University Students' Perceived Peer Support and Experienced Depressive Symptoms during the COVID-19 Pandemic: The Mediating Role of Emotional Well-Being

Interpersonal Sensitivity and Subjective Well-Being of Migrant Workers' Accompanying Children: Role of Perception of Exclusion and Peer Support

Introduction

To investigate the impact of interpersonal sensitivity on the subjective well-being of accompanying children of migrant workers and the role of perception of exclusion and peer support in the process.

Methods

A questionnaire survey was conducted among 304 migrant workers' accompanying children and 501 urban children in grades 4-9 in seven schools in Jiangxi Province, China. Hierarchical regression and bootstrap analysis were used.

Results

Interpersonal sensitivity not only had a significant direct negative effect on the subjective well-being of migrant workers' accompanying children (β= -0.27, 95% CI = [-0.37, -0.17]), but also had an indirect effect through perception of exclusion (β= -0.06, 95% CI = [-0.11, -0.03]). Peer support negatively moderated the relationship between interpersonal sensitivity and perception of exclusion (β= -0.18, 95% CI = [-0.28, -0.08]) and the mediating effect of perceptions of exclusion between interpersonal sensitivity and subjective well-being (β = 0.06, CI = [0.02, 0.11]).

Conclusion

The subjective well-being of migrant children is indeed lower than that of urban children, and one of the most important reasons is their higher interpersonal sensitivity. Interpersonal sensitivity not only directly reduces their subjective well-being, but also reduces it by triggering their perception of exclusion, while peer support can effectively mitigate this negative effect. Therefore, one way to improve the subjective well-being of these children is to reduce their excessive interpersonal sensitivity. Their parents should help them to adapt to urban life, to develop correct professional values and to deal correctly with "occupational stigma", to overcome feelings of inferiority, while communities can create specialized activity centers to provide more social opportunities and psychological counseling services for these children.

Changes in mental health among Chinese university students before and during campus lockdowns due to the COVID-19 pandemic: a three-wave longitudinal study

The campus lockdown due to the COVID-19 pandemic has adversely affected mental health among university students. However, the heterogeneity in responses to campus lockdown is still poorly known. We collected three-wave prospective data on university students' mental health in Shanghai, China, in 2022: (i) in February before the pandemic; (ii) in April at the initial COVID-19 campus lockdown; and (iii) in May amidst the citywide lockdown. Overall, 205 university students completed sociodemographic questionnaires, the General Health Questionnaire-12 items (GHQ-12), and the Depression, Anxiety and Stress Scale-21 items (DASS-21). Generalized estimating equations were used to examine the longitudinal changes in mental health and symptoms of depression, anxiety, and stress. Latent class mixed models (LCMM) were constructed to identify distinct trajectories. Multinomial regression models were used to identify factors associated with status variation patterns. Mean GHQ-12 scores were 8.49, 9.66, and 11.26 at pre-pandemic and lockdown T1 and T2, respectively (p < 0.001). Mean scores for depression, anxiety, and stress were (5.96, 10.36, and 8.06, p < 0.001), (7.13, 6.67, and 7.16, p = 0.243), and (9.83, 7.28, and 11.43, p < 0.001), respectively. Changing trends of numbers of participants with clinical symptoms were consistent with those of mean scores. LCMM fitted three distinct trajectory classes, respectively, for GHQ-12, depression and anxiety symptoms, and four classes for stress symptoms. Participants with fair or poor peer relationships were more likely to belong to vulnerable trajectories concerning depression, anxiety, and stress symptoms. This study proves heterogeneity in mental health of university students in response to pandemic campus lockdown and highlights the necessity for identifying vulnerable groups to provide targeted support in future pandemics.

Profiles and predictors of mental health of university students in Hong Kong under the COVID-19 pandemic

This study investigated the mental health problems of university students in Hong Kong and related sociodemographic and psychosocial predictors under the pandemic. A total of 978 undergraduate students (mean age = 20.69 ± 1.61) completed an online questionnaire measuring sociodemographic factors, psychological morbidity, positive well-being, COVID-19 related stress and self-efficacy, and positive psychosocial attributes. Psychosocial risk factors included psychological morbidity, COVID-19 related stress, and difficulties encountered under the pandemic, whereas protective factors comprised pandemic related self-efficacy, positive psychological attributes, positive environmental factors, need satisfaction and positive perception toward service. Results showed that psychological morbidity in the participants was widespread, and it was related to sociodemographic factors, particularly family financial difficulties. While pandemic related stress positively predicted psychological morbidity and negatively predicted well-being indicators, COVID-19 self-efficacy showed an opposite effect. Besides, positive psychological attributes (resilience, emotional competence, and positive beliefs related to adversity) and environmental factors (healthy family functioning, peer support, and supportive community atmosphere) negatively predicted psychological morbidity and positively predicted well-being. Furthermore, need satisfaction and positive perception toward service were negatively associated with psychological morbidity and positively associated with well-being, while perceived difficulties showed an opposite effect.

The Mediating Roles of Future Work Self and Hope on the Association Between Perceived Social Support and Depressive Symptoms Among Chinese Vocational School Students: A Cross-Sectional Study

Purpose

Depressive symptoms are serious mental health problems, which are harmful for adolescents' physical and psychological development. Limited studies have focused on depressive symptoms of vocational high school students, who are more susceptible to mental health problems than high school students. Based on the main effect model of social support and self-regulation theory, the current study aims at exploring two potential mediating roles of hope and future work self on the relationship between perceived social support and depressive symptoms among vocational high school students by a cross-sectional study.

