1
|
Huang K, Beckman EM, Ng N, Dingle GA, Han R, James K, Winkler E, Stylianou M, Gomersall SR. Effectiveness of physical activity interventions on undergraduate students' mental health: systematic review and meta-analysis. Health Promot Int 2024; 39:daae054. [PMID: 38916148 PMCID: PMC11196957 DOI: 10.1093/heapro/daae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
This systematic review and meta-analysis assessed the effectiveness of physical activity interventions on undergraduate students' mental health. Seven databases were searched and a total of 59 studies were included. Studies with a comparable control group were meta-analysed, and remaining studies were narratively synthesized. The included studies scored very low GRADE and had a high risk of bias. Meta-analyses indicated physical activity interventions are effective in reducing symptoms of anxiety (n = 20, standardized mean difference (SMD) = -0.88, 95% CI [-1.23, -0.52]), depression (n = 14, SMD = -0.73, 95% CI [-1.00, -0.47]) and stress (n = 10, SMD = -0.61, 95% CI [-0.94, -0.28]); however, there was considerable heterogeneity (anxiety, I2 = 90.29%; depression I2 = 49.66%; stress I2 = 86.97%). The narrative synthesis had mixed findings. Only five studies reported being informed by a behavioural change theory and only 30 reported intervention fidelity. Our review provides evidence supporting the potential of physical activity interventions in enhancing the mental health of undergraduate students. More robust intervention design and implementation are required to better understand the effectiveness of PA interventions on mental health outcomes.
Collapse
Affiliation(s)
- Kevin Huang
- Health and Wellbeing Centre for Research Innovation, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Emma M Beckman
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Norman Ng
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Genevieve A Dingle
- School of Psychology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Rong Han
- School of Psychology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Kari James
- School of Psychology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Elisabeth Winkler
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Sjaan R Gomersall
- Health and Wellbeing Centre for Research Innovation, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland 4072, Australia
| |
Collapse
|
2
|
Dingle GA, Han R, Alhadad SSJ, Beckman E, Bentley SV, Gomersall SR, Hides L, Maccallum F, McKimmie BM, Rossa K, Smith SS, Walter ZC, Williams E, Wright O. Data from four consecutive cohorts of students in Australia (2019-2022) show the impact of the COVID-19 pandemic on domestic and international university students' mental health. Aust N Z J Psychiatry 2024; 58:528-536. [PMID: 38383969 PMCID: PMC11128135 DOI: 10.1177/00048674241233111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
INTRODUCTION COVID-19 and related travel and social restrictions caused significant stress for university students in Australia and globally. Learning quickly moved online and many students (particularly international students) were separated from social and economic support. This study examined the impact of the pandemic from pre-pandemic (2019) to the COVID-19 Omicron wave (2022) on domestic and international students' mental health. METHODS Participants were 1540 students (72% females, 28% international) in four first-year cohorts (2019, 2020, 2021, 2022). We screened for mental health concerns (% positive) and symptom scores for depression, anxiety and somatic distress using the PsyCheck, and general wellbeing using the Warwick-Edinburgh Mental Well-being scale. RESULTS From pre-COVID (2019) to the first wave of COVID-19 (2020), the proportion of students screening positive for mental health problems rose in both domestic students (66-76%) and international students (46-67%). Depression symptoms and wellbeing were worse in 2020 than in 2019, 2021 and 2022. Anxiety symptoms increased from 2019 to 2020 and continued to rise in 2021 and 2022. Somatic symptoms did not show an effect of cohort. Contrary to expectations, domestic students reported higher distress and lower wellbeing than international students across cohorts. CONCLUSION The pandemic was associated with a marked increase in psychological distress in first-year university students, not all of which settled with the easing of restrictions. Post-pandemic recovery in the Australian university sector must include university-wide access to mental health information and support for incoming students.
