Depression, anxiety, and academic performance in COVID-19: a cross-sectional study

Path analysis reveals cross-country differences between Czech and Chinese university students in effect of internet and smartphone addiction, mental health, and personality traits on academic achievement in the post-pandemic era

Despite extensive evidence on the impact of various mental health issues including smartphone/internet addiction, and personality traits on academic achievement, little is known about the complex interactions between multiple of these factors simultaneously, as well as cross-country differences in these nuanced relationships. In particular, understanding the role of the mentioned addictions has become increasingly important in recent years in the context of the COVID-19 pandemic. The aim of this cross-country study was to investigate, using path analysis, the complex relationships between mental health determinants (depression, anxiety, stress, resilience, and smartphone/internet addiction) and academic achievement in 1785 Czech and Chinese university students using an online battery of psychological tests. The results confirmed the previously described effect of multiple factors (anxiety, stress, resilience, smartphone/internet addiction, personality traits, and sex, Extraversion, Agreeableness, Conscientiousness) on academic achievement, overlapping in most cases for both groups of students. At the same time, however, different country-dependent patterns of interactions emerged. For the Czech students, the variables formed a complex network of interacting factors, whereas for the Chinese students, the effect of each cluster of factors was separate for individual domains of academic achievement. These cross-country differences have implications particularly for planning and targeting the most effective interventions to promote and develop academic achievement.

Substantial parallel mediation contribution by cognitive domains in the relationship between adolescents' physical fitness and academic achievements: the Cogni-Action Project

Objective

To determine how cognitive domains mediate the link between fitness components, their global score (GFS), and adolescents' academic achievement (ACA) across various school subjects.

Methods

In this study, 1,296 adolescents aged 10-14 participated. GFS was computed by three fitness components (strength, muscular, and cardiorespiratory fitness) through the ALPHA-fitness test battery. ACA was determined by five school subjects (Language, English, Mathematics, Science, and History) and two academic scores (a) "Academic Average" (five subjects) and (b) "Academic-PISA" (Language, Mathematics, and Science). A principal component analysis was performed to establish four factors (working memory [WM], cognitive flexibility [CF], inhibitory control [IC], and fluid reasoning [FR]). A parallel mediation approach was implemented with 5,000 bootstrapped samples controlled for sex, maturity, central obesity, having breakfast before cognitive tasks, schools, and school vulnerability. Total, direct, indirect effects, and mediation percentages were estimated.

Results

Overall, the finding showed a full parallel mediation effect for Language (92.5%) and English (53.9%), while a partial mediation for Mathematics (43.0%), Science (43.8%), History (45.9%), "Academic Average" (50.6%), and "Academic-PISA" (51.5%). In particular, WM, IC, and FR mediated all school subjects except mathematics, where IC was not significant. CF has not mediated any relationship between GF and academic performance.

Conclusion

This study underscores the pivotal role of cognitive domains, specifically WM, IC, and FR, in mediating the link between physical fitness and academic performance in adolescents. These insights have relevant implications for educational and public health policies.

Unmasking the mental health scars of COVID-19: A longitudinal investigation of children and adolescents in post-lockdown China

The long-term mental health consequences of COVID-19 in children and adolescents remain unclear. We investigated the impact of COVID-19 infection on mental health after China's zero-COVID policy relaxation, focusing on symptom-specific and social-family risk factors for mental health issues in children and adolescents. In a longitudinal study, 8348 youths (aged 10-18) were assessed twice (T1: September to October 2022 and T2: April to May 2023). Mental health changes (Δ=T1-T2) were compared between COVID-19-infected (COVID+, n = 4108) and non-infected (COVID-, n = 4240). After balancing social-family confounding factors at T1 with propensity score-based inverse probability weights, multivariable logistic regression was employed to assess associations between COVID-19 infection and the onset/worsening of mental health symptoms. Multivariable logistic regression was conducted to explore specific acute COVID-19 symptoms and social-family risk factors associated with the onset/worsening of mental health symptoms in COVID + group. Compared to COVID- group, COVID + group exhibited lower overall mental health improvement (Δ). COVID + group was associated with increased risks of depression worsening (OR 1.20, 95 % CI 1.04-1.39), anxiety worsening (OR 1.30, 95 % CI 1.15-1.47), stress worsening (OR 1.23, 95 % CI 1.03-1.46), insomnia worsening (OR 1.21, 95 % CI 1.05-1.39), and emotional symptoms worsening (OR 1.72, 95 % CI 1.27-2.33). Moderate-to-severe difficulty thinking, breathlessness, and gastrointestinal symptoms were specific COVID-19 symptoms associated with worsening of various mental health outcomes. Furthermore, academic difficulties, economic disadvantages, family conflicts, food addiction, and alcohol consumption were identified as social-family risk factors for worsening mental health symptoms in COVID + youths. COVID-19 infection leaves lasting mental health scars in youths, extending beyond the acute phase. Specific symptoms, particularly cognitive dysfunction and respiratory/gastrointestinal distress play a significant role in this vulnerability. Social-family factors further modulate these effects, highlighting the need for comprehensive interventions that address both biological and psychosocial aspects. This study provides valuable insights for tailoring mental health support to youths navigating the consequences of the COVID-19 pandemic.