Participants and Methods

A total of 521 vocational high school students aged 14-21 (M= 16.45; SD= 0.91) participated in the survey. There were 266 males (51.1%) and 255 females (48.9%). The multidimensional scale of perceived social support, the future work self scale, the children's hope scale, and the center for epidemiologic studies depression scale were applied in the study.

Results

The results revealed that: (1) perceived social support, future work self, and hope were negatively related to depressive symptoms (r = -0.25 to -0.35, p < 0.001); (2) students who perceived more social support have fewer depressive symptoms (β = -0.22, p < 0.001); (3) perceived social support predicted a more salient future work self and then was associated with higher levels of hope, which in turn, was related to lower levels of depressive symptoms (β = -0.02, and 95% CI = [-0.035, -0.005]).

Conclusion

Perceived social support was the protective factor against vocational school students' depressive symptoms. More specifically, stronger perceived social support predicted a more salient future work self, which promoted high level of hope, and ultimately decreased vocational school students' depressive symptoms. The findings provide enlighten implications for interventions on depressive symptoms among vocational high school students.

Effects of mindfulness on stress, life satisfaction, and savoring beliefs among Hong Kong Chinese adolescents during the COVID-19 pandemic

Adolescents all over the world are vulnerable in facing developmental challenges. Recent studies have evidenced that the unexpected interruptions of school learning during the COVID-19 pandemic have raised concerns about the well-being of adolescents. This present study sought to investigate the relationship between mindfulness, stress, savoring beliefs, and satisfaction of life among adolescents in Hong Kong during COVID-19. A total of 240 Hong Kong Chinese adolescents between 15 and 19 years of age (M = 15.60; SD = 0.70) from schools with different religious backgrounds completed an online survey. Findings from hierarchical linear regression indicated that statistically, mindfulness negatively predicted stress and positively predicted life satisfaction and savoring beliefs. Students with faiths did not show any significant differences in mindfulness and other variables in this study from students without faiths. In terms of implications, these findings provide positive evidence that mindfulness may be an important aspect for interventions designed to enhance life satisfaction and savoring beliefs, and reduce stress of adolescents over challenging times. Overall, this study suggests youth service providers to develop effective strategies in schools and communities for further promoting wellbeing and resilience of adolescents.

Incidence, Risk Factors, and Consequences of Post-Traumatic Stress Disorder Symptoms in Survivors of COVID-19-Related ARDS

Purpose: To assess the prevalence of symptoms of Post-Traumatic Stress Disorder (PTSD) in survivors of COVID-19 Acute Respiratory Distress Syndrome that needed ICU care; to investigate risk factors and their impact on the Health-Related Quality of life (HR-QoL). Materials and Methods: This multicenter, prospective, observational study included all patients who were discharged from the ICU. Patients were administered the European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire, the Short-Form Health Survey 36Version 2 (SF-36v2), a socioeconomic question set and the Impact of Event Scale-Revised (IES-R) to assess PTSD. Results: The multivariate logistic regression model found that an International Standard Classification of Education Score (ISCED) higher than 2 (OR 3.42 (95% CI 1.28-9.85)), monthly income less than EUR 1500 (OR 0.36 (95% CI 0.13-0.97)), and more than two comorbidities (OR 4.62 (95% CI 1.33-16.88)) are risk factors for developing PTSD symptoms. Patients with PTSD symptoms are more likely to present a worsening in their quality of life as assessed by EQ-5D-5L and SF-36 scales. Conclusion: The main factors associated with the development of PTSD-related symptoms were a higher education level, a lower monthly income, and more than two comorbidities. Patients who developed symptoms of PTSD reported a significantly lower Health-Related Quality of life as compared to patients without PTSD. Future research areas should be oriented toward recognizing potential psychosocial and psychopathological variables capable of influencing the quality of life of patients discharged from the intensive care unit to better recognize the prognosis and longtime effects of diseases.

Revival of positive nostalgic music during the first Covid-19 lockdown in the UK: evidence from Spotify streaming data

This work shows that positive old music listening surged during the early phase of the Covid-19 pandemic, suggesting a rise in preference for nostalgia and positivity in music. Using the music streaming data of Spotify users in the UK and employing multivariate regression analysis, this work documents that users were more likely to listen to songs older than 5 years during the national lockdown that began in late March 2020 compared with the pre-lockdown period. Such a change in preference was not observed in the same period in 2019. Meanwhile, more frequent listening to old music is found in samples of positive songs and also negative songs. This suggests that the preference for nostalgic music is to a certain extent independent of the positivity bias during the pandemic found in the literature. Yet, this work also provides evidence that the nostalgia-seeking behaviour and the preference for positive songs reinforced each other during the lockdown as the surge in positive old music was more persistent than that in positive recent music.

Brief repeated virtual nature contact for three weeks boosts university students' nature connectedness and psychological and physiological health during the COVID-19 pandemic: A pilot study

The COVID-19 pandemic and its associated uncertainties and restrictions have adverse impacts on university students' mental wellbeing. Evidence shows that virtual nature contact has mental health benefits. However, little is known about the potential beneficial health impacts of virtual nature contact during times of social distancing, when access to the natural environment is restricted. This pilot study aimed to examine the effectiveness of a 3-week virtual nature contact in improving nature connectedness and reducing psychophysiological stress. A sample of 56 university students in Hong Kong was randomly assigned to control and nature interventions using 2-D video played for 15 min three times a week for 3 weeks. Nature connectedness, perceived restorativeness and psycho-physiological wellbeing were measured. Our findings show significant changes in psychological stress levels after nature interventions compared with the baseline, including increased happiness and stronger emotions of comfort and relaxation. When compared with the control group, the results show the nature intervention group has significantly higher levels of nature connectedness, happiness, and positive affect, but no significant effects on other psychological and physiological variables (e.g., cardiovascular responses). Our preliminary findings highlight the potential use of virtual nature contacts in bolstering university students' wellbeing at times of pandemic or when in-person visit to the natural environment is not feasible.

