Prevalence of Mental Health Complaints Among Performing Arts Students Is Associated With COVID-19 Preventive Measures

Prevalence of Mental Health Problems and their Potential Association with Sleep Disturbance, Coping Skills and Social Support in Professional Ballet Dancers

Introduction: While several studies have analyzed the characteristics and burden of injuries and physical complaints in (pre-)professional dancers, mental health problems, other than eating disorders, have rarely been studied in professional ballet dancers. The aims were to (a) investigate the prevalence of self-reported mental health problems, and (b) analyze their potential associations with sleep disturbance, coping skills and social support in professional ballet dancers. Methods: During a pre-season health screening, professional ballet dancers of three companies were asked to answer questions on personal characteristics, current need and attempt to lose weight, chronic/recurrent mental health problems, and need of support from a psychotherapist as well as established questionnaires on depression (PHQ-9), generalized anxiety (GAD-7), eating disorders (EDE-QS), sleep disturbance (ASSQ), athletic coping skills (ACSI-28) and perceived social support (F-SozU-K6). Results: All 96 dancers (average age 27.3 years, 51.0% male) who participated in the screening answered the questionnaire. In the PHQ-9, 19 (19.8%) dancers reported mild, and 4 (4.2%) moderate to severe symptoms. In the GAD-7, 19 (19.8%) dancers reported mild, 11 (11.5%) moderate and three (3.1%) severe symptoms. Ten (10.4%) dancers were screened positive for an eating disorder in the EDE-QS. Almost two thirds of the dancers reported sleep problems of mild (n = 39; 40.6%), moderate (n = 19; 19.8%) or severe extent (n = 3; 3.1%) in the ASSQ. One in five dancers (n = 19; 19.8%) wanted or needed support from a psychotherapist at the time of the screening. The mean score of ASSQ correlated significantly with PHQ-9 (r = .34; P = .001) and GAD-7 (r = .27; P = .008). Correlations of mental health problems with athletic coping skills and social support were generally low. Conclusion: The prevalence of mental health problems, especially anxiety and eating disorders, was high in professional ballet dancers. Routine screening of mental health and sleep problems as well as interventions to improve mental health and sleep quality are strongly recommended. Level of Evidence: 2b cross-sectional study.

Poor Health Behaviour in Medical Students at a South African University: A Cross-Sectional Survey Study

BACKGROUND

Personal health behaviours and lifestyle habits of health professionals influence their counselling practices related to non-communicable diseases (NCDs). There are limited data on the prevalence of unhealthy lifestyle habits among medical students and the impact of acquired health knowledge throughout the curriculum. The aim of this study was to determine and compare the prevalence of modifiable behavioural NCD risk factors of medical students in different academic years at a South African tertiary institution.

METHODS

A cross-sectional observational study of 532 consenting medical students was conducted. Participants completed five online questionnaires regarding lifestyle behaviours (physical activity, dietary habits, smoking, alcohol consumption and sleep).

RESULTS

Lifestyle-related risk factors with the highest prevalence were poor sleep quality (66.0%), low levels of habitual physical activity (55.8%) and low-to-moderate diet quality (54.5%). There were no differences between academic years for all risk factors measured. Over 60% of the cohort had two or more NCD risk factors and this prevalence did not differ across the degree program with the acquisition of more health knowledge.

CONCLUSION

Medical students have a high prevalence of poor sleep quality, low levels of physical activity and low-to-moderate diet quality, which does not appear to change over the course of their academic career. Sleep hygiene, regular physical activity and healthy nutrition should be targeted in intervention programmes and be more prevalent in the medical curriculum.

Health consultations at a performing arts health centre among classical music students based on electronic health record data: a cross-sectional study

Physical and mental health problems in music students are usually identified using self-reported data. The use of an Electronic Health Record database can avoid biases to give an overview of the extent of health problems in this population. Therefore, the aim of this study is to gain insight into both physical and mental health related issues in classical music students using this type of data collection. An Electronic Health Record database including five years of data from a Performing Arts Health Centre (PAHC) of a university or the arts, was used to analyze the number and characteristics of health consultations in music students. The total number of students, health consultations and the average number of visits per health consultation were calculated over five years. Furthermore, numbers and percentages of both physical and mental health consultations were registered. Also, the number and percentage of health consultations per instrument group were compared to the proportion of each instrument group within the specific sample. Over a period of five years, 230 students visited the PAHC and 417 health consultations were reported. 43.5% of the students who visited a health professional indicated at least one physical health consultation, 29.1% at least one mental health consultation and 27.4% at least one in both categories. An injury was the most frequently registered physical health consultation (40.2%), followed by performance improvement (9.8%) and stress (9.6%). Voice students registered relatively most health consultations. As far as we know, this is the first cross-sectional study using Electronic Health Record data from a PAHC to gain insight into both physical and mental health related issues in a population of classical music students. Looking at the variety of health consultations registered in the database, a multidisciplinary team and multidisciplinary approach are necessary to meet the needs of the students in terms of physical and mental health support and performance improvement.