Depressive symptoms and their correlates among predoctoral dental students in the United States

OBJECTIVE

To investigate the prevalence of self-reported depressive symptoms among predoctoral dental students in the United States and examine potential correlates.

METHODS

A survey was emailed to all 66 dental schools in the United States, inviting them to distribute it to their predoctoral students. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Data collection occurred from February to April 2020. Multivariable ordinal logistic regression was used to assess associations between demographic variables and depressive symptom severity category, adjusting for potential confounding.

RESULTS

Of an estimated 25,000 predoctoral dental students at the 66 schools, 631 students from 21 schools completed the survey. A total of 24.1% were categorized as having minimal or no depressive symptoms, 33.6% as having mild depressive symptoms, and 42.3% as having moderate, moderately severe, or severe depressive symptoms. Gender (p = 0.015) and race/ethnicity (p = 0.002) were significant predictors of severity, adjusting for other variables. Students identifying as female had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as male. Students identifying as African American/Black (non-Hispanic) and Asian/Pacific Islander had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as White.

CONCLUSION

There is evidence of a high prevalence of depressive symptoms among predoctoral dental students in the United States. Demographic variables may be risk indicators within this population. Approaches to reduce depressive symptoms among US predoctoral dental students are needed.

The Relationship Between Trait Mindfulness and Depression in Elementary Pre-Service Teachers: The Sequential Mediating Role of Flow Experience and Learning Engagement

Objective

The purpose of this study is to investigate the relationship between trait mindfulness, flow experience, learning engagement, and depression among elementary pre-service teachers.

Methods

We employed the Five Facet Mindfulness Questionnaire, Flow Experience Scale, Learning Engagement Scale, and Center for Epidemiologic Studies Depression Scale to assess 614 elementary pre-service teachers.

Results

Trait mindfulness in elementary pre-service teachers negatively predicts depression. Trait mindfulness indirectly impacts depression through flow experience and learning engagement. Furthermore, flow experience and learning engagement serve as mediating factors in the relationship between trait mindfulness and depression among elementary pre-service teachers.

Conclusion

Flow experience and learning engagement play a mediating role in the relationship between trait mindfulness and depression among elementary pre-service teachers. This study enriches our understanding of depression cognitive theory, emphasizing the positive influence of internal resources on depression prevention. Additionally, it provides a deeper explanation of the mechanism through which trait mindfulness affects depression, offering valuable insights for future depression intervention programs.

The impact of problematic mobile phone use and the number of close friends on depression and anxiety symptoms among college students

Background

Psychological problems often occur in college students, with the most common ones being depression and anxiety symptoms. Exploring the risk factors that influence depression and anxiety symptoms in college students is essential to promote their physical and mental health.

Objective

This study aimed to investigate the independent and interaction effects of problematic mobile phone use (PMPU) and the number of close friends (NCFs) on depression and anxiety symptoms and the comorbidity of these symptoms among college students.

Methods

A cross-sectional survey was conducted in Huainan, Anhui Province, and Suzhou, Jiangsu Province in China from October to December 2022. Data from 7,617 college students were collected. The Patient Health Questionnaire and Generalized Anxiety Disorder-7 were used to evaluate depression and anxiety symptoms. The PMPU data were collected by the Mobile Phone Addiction Type Scale. Multinomial logistic regression models were performed to examine the associations of PMPU and NCFs with depression and anxiety symptoms and their interaction effects.

Results

PMPU and lack of close friends significantly increased the risk of depression and anxiety symptoms and the comorbidity of these symptoms in college students (p < 0.001). In addition, the effects of PMPU and lack of close friends on depression and anxiety symptoms in college students were interactive (p < 0.001). No significant sex differences were found.

Conclusion

PMPU and lack of close friends are important risk factors for depression, anxiety, and the comorbidity of these symptoms in college students in China.