Collapse
Affiliation(s)
- Genevieve A Dingle
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Rong Han
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Sakinah SJ Alhadad
- School of Education and Professional Studies, Griffith University, Nathan, QLD, Australia
| | - Emma Beckman
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Sarah V Bentley
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Sjaan R Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Leanne Hides
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
- Lives Lived Well Research Group, The University of Queensland, St Lucia, QLD, Australia
| | - Fiona Maccallum
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Blake M McKimmie
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Kalina Rossa
- Institute for Social Science Research, The University of Queensland, St Lucia, QLD, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course, Indooroopilly, QLD, Australia
| | - Simon S Smith
- Institute for Social Science Research, The University of Queensland, St Lucia, QLD, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course, Indooroopilly, QLD, Australia
| | - Zoe C Walter
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Elyse Williams
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Olivia Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia
| |
Collapse
|
3
|
Comotti A, Barnini T, Fattori A, Paladino ME, Riva MA, Bonzini M, Belingheri M. Rethinking students' mental health assessment through GHQ-12: evidence from the IRT approach. BMC Psychol 2024; 12:308. [PMID: 38812050 PMCID: PMC11134724 DOI: 10.1186/s40359-024-01808-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/22/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND The General Health Questionnaire-12 (GHQ-12) is a widely used screening tool for mental health assessment however its traditional scoring methods and cutoffs may not adequately capture the mental health complexities of younger populations. METHODS This study explores GHQ-12 responses from a sample of university students. Possible differences in means scores considering gender, age, academic field and degree course were assessed through t-test or one-way ANOVA as appropriate. To deeper understanding different levels of severity and individual item impact on general distress measurement, we applied Item-Response-Theory (IRT) techniques (two-parameters logistic model). We compared students' population with a population of workers who underwent a similar psychological evaluation. RESULTS A total of 3834 university students participated in the study. Results showed that a significant proportion (79%) of students reported psychological distress. Females and younger students obtained significantly higher average scores compared to others. IRT analysis found item-specific variations in mental distress levels, with more indicative items for short-term fluctuations and potential severe mental health concerns. Latent class analysis identified three distinct subgroups among students (including 20%, 37%, 43% of the participants respectively) with different levels of psychological distress severity. Comparison with a population of adults showed that students reported significantly higher scores with differences in the scale behavior. CONCLUSION Our results highlighted the unique mental health challenges faced by students, suggesting a reevaluation of GHQ-12 applicability and cutoff scores for younger populations, emphasizing the need for accurate instruments in mental health evaluation.
Collapse
Affiliation(s)
- Anna Comotti
- Occupational Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Teresa Barnini
- Occupational Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Fattori
- Occupational Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Emilia Paladino
- Unit of Occupational Health, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Michele Augusto Riva
- Unit of Occupational Health, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Matteo Bonzini
- Occupational Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Michael Belingheri
- Unit of Occupational Health, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| |
Collapse
|
4
|
El Ansari W, Sebena R, El-Ansari K, Suominen S. Clusters of lifestyle behavioral risk factors and their associations with depressive symptoms and stress: evidence from students at a university in Finland. BMC Public Health 2024; 24:1103. [PMID: 38649903 PMCID: PMC11034152 DOI: 10.1186/s12889-024-18421-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 03/23/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND No previous research of university students in Finland assessed lifestyle behavioral risk factors (BRFs), grouped students into clusters, appraised the relationships of the clusters with their mental well-being, whilst controlling for confounders. The current study undertook this task. METHODS Students at the University of Turku (n = 1177, aged 22.96 ± 5.2 years) completed an online questionnaire that tapped information on sociodemographic variables (age, sex, income sufficiency, accommodation during the semester), four BRFs [problematic alcohol consumption, smoking, food consumption habits, moderate-to-vigorous physical activity (MVPA)], as well as depressive symptoms and stress. Two-step cluster analysis of the BRFs using log-likelihood distance measure categorized students into well-defined clusters. Two regression models appraised the associations between cluster membership and depressive symptoms and stress, controlling for sex, income sufficiency and accommodation during the semester. RESULTS Slightly more than half the study participants (56.8%) had always/mostly sufficient income and 33% lived with parents/partner. Cluster analysis of BRFs identified three distinct student clusters, namely Cluster 1 (Healthy Group), Cluster 2 (Smokers), and Cluster 3 (Nonsmokers but Problematic Drinkers). Age, sex and MVPA were not different across the clusters, but Clusters 1 and 3 comprised significantly more respondents with always/mostly sufficient income and lived with their parents/partner during the semester. All members in Clusters 1 and 3 were non-smokers, while all Cluster 2 members comprised occasional/daily smokers. Problematic drinking was significantly different between clusters (Cluster 1 = 0%, Cluster 2 = 54%, Cluster 3 = 100%). Cluster 3 exhibited significantly healthier nutrition habits than both other clusters. Regression analysis showed: (1) males and those with sufficient income were significantly less likely to report depressive symptoms or stress; (2) those living with parents/partner were significantly less likely to experience depressive symptoms; (3) compared to Cluster 1, students in the two other clusters were significantly more likely to report higher depressive symptoms; and (4) only students in Cluster 2 were more likely to report higher stress. CONCLUSIONS BRFs cluster together, however, such clustering is not a clear-cut, all-or-none phenomenon. Students with BRFs consistently exhibited higher levels of depressive symptoms and stress. Educational and motivational interventions should target at-risk individuals including those with insufficient income or living with roommates or alone.