Positive Childhood Experiences and Depression Among College Students During the COVID-19 Pandemic: A Moderated Mediation Model

Purpose

In light of the ongoing COVID-19 pandemic, mental health concerns have become more prevalent worldwide. However, there is a lack of research specifically addressing the mental well-being of college art students. Therefore, the purpose of this study is to examine the prevalence of depressive symptoms among college music students and explore the factors that predict and alleviate these symptoms amidst the challenges posed by the COVID-19 pandemic.

Materials and Methods

An online survey was conducted among college music students (n = 407) from two universities at May 2022 in China. Self-report scales were used to measure levels of depression (Zung Self-Rating Depression Scale), positive childhood experiences (Benevolent Childhood Experiences Scale), social support (Multi-Dimensional Scale of Perceived Social Support), and regulatory emotional self-efficacy (Regulatory Emotional Self-Efficacy Scale). Hayes PROCESS macro for SPSS was used to test the hypothesized effects of regulatory emotional self-efficacy and social support in the relationship between positive childhood experiences and depression.

Results

Results showed that, the prevalence of depression symptoms of the current study sample was 64.13%, positive childhood experiences had a significant and negative predictive effect on the depression of college music students, and the relation was partially mediated by regulatory emotional self-efficacy. Furthermore, social support moderated the relationship between positive childhood experiences and regulatory emotional self-efficacy, the relation was significant only for students with higher levels of social support, social support may enhance and amplify the positive impacts of positive childhood experiences on regulatory emotional self-efficacy.

Conclusion

The findings reveal a significant prevalence of depression among college music students during the COVID-19 epidemic, underscoring the seriousness of the issue. Moreover, this study contributes to a deeper comprehension of how positive childhood experiences alleviate depression among college music students. These insights hold potential for informing mental health education initiatives tailored to college art students in the post-pandemic era, offering valuable guidance for promoting their well-being and resilience.

The impact of the COVID-19 pandemic on adolescent sleep behavior

Restorative sleep is a fundamental component of adolescent wellbeing, and the COVID-19 pandemic presented both challenges and opportunities for adolescents' sleep. In this review, we synthesize emergent themes from the growing scientific evidence for the impact of the pandemic on adolescent sleep behavior across different stages of the pandemic and in different locations around the world. We also highlight the ways in which COVID-19 shaped sleep patterns among college students-a subgroup of adolescents transitioning to emerging adulthood that were particularly impacted by the shift to remote learning. Finally, we discuss variations in the impact according to several potential moderating factors in adolescents' lives and point to areas that require additional longitudinal research.

Impact of COVID-19 on the physical activity, quality of life and mental health of adolescent athletes: a 2-year evaluation of over 17 000 athletes

PURPOSE

To evaluate the changes in mental health, quality of life (QOL) and physical activity (PA) among adolescent athletes during the COVID-19 pandemic as organised sports resumed.

METHODS

Adolescent athletes completed surveys including demographic and sport participation information, 7-item Generalized Anxiety Disorder, 9-item Patient Health Questionnaire, Pediatric Quality of Life Inventory and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale in May 2020 following COVID-19-related sport cancellations (Spring20) and after returning to sports in May 2021 (Spring21). The groups were balanced by inverse propensity score weighting and compared using analysis of variance models and ordinal regression models.