Assessing Anxiety and Depression Among Students Post-COVID-19: Exploring Associating Factors

Background

The COVID-19 pandemic has had a large impact on global mental health including anxiety and depression rates, many factors affected the vulnerability to these psychological conditions amongst university students.

Aim

To explore the level of anxiety and depression of university students living in Jordan.

Methods

A cross-sectional study design was conducted in which an electronic survey was created and distributed, university students residing in Jordan participated in the study.

Results

A total of 1241 students were enrolled in the study. The mean anxiety score among males and females was (9.68 (SD = 4.10)) and (10.46 (SD = 4.14)), respectively. 42.1% of males had "abnormal" anxiety score compared to 48.4% females. The mean depression score among males (7.77 (SD = 4.31)) was similar to that for the females (7.64 (SD = 4.14)), and 26.0% of the males had "abnormal" depression score compared to 22.6% of the females. Factors affecting anxiety scores included younger age, being a female, taking medication/s, or drinking two cups of coffee or more a day.

Conclusion

With 46% and 24% of students suffering from abnormal anxiety and depression respectively, it is important for education policy makers to take immediate measures to allocate students in need of psychological assessment and help to deliver suitable interventions.

Mothers' and fathers' stress and severity of depressive symptoms during the COVID-19 pandemic: actor-partner effects with parental negative emotions as a moderator

BACKGROUND

In the face of the coronavirus disease 2019 (COVID-19) pandemic, families with young children are bombarded with new challenges and stressors. This study examined the additive and interactive effects of parental stress and negative emotions during COVID-19 on parents' severity of depressive symptoms.

METHODS

Participants were 221 Chinese families involving maritally intact mothers and fathers of preschool-aged children.

DISCUSSION

Path analysis indicated that mothers' parental stress interacted with their negative emotions, such that their stress was related to their severity of depressive symptoms only when negative emotions were high. By comparison, fathers' stress and negative emotions were additively associated with their severity of depressive symptoms. Supporting the cumulative risk model, parental stress during COVID-19 and negative emotions were linked to parents' severity of depressive symptoms additively or interactively, depending on the gender of the parent. These findings inform practitioners about the relevance of parents' stress and negative emotions to their severity of depressive symptoms during the pandemic.

Linking University Students' Mindfulness to Positive Adjustment Amidst COVID-19 Pandemic: a 6-month Cross-Lagged Panel Design

Objectives

In the face of a global pandemic, research on wellness-fostering resources is urgently needed, especially with longitudinal designs and diverse samples. According to the mindfulness-to-meaning theory and broaden-and-build theory, this study examined the reciprocal associations among a group of Chinese university students' trait mindfulness, positive and negative affect, and use of positive coping strategies, including positive reappraisal, planning, and seeking of emotional support during the COVID-19 pandemic.

Methods

Participants were 247 Hong Kong university students (M _age = 20.96, SD = 2.38; female = 86%) who completed survey measures of mindfulness, positive and negative affect, and positive coping strategies at baseline and 6-month follow-up. Data were analysed using a cross-lagged panel design, controlling for participants' age.

Results

The proposed reciprocal model exhibited an excellent fit with the data. There was a reciprocal association between trait mindfulness and positive affect over time. However, no significant reciprocal effect was found among mindfulness, negative affect, and positive coping strategies.

Conclusions

Theoretically, the current findings extended the two theories to a non-Western population during a critical time and suggested a long-term reciprocal association between positive affect and mindfulness. Our study provided important insight into university students' positive well-being during COVID-19 and demonstrated the wellness-fostering effect of mindfulness.

Mining voices from self-expressed messages on social-media: Diagnostics of mental distress during COVID-19

The COVID-19 pandemic has had a severe impact on mankind, causing physical suffering and deaths across the globe. Even those who have not contracted the virus have experienced its far-reaching impacts, particularly on their mental health. The increased incidences of psychological problems, anxiety associated with the infection, social restrictions, economic downturn, etc., are likely to aggravate with the virus spread and leave a longer impact on humankind. These reasons in aggregation have raised concerns on mental health and created a need to identify novel precursors of depression and suicidal tendencies during COVID-19. Identifying factors affecting mental health and causing suicidal ideation is of paramount importance for timely intervention and suicide prevention. This study, thus, bridges this gap by utilizing computational intelligence and Natural Language Processing (NLP) to unveil the factors underlying mental health issues. We observed that the pandemic and subsequent lockdown anxiety emerged as significant factors leading to poor mental health outcomes after the onset of COVID-19. Consistent with previous works, we found that psychological disorders have remained pre-eminent. Interestingly, financial burden was found to cause suicidal ideation before the pandemic, while it led to higher odds of depressive (non-suicidal) thoughts for individuals who lost their jobs. This study offers significant implications for health policy makers, governments, psychiatric practitioners, and psychologists.