Parenthood during the COVID-19 pandemic: Post-traumatic growth amongst university students

This study sought to investigate a positive dimension of coping with the COVID-19 pandemic, that of post-traumatic growth (PTG). This study investigated coping difficulties and PTG amongst parent and nonparent students in Israeli Universities. A total of 4022 parents (3648 Jews and 374 Palestinian-Arab Citizens [PACs]) and 14,651 nonparents (12,010 Jews and 2641 PACs) completed measures of coping, social support and PTG. Parents demonstrated significantly higher levels of coping and PTG. Amongst parents, fathers coped slightly better than mothers; however, while Jewish mothers demonstrated greater PTG than Jewish fathers, PAC fathers had significantly greater PTG than both PAC mothers and Jewish parents. These findings, while specific to COVID-19, indicate that PTG should be studied in greater depth in different ethnic and minority groups in order to develop enhanced understanding and facilitate promotion of post-traumatic growth, in addition to the prevention of COVID-19-related distress.

Good performance in difficult times? Threat and challenge as contributors to achievement emotions and academic performance during the COVID-19 outbreak

Introduction

The COVID-19 pandemic has emerged as one of the most formidable global crises, leading to the disruptions to education systems worldwide and impacting learning attitudes and psychological well-being of various learner groups, including university students. In this context, students' appraisals of adverse learning situations play a key role. It is not just the learning situation, but rather students' appraisal of it which impacts their emotions, attitudes, and behaviors in academic context. The aim of the present study was to investigate how university students' challenge and threat appraisals were related to emotional learning experiences and learning outcomes during the COVID-19 pandemic. Furthermore, the study focuses on the role of personal and external resources for learning in this context.

Methods

Altogether, 428 students, who attended a Psychology lecture at one Austrian university, filled in a questionnaire about their challenge and threat appraisals of learning circumstances during the COVID-19 pandemic, achievement emotions they experienced during this time as well as gender, proneness to anxiety, academic self-concept, and learning resources. Additionally, students' performance in the examination was recorded.

Results

The structural equation model emphasizes a crucial role of challenge and threat appraisals for students' achievement emotions in learning and exam preparation during the COVID-19 pandemic. Challenge appraisals were the strongest predictor for pleasant emotions and threat appraisals were strongest predictor for unpleasant emotions. Proneness to anxiety was related to threat appraisal as well as to experience of more unpleasant and, surprisingly, to positive emotions in adverse learning situation. Academic self-concept and learning resources were identified as important resources for learning in adverse learning situation. Unpleasant achievement emotions were directly and negatively related to academic performance and may thus be seen as a critical variable and crucial obstacle to academic performance.

Discussion

The present study provides implications for learning and instructions which could be implemented by universities in order to support learning and learning attitudes among university students in adverse learning situations.

From Alpha to Omicron: How Different Variants of Concern of the SARS-Coronavirus-2 Impacted the World

SARS-CoV-2, the virus that causes COVID-19, is prone to mutations and the generation of genetic variants. Since its first outbreak in 2019, SARS-CoV-2 has continually evolved, resulting in the emergence of several lineages and variants of concern (VOC) that have gained more efficient transmission, severity, and immune evasion properties. The World Health Organization has given these variants names according to the letters of the Greek Alphabet, starting with the Alpha (B.1.1.7) variant, which emerged in 2020, followed by the Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2), and Omicron (B.1.1.529) variants. This review explores the genetic variation among different VOCs of SARS-CoV-2 and how the emergence of variants made a global impact on the pandemic.

Academic performance and mental health among Chinese middle and high school students after the lifting of COVID-19 restrictions

Background

Although the COVID-19 pandemic has greatly changed the way students studied, it is still unknown about the impact of the COVID-19 pandemic on students' academic performance and mental health.

Objective

To explore the academic performance and mental health status of middle and high school students after the lifting of COVID-19 restrictions in China.

Methods

An online survey was conducted in Sichuan province, China from Dec 14, 2022 to Feb 28, 2023. All participants were students in middle and high schools, recruited via their teachers. The general information, COVID-19-related information, and academic performance were collected. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Internet Addiction Test (IAT) were used to assess the mental health problems.