RESULTS

17 421 participants were included (Spring20=13 002; Spring21=4419; 16.2±1.2 years; 53% female). Anxiety was significantly lower (better) in Spring21 (Spring20=7.0, 95% CI 6.9 to 7.1; Spring21=4.9, 95% CI 4.8 to 5.0, p<0.001), as was the prevalence of moderate to severe anxiety (Spring20=29.4%, Spring21=17.1%, p<0.001). Depression was significantly improved in Spring21 (Spring20=7.6, 95% CI 7.5 to 7.7; Spring21=4.6, 95% CI 4.5 to 4.8, p<0.001), as was the prevalence of moderate to severe depression (Spring20=32.2%, Spring21=15.4%, p<0.001). Athletes in Spring21 reported higher QOL (Spring20=79.6, 95% CI 79.3 to 79.9; Spring21=84.7, 95% CI 84.4 to 85.0, p<0.001) and increased levels of PA (Spring20=13.8, 95% CI 13.6 to 13.9; Spring21=22.7, 95% CI 22.6 to 22.9, p<0.001).

CONCLUSION

Early COVID-19 sports restrictions were associated with worsening mental health in adolescents. In 2021, after returning to sports, athletes reported significant improvements in mental health, QOL and PA, although mental health adversities remain an important priority.

Impact of COVID-19 pandemic on sleep of undergraduate students: A systematic literature review

The 2019 coronavirus pandemic forced the shift to distance education aggravating mental and physical vulnerabilities of undergraduate students, including sleep. This review aims to describe sleep problem rates and prevalence, sleep pattern disruption, sleep duration, sleep quality, insomnia symptoms, psychological and socio-economic factors affecting sleep of undergraduates in 22 countries. A systematic search for articles published from 2020 to 2021 using 'COVID-19,' 'Coronavirus,' 'Pandemic,' 'Sleep,' 'Mental Health,' and 'Students' from PubMed, Scopus, and Cochrane yielded 2550 articles, where 72 were included. Selection criteria were: English full-text available articles, undergraduates and not postgraduates, reported sleep outcomes, and participants not from allied health courses. Risk of bias was assessed using various Joanna Briggs Institute checklists and outcomes were descriptively synthesized. Prevalence of sleep problems was notable, while longitudinal studies showed increased rates. There was significantly increased sleep duration, and sleep pattern disruption during lockdowns. Several psychological, behavioural, environmental, demographic, and socio-economic factors were found to be associated with sleep changes. These highlight the pandemic's impact on sleep of undergraduate students and reveal opportunities for institutions to intervene with policies and programs to promote the well-being of undergraduates. Limitations include recall bias and underrepresentation of other countries. This study is self-funded with registration number RGAO-2021-0071.

Determinants of Sleep Quality: A Cross-Sectional Study in University Students

When entering the university setting, poor sleep quality is reportedly prevalent among students and has been linked to a range of adverse health outcomes, including reduced academic performance. Moreover, determinants of sleep quality are not yet fully understood. This study was designed to (1) assess the prevalence of poor sleep quality and (2) identify determinants of sleep quality in German university students. In total, 1,684 undergraduate and graduate students (50.6% female, mean age 22.87 ± 3.15 years) from multiple academic disciplines completed a cross-sectional online survey assessing socio-demographic, health, and study-related indicators and sleep quality using the Pittsburgh Sleep Quality Index (PSQI). In our sample, 820 (48.7%) met the PSQI cut-off score (>5) for poor sleep quality. Multiple regression analysis showed that older age, being a business student, lower subjective social status, poorer self-rated health, stress, exhaustion, and poor academic performance significantly predicted poor sleep quality. Our findings document a high prevalence of poor sleep quality among university students and suggest that business students, especially, might be exposed to a greater risk for poor sleep quality. Furthermore, the results of this study are valuable for academic staff to develop tailored interventions to promote healthy sleep-in university students.

The Association Between Stress and Injury: A Prospective Cohort Study Among 186 First-Year Contemporary Dance Students