Explaining individual differences in cognitive performance: The role of anxiety, social support and living arrangements during COVID-19

The present study investigated the relationship between anxiety, social support, living arrangements and cognitive performance of university students during the global pandemic. Two hundred and fifteen students participated by completing online questionnaires. Separate moderated multiple regression models were used to test whether social support (Family, Friends, Significant Other subscales of the Multidimensional Scale of Perceived Social Support) moderated the relationship between anxiety (Anxiety subscale of Depression, Anxiety Stress Scale), living arrangements (Living Alone vs Living with Friends and Family) and cognitive performance (Cognitive Failures Questionnaire), after controlling for comorbid depression. The results for each level of perceived social support suggested that anxiety was negatively associated with cognitive performance. Our most significant finding was that for students living alone, social support from a significant other offered a protective factor, whereby buffering the anxiety related cognitive deficits prevalent in those who reported lower social support. These data have important practical implications for supporting the social-emotional and academic needs of university students during the global pandemic.

Mental Health, Support System, and Perceived Usefulness of Support in University Students in Hong Kong Amidst COVID-19 Pandemic: A Mixed-Method Survey

BACKGROUND

This study explored the association of students' mental health with their support system, identified the preferred ways and sources of support, investigated the perceived usefulness of available university support, and recommended actionable strategies to enhance students' mental health.

METHOD

An online questionnaire survey and semi-structured focus group interviews were conducted in 2021.

RESULTS

Among 1121 university students, 39.4% reported anxiety symptoms, which were less common in Chinese students and those pursuing medical and health programmes. Overall, 32.6% reported depression symptoms, which were more common in undergraduates. Both anxiety and depression symptoms were less common in students with higher resilience and support system and more common in students with family distress. Students with higher resilience had a better support system and less family distress. Perceived support from universities was lower than from peers and families. Peer support and phone contacts were the most preferred sources and ways of support. The most useful available university support was updated university guidelines, and the least useful was the emotional hotline service from universities The qualitative findings corroborated the quantitative results.

CONCLUSION

We suggested that a holistic care approach and more proactive student-oriented university support would help students face adversity and enhance mental health.

Resilience, Social Support, Loneliness and Quality of Life during COVID-19 Pandemic: A Structural Equation Model

AIM

To determine the parsimonious model of the interrelationships of personal resilience, social support, loneliness and quality of life (QoL) and to identify the mediating effect of loneliness among nursing students amidst the pandemic.

BACKGROUND

The coronavirus 2019 (COVID-19) pandemic led to control measures which increased loneliness among students due to disrupted social connections and sudden shift to virtual learning. During these changes, resilience and social support can significantly influence how learners deal with pandemic-related stresses thus, minimizing loneliness and enhancing QoL. Although studies posited the influence of resilience and social support with loneliness and QoL, these were conducted prior the COVID-19 pandemic wherein loneliness and feelings of isolation play a crucial part.

DESIGN

Correlational, theory testing using covariance-based structural equation modeling METHODS: A total of 550 nursing students from a comprehensive university in Manila, Philippines were recruited from September to October 2021 and answered four standardized, validated scales.

RESULTS

A good and parsimonious model (x2/df = 2.84, RMSEA = 0.058, GFI = 0.999, CFI = 0.999, PNFI = 0.048) highlighted the mediating effect of loneliness between social support, personal resilience and QoL. While personal resilience positively influenced the physical and psychological domains of QoL, social support positively affected the social relationships and environmental domains. Loneliness was a strong, negative predictor of the psychological and social domains of QoL and had a moderate, negative effect on the physical domain. Personal resilience also mediated the influence of social support on loneliness and QoL.

CONCLUSION

Social support and personal resilience positively affected QoL, while loneliness had a negative effect. Through the mediation of loneliness, the effects of social support on QoL decreases. However, the mediation of resilience further decreases loneliness and improves QoL. The presented model assists nurse educators and administrators in developing strategies to enhance social support, resilience and QoL among students while mitigating the negative effects loneliness during the pandemic.

TWEETABLE ABSTRACT

Loneliness and Resilience are mediators of student nurses' quality of life during COVID-19 pandemic. Social support is the common predictor.

Multivariate Analysis on Physical Activity, Emotional and Health Status of University Students Caused by COVID-19 Confinement

Confinement as a result of COVID-19 had a strong impact around the world and restricted mobility. The university community started to take routine classes in a virtual and sedentary way, causing negative effects on their health and habits. The objective of this research is to analyze the impact of confinement through surveys of students and interviews with university professors, in order to study the effects of confinement on physical activity, emotional state, and health. The methodology was as follows: (i) preliminary data; (ii) survey development, interviews, and information collection; (iii) data processing and multivariate presentation of the results, using multiple correspondence analysis (MCA) and multiple factor analysis (MFA). The results of 375 respondents show that there is a low level of physical activity (<300 METs, 49.6%), where women register sedentary behavior (73%). Emotionally, most of them show feeling bored. Some express anxiety, depression, discomfort, and frustration. In terms of health, there are rheumatic, circulatory, respiratory, and other diseases related to obesity. It is essential to create programs that promote physical exercise to reduce the consequences of sedentary lifestyles on the physical, social, and mental health of university students, especially engineering students, who experienced greater effects of confinement than those studying nutrition and social sciences.

