-related emotions on distress and achievement over the following three exam sessions. A total of 331 university students took part in the study during the first Italian nationwide lockdown (T1; March–May 2020). Of those, 121 also completed at least one follow-up (T2: August 2020; T3: September 2020; T4: February 2021). At T1, study-related dispositions and soft skills were positively associated with online self-regulated learning and study-related emotions, while study-related dispositions were also negatively associated with general distress. Intolerance of uncertainty was associated positively with general distress and negatively with study-related emotions. Longitudinal effects of T2 and T3 for intolerance of uncertainty and study-related emotions were observed for distress, while those for T4 were study-related dispositions for achievement. Nurturing intraindividual factors can help students cope with a prolonged stressful situation such as a pandemic.

Prevalence and associated factors of depression, anxiety and suicidality among Chinese high school E-learning students during the COVID-19 lockdown

BACKGROUND

The outbreak of Coronavirus disease (COVID-19) in 2019 and the resulting quarantine may have increased the prevalence of mental health problems in adolescents. The aim of this study was to explore the association between the effects of home-based learning during the pandemic and the risks of depression, anxiety, and suicidality among junior and senior high school students.

METHODS

An online survey using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) was conducted between 12 to 30 April 2020, on a total of 39,751 students. Multivariable logistic regression analysis was used to analyze the risk factors of associated depression, anxiety and suicidality during the pandemic.

RESULTS

Prevalence of depression, anxiety symptoms and suicidality found was 16.3% (95% CI: 16.0, 16.7), 10.3% (95% CI: 10.0, 10.6) and 20.3% (95% CI: 19.9, 20.7), respectively. Participants with female gender and in junior high school, with poor overall sleep quality and poor academic performance and very worried about being infected during COVID-19 were highly associated with the risk of depression, anxiety symptoms and suicidal ideation (all P<0.001).

CONCLUSIONS

Prevalence of self-reported mental health problems for adolescents using home-based distance learning was high. Implementing measures (e.g., wearing face masks) and spending only moderate time focusing on COVID-19-related information could be protective factors for mental health. These results provide suggestions for teachers and policy makers regarding adolescent improving sleep quality (sufficient sleep) and academic performance and reducing worry about pandemic during quarantine to prevent mental health problems.

Real-time individual benefit from social interactions before and during the lockdown: the crucial role of personality, neurobiology and genes

Social integration is a major resilience factor for staying healthy. However, the COVID-19-pandemic led to unprecedented restrictions in social life. The consequences of these social lockdowns on momentary well-being are yet not fully understood. We investigated the affective benefit from social interactions in a longitudinal birth cohort. We used two real-time, real-life ecological momentary assessments once before and once during the initial lockdown of the pandemic (N = 70 participants; n~6800 observations) capturing the protective role of social interactions on well-being. Moreover, we used a multimethod approach to analyze ecological assessment data with individual risk and resilience factors, which are promising moderators in the relationship of social behavior, stress reactivity, and affective states (i.e., amygdala volume, neuroticism, polygenic risk for schizophrenia). Social contacts were linked to higher positive affect both during normal times and during the COVID-19-pandemic (beta coefficient = 0.1035), highlighting the beneficial role of social embedding. Interestingly, this relationship was differentially moderated by individual risk and resilience factors. In detail, participants with a larger left amygdala volume (beta coefficient = -0.0793) and higher neuroticism (beta coefficient = -0.0958) exhibited an affective benefit from more social interactions prior to the pandemic. This pattern changed during the pandemic with participants with smaller amygdala volumes and lower neurotic traits showing an affective gain during the pandemic. Moreover, participants with low genetic risk for schizophrenia showed an affective benefit (beta coefficient = -0.0528) from social interactions irrespective of the time point. Our results highlight the protective role of social integration on momentary well-being. Thereby, we offer new insights into how this relationship is differently affected by a person's neurobiology, personality, and genes under adverse circumstances.

