Depressive symptoms and social demographic, stress and health risk behaviour among university students in 26 low-, middle- and high-income countries

Sociodemographic Factors, Health-Risk Behaviors, and Chronic Conditions Are Associated with a High Prevalence of Depressive Symptoms: Findings from the Indonesian Family Life Survey-5

Depression is a significant public health challenge. However, limited research exists regarding the risk of sociodemographic factors, health-risk behavior, and chronic conditions in relation to the development of depression in Indonesia. This study assesses the prevalence of depressive symptoms in adolescents and adults, and identifies its potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions. A national cross-sectional population-based survey was performed, using the Indonesian Family Life Survey (IFLS-5), to assess depressive symptoms in respondents aged 15 years and older. Depression was evaluated using the Center for Epidemiologic Studies-Depression (CES-D) scale, and potential associations with sociodemographic factors, health-risk behaviors, and chronic conditions were examined using logistic regression analysis. The study revealed a high prevalence of depressive symptoms, with the highest incidence observed in the age group of 25-34 years. Factors such as unmarried status, younger age, good physical activity, and having chronic conditions showed associations with depression. These findings have implications for developing public mental health strategies to reduce the prevalence of depression in Indonesia.

Occupational balance and associated factors among students during higher education within healthcare and social work in Sweden: a multicentre repeated cross-sectional study

OBJECTIVE

The aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work.

DESIGN

The study has a multicentre repeated cross-sectional design. Data were collected via a self-reported, web-based questionnaire based on the validated instruments: the 11-item Occupational Balance Questionnaire (OBQ11), the Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS) and five questions from the General Nordic Questionnaire (QPS Nordic) together with questions about general health and lifestyle factors.

SETTING

Students at six universities in western Sweden at one of the following healthcare or social work programmes: biomedical scientists, dental hygienists, nurses, occupational therapists, physiotherapists, radiology nurses and social workers.

PARTICIPANTS

Of 2283 students, 851 (37.3%) participated.

RESULTS

The students experienced that occupational balance increased during education. The total OBQ11 score was higher among students in semesters 4 and 6/7, compared with semester 1 students. Students with higher OBQ11 also reported higher SOC throughout their education, while health seemed to decrease. Students who reported higher levels of OBQ11 reported lower levels of health and well-being in semesters 4 and 6/7, compared with semester 1. There was an opposite pattern for students reporting lower levels of OBQ11.

CONCLUSIONS

The association between higher levels of OBQ11 and lower levels of health and well-being is remarkable. There is a need for more research on this contradiction and what it means for students' health and well-being in the long run.

Moderated moderation modelling of subjective social status, pocket money and depressive symptoms of university students in Ghana

Introduction

Although the relationship between subjective social status and depression in university students has been well-established, this association could be seen as a spurious one. Previous studies have shown that key variables like financial resources and age could play key roles in explaining the variances in social status and mental health outcomes. In this research, we assessed the complex interrelationships between subjective social status, financial resources at their disposal and depressive symptoms among university students within their young and middle adulthood stages.

Methods

A cross-sectional survey was conducted in a university in Ghana to sample 1134 university students through accidental sampling. The McArthur Scale and WHO-5 Well-being measure were used for the data collection.

Results

The results revealed that higher levels of subjective social status were associated with lower levels of depression. It was further found that the interaction between students' pocket money and age played unique roles in the relationship between subjective social status and depression.

Conclusion

The study findings call on stakeholders in education to explore funding opportunities and to examine ways of empowering parents (financially) to adequately support the students. Health educationists and promoters, including psychologists, school counsellors and parents could compliment these efforts by helping to train and empower students through self-regulation or management skills to help improve their well-being. Continuous efforts are required to improve the financial status and mental health of students.

Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use

Background

There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however.

Objective

The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons.

Methods

Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency.

Results

From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses.

Conclusion

This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.

The Barriers to Seeking Mental Health Services at King Saud Bin Abdulaziz University for Health Sciences

BACKGROUND

The mental health of college students, especially medical students, is a major issue worldwide. Depression and anxiety are among the top causes of death among people aged 15-29 years old. Mental health disorders, especially mood disorders such as depression and anxiety, are common among university students. Psychological problems can negatively impact academic performance and life satisfaction. The earlier mental illness is detected, the better the treatment and outcome. The aim of this study is to determine the barriers among students to seeking mental health services.

METHODS

This cross-sectional questionnaire-based study was carried out at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia The cross-sectional questionnaire-based study involved 434 students: 72.1% men and 27.9% women. This study had a response rate of 28.5% and responses were gathered in May 2023.

RESULTS

The top three barriers identified in this study were "Feeling that my problems are not important," "Concern that no one will understand my problems," and "Difficulty with access to care." The majority of students reported feeling "I feel reluctance a little" to use mental health services; 31.4% chose "I need it a little" when asked whether they needed to use mental health services. Furthermore, 34.8% of students reported having mild anxiety, and 34.1% reported having mild depression.