Results

Of 60,268 participants, 36,247 (60.2%) middle and high school students reported that their studies were affected by the COVID-19 pandemic, and 24,864 (41.2%) reported that their academic performance had worsened. The prevalence of depression and anxiety symptoms was 38.4 and 32.7%, respectively. There was a significant association between academic performance change and mental health problems. The logistic regression analysis showed that improved academic performance was a protective factor for depression, and declined academic performance was a risk factor for depression and anxiety. Being COVID-19 infected, family members being infected, with quarantine experience, and with COVID-19-related stigma were risk factors for depression and anxiety.

Conclusion

Academic studies and mental health status of middle and high school students in Sichuan, China have been negatively impacted by the COVID-19 pandemic, even after the lifting of COVID-19 restrictions. Students' academic performance, academic concerns, and mental health status should be considered for educational policymakers and institutions to improve students' academic studies and mental well-being.

Cross-Sectional Analysis of Colombian University Students' Perceptions of Mental Health during the COVID-19 Pandemic: Repercussions on Academic Achievement

BACKGROUND

During the COVID-19 pandemic, the increase in academic activities at home negatively impacted mental health, due to significant levels of stress, anxiety, and depression. We investigated the association of depression and anxiety with university students' academic performance during the COVID-19 lockdown in Bucaramanga, Colombia.

MATERIALS AND METHODS

A cross-sectional study was conducted through an online survey during the lockdown, through the use of the Hospital Anxiety and Depression Scale (HADS) and the grade-point average.

RESULTS

1090 females, out of 1957 students, with mean age 22.2 ± 5.3 years, participated in the study. The prevalence of low academic performance was higher in men (4.7% p = 0.014). As for mental health, 2.5% of the students were classified as "definite cases" of anxiety and 8.2% were diagnosed with depression. Women with a low academic performance had a greater percentage of being "definite cases" (3.8%) of anxiety as compared to men (1.1%). Regarding depression, in men, 12.2% of those with low academic performance were "definite cases" (6.9% p < 0.05); in females with low academic performance, 10.1% were "definite cases" of depression, according to the Poisson regression analysis. The probability of low performance was 100% higher for women identified as "doubtful cases" of depression (PR = 2.0; 95% CI: 1.10-5.18, p = 0.03).

CONCLUSIONS

A positive association between the severity of anxiety/depression and lower grades, especially in women, was found. Mental health should be a special concern when considering university students, in order to improve their academic performance.

Academic stress and academic burnout in adolescents: a moderated mediating model

Objective

This study aims to investigate the relationship and mechanisms of action among academic stress, academic anxiety, academic self-efficacy, and academic burnout among adolescents.

Methods

A study of 929 Chinese adolescents (53.71% males, mean age = 11.94 years, SD = 0.77) was conducted using the Study Stress Questionnaire, Academic Anxiety Subscale, Junior Middle School Students' Learning Weariness Scale, and the Academic Self-efficacy Questionnaire.

Results

①Academic stress was significantly and positively correlated with academic anxiety and academic burnout, and significantly and negatively correlated with academic self-efficacy. ②Academic anxiety partially mediated the relationship between academic stress and academic burnout. ③Academic self-efficacy significantly moderated the direct effect of academic stress on academic burnout, and higher academic self-efficacy could buffer the negative effect of academic stress. ④Academic self-efficacy significantly moderated the second half of the mediated model's path (academic anxiety → academic burnout), that is, low academic self-efficacy amplified the risk effect of academic anxiety on academic burnout.

Conclusion

Academic anxiety partially mediates the relationship between academic stress and academic burnout, and this mediating role is moderated by academic self-efficacy.

Impact of COVID-19 pandemic on major depressive disorder in acute psychiatric inpatients

Introduction

The spread of the coronavirus disease 2019 (COVID-19) pandemic and the subsequent restrictions significantly affected mental health, especially major depressive disorder (MDD) whose incidence increased by 27.6% in 2020, after the COVID-19 outbreak. Few studies focused on the impact of the pandemic on the clinical characteristics of outpatients with MDD and even fewer on inpatients admitted for a major depressive episode (MDE). We aimed to compare the characteristics of MDD of two groups of patients admitted for an MDE before and after the pandemic outbreak and to investigate which variables are significantly related to post-lockdown hospitalizations.

Methods

This retrospective study included 314 patients with MDD hospitalized from January 2018 to December 2021 for an MDE (DSM-5) before (n = 154) and after (n = 160) the Italian lockdown (9th of March 2020). We compared patients' sociodemographic and clinical characteristics. The characteristics significantly different between the two groups were included in a logistic regression to identify the factors more strictly associated with post-lockdown hospitalizations.