Coping, COVID knowledge, communication, and HBCU student's emotional well-being: Mediating role of perceived control and social connectedness

The pandemic has disproportionately affected African American college students, who have experienced significant work-related, academic, financial, and socio-emotional challenges due to COVID-19. The purpose of the study is to investigate how African American students cope with the severe impact of COVID-19 on their emotional well-being leveraging the benefits of self-care coping measures, COVID-19 knowledge, and communication with others to enhance perceived control and social connectedness. A structural equation modeling and a path analysis of 254 responses from a Historically Black College and University showed that emotional well-being was positively predicted by self-care coping strategies, feelings of being in control in life, and social connectedness. In addition, respondents who adopted mind-body balance coping strategies, those who are knowledgeable about COVID-19, and those in more constant communication with others attained a strong sense of being in control, and in turn the empowerment increased their emotional well-being.

Exploring the Psychological Impacts of COVID-19 Social Restrictions on International University Students: A Qualitative Study

The global COVID-19 pandemic has impacted on the mental well-being of university students, but little attention has been given to international students, who may have a unique experience and perspective. The aim of this study was to explore the views of international students and university staff towards COVID-19 restrictions, self-isolation, their well-being, and support needs, through eight online focus groups with international students (n = 29) and semi-structured interviews with university staff (n = 17) at a higher education institution in England. Data were analysed using an inductive thematic approach, revealing three key themes and six subthemes: (1) practical, academic, and psychological challenges faced during self-isolation and the COVID-19 pandemic; (2) coping strategies to self-isolation and life during the pandemic; and (3) views on further support needed for international students. International students faced practical, academic, and psychological challenges during the COVID-19 pandemic, particularly relating to the rapid transition to online learning and the impact of social restrictions on integration with peers and well-being. Online social connections with peers, family, or new acquaintances reduced feelings of isolation and encouraged involvement in university life. Despite raising mental health concerns, most international students did not access mental health support services. Staff related this to perceived stigma around mental health in certain cultural groups. In conclusion, international students experienced specific practical and emotional challenges during the pandemic, and are at risk of mental ill-health, but may not actively seek out support from university services. Proactive and personalised approaches to student support will be important for positive student experiences and the retention of students who are studying abroad in the UK higher education system.

Interventions in Chinese Undergraduate Students' Mental Health: Systematic Review

BACKGROUND

Over 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students' mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being.

OBJECTIVE

The aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students' affairs counselors, and mental health providers.

METHODS

We performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis.

RESULTS

We retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students' affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers.

CONCLUSIONS

This was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students' mental health is a research topic worth further investigation.

Uncertainty and psychological distress during COVID-19: What about protective factors?

The present study examined the relationship between perceived uncertainty and depression/ anxiety symptoms during the COVID-19 pandemic and it tested the moderating roles of resilience and perceived social support in this relationship. A cross-sectional study was conducted between March 31st and May 15th, 2020, using an online, multi-language, international survey built within Qualtrics. We collected data on sociodemographic features, perceived uncertainty, perceived social support, depression and anxiety symptoms, and resilience. A moderation model was tested using model 2 of Hayes' PROCESS macro for SPSS. The study included 3786 respondents from 94 different countries, 47.7% of whom reported residence in the United States of America. Results demonstrated that higher perceived uncertainty was associated with more symptoms of depression and anxiety. Higher resilience levels and higher perceived social support were associated with fewer depression and anxiety symptoms. The moderation hypotheses were supported; the relationship between uncertainty and symptoms of depression and anxiety decreased as levels of resilience increased and as perceived social support increased. The results suggest that resilience and social support could be helpful targets to reduce the negative effects of uncertainty on depression and anxiety symptoms.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03244-2.

Getting Through the Crisis Together: Do Friendships Contribute to University Students' Resilience During the COVID-19 Pandemic?

Social contacts and social support represent resources that contribute to resilience. However, the COVID-19 pandemic and the associated measures, including contact restrictions, posed challenges for young adults' social networks, in particular for their friendships. Employing a mixed-method approach, we investigated the pandemic's effects on friendships and their role in successfully navigating the crisis. We combined a qualitative approach based on narratives and in-depth interviews and a quantitative approach based on online surveys focusing on university students in Austria. Longitudinal data collections allowed investigating changes and developments as the pandemic progressed. Results indicate profound challenges for participants' friendships and difficulties in both building new and maintaining existing friendships. This also impaired the provision of social support by friends, scattering participants' social resources and diminishing their resilience rather than strengthening it. Altogether, the results of this longitudinal study suggest a lasting negative effect of the pandemic on friendships for students.

Cost-effectiveness of internet-supported cognitive behavioral therapy for university students with anxiety symptoms: A Markov-model analysis

Background and aim

High prevalence of anxiety symptoms has been reported globally in the university students. Cognitive behavioral therapy (CBT) is the recognized treatment for anxiety and is traditionally conducted face-to-face (f-CBT). The efficacy of internet-based CBT (i-CBT) for anxiety has been extensively studied, yet evidence on its cost-effectiveness is scarce. We aimed to evaluate the cost-effectiveness of guided low-intensity i-CBT for university students with mild anxiety symptoms from the societal perspective of Hong Kong.

Methods

A 5-year Markov model was designed to compare outcomes of guided i-CBT and f-CBT in a hypothetical cohort of university students with mild anxiety symptoms. Model inputs of cost and healthcare resources associated with anxiety were retrospectively collected from a cohort of university students with anxiety symptoms. Clinical and utility model inputs were retrieved from published literature. Model outcome measures were anxiety-related total cost (including direct medical and indirect costs) and quality-adjusted life-year (QALY). Sensitivity analyses were performed to examine the robustness of base-case results.