CONCLUSION

Mental illness is a serious issue, which is why medical students should be aware of it to improve their quality of life and reduce the stress and obstacles they face. Medical schools should address awareness of mental illness and how to approach a clinic. This is important for students to succeed and overcome the psychological difficulties that might affect academic performance. In addition, recognizing the barriers will help achieve better outcomes in seeking help and utilizing existing services.

Assessment of health-related behaviors among medical students: A cross-sectional study

Background and Aim

Students sometimes participate in harmful activities that adversely influence their behaviors and well-being throughout college, which is one of the sensitive phases in an individual's life. Aim: To assess the health-related behaviors of university students.

Methods

A cross-sectional study that includes systematic randomly selected 383 students from various colleges of Ras Al Khaimah Medical and Health Sciences University (RAKMHSU), Ras Al Khaimah Emirate, United Arab Emirates. A self-reported questionnaire included students' demographic traits and behaviors, including safety, medication intake, cigarette smoking, nutrition, physical activity, and health-related topics.

Results

Most participants were females (69.7%), 13.3% were obese while 28.2% were overweight. The data revealed a significant difference between male and female students regarding medication intake without prescription, nutrition, physical activity, and health-related topics. The data also revealed that the majority of the students were attempting to lose weight, and the former male smokers had fewer trials to quit the use of all tobacco products than females.

Conclusion

More than a quarter of participants were overweight, and the majority of students did not adhere to the guidelines for safety and nutritious eating. This study recognized significant health promotion opportunities for university students that can be carried out to establish a healthier youth for society.

Danger and sexuality: exploring negotiations in romantic and sexual relationships among university students in Ghana

Gender inequalities and social mores normalise gender-based violence in many settings. The goal of this study was to gain a more in-depth understanding of romantic and sexual relationships, consent, and gender-based violence among university students in Ghana. We used focus group discussions to explore individual factors influencing romantic and sexual relationships among students enrolled at a university in the Central Region of the country to inform the development and tailoring of future interventions. During a series of four focus group discussions comprising students recruited via convenience and snowball sampling, participants were asked to reflect on the nature of their romantic and sexual relationships. Demographic data and experiences of gender-based violence were also collected. The focus groups discussions were recorded and transcribed verbatim and analysed thematically. Five themes were developed from the data: (1) traditional gender roles; (2) self-control; (3) relationship-based consent; (4) cheating; and (5) non-verbal communication. This study suggests negative health and social ramifications of violence will continue until there is a resolution of conflicting social norms that result in different expectations about how men and women can address their sexual needs. Future programming and interventions for gender-based violence prevention should reflect on their impact across all ecological levels.

Key characteristics including sex, sexual orientation and internet use associated with worse mental health among university students in Brazil and implications

BACKGROUND

The symptoms of anxiety and depression disorders are multifactorial and can trigger a series of problems especially among university students. The aim of this study was to assess the prevalence and associated factors with anxiety and depression symptoms among first-semester university students at a Federal University in Brazil given the paucity of such data and the first semester is the most stressfultime.

METHODS

Cross-sectional study with first-semester university students. The questionnaire included socio-demographic variables, lifestyles, health conditions and the Depression Anxiety Stress Scales. Descriptive analysis was performed, followed by bivariate analysis and Poisson regression analysis.

RESULTS

Three hundred and fifty-six students (65.2%) across a range of courses in their first semester participated. The prevalence of anxiety was 42.5% and depression 33.2%. Regarding symptoms of anxiety and depression disorders, a positive association was observed among females, non-heterosexual, non-white skin color, excessive internet use, lack of physical activity, not attending university parties, having psychological counseling, history of anxiety in first- or second-degree relatives, poor self-rated health and use of psychotropic medicines.

CONCLUSIONS

Due to the high prevalence of anxiety and depression symptoms, the importance of developing programs to promote mental and physical health of university students is highlighted.

College student symptoms as assessed by a student health survey

ObjectiveWe sought to identify the general health of college students.ParticipantsA total of 4402 university freshmen and sophomores were recruited to report their general health through an online questionnaire.MethodsResponses from the DePaul Symptom Questionnaire were analyzed. We then conducted latent class analyses to evaluate 54 different symptoms among participants.ResultsA four class solution was identified, consisting of a group of asymptomatic students (35.65%), a second group of students reporting mild fatigue and sleep symptoms (38.87%), a third group reporting moderate sleep and fatigue symptoms (20.36%), and a group reporting moderate and severe complaints on the majority of symptoms (5.11%). Female students had 2.07 times the relative risk of the severe symptom class of men. Indigenous students have 2.88 times the relative risk of occupying the severe symptom class than non-indigenous students.ConclusionsThe results suggest that about 5% of college students have varied symptoms of a moderate to severe degree. Future research is needed to better assess whether there are biological associations with these self-report findings, as well as to determine longer-term implications of these symptoms.