Results

During post-lockdown hospitalization, we found a higher rate of severe MDE (33 patients, 21.4%, in the pre-lockdown and 55 patients, 34.4%, in the post), MDE with psychotic features (3 patients, 2.0%, in the pre-lockdown and 11 patients, 6.9%, in the post-lockdown), and suicidal ideation (42, 27.3%, in the pre-lockdown and 67, 41.9%, in the post-lockdown), with a lower proportion of patients followed by psychiatric services before admission (106 patients, 68.8%, in the pre-lockdown and 90 patients, 56.3%, in the post-lockdown) and a higher percentage of them in treatment with psychotherapy (18 patients, 11.7% in the pre-lockdown and 32, 20.0%, in the post-lockdown) and more frequent increase of the antidepressant dosage (16 patients, 10.4% in the pre-lockdown and 32 patients, 20.0% in the post-lockdown) and adoption of augmentation strategies (13 patients, 8.4%, in the pre-lockdown and 26 patients, 16.3%, in the post-lockdown) to treat the MDE. In the regression model, post-lockdown hospitalizations were significantly associated with suicidal ideation (OR = 1.86; p = 0.016) and psychotic features (OR = 4.41; p = 0.029) at admission, the increase in the antidepressant daily dose (OR = 2.45; p = 0.009), and the employment of an augmentation therapy (OR = 2.25; p = 0.029).

Discussion

These results showed an association between the COVID-19 pandemic and the occurrence of MDE with more severe clinical features. This might be true also for future calamities, suggesting that in these emergency contexts, patients with MDD would require more attention, resources, and intense treatments with a specific focus on suicide prevention.

Collaborative group work: university students' perceptions and experiences before and during COVID-19

The present study examines how the transition from in-person to online instruction following COVID-19 restrictions impacted group work in higher education contexts. Senior undergraduate students were surveyed regarding their perceptions and experiences with collaborative instructional methods in the Fall term preceding shutdown associated with COVID-19 and one year later when learning had shifted to online formats due to health mandates. Although students had fewer courses, they had more group work assignments during the pandemic than before. Group work experiences were rated less favorably in terms of efficiency, satisfaction, motivation, and workload demands during the pandemic versus before. However, forming friendships among group members was a salient feature associated with positive perceptions toward group work both before and during the pandemic. Anxiety was associated with negative perceptions toward group work only during the pandemic. Despite considerable comfort and familiarity with online tools, in-person contexts were rated more favorably than online contexts in terms of quality of work produced and learning. Findings reinforce the need to consider inclusion of interactive and social opportunities as important aspects of instructional design, especially in online contexts.

Experiential COVID-19 factors predicting resilience among Spanish adults

BACKGROUND

The pandemic caused by COVID-19 has meant for spanish citizens a constant adaptation to health measures in order to try to stop transmission of the virus. During this adaptation process, different psychosocial aspects have caused consequences for people?s mental health to a greater or lesser extent. Makes sense of an emotional torrent who has gone through fear, anxiety, loneliness and anger. The interaction between perception and reality has given rise to situations where loneliness and social isolation have been imposed and lived with a load of emotional discomfort. In others, social isolation and measures to stop the pandemic have been accepted as a protection system and has been experienced since serenity and the feeling of self-protection fostering individual resilience. Studying the predictors of resilience is going to be key since it is the ideal antidote to stop the appearance of mental disorders associated with the pandemic (such as depression, anxiety, post-traumatic stress, social phobia, cleaning obsessions, and generalized anxiety disorder). The objective of this research is to analyze the relationship between resilience and experiential COVID-19 factors.

METHODS

Sample was comprised of Spanish adults (n = 1000; age 18-79 [mean =40.43],793 female, 201 male, and 2 non binary sex). These people participating in an online study focused on the impact of COVID-19 experiences. The research has been cross-sectional, descriptive and correlational design. The instrument created for this research was a specific online questionnaire, including the "Scale of resilience" (RS, Wagnild & Young, 1993, Spanish version, Sánchez-Teruel, et al., 2015). That questionnaire has been administered during the months of April 2022 to July 2022.

RESULTS

The results obtained show how people who have been able to face the pandemic in a responsive and adaptive way have high resilience. Specifically, those participants that accepting the use of masks, vaccinations and confinement obtained high resilience.

CONCLUSIONS

Using public funding and allocating research to the development of programs to promote resilience, adaptative beliefs and prosocial behaviors becomes basic to live in a world in constant change.

