Depression and anxiety of medical students at Kunming Medical University during COVID-19: A cross-sectional survey

Prevalence of depression and anxiety among university students in Jeddah, Saudi Arabia: exploring sociodemographic and associated factors

Introduction

Previous studies have shown that mental health issues such as depression and anxiety are on the rise globally, particularly among university students. The aim of this study is to assess the prevalence of depressive and anxiety symptoms among university students, and the associated potential risk factors, in Jeddah, Saudi Arabia.

Methods

A cross-sectional questionnaire study was conducted in a sample of 728 students who anonymously completed three sets of questionnaires: a sociodemographic and lifestyle information questionnaire, the Patient Health Questionnaire-9 (PHQ-9) to screen for depressive symptoms and the Generalized Anxiety Disorder-7 (GAD-7) scale to screen for anxiety symptoms.

Results

In a survey of 728 students, 81.5% reported depression and 63.6% anxiety, with no difference between medical and non-medical majors. Regular exercise, a history of psychological disorders, a diagnosis of chronic illness, and the use of antidepressant medications were significant indicators of depression. Significant anxiety markers included female gender, a diagnosis of chronic illness, a history of psychological disorders, the use of antidepressant medications, and smoking. Surprisingly, we did not observe any significant differences between the prevalence of depression or anxiety symptoms and common risk predictors, such as poor academic performance, low family income, and year of study.

Conclusion

Depression and anxiety had a high prevalence among undergraduates, regardless of their field of study; therefore, we recommend the implementation and expansion of community-based mental health prevention programs and mentorship programs. Universities with counseling programs should identify and eliminate factors that contribute to depression and anxiety.

Global prevalence of anxiety and depression among medical students during the COVID-19 pandemic: a systematic review and meta-analysis

PURPOSE

As future physicians, medical students have experienced tremendous pressure during the ongoing COVID-19 pandemic, which is associated with a high risk of depression and anxiety. We aimed to investigate an overview of the prevalence of anxiety and depression among medical students in various countries during the global COVID-19 pandemic, and discuss associated stressors.

METHODS

We systematically searched CINAHL, EMBASE, MEDLINE, PubMed, and Web of Science for relevant articles from December 1, 2019 to March 15, 2023. We performed meta-analysis using a random-effects model with REML method to calculate the pooled prevalence of anxiety and depression. Begg's and Egger's tests were used to identify the potential risk of publication bias. Meta-regression was used to explore potential sources of heterogeneity.

RESULTS

We identified 130 studies reporting anxiety and depression among 132,068 medical students during the COVID-19 pandemic. Eight screening tools were identified for anxiety and six for depression. The pooled prevalence of mental health outcomes for anxiety and depression was 45% (95% confidence interval [CI], 40%-49%) and 48% (95% CI, 43%-52%), respectively. The pooled prevalence of mental health outcomes for moderate and severe anxiety and moderate and severe depression was 28% (95% CI, 24%-32%) and 30% (95% CI, 26%-35%), respectively. There was high heterogeneity between studies, with I2 ranging from 99.58%-99.66%. Continent and survey date were included in the meta-regression model. The results of meta-regression revealed that medical students in Asia had a lower prevalence of anxiety, and depression than those in other regions. The survey date (from February to June, 2020) showed a significantly positive correlation with the prevalence of anxiety and depression.

CONCLUSIONS

We demonstrated the global prevalence of anxiety and depression among medical students during the COVID-19 pandemic. The data highlight that medical students worldwide are at high risk of experiencing anxiety and depression. The reported stressors can be categorized into personal, academic, environmental and cultural, and pandemic factors. Schools and institutions should ensure optimal alternative learning environments for uninterrupted provision of medical education. The appropriate authorities should prioritize the provision of adequate protection for medical students and establish policies to promote new methods of training and education during a disaster, such as via distance learning.

Evaluation of Depression and Its Correlates in Terms of Demographics, Eating Habits, and Exercises Among University Students: A Multicenter Cross-Sectional Analysis

Background

University students are a vulnerable population prone to mental health challenges. This study aimed to investigate depression and its associated factors among university students in terms of demographics, eating habits, and exercises.

Methods

A total of 2891 university students from three universities participated in this study between January 2024 and February 2024. An online survey questionnaire was distributed using a snow-ball strategy. The survey collected demographic, lifestyle, and psychological data, including depression and anxiety scores using the PHQ-9 and GAD-7 screening tools. Subgroup analysis was conducted according to sport frequency and sport type using Chi-square test for qualitative data and t-test for quantitative data. Multiple linear regression analysis was performed to identify risk factors for depression.