Measuring mental well-being in Sri Lanka: validation of the Warwick Edinburgh Mental Well-being Scale (WEMWBS) in a Sinhala speaking community

BACKGROUND

Well-being is an important aspect of people's lives and can be considered as an index of social progress. The Warwick Edinburgh Mental Well-being scale (WEMWBS) was developed to capture subjective mental well-being. It is a widely tested measure of mental well-being at the population level and has 14 items and a short-form with 7 items. This study was carried out to culturally validate and adapt the WEMWBS among a Sinhala speaking population in Sri Lanka.

METHODS

A forward and backward translation of the scale into Sinhala was done followed by a cognitive interview. The translated and culturally adapted scale and other mental health scales were administered to a sample of 294 persons between the ages of 17-73 using a paper-based version (n = 210) and an online survey (n = 84). Internal consistency reliability and test-retest reliability were tested. Construct validity, and convergent and discriminant validity were assessed using the total sample.

RESULTS

The translated questionnaire had good face and content validity. Internal consistency reliability was 0.91 and 0.84 for the 14-item and 7-item scales, respectively. Test-retest reliability over two weeks was satisfactory (Spearman r = 0.72 p < 0.001). Confirmatory factor analysis supported a one factor model. Convergent validity was assessed using WHO-5 well-being index (Spearman r = 0.67, p < 0.001), Patient Health Questionnaire (PHQ-9) (Spearman r = (-0.45), p < 0.001) and Kessler psychological distress scale (K10) (Spearman r = (-0.55), p < 0.001).

CONCLUSIONS

The translated and culturally adapted Sinhala version of the WEMWBS has acceptable psychometric properties to assess mental well-being at the population level among the Sinhala speaking population in Sri Lanka.

Association between Sleep Quality and Depression Symptoms in Chinese College Students during the COVID-19 Lockdown Period

Background: The outbreak of COVID-19 has seriously threatened the health of people around the world. To prevent the spread of the epidemic, Chinese universities have implemented closed management of campuses. The implementation of restrictive measures has gradually caused changes in the quality of sleep and the psychological state of college students. In addition, college students are faced with the dual pressure of employment and study, and the psychological pressure is huge. Therefore, it is necessary to investigate sleep and depressive symptoms among college students. Methods: Using the method of stratified cluster sampling, 6695 college students were selected from three universities in Jiangxi, Anhui, and Xinjiang provinces from April to May 2022. The Chinese version of the Pittsburgh sleep quality index (PSQI) and the self-rating depression scale (SDS) were used for the survey. Hierarchical logistic regression analysis was used to analyze the relationship between the PSQI and the SDS. Results: Overall, during the outbreak of COVID-19, 69.0% of males and 73.5% of females had poor sleep quality among Chinese college students and the detection rate of depressive symptoms was 43.6% for males and 47.8% for females, respectively. Taking students with good sleep quality as references, after controlling for covariates, hierarchical logistic regression shows that Chinese college students with poor sleep quality have a higher OR value (OR = 12.0, 95%CI: 10.2~14.1, p < 0.001), especially in males (OR = 43.8, 95%CI:30.2~63.6, p < 0.001). For both males and females, the OR value of college students with the following characteristics was higher: rural college students (males, OR = 50.32, 95%CI: 32.50−77.93; females, OR = 8.03, 95%CI: 6.45−9.99), overweight college students (males, OR = 62.17, 95%CI: 19.47−198.53; females, OR = 16.67, 95%CI: 6.48−42.88), and college students drinking sugar-sweetened beverages (males, OR = 59.00, 95%CI: 36.96−94.18; females, OR = 8.16, 95%CI: 6.63−10.05) (p < 0.001). Conclusions: Poor sleep quality is associated with depressive symptoms among Chinese college students, especially college males. Our research suggests that it is necessary to consider the improvement of sleep quality and depressive symptoms among college students during the COVID-19 epidemic.

The mediating roles of sleep quality and sedentary behavior between physical fitness and depression among female college freshmen

Objective: This study aimed to investigate interactions among physical fitness, sleep quality, sedentary behavior, and depression among female college freshmen. Participants: A cohort of 1,514 Chinese female college freshmen (M_age = 18.8 ± .63) were recruited from four universities. Methods: Participants completed a survey assessing depression, sleep quality (sleep duration and sleep onset latency), and sedentary behavior, and performed physical fitness measurements. Results: Physical fitness indexes were associated with sleep quality and sedentary behavior (ps < .05) but not with depression. Depression was positively associated with sedentary behavior and sleep onset latency, but negatively associated with sleep duration (ps < .01). The model tests revealed that sleep quality (β = -.57, p < .01) and sedentary behavior (β = .14, p < .01) served as mediators between physical fitness and depression, respectively. Conclusions: Increasing sleep quality and minimizing sedentary behavior may build resilience to depression among Chinese female college freshmen.