Risk factors and digital interventions for anxiety disorders in college students: Stakeholder perspectives

The worldwide prevalence of anxiety disorders among college students is high, which negatively affects countries, schools, families, and individual students to varying degrees. This paper reviews the relevant literature regarding risk factors and digital interventions for anxiety disorders among college students from the perspectives of different stakeholders. Risk factors at the national and societal levels include class differences and the coronavirus disease 2019 pandemic. College-level risk factors include the indoor environment design of the college environment, peer relationships, student satisfaction with college culture, and school functional levels. Family-level risk factors include parenting style, family relationship, and parental level of education. Individual-level risk factors include biological factors, lifestyle, and personality. Among the intervention options for college students' anxiety disorders, in addition to traditional cognitive behavioral therapy, mindfulness-based interventions, psychological counseling, and group counseling, digital mental health interventions are increasingly popular due to their low cost, positive effect, and convenient diagnostics and treatment. To better apply digital intervention to the prevention and treatment of college students' anxiety, this paper suggests that the different stakeholders form a synergy among themselves. The nation and society should provide necessary policy guarantees, financial support, and moral and ethical supervision for the prevention and treatment of college students' anxiety disorders. Colleges should actively participate in the screening and intervention of college students' anxiety disorders. Families should increase their awareness of college students' anxiety disorders and take the initiative to study and understand various digital intervention methods. College students with anxiety disorders should actively seek psychological assistance and actively accept and participate in digital intervention projects and services. We believe that in the future, the application of methods such as big data and artificial intelligence to improve digital interventions and provide individualized treatment plans will become the primary means of preventing and treating anxiety disorders among college students.

Mental Health of Students at Polish Universities after Two Years of the Outbreak of COVID-19

BACKGROUND

Mental health deterioration in young adults in the aftermath of the COVID-19 pandemic is being increasingly studied. It is clear that the psychological consequences of the pandemic will be evident for many years, especially among the younger generation, who did not have time to acquire adaptive coping strategies before the outbreak of COVID-19. The purpose of this study was to assess the condition of the mental health of students at Polish universities after two years of the pandemic. The types of coping strategies used by the respondents to deal with stress were also evaluated in order to establish which of them could have a beneficial effect on the psyche of young people.

METHODS

This study included 721 participants (age [years]: M = 25.7, SD = 5.3; 269 (37.2%) males) recruited using snowball sampling from students at two universities in Lodz, Poland, and full-time doctoral students from across Poland (phase I of the study was conducted in March 2019 (N = 352); phase II of the study was conducted in April 2022 (N = 369)). The following tools were used in this study: The General Health Questionnaire (GHQ-28) by D. Goldberg, the Perceived Stress Scale (PSS-10), and the Inventory for Measuring Coping with Stress (Mini-COPE) by Carver et al. Pearson's chi-square test and multivariate logistic regression were used in the statistical analysis.

RESULTS

The results detailing the condition of the mental health of the subjects, as measured using GHQ-28, were significantly worse in the group surveyed after two years of the pandemic than the results of the survey conducted in March 2019 (adjusted odds ratio for GHQ-28 ≥ 5: 3.66, 95%CI 2.12-6.30, p < 0.001). Statistically significant differences were seen for each of the subscales of the GHQ-28 questionnaire. Most often, the subjects complained of anxiety symptoms and sleep disorders, in addition to somatic symptoms. The risk factors for worsening mental health included female (odds ratio 1.70, 95%CI 1.20-2.40, p = 0.003) and professional inactivity (odds ratio 1.55, 95%CI 1.04-2.31, p = 0.031). On the other hand, the ages of the people surveyed, their relationship status, whether they had children, or the type of university they attended all proved to be insignificant. The following coping strategies had a positive impact on the mental health of the respondents: positive reframing (Z = -2.951; p = 0.003) and seeking emotional support (Z = -2.351; p = 0.019). In contrast, strategies such as self-distraction (Z = 2.785; p = 0.005), denial (Z = 2.948; p = 0.003), venting (Z = 2.337; p = 0.019), self-blame (Z = 5.511; p < 0.001) and behavioral disengagement (Z = 4.004; p < 0.001) were associated with poorer mental health among the respondents.

CONCLUSIONS

1. Of the students surveyed, 33% reported elevated stress levels after two years of the COVID-19 pandemic. 2. The overall mental health of students at Polish universities, as measured by GHQ-28, was significantly worse in the group evaluated after two years of the COVID-19 pandemic, mainly in respect of anxiety symptoms and sleep disorders. 3. Female gender and professional inactivity appeared to be risk factors for the students' worsening mental health, which may be an indication of the need for further research and planning of psychotherapeutic interventions.