Results

A total of 44.2% and 39.5% of the participants reported symptoms of depression and anxiety, respectively. Significant differences were observed in various characteristics across different sport frequency groups, with participants with higher sport frequency tending to have less depression (P<0.001) and anxiety (P<0.001) symptoms. As the frequency of weekly exercise increased, anxiety and depression scores gradually decreased. The mean PHQ-9 and GAD-7 scores were highest in the group with no sports and lowest in the group with a sport frequency of 3-4 times per week (P<0.001). Additionally, once exercise frequency reached 5 times per week or more, anxiety and depression scores no longer decreased. Subgroup analysis based on sport type revealed that participants engaging in specific sports, such as basketball, tennis, dance, and running, had lower depression (P<0.001) and anxiety (P<0.001) scores compared to the overall average. Based on multiple linear regression analysis, married status (P=0.036), enjoying barbecue food (P<0.001), prolonged sedentary time (P=0.001), experiencing stress events (P<0.001), and electronic device usage time (P<0.001) were positively associated with depression scores, while loving eating vegetables (P=0.007), a relatively longer sport time (P=0.005), a higher exercise frequency (P=0.064), and no chronic disease (P<0.001) were negatively associated with depression scores.

Conclusion

This study highlights the importance of a healthy lifestyle, including regular exercise, limited exposure to electronic screens, and a balanced diet, in preventing and mitigating depression among university students. This study also suggests that exercising 3-4 times a week is associated with the lowest levels of anxiety and depression. Activities such as basketball, tennis, dance, and running are effective in alleviating these mental health issues through regular exercise.

Association between physical activity levels and anxiety or depression among college students in China during the COVID-19 pandemic: A meta-analysis

BACKGROUND

This meta-analysis aimed to investigate the links between the level of physical activity and the risk of anxiety or depression among college students in China during the Coronavirus Disease 2019 pandemic.

METHODS

Eligible studies were searched from the PubMed, Embase, and Web of Science databases. The associations between them were assessed with odd ratio (OR) and 95% confidence interval (CI). The heterogeneity of the included studies was evaluated and subgroup analysis was performed. Sensitivity analysis was executed using leave-one-out method. Publication bias of included studies was evaluated. Ten studies with moderate quality were included.

RESULTS

Physical activity levels of college students were associated with reduced risk of depression (OR [95%CI] = 0.69 [0.58, 0.82], P < .001) and anxiety (OR [95%CI] = 0.71 [0.62, 0.80], P < .001). The measurement scale of depression or anxiety and whether multi-factor correction was performed or not did not influence the pooled results. The pooled results of depression and anxiety were stable and were not significantly influenced by a single study. No publication bias was observed in the included studies reporting depression and anxiety.

CONCLUSION

The physical activity level of college students is negatively correlated with anxiety and depression in China during the pandemic. During the Coronavirus Disease 2019 pandemic, it is necessary to strengthen the construction of university physical education courses. As an organized form of physical activity, physical education classes are a necessary and effective way to increase physical activity among college students.

Association between Body Image Flexibility and Intermittent Fasting in Chinese Medical Students: A Cross-Sectional Study

Unhealthy dietary behaviors and body dissatisfaction are becoming increasingly common among college students. Understanding the association between body image flexibility and intermittent fasting is particularly meaningful, especially for medical college students. This study aimed to investigate the association between body image flexibility and intermittent fasting among medical students. We conducted a cross-sectional study with 5138 medical college students at Jitang College of North China University of Science and Technology. Univariate and multivariate logistic regression were used to evaluate the association between body image flexibility and intermittent fasting. Subgroup analysis and interaction tests were further used to examine the possible interaction between body image flexibility and intermittent fasting. In this study, 1329 (25.87%) students had intermittent fasting behavior. After adjustment for confounding factors, there was a negative association between body image flexibility and intermittent fasting (OR = 0.94, 95%CI = 0.93 to 0.95, p < 0.001). A significant interaction between body image flexibility and intermittent fasting was found in gender, academic year, major, and monthly living expenses (p for interaction < 0.05). E-value analysis suggested there was unlikely to be an unmeasured confounding. This association could contribute to the establishment of personalized health intervention strategies and provide recommendations for promoting the physical and mental health of medical students.

Prevalence and factors associated with anxiety and depression among Chinese prison officers during the prolonged COVID-19 pandemic

Objective

This study examined the prevalence of anxiety and depression-along with the potential risk and protective factors-among Chinese prison officers during the prolonged COVID-19 pandemic.

Method

A cross-sectional survey of 1,268 officers from five prisons in western and southern China was administered between June and July 2022. The questionnaires comprised two sections. In the first section, the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the prevalence of anxiety and depression, respectively, among prison officers. In the second section, the potential influencing factors were examined. Categorical data were compared using χ2 tests and t-tests; binary logistic regression analysis was performed to identify factors associated with anxiety and depression.

Results

The prevalence rates of anxiety and depression among the prison officers were 72.6% and 69.8%, respectively. Risk factors for anxiety were older age, being unmarried, work-family conflicts, job demands, and COVID-19 burnout; protective factors were exercise, positive family relationships, and group cohesion. Work-family conflicts, job demands, intolerance of uncertainty regarding COVID-19, and COVID-19 burnout were risk factors for depression, whereas annual income >150,000 RMB, exercise, positive family relationships, group cohesion, and job autonomy were protective factors against depression.

Conclusion

The prevalence of anxiety and depression among Chinese prison officers was relatively high during the prolonged COVID-19 pandemic, and more targeted measures should be implemented to improve their mental health. This study offers a reference for improving prison officers' mental health in response to similar public health emergencies in the future.