Results

In base-case analysis, i-CBT gained higher QALYs (2.9956 versus 2.9917) at lower total cost (US$6,101 versus US$6,246) than f-CBT. In one-way sensitivity analysis, the QALY gained by i-CBT was sensitive to the relative patient acceptance and adherence to CBT. In probabilistic sensitivity analysis, i-CBT was cost-effective in 90.9% of the time at the willingness-to-pay threshold of 138,210 per QALY (3× GDP per capita in Hong Kong). The probability of i-CBT to be cost-effective was 99.9% at a willingness-to-pay threshold of zero.

Conclusions

Guided i-CBT appears to be cost-saving and effective for management of university students with mild symptoms of anxiety from the societal perspective of Hong Kong. The cost-effectiveness of i-CBT is highly subject to the individual acceptance and adherence of CBT delivered by the internet platform.

Pandemic-related experiences, mental health symptoms, substance use, and relationship conflict among older adolescents and young adults from Manitoba, Canada

There is growing awareness of the negative impact of the COVID-19 pandemic on young people. The purpose of this study was to examine older adolescents' and young adults' pandemic-related experiences, including financial difficulties, emotional support, social connections, mental health symptoms, substance use, and relationship conflict. Data from the Well-being and Experiences Study (The WE Study) were gathered from November to December 2020 in Manitoba, Canada, among a community sample (n = 664; ages 16-21 years). Over half of the sample self-reported increased stress/anxiety (57.6%) and depression (54.2%) attributed to the pandemic. Increased alcohol consumption was reported by 18.2% of alcohol-users. Among cannabis-users, 35.1% reported increased use. Conflict with parents, siblings, and an intimate partner increased for 19.9%, 15.2%, and 24.0% of respondents, respectively. Females reported greater financial burden, mental health burden, and conflict with parents than males. Young adults reported greater financial and mental health burden than older adolescents. Higher household income was protective of some experiences. The current study adds to growing evidence that young people were adversely impacted by the COVID-19 pandemic. Increased access to virtual support resources is needed and should continue following the pandemic. Evidence-based interventions may need to be tailored to females and young adults.

Psychological Well-being and Coping Strategies of Healthcare Students during the Prolonged COVID-19 Pandemic

Background

This study aimed to investigate the psychological well-being, and stress coping strategies, as well as their relationships, among healthcare students during prolonged COVID-19 pandemic.

Methods

An online questionnaire was used to assess psychological well-being (the Ryff Scale) and coping strategies (the brief Coping Orientation to Problems Experienced Inventory [COPE] Scale). COPE scores were categorized to identify the primary coping strategies: “approach” indicates more active coping strategies; “avoidant” indicates more dysfunctional and maladaptive mechanisms.

Results

A total of 202 valid questionnaire were collected. Those with lower academic confidence and lower self-rated peer and family relationship scores during the COVID-19 pandemic had lower Ryff scores, indicating poorer psychological well-being. Nursing students reported the lowest psychological well-being and the highest levels of adopting avoidant coping strategies (26.4%).

Conclusion

The study's findings may help educators identify the healthcare students most vulnerable to stress and develop interventions to empower students to adopt problem-focused stress coping strategies.

Being Hopeful and Mindful During Adversity: A Longitudinal Study on College Students’ Adjustment During COVID-19

Objectives

The current study examined whether hope and mindfulness were associated with changes in two maladjustment measures, internalizing and externalizing behaviors, during the COVID-19 pandemic and tested sense of coherence as a mediator. The salutogenic theory of health, which posits that sense of coherence is central to individuals’ well-being in stressful situations and that individuals derive their sense of coherence from their generalized resistance resources (GRRs), was used to guide the analyses.

Methods

On two occasions separated by about 6 months, 253 Hong Kong college students (mean age = 21.0 years at time 1; 86% of them were women) filled in online questionnaires during the COVID-19 outbreaks. Path analysis was conducted to examine the interrelationships among hope and mindfulness, sense of coherence, and internalizing and externalizing behaviors.

Results

Results indicated that hope and mindfulness at time 1 were associated with internalizing and externalizing behaviors at time 2, even after controlling for confounding variables and prior levels of internalizing and externalizing behaviors. Moreover, sense of coherence at time 1 significantly mediated these associations.

Conclusions

Findings pointed to the potential roles of hope, mindfulness, and sense of coherence in understanding Chinese college students’ adjustment during the COVID-19 pandemic. Future research is needed to test whether sense of coherence and behavioral adjustment can be promoted through hope- and mindfulness-based intervention programs. Future research is also needed to examine the interrelationships among health-promoting assets, sense of coherence, and individual adjustment in samples of diverse cultural backgrounds.

Subjective well-being among AIDS orphans in southwest China: the role of school connectedness, peer support, and resilience

BACKGROUND

Few studies have explored the health and development of AIDS orphans using the positive youth development (PYD) framework. Grounded in this framework, the main objective of this study is to examine how internal assets (i.e., resilience) and external assets (i.e., school connectedness, peer support) affect subjective well-being among Yi AIDS orphans in the Liangshan Yi Autonomous Prefecture, Sichuan province, China.

METHODS

A cross-sectional survey was conducted by interviewing 571 AIDS orphans and 979 non-orphans of Yi ethnic minority from 5th-10th grades. Structural equation models (SEM) were utilized to identify and estimate the direct and indirect effects of internal and external assets on subjective well-being.

RESULTS

The average score of subjective well-being was significantly lower for AIDS orphans than for in non-orphans (P < 0.05). Resilience, school connectedness, peer support (number of friends, caring friends), and self-rated physical health had significant and positive direct effects on subjective well-being. In addition, the effects of school connectedness, and peer support on subjective well-being were mediated by resilience.