The Validation of Indonesian Version of Patient Health Questionnaire-9

Background: The level of depression among college students differ to each other based on their activities, particularly in terms of their educational backgrounds. However, the national depression level among these students needs to be investigated further due to the differences of social and cultural environments.  Aims: This research aims to investigate the level of depression among medical students in the range of ages 17-22.  Research Design: The study performed the Indonesian version of PHQ-9 which was assessed to 500 medical students.  Methodology: The Indonesian version of PHQ-9 was prepared via forward-backward translation. The statistical analysis such as the Receiver Operating Characteristic (ROC), the Internal Concurrent Reliability, and concurrent validity were performed.  Results: Our findings have confirmed that the correlation of Indonesian version of PHQ-9 to the original version. The ROC analysis has suggested that the Area under the Curve (AUC) was accounted for 92.0, whereas the Cut-off value was 5.5. With sensitivity and specificity respectively were 0.907 and 0.865, the results could confirm the depression level that equals 5.5 or above.  Conclusion: The PHQ-9 translated version could be used as an evaluation to determine the depression level to the sample of medical students with acceptable validation results. 

Association Between Socio-Affective Symptoms and Glutathione and CD4 and CD8 Lymphocytes in College Students

Background: The prevalence of anxiety and depression in young students is associated with biosocial factors and scholastic stress. However, few studies have evaluated emotional-affective symptoms that are related to the immune system and antioxidant parameters in young individuals without diagnoses of affective disorders. Aim: This study aims to assess the relationship between emotional-affective symptoms and glutathione concentrations and CD4 and CD8 lymphocyte counts in college students. Methods: College students (n = 177) completed standardized psychometric instruments, including the Perceived Stress Scale, Hamilton Anxiety Scale, Beck Depression Inventory, Familiar Social and Friends Support Scale, and Rosenberg Scale. Blood samples were biochemically analyzed. Analyses of variance were conducted between four groups according to symptom severity. Results: A considerable prevalence of stress, anxiety, and depression symptoms was observed and negatively correlated with self-esteem and socio-familiar support. Perceived stress was sexually dimorphic. Although biochemical parameters were within reference ranges, glutathione, CD4, and CD8 tended to be lower in participants with anxiety and depression symptoms, which may be of predictive value. Conclusion: The relationship between antioxidant/immune parameters and socio-affective scores is latent in undiagnosed college students who might develop affective disorders. The findings suggest that during the initial development of affective disorders, stress management strategies should be implemented to help college students cope with the academic load and monitor negative changes in their physiological state.

Mental Health of University Students in Southeastern Asia: A Systematic Review

Mental health in young people is a public health challenge worldwide, with around one-fifth of university students suffering from a 12-month mental disorder. In low- and middle-income countries (LMICs) of Southeastern Asia, resources for mental health are limited and counseling services are not regularly established at universities. This review aims to determine the prevalence of mental health problems among university students in six ASEAN (Association of Southeast Asian Nations) countries (Cambodia, Laos, Malaysia, Myanmar, Thailand, and Vietnam) and to identify the determinants of mental health. A systematic database search (PubMed, CINAHL, PsycINFO, PubPsych, and Scopus) for peer-reviewed, English language articles, published 2010-2020, reporting prevalence data based on standardized screening instruments resulted in 335 articles; 108 were eligible for full-text analysis, of which 34 could be included in the review. Median point prevalence was 29.4% for depression, 42.4% for anxiety, 16.4% for stress, and 13.9% for disordered eating. Current suicidality was present in 7% to 8% of students. There was a high rate of psychiatric comorbidity. Despite the high prevalence of mental health problems, the willingness to seek professional help was comparatively low. Implications for mental health promotion and prevention in university settings are discussed.

Epidemiology of Campus Sexual Assault Among University Women in Eswatini

Sexual assault on university campuses has attracted growing attention, but there is little data available on the scope of the problem in Southern Africa. We sought to measure the prevalence of campus sexual assault among female university students at the University of Eswatini and describe the experience of survivors using a mixed-methods study design. Women were randomly sampled from a list of all full-time female university students provided by the office of the registrar, and participants completed a brief behavioral survey in a private study office using a tablet with computer-assisted self-interview software. Women who indicated experiences of sexual violence during the survey were invited to self-identify themselves to study staff to participate in a follow-up qualitative interview. We measured sexual assault using the Sexual Experiences Survey-Short Form Version (SES-SFV). We found that women in University were over 6 times more likely to report forced or coerced sex in the previous 12 months than has been previously reported in the general population. Sixty percent of participants reported experiencing an attempted or completed sexual assault in their lifetime, and a total of 38% reported an assault in the past 12 months. The vast majority (93%) of assailants were known to their victim, and the majority (56%) of perpetrators were romantic partners. The majority of participants had never disclosed their assault, and victim blaming and stigma emerged as highly salient themes during in-depth qualitative interviews. Food insecurity, losing a parent before age 21, and hazardous drinking were all significantly associated with experiencing sexual assault in the previous 12 months, as was experiencing a previous assault before the age of 18. To our knowledge, this is the first generalizable study of campus sexual assault prevalence conducted in the Southern African region.