Trends and Factors Associated With Risk Perception, Anxiety, and Behavior From the Early Outbreak Period to the Controlled Period of COVID-19 Epidemic: Four Cross-Sectional Online Surveys in China in 2020

Background: The first wave of the COVID-19 epidemic in China was brought under with 3 months-from mid-January 2020 to the end of March 2020. Less studies examined dynamic psychological effect and behaviors during COVID-19 pandemic. This study aims to examine perceived risk, anxiety, and behavioral response of the general public related to the outbreak of COVID-19 in four cross-sectional surveys conducted throughout China. Methods: In 2020, four cross-sectional, population-based online survey were conducted from January 28 to February 3, from February 10 to 12, from February 20 to 22, and from March 1 to 10, respectively. Convenience sampling was used for easy recruiting survey participants under the long-term impact of the COVID-19 epidemic. The four independent online questionnaires were sent from the same approach (WeChat and MicroBlog), and anyone who receives the questionnaire on the Internet or mobile phone and meets the inclusion criteria could fill in it. The same questionnaires repeatedly used in the four surveys. Socio-demographic information and individual protective practice were collected and the state-trait anxiety inventory (STAI) was used for measuring anxiety. Propensity score matching was used to adjust for differences in baseline characteristics among the four surveys. Wilcoxon signed ranks test was used to compare people's perceived risk, anxiety and protective behaviors changes in four stages. General linear model was used to identify associations between some demographic factors and perceived risk, anxiety scores, and protective behaviors. Results: The proportion of high perceived risk has dropped from 24.7 to 4.7%. The proportion of severe anxiety has declined from 12.2 to 1.2%. The proportion of people wore masks when they went out has increased from 97.0 to 98.3%. Women were more likely to develop anxiety (OR = 1.5, 95%CI: 1.4-1.6) and more positively adopted recommended behaviors (OR = 2.1, 95%CI: 1.3-3.4) than men. People at age 30-39 years, with high-degree education, with married status, and accompanied with poor self-rated health status were prone to have higher risk perception and anxiety. Perceived risk was significantly associated with anxiety over the entire periods. Anxiety levels had stronger associations with adoption of protective behaviors (wearing mask and avoiding crowed place) in the early epidemic periods than in the late epidemic periods. Conclusions: The levels of perceived risk and anxiety showed a trend of rising first and then falling. Gradually upward trend on initiative preventive behaviors including wearing mask and avoiding visiting crowded places also was observed through scanning data at four stages. People at age 30-39 years, with high-degree education, and accompanied with poor self-rated health status were prone to have higher risk perception and anxiety. Our findings showed that people simultaneously presented both high-level risk perception and anxiety across the four wave surveys, leading to their positive self-prevention and protective behavior.

Mental Health Impact of COVID-19 among Children and College Students: A Systematic Review

The COVID-19 pandemic led to a worldwide lockdown and school closures, which have placed a substantial mental health burden on children and college students. Through a systematic search of the literature on PubMed and Collabovid of studies published January 2020-July 2021, our findings of five studies on children and 16 studies on college students found that both groups reported feeling more anxious, depressed, fatigued, and distressed than prior to the pandemic. Several risk factors such as living in rural areas, low family socioeconomic status, and being a family member or friend to a healthcare worker were strongly associated with worse mental health outcomes. As schools and researchers discuss future strategies on how to combine on-site teaching with online courses, our results indicate the importance of considering social contacts in students' mental health to support students at higher risk of social isolation during the COVID-19 pandemic.

Effect of COVID-19 outbreak on anxiety among students of higher education; A review of literature

BACKGROUND AND PURPOSE

The Covid-19 pandemic has impacted the mental health of students and exacerbated the prevalence of anxiety among them. The purpose of the literature review was to consolidate evidence for the prevalence of anxiety among students of higher education during the COVID-19 pandemic and to underscore the effect of various pandemic-related factors on this anxiety.

METHODS

A comprehensive literature search was conducted utilizing various databases such as MEDLINE, PsycInfo Google Scholar, ScienceDirect, Scopus, and Embase to identify relevant studies. To be incorporated in this review, studies had to include students of higher education, measure the prevalence of anxiety, and assess anxiety during Covid-19 pandemic.