Collapse
Affiliation(s)
- Walid El Ansari
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, 3050, Doha, Qatar
- College of Medicine, Qatar University, 3050, Doha, Qatar
- Department of Population Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Rene Sebena
- Department of Psychology, Faculty of Arts, PJ Safarik University, Kosice, Slovak Republic
| | - Kareem El-Ansari
- Faculty of Medicine, St. George's University, Saint George's, Grenada
| | - Sakari Suominen
- School of Health Sciences, University of Skövde, 541 28, Skövde, Sweden.
- Department of Public Health, University of Turku, Turku, Finland.
- Research Services, The wellbeing services county of Southwest Finland, Turku, Finland.
| |
Collapse
|
5
|
Pointon-Haas J, Waqar L, Upsher R, Foster J, Byrom N, Oates J. A systematic review of peer support interventions for student mental health and well-being in higher education. BJPsych Open 2023; 10:e12. [PMID: 38098123 PMCID: PMC10755562 DOI: 10.1192/bjo.2023.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/06/2023] [Accepted: 09/25/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Higher education institutions (HEIs) are seeking effective ways to address the rising demand for student mental health services. Peer support is widely considered a viable option to increase service capacity; however, there are no agreed definitions of peer support, making it difficult to establish its impact on student mental health and well-being. AIMS This systematic review aims to better understand and evaluate peer support in HEIs. METHOD Five databases, OpenGrey and Grey Matters were searched in May 2021. Included studies were quantitative, longitudinal (with and without a control) or cross-sectional with a control. The vote-counting method was used for synthesis. The risk of bias was assessed with the National Institutes of Health Quality Assessment Tool. RESULTS Three types of peer support were represented in 28 papers: peer-led support groups, peer mentoring and peer learning. Peer learning and peer mentoring had more positive, significant results reported for the outcomes of anxiety and stress. Peer-led support groups were the only type targeting students with mental health difficulties. CONCLUSIONS The heterogeneity of measures and outcomes prevents firm conclusions on the effectiveness of peer support for mental health and well-being. Most studies were rated 'poor' or 'fair' in their risk of bias. There is not a solid evidence base for the effectiveness of peer support. Nonetheless, HEIs can use the terminology developed in this review for shared discussions that guide more robust research and evaluation of peer support as an intervention.
Collapse
Affiliation(s)
- Julia Pointon-Haas
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Luqmaan Waqar
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Rebecca Upsher
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Juliet Foster
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Nicola Byrom
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, UK
| | - Jennifer Oates
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, UK
| |
Collapse
|
6
|
Herselman MF, Bailey S, Deo P, Zhou XF, Gunn KM, Bobrovskaya L. The Effects of Walnuts and Academic Stress on Mental Health, General Well-Being and the Gut Microbiota in a Sample of University Students: A Randomised Clinical Trial. Nutrients 2022; 14:nu14224776. [PMID: 36432461 PMCID: PMC9697272 DOI: 10.3390/nu14224776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Poorer mental health is common in undergraduate students due to academic stress. An interplay between stress and diet exists, with stress influencing food choices. Nutritional interventions may be effective in preventing mental health decline due to complex bidirectional interactions between the brain, the gut and the gut microbiota. Previous studies have shown walnut consumption has a positive effect on mental health. Here, using a randomized clinical trial (Australian New Zealand Clinical Trials Registry, #ACTRN12619000972123), we aimed to investigate the effects of academic stress and daily walnut consumption in university students on mental health, biochemical markers of general health, and the gut microbiota. We found academic stress had a negative impact on self-reported mood and mental health status, while daily walnut consumption improved mental health indicators and protected against some of the negative effects of academic stress on metabolic and stress biomarkers. Academic stress was associated with lower gut microbial diversity in females, which was improved by walnut consumption. The effects of academic stress or walnut consumption in male participants could not be established due to small numbers of participants. Thus, walnut consumption may have a protective effect against some of the negative impacts of academic stress, however sex-dependent mechanisms require further study.
Collapse
Affiliation(s)
- Mauritz F. Herselman
- Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Sheree Bailey
- Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Permal Deo
- Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Xin-Fu Zhou
- Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Kate M. Gunn
- Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia
| | - Larisa Bobrovskaya
- Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
- Correspondence:
| |
Collapse
|