Prevalence of Depressive Symptoms and Associated Psychosocial Risk Factors among French University Students: the Moderating and Mediating Effects of Resilience

University students constitute a higher risk population for mental health problems, especially for depression. Given the lack of literature addressing such issues in France, this study estimated the prevalence rates of depression, its sociodemographic correlates in French university students [FUS], and examined whether resilience resources moderated and mediated the relationship between perceived stress and depressive symptoms. Participants (N = 1435, Mage = 20.5) completed the Beck Depression Inventory (BDI-II), the Perceived Stress Scale, the Brief Resilience Scale, and a sociodemographic questionnaire. Descriptive, multiple logistic regressions, and mediation analyses were used. With respect to the BDI-II's cutoff scores, 20.3% (95% CI: 18.3 to 22.4%) and 22.8% (95% CI: 20.7 to 25.0%) were positive to moderate and severe depression, respectively. Gender and education attainment appeared to be moderate risk factors when accounting for cumulative effect of perceived stress and resilience. Resilience buffered and partially mediated the perceived stress-depression relationship. In conclusion, the prevalence of depression was higher in FUS, as reported in previous studies. The amount of academic and daily stress explained this prevalence. University students with low resilience level were more at risk. Interventions aiming to improve resilience skills could help to mitigate the negative effects of stress and to promote mental health in this population.

Prolonged grief and depression: A latent class analysis

Recent trends in grief research have been exploring how symptoms of prolonged grief disorder (PGD) and depression co-occur in bereaved individuals using Latent Class Analysis (LCA). However, the PGD criteria have kept undergoing changes and the newest DSM-5 PGD criteria have not been captured in these studies. Also, previous LCA-grief studies have been conducted in Western cultures, focusing more on bereaved adult populations. In this study, we applied LCA on a non-Western sample of bereaved young and middle-aged adults to examine whether the consistently observed 3 latent classes will emerge. We explored if the socio-demographic, loss-related factors, religiousness, spirituality, and continuing bond to the deceased, differentiated the latent classes. We confirmed the 3 latent classes comprising the Resilient class (20.6%), the predominantly PGD class (44.7%), and the combined PGD and Depression class (34.7%). Age, time elapsed since the loss, continuing bond and relationship with the deceased as well as spiritual beliefs were the differential predictors of class membership. This study increases our conceptual and clinical understanding of the predictability of PGD symptomology outcome, according to the newest DSM-5 criteria following bereavement in a non-Western sample. In addition to the continuing bond which was the strongest correlate, attention should be paid to important sociocultural frameworks in grief management.

Impacts of childhood adversity forms and drinker self-schema on undergraduate drinking behaviors and depression

PURPOSE

Drinking behaviors and depression are common and highly correlated behaviors in undergraduates. Child adversity and drinker self-schemas have been recognized as significant risk factors of drinking behaviors and depression. However, how the various child adversity forms differentially influence the formation of drinker self-schema and behaviors is underexplored. We aimed to determine whether drinker self-schema serves as a mechanism underlying the influence of child adversity forms on drinking frequency, drinking problems, and depressive symptoms.

METHODS

A cross-sectional, correlational study design with an anonymous, internet-based survey was conducted. Participants were 330 first- and second-year undergraduates enrolled in a four-year college/university as full-time students in Taiwan. Path analysis was performed to examine the direct and indirect effects (through drinker self-schema) of child adversity forms on drinking frequency, drinking problems, and depressive symptoms. Gender and friend's alcohol use were the covariates.

RESULTS

Psychological abuse, psychological neglect, physical neglect, and household substance use were associated with drinker self-schema, which was associated with drinking frequency, drinking problems, and depressive symptoms. Physical abuse was associated with drinking frequency. Household substance use and parent(s) treated violently were associated with drinking problems. Psychological neglect and household mental illness were associated with depressive symptoms. Moreover, psychological abuse and psychological neglect had indirect effects on drinking frequency and drinking problems through drinker self-schema.

CONCLUSIONS

Different forms of childhood adversity are differently associated with drinker self-schema, drinking behaviors, and depression. Drinker self-schema serves as an underlying mechanism linking psychological maltreatments to drinking behaviors.

Association between Mental Health Knowledge Level and Depressive Symptoms among Chinese College Students

This study aimed to explore the association between mental health knowledge level and the prevalence of depressive symptoms among Chinese college students. A cross-sectional study was conducted in six universities in Jinan, Shandong Province, China, and a total of 600 college students were recruited to self-complete a series of questionnaires. The Mental Health Knowledge Questionnaire (MHKQ) was used to investigate the level of mental health knowledge. Depressive symptoms were investigated with the depression subscale of the Depression Anxiety Stress Scale (DASS-21). The prevalence rate of depressive symptoms among college students was 31.2%. Compared with MHKQ scoring in the 1st quartile, college students with MHKQ scoring in the 3rd quartile and in the 4th quartile reported lower levels of depressive symptoms after adjusting for potential confounding factors. Since mental health knowledge level was related to depressive symptoms among college students, increased efforts to promote the level of mental health knowledge in Chinese college students are critical.

Associated factors of depression among young adults in Indonesia: A population-based longitudinal study

BACKGROUND/PURPOSE

Depression is highly prevalent among young adults in Indonesia; despite this, information pertaining to the associated factors of depression remains scarce. In this study, we aimed to identify these associated factors among young adults in Indonesia by using a longitudinal study design.