RESULTS

37 studies met the inclusion criteria and assessed the prevalence of anxiety among students during confinement. Studies showed that more than one-third of the students suffered from anxiety during the early stages of the pandemic. Moreover, being a female, living in rural areas, facing financial hardship, working full-time, spending the quarantine in isolation, worrying about infection for themselves and others, having the uncertainty of the future, having reduced sleep quality, and transitioning to online learning, were factors associated with increased anxiety during the pandemic.

CONCLUSION

Anxiety was shown to be highly prevalent among the student population during the Covid-19 pandemic. Higher education institutions and governments should take action to ensure the safety and the physical, social, and mental wellbeing of the students.

Anxiety and its relationship with sleep disturbance and problematic smartphone use among Chinese medical students during COVID-19 home confinement - A structural equation model analysis

BACKGROUND

The majority of medical students in China have experienced home confinement and a reliance on online resources to study medicine since the outbreak of COVID-19. More time spent studying online during the COVID-19 pandemic may be a potential risk factor for problematic smartphone use, since smartphones have become the most commonly used device for accessing the internet. The objective of the present study was to explore the association between anxiety, smartphone problematic use and sleep disturbance among medical students during the enforced COVID-19 home confinement.

METHODS

Altogether, 666 medical students validly answered a self-administered questionnaire, which included the Chinese version of the Generalized Anxiety Disorder scale, Smartphone addiction scale - short version, and the PROMIS Sleep Disturbance scale (short form). Hierarchical multiple regression analyses were employed to explore the associated factors of anxiety. Structural equation modeling was conducted to test hypothesized associations.

RESULTS

Anxiety was significantly associated with problematic smartphone use and sleep disturbance among medical students during the COVID-19 pandemic. Problematic smartphone use not only directly affected anxiety, but also exerted a significant indirect effect on anxiety via sleep disturbance. A significant decrease of the path coefficient of problematic smartphone use on anxiety (from β=0.53 to β=0.22, P<0.01) was observed with sleep disturbance being modeled as a mediator.

LIMITATIONS

Limitations include its cross-sectional design and samples recruited from only one medical school.

CONCLUSIONS

The detrimental impact of problematic smartphone use and the importance of sleep health on mitigating anxiety should be highlighted and incorporated into medical education.

Equilibrio ocupacional durante el confinamiento por Covid-19 en docentes de terapia ocupacional de una institución universitaria

Resumen Introducción El confinamiento obligatorio en respuesta al Covid-19 obligó al cierre de institutos y universidades, haciendo que los docentes adaptarán sus estrategias de enseñanza a medios digitales, experimentando un incremento de la jornada laboral, mayor estrés, fatiga y dificultades para separar el trabajo de otras ocupaciones, lo cual compromete su salud física y mental. Objetivos Describir el equilibrio ocupacional de docentes de Terapia ocupacional de una institución universitaria de Cali-Colombia, durante el confinamiento por Covid-19, y establecer la relación con variables sociodemográficas y la presencia de sintomatología de ansiedad y depresión. Metodo Estudio observacional de corte transversal con 32 docentes de terapia ocupacional. La información se recopiló mediante un cuestionario sociodemográfico, los cuestionarios OBQ-E, PHQ-9 y la escala GAD-7. Se realizaron tablas de frecuencias y porcentajes para variables cualitativas y las cuantitativas se presentaron en promedio y desviación estándar. El análisis bivariado se hizo mediante análisis de correspondencia múltiple, t-student, ANOVA y correlaciones de Pearson. Resultados El 75,0% de participantes eran mujeres. El promedio en el equilibrio ocupacional fue 36,5; el 31,3% manifestó síntomas de ansiedad y 43,8% de depresión. Conclusiones La mayoría de docentes eran mujeres, sexo que se relacionó con el cuidado de adultos mayores. Las puntuaciones en equilibrio ocupacional y la presencia de síntomas de ansiedad y depresión reflejan los ajustes que los docentes asumieron durante el confinamiento, en respuesta al aumento de las actividades diarias, la poca variedad entre ocupaciones que querían y que debían hacer y la satisfacción con el tiempo de descanso y sueño.