The demanding environment that contemporary dance students are exposed to could result in high stress levels, which can influence injury susceptibility. Therefore, this study aims to investigate the association between stress and injuries. In the period between September 2016 and March 2020, four cohorts of first-year dance students (N = 186; mean age 19.21 ± 1.35 years) were followed for one academic year. Each month, general stress was assessed on a 0-100 visual analogous scale. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used on a monthly basis to monitor injuries. Injuries were defined as "all injuries" (i.e., any physical complaint irrespective of the need for medical attention or time-loss from dance) and "substantial injuries" (i.e., leading to moderate/severe/complete reductions in training volume or performance). Mann-Whitney tests were performed to measure differences in general stress levels between injured and injury-free students, while repeated-measures ANOVA were performed to investigate whether general stress scores increased before and during injury occurrence. The overall average monthly general stress score over all cohorts for all students was 39.81. The monthly general stress scores ranged from 31.75 to 49.16. Overall, injured and substantially injured students reported higher stress scores than injury-free students, with significant differences in 3 out of the 9 months for all injuries (September, October, March, p < 0.05), and in 5 months for substantial injuries (September, October, November, December, April, p < 0.05). Within the 3-month period before and during injury occurrence, a (marginally) significant linear effect of general stress across the time periods was found for all injuries [F(1.87,216.49) = 3.10, p = 0.051] and substantial injuries [F(2,138) = 4.16, p = 0.018]. The results indicate an association between general stress and injuries. Future research should focus on effects of varying stress levels on injury risk using higher sampling frequency, for instance by measuring weekly since stress levels are likely to fluctuate daily. Practically, strategies aiming at stress reduction might have the potential to reduce the burden of dance injuries and may have positive outcomes for dancers, teachers, schools, and companies.

COVID-19 Lockdown Effects on Academic Functioning, Mood, and Health Correlates: Data from Dutch Pharmacy Students, PhD Candidates and Postdocs

Mixed results have been published on the impact of the 2019 coronavirus (COVID-19) pandemic and its associated lockdown periods on academic functioning, mood, and health correlates such as alcohol consumption. Whereas a number of students report an impaired academic performance and increased alcohol intake during lockdown periods, other students report no change or an improvement in academic functioning and a reduced alcohol consumption. This data descriptor article describes the dataset of a study investigating the impact of the COVID-19 pandemic on academic functioning. To investigate this, an online survey was conducted among Dutch pharmacy students, PhD candidates and postdoctoral researchers (postdocs) of Utrecht University, the Netherlands. Compared to before the COVID-19 pandemic, the survey assessed possible changes in self-reported academic functioning, mood and health correlates such as alcohol consumption, perceived immune functioning and sleep quality. Retrospective assessments were made for four periods, including (1) the year 2019 (the period before COVID-19), (2) the first lockdown period (15 March–11 May 2020), (3) summer 2020 (no lockdown) and (4) the second lockdown (November 2020–April 2021). This article describes the content of the survey and corresponding dataset. The survey had a response rate of 24.3% and was completed by 345 participants.

Psychological Outcomes and Associated Factors Among the International Students Living in China During the COVID-19 Pandemic

Background: The emergence of coronavirus disease 2019 (COVID-19) has created a severe mental health problem for international students living in China. Despite the little information on the psychological impact on international students, we aimed to assess the psychological outcomes and associated factors among international students currently living in China during the COVID-19 pandemic. Methods: An online cross-sectional survey was conducted from May 28, 2020 to June 12, 2020 on 402 full-time international students across 26 provinces in China. The frequency of symptoms of depression, anxiety, stress, insomnia, psychological distress, loneliness, and fear was assessed with the English versions of the Depression Anxiety Stress Scale (DASS-21), Insomnia Severity Index (ISI), Kessler Psychological Distress Scale (K6), University of California, Los Angeles, Loneliness Scale (UCLA-LS), and Fear of COVID-19 scale (FCV-19S) scales, respectively. Results: The prevalence of symptoms of depression (73.4%), anxiety (76.6%), stress (58.5%), insomnia (77.6%), psychological distress (71.4%), loneliness (62.4%), and fear (73.1%) among international students during the COVID-19 pandemic was shown. The prevalence of moderate to extremely severe symptoms of all psychological outcomes was significantly associated with 26-30-year-old students, students who lived with roommates, and students who stayed in China shorter than 2 years. Participants in the central region reported significantly moderate to extremely severe symptom levels of all the psychological outcomes except fear symptoms. Univariate analysis indicated that a significant association of all psychological outcomes was found among 26-30-year-old students and students who stayed in China shorter than 2 years. Multivariate analysis showed that Engineering, Business, Social Sciences and Law, and Language students were significantly associated with the symptoms of depression, anxiety, insomnia, and fear. Participants staying in China for shorter than 2 years were associated with a higher risk of all psychological outcomes except psychological distress and loneliness symptoms. Conclusions: We found a higher prevalence of psychological outcomes and risk factors among international students during the COVID-19 pandemic. We immediately appealed to university authorities, mental health professionals, and government officials to provide mental health interventions and strategies for their international students, particularly young, central region students, living with roommates, different study backgrounds, and short time staying during the pandemic.