METHODS

We undertook secondary data analyses of the Indonesia Family Life Survey. Questionnaires related to smoking behavior, acute morbidities, perceived health, experience of natural disasters, and sociodemographic records from 2007 were used as independent variables and depression in 2014 was used as the outcome variable. The generalized estimating equation (GEE) approach was used to investigate the associated factors of depression.

RESULTS

The prevalence of depression among 1960 young adults was 27.86%. Based on the GEE results, perceived health was significantly negatively correlated with depression in 2014 (p < .001), whereas smoking behavior, smoking cessation, and acute morbidities in 2007 were significantly positively correlated with depression in 2014 (p < .001).

CONCLUSION

We report that the early identification of depression in this population is pivotal and relevant associated factors should be considered when developing preventive programs to avoid depression in the community.

Interplay between social media use, sleep quality, and mental health in youth: A systematic review

Social media applications are increasingly prominent among youth. This systematic review provides a comprehensive assessment of the literature on the relationship between active social media use, sleep quality, and common mental health outcomes (anxiety, depression, and psychological distress) among youth. MEDLINE, PsychINFO, EMBASE and Scopus were searched for observational studies investigating this relationship among youth (aged 16-25). Thirty-six cross-sectional studies and six prospective cohort studies met the inclusion criteria. Among cross-sectional studies, significant associations between excessive social media use with poor mental health outcomes (n = 33), poor sleep quality (n = 24), and significant associations between poor sleep quality and negative mental health (n = 16) were found. In longitudinal studies, frequent social media use was a risk factor for both poor mental health (n = 6) and poor sleep outcomes (n = 5). Some studies showed sleep quality mediating the relationship between social media use and negative mental health outcomes in youth. Overall, included evidence links excessive social media use to poor sleep quality and negative mental health in youth. Given the public health implications of sleep problems, excessive social media use warrants further investigation to clarify the directionality and strength of their associations with poor sleep quality and negative mental health outcomes.

Depressive symptoms and suicidal ideation among Vietnamese students aged 13-17: Results from a cross-sectional study throughout four geographical regions of Vietnam

We conducted a cross-sectional study in four provinces located in four different geographical areas in Vietnam to examine the prevalence and associated factors of depression and suicide ideation among school students aged 13-17. A sample of 6407 students from secondary school and high school participated in our survey to complete self-reported questionnaires. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression scale (CES-D). Suicidal ideation and associated factors were measured by the Global School Student Health Survey (GSHS) questionnaire. We found that 31.7% of students had depressive symptoms, and 11% reported suicidal ideation during the last year. Female students and older students were more at risk of experiencing depressive symptoms and suicidal ideation than male students and younger students. Bullying, violence, smoking, and alcohol consumption appear as risk factors, while a good relationship with parents/guardians may protect school students from having depressive symptoms and suicidal ideation.

Prevalence of depression and its relationship with quality of life among university students in Macau, Hong Kong and mainland China

There is compelling evidence that depressive symptoms (depression hereafter) are common in university students and are considerably influenced by the given socioeconomic context. Being former European colonies, Macau and Hong Kong are China’s special administrative regions, with different sociocultural and economic background compared to mainland China. This study compared the prevalence of depression in university students between Macau, Hong Kong and mainland China and examined the association between depression and quality of life (QOL). The Beck Depression Inventory-II and the World Health Organization Quality of Life—Brief Version (WHOQOL-BREF) were used to measure depression and QOL, respectively. Altogether, 2,312 university students participated in this study. The overall prevalence of depression was 28.9%; 35.2% in Macau, 41.0% in Hong Kong, and 16.8% in mainland China. Compared to the “No depression” group, students with depression had significantly lower QOL scores in the physical, psychological, social and environmental domains. Factors associated with depression were different between the three study sites. Sleep disturbances and high academic pressure were positively associated with depression in all the three samples. In mainland China, male students (OR = 1.68; 95% CI: 1.10–2.56) were more likely to have depression while those who were interested in their major (OR = 0.45; 95% CI: 0.29–0.69) were less likely to have depression. In Macau, students in Grade 3 (OR = 0.56; 95% CI: 0.36–0.89) and those who were interested in their major (OR = 0.58; 95% CI: 0.42–0.81) or had optimistic perspective about their future (OR = 0.51; 95% CI: 0.36–0.73) were less likely to have depression. Nursing students (OR = 1.86; 95% CI: 1.21–2.87) and students with the average score on major subject less than 65 (OR = 3.13; 95% CI: 1.70–5.78) were more likely to have depression. In Hong Kong, students with optimistic perspective about their future (OR = 0.44; 95% CI: 0.22–0.91) were less prone to have depression. Depression is common among Chinese university students, particularly in Macau and Hong Kong. Considering the negative impact of depression on QOL, regular screening and effective treatments should be offered to this population.