CONCLUSIONS

Positive individual and school-related contextual assets can bolster subjective well-being among AIDS orphans. The design of health intervention programs for AIDS orphans should incorporate these positive development assets.

The mental health of university students during the COVID-19 pandemic: An online survey in the UK

Higher education students’ mental health has been a growing concern in recent years even before the COVID-19 pandemic. The stresses and restrictions associated with the pandemic have put university students at greater risk of developing mental health issues, which may significantly impair their academic success, social interactions and their future career and personal opportunities. This paper aimed to understand the mental health status of University students at an early stage in the pandemic and to investigate factors associated with higher levels of distress. An online survey including demographics, lifestyle/living situations, brief mental well-being history, questions relating to COVID-19 and standardised measures of depression, anxiety, resilience and quality of life was completed by 1173 students at one University in the North of England. We found high levels of anxiety and depression, with more than 50% experiencing levels above the clinical cut offs, and females scoring significantly higher than males. The survey also suggested relatively low levels of resilience which we attribute to restrictions and isolation which reduced the opportunities to engage in helpful coping strategies and activities rather than enduring personality characteristics. Higher levels of distress were associated with lower levels of exercising, higher levels of tobacco use, and a number of life events associated with the pandemic and lockdown, such as cancelled events, worsening in personal relationships and financial concerns. We discuss the importance of longer-term monitoring and mental health support for university students.

How Children and Adolescents Perceive Their Coping With Home Learning in Times of COVID-19: A Mixed Method Approach

With the COVID-19 pandemic, children and adolescents confronted a completely new learning situation. Instead of learning in class, they had to cope with home learning to achieve academically. This mixed-method study examines how children and adolescents in Germany perceive their coping success with home learning during the COVID-19 pandemic and how personal, school, family, and peer context factors relate to this self-perceived coping success. Quantitative data from an online survey of n=141 children (m_age=10,8y) and n=266 adolescents (m_age=15,2y; study 1) were used to analyze the questions with multiple regression analysis. With the qualitative data from 10 interviews with parents and their children (study 2), we examined the process of how school, family, and peer groups interact with students’ way of coping with home learning. Quantitative data show that most children and adolescents perceived their coping with home learning as successful and that school joy before COVID-19, parental support, and available equipment during home learning are still relevant for children, and family climate, calm place to learn, and equipment during home learning are important for adolescents learning at home. Qualitative data show that students apply individual ways of coping with home learning, where family and peers have a vital role, especially when contact with teachers is limited. Quantitative data confirm the importance of family context for students’ self-perceived coping success.

New Insights on the Mediating Role of Emotional Intelligence and Social Support on University Students' Mental Health during COVID-19 Pandemic: Gender Matters

Due to the demanding changes caused in the population by the COVID-19 pandemic, including a persisting experience of fear and social isolation, multiple studies have focused on the protective role of several psychological characteristics on mental health. Emotional intelligence and social support are commonly linked to mental health and well-being. The present study aims to analyze the mediator role of emotional intelligence and social support on university students’ mental health, taking into consideration the role of gender differences. An online questionnaire was administered to a sample of 923 university students during the COVID-19 lockdown in Portugal. Significant gender differences were found on mental health symptoms, emotional intelligence, and social support. A double mediation model was computed to verify if gender influences on mental health were mediated by emotional intelligence and social support. The results show indirect effects of gender on mental health. However, as both mediators mediate in the opposite direction, the total indirect effects become null. Thus, a strong direct effect of gender on mental health remains. The results of the present study have theoretical implications on protective factors of mental health by gender and practical implications for psychological intervention in university counselling services.

Association Between Online Self-Directed Learning Ability and Negative Emotions Among College Students During the COVID-19 Pandemic: A Cross-Sectional Study in Anhui Province, East China

Background: This study investigated the correlation between depression, anxiety, and stress among college students engaged in online learning during the coronavirus disease 2019 (COVID-19) pandemic and self-directed learning (SDL) ability, which could provide a scientific basis for mental health education of the college students. Methods: A cross-sectional study was conducted among 5,558 students from two universities in Anhui province, East China. The Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Self-directed Learning Ability Scale were used to conduct an online questionnaire survey. Results: A total of 35.15, 36.32, and 17.24% of college students reported symptoms of depression, anxiety, and stress, respectively. Males and nonmedical students were at higher risks to suffer from depression, anxiety, and stress. In adjusted model, compared with Q1 of self-management ability, the odds ratio (OR) of the Q2, Q3, and Q4 were as follows: 0.635 (0.531-0.759), 0.504 (0.415-0.611), and 0.312 (0.248-0.392) for depression; 0.639 (0.535-0.764), 0.653 (0.540-0.789), and 0.421 (0.338-0.525) for anxiety; and 0.649 (0.523-0.805), 0.579 (0.457-0.733), and 0.482 (0.364-0.637) for stress. For information capability, decrease in risk was even more pronounced: Q2 (0.654, 0.540-0.794), Q3 (0.560, 0.454-0.690), and Q4 (0.233, 0.181-0.301) for depression; Q2 (0.781, 0.646-0.945), Q3 (0.616, 0.501-0.757), and Q4 (0.276, 0.216-0.353) for anxiety; and Q2 (0.444, 0.357-0.553), Q3 (0.454, 0.357-0.578), and Q4 (0.272, 0.202-0.368) for stress. Compared with the Q2 group of cooperation learning ability, cooperation learning ability quartiles were positively associated with depression (Q1: 1.382, 95% CI: 1.138-1.678), anxiety (Q4: 1.260, 95% CI: 1.008-1.576), and stress (Q1: 2.002, 95% CI: 1.583-2.532; Q3: 1.600, 95% CI: 1.252-2.044; Q4: 1.674, 95% CI: 1.243-2.255). Conclusion: The prevalence of depression, anxiety, and stress among college students was high for those studying online at home during the COVID-19 pandemic, especially among nonmedical students and males. SDL ability was negatively associated with negative emotions of the college students during this period of online learning.