Protective factors for depressive symptoms in emerging adulthood

Emerging adulthood is characterized by pervasive changes in identity and relationships. These challenges can entail problems for subjective well-being, leading to depressive symptoms. The development of an autonomous-related self is considered crucial for emerging adults' personal growth and psychological well-being. Autonomous-related self is linked to self-esteem and secure attachment style, which are also protective factors for depression. The current research sought to investigate the relation between autonomous-related self and depressive symptoms, as well as the role of secure attachment style and self-esteem, in a sample of 356 Italian emerging adults. Gender differences were taken into account in preliminary analyses. Gender differences emerged for autonomous-related self and self-esteem, while secure attachment and depression levels were similar across gender. Our results suggest that autonomous-related self, mediated by self-esteem and secure attachment style, is a protective factor for emotional states of depression, controlling for social desirability. These findings emphasize the importance of taking autonomy and relatedness into account in emerging adulthood and represent a starting point for future studies.

Grit is associated with lower level of depression and anxiety among university students in Chiang Mai, Thailand: A cross-sectional study

BACKGROUND

Depression and anxiety symptoms are prevalent among university students in both developed and developing settings. Recently, grit, defined as perseverance and passion for long-term goals, has emerged as an indicator of success and well-being. However, the relationship between grit and poor mental health outcomes among university students is largely unknown. The current study investigates the relationship of grit with depression and anxiety among university students in Chiang Mai, Thailand.

METHODS

This cross-sectional study was conducted from January to March 2018 among university students aged 18-24 years from Chiang Mai University, the first largest university in Chiang Mai Province. Depression and anxiety were assessed with the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) Scales, respectively. Grit was measured using the 8-item Short Grit Scale (GRIT-S). Grit scores were grouped into three categories: low (below the 25th percentile); average (from the 25th to the 75th percentiles); and high (above the 75th percentile). The other covariates included variables such self-esteem and socio-demographic variables.

RESULTS

Of the 800 participants included in the study, 405 (50.6%) were female and 395 (49.4%) were male. Respectively 21.4% and 7.8% of the participants had depression and clinical symptoms of GAD. Increasing levels of grit negatively correlated with PHQ-9 and GAD-7 scores. Participants with high level of grit scored respectively 1.69 points (P <0.001) and 1.71 points (P < 0.001) lower on the PHQ-9 scale and GAD-7 scores. Similarly, self-esteem was negatively associated with PHQ-9 and GAD-7 scores.

CONCLUSION

Our findings highlight the negative correlation of grit with poor mental health outcomes, particularly depression and anxiety. Interventions designed to improve grit could play an essential role in the prevention of adverse mental health outcomes among university students.

Physical activity and sedentary behaviour research in Thailand: a systematic scoping review

BACKGROUND

The number of deaths per year attributed to non-communicable diseases is increasing in low- and middle-income countries, including Thailand. To facilitate the development of evidence-based public health programs and policies in Thailand, research on physical activity (PA) and sedentary behaviour (SB) is needed. The aims of this scoping review were to: (i) map all available evidence on PA and SB in Thailand; (ii) identify research gaps; and (iii) suggest directions for future research.

METHODS

A systematic literature search was conducted through 10 bibliographic databases. Additional articles were identified through secondary searches of reference lists, websites of relevant Thai health organisations, Google, and Google Scholar. Studies written in Thai or English were screened independently by two authors and included if they presented quantitative or qualitative data relevant to public health research on PA and/or SB.

RESULTS

Out of 25,007 screened articles, a total of 564 studies were included in the review. Most studies included PA only (80%), 6.7% included SB only, and 13.3% included both PA and SB. The most common research focus was correlates (58.9%), followed by outcomes of PA/SB (22.2%), prevalence of PA/SB (12.4%), and instrument validation (3.2%). Most PA/SB research was cross-sectional (69.3%), while interventions (19.7%) and longitudinal studies (2.8%) were less represented. Most studies (94%) used self-reports of PA/SB, and few (2.5%) used device-based measures. Both sexes were examined in most studies (82.5%). Adults were the main target population group (51.1%), followed by older adults (26.9%), adolescents (15.7%), and children (6.3%). Clinical populations were investigated in the context of PA/SB in a relatively large number of studies (15.3%), most frequently those with cardiovascular disease, diabetes, and hypertension (22%, 21%, and 21% respectively).

CONCLUSIONS

The number of Thai papers on PA published per year has been increasing, indicating a growing interest in this research area. More studies using population-representative samples are needed, particularly among children and adolescents, and investigating SB as a health risk factor. To provide stronger evidence on determinants and outcomes of PA/SB, longitudinal studies using standardised measures of PA and SB are required.

Predicting intentions to seek help for depression among undergraduates in Sri Lanka

BACKGROUND

Studies have found that although there are high rates of depression among university students, their help-seeking practices are poor. It is important to identify students who are less likely to seek the necessary help, to encourage better help-seeking among them. This study, which was conducted among undergraduates in Sri Lanka, examined the associations between personal characteristics of the undergraduates and their intentions to seek help for depression.

METHODS

This was a cross-sectional study in which 4461 undergraduates (Male: n = 1358, 30.4%, Female: n = 3099, 69.5%; Mean age = 22.18; SD = 1.47) indicated their intentions to seek help if personally affected by depression, which was described in a hypothetical vignette about a peer experiencing depression symptomatology. The predictors of the undergraduates' help-seeking intentions, including their sociodemographic characteristics, prior exposure to and recognition of the problem, and their stigma towards those with depression were examined using binary logistic regression analyses models.

RESULTS

The undergraduates' ability to recognise the problem was one of the strongest predictors of their intentions to seek professional help. Those with higher levels of stigma were less likely to seek both professional and informal help. While females were less likely to consider professional help, they were more likely to consider the help of informal help-providers and to consider religious strategies. Medical undergraduates and those who had sought help for personal experiences of the problem were also more likely to consider informal help. However, all these associations resulted in small effect sizes, except for those between recognition of the problem and the undergraduates' intentions to seek professional help, where medium to very large effect sizes were observed in the case of some the associations examined.

CONCLUSIONS

Improvement of problem-recognition may be a key strategy for improving help-seeking among these undergraduates. Reduction of stigma may also be associated with better depression-related help-seeking of undergraduates. Females and medical undergraduates need to be educated about the importance of seeking appropriate types of help, and their informal social networks must be educated about how best to help them.

High prevalence of depressive symptoms in a national sample of adults in Indonesia: Childhood adversity, sociodemographic factors and health risk behaviour

BACKGROUND

The aim of this study was to investigate depressive symptoms and their association with sociodemographic factors, stressors and support, including childhood adversity, health status risk and behaviour in Indonesia.

METHOD

In a cross-sectional national population survey in 2014-15 in Indonesia, 31442 adults (mean age 37.3 years, SD = 14.9, age range 15-101 years) responded to the Centers for Epidemiologic Studies Depression Scale (CES-D-10) and various other measures.

RESULTS

Overall, 15.0% of participants reported moderate and 6.9% severe depressive symptoms, or 21.8% moderate or severe depressive symptoms (21.4% among men and 22.3% among women). In multivariable logistic regression among both men and women, sociodemographic factors (younger age, poor subjective economic background, being unemployed, residing in Java and main island groups), stressors (childhood hunger and poor or fair self-rated health status and having experienced disasters), lack of social trust and religiosity, having one or more chronic conditions, tobacco use and soft drink consumption were positively and obesity negatively associated with moderate or severe depressive symptoms.

CONCLUSION

High rates (21.8%) of depressive symptoms were found. Several risk factors including sociodemographic factors such as younger age, stressors, lack of social support, health risk status and behaviour variables were identified which can be utilized in guiding interventions.

Vigorous physical activity, perceived stress, sleep and mental health among university students from 23 low- and middle-income countries

Background Vigorous physical activity (VPA) may be beneficial for mental health. The aim of the study was to investigate cross-sectional associations between VPA, perceived stress, sleep quality and quantity and mental health among university students. Methods In a cross-sectional study, using anonymous questionnaires, data was collected from 15122 (42.1% male and 57.9% female) university students [mean age 20.6, standard deviation (SD) = 2.0] from 23 countries in the Americas, Africa and Asia. They were assessed using the International Physical Activity Questionnaire (short version), and measures of sociodemographic, health status, health behaviour and anthropometrics. Results Students who met VPA recommendations were less likely to report perceived stress, more likely to report subjective good health and depression than students without VPA. There was no association between VPA and sleep quality and quantity and PTSD symptoms. Conclusion This study only found partial benefits of VPA in relation to well-being of university students.

Helping intentions of undergraduates towards their depressed peers: a cross-sectional study in Sri Lanka

BACKGROUND

Despite showing high rates of depression, university students prefer to seek assistance for their depression from informal sources, such as their friends, rather than seeking professional assistance. Therefore, the helping behaviours of those who provide informal help to these students need examination. This study examines the helping intentions of undergraduates in Sri Lanka towards their depressed peers and the correlates of their helping intentions.

METHOD

The undergraduates were presented with a vignette of a hypothetical depressed undergraduate. A total of 4442 undergraduates responded to an open-ended question about how the person in the vignette should be helped if this person was someone they knew well. Their responses were coded in reference to established mental health first aid guidelines. Logistic and linear regression models were used to examine the predictors of their helping intentions.

RESULTS

The undergraduates' most common helping intentions were to listen/talk and support their peer. Only around a third considered the need for professional help. The overall quality of their helping intentions was poor, but better among those who recognised the problem as depression and those who had less stigmatising attitudes. There was some evidence that certain helping intentions of the undergraduates which were person-oriented or social network-related were better among females, those in higher years of study and among certain non-medical student groups. Intentions to encourage professional help were better among those who recognised the problem, but poorer among those with personal experiences of this problem and among those who perceived this problem to be a weakness and not a sickness.

CONCLUSIONS

Although the undergraduates may attempt to support their distressed peers, they may not show appropriate helping actions and may not encourage the use of professional assistance. Hence, they need to be educated on how best to respond to their distressed peers. Those with higher levels of stigma and inability to recognise the problem may be at greater risk of showing poorer helping responses towards their distressed peers.