The impact of lockdown stress and loneliness during the COVID-19 pandemic on mental health among university students in Germany

The COVID-19 pandemic led to a shutdown of universities in Germany. In a longitudinal design, we compared mental health (depression, anxiety, somatic complaints) of university students in Germany before (June to August 2019) and in the course of the COVID-19 pandemic (June 2020) and determined the impact of pandemic-related stress and loneliness on students' mental health in self-report online surveys. We investigated 443 participants (mean age 22.8 years), among them 77% female, and 10.4% medical students. A small increase of depression mean scores was observed (F(1,420) = 5.21; p = .023), anxiety and somatic complaints have not significantly changed. There was a medium increase in loneliness from pre-pandemic scores to the pandemic situation (F(1,423) = 30.56; p < .001). Analyzed with regression analyses, current loneliness and pre-pandemic distress represented the strongest associations with mental health during the pandemic. Additionally, health-related concerns during the pandemic were associated with symptoms of depression [b = 0.21; 95%CI(0.08; 0.34); t = 3.12; p = .002], anxiety [b = 0.07; 95%CI(0.01; 0.12); t = 2.50; p = .013], somatic complaints [b = 0.33; 95%CI(0.18; 0.47); t = 4.49; p < .001], and loneliness [b = 0.10; 95%CI(0.03; 0.17); t = 2.74; p = .006]. Social stress due to the pandemic situation was associated with loneliness [b = 0.38; 95%CI(0.32; 0.45); t = 11.75; p < .001]. The results imply that university students represent a risk group for psychosocial long-term ramifications of the pandemic.

Risk Perception, Perception of Collective Efficacy and Sleep Quality in Chinese Adults during COVID-19 Pandemic in Hong Kong: A Cross-Sectional Study

Background: Only a few studies have studied the link between risk perception and sleep in the context of the COVID-19 pandemic. The purpose of our study is to propose and test a theoretical model to understand the relationships between COVID-19 risk appraisals—risk perception and perception of collective coordinated defense (PCCD) in particular—and subjective sleep quality in Chinese adults in Hong Kong during the COVID-19 pandemic. COVID-19-related fear and rumination were examined as potential mediators of the relationships. Methods: Data were collected using a self-report online questionnaire from a convenience sample of 224 Chinese adults during the fourth wave of the COVID-19 pandemic in Hong Kong. Results: Risk perception and PCCD were found to predict poor sleep quality. Mediation analysis showed that both fear and rumination mediated the relationship between risk perception and sleep quality, whereas only fear mediated the relationship between PCCD and sleep quality. The model was an excellent fit to the data and accounted for 44% of the variance in sleep quality in Chinese adults. This study indicated that both perception of high risks of contracting COVID-19 and anticipations of collective disease preventive efforts had adverse effects on subjective sleep quality via increasing COVID-19-related fear. Conclusions: These findings underscore the need for addressing sleep problems induced by psychological consequences of the pandemic. While policy makers often deliver public messaging campaigns that frame disease prevention as a collective goal, developing evidence-based coping strategies to combat COVID-19 adverse impacts on psychological health is equally important.

Computer-Mediated Communication and Child/Adolescent Friendship Quality after Residential Relocation

The experience of residential relocation can affect children and adolescents in various ways. It often affects their close social relationships, and this is especially true when these individuals are no longer in close proximity to their family members and friends. Although face-to-face communication may be limited after relocation, computer-mediated communication can assist in maintaining and developing existing relationships. It may even help individuals initiate new social relationships. In the present study, we investigated the role of communication behavior with friends for perceived friendship quality among children and adolescents who recently experienced residential relocation. Based on a representative survey study of families in Germany, we selected parents having moved with their child (8 to 14 years) to another village or town within the last 24 months. In total, 57 parents who had recently moved - majority of whom were mothers - allowed their child to participate in the phone interview. These participants were, on average, 11 years of age, and 58% of them were male. The children answered questions about their communication behavior and the friendships they had with their three current best friends. Using multilevel analysis, we found that children and adolescents who more often communicated face-to-face with their friends also more intensively used computer-mediated technologies to stay in touch. However, the findings further revealed that computer-mediated communication has the potential to remove limitations in existing friendships in the event of relocation. In the following discussion, implications are examined regarding the role of new communication technologies for families with enhanced mobility requirements.

Predictors of academic performance during the covid-19 outbreak: impact of distance education on mental health, social cognition and memory abilities in an Italian university student sample

BACKGROUND

This study aimed to investigate the impact of distance education (DE) on mental health, social cognition, and memory abilities in a sample of university students during the national COVID-19 lockdown in Italy and to identify the predictors of academic performance.

METHODS

Two hundred and three students (76.4% women, mean age 24.3, SD ± 4.9) responded to an anonymous online cross-sectional survey between July 15 and September 30, 2020, on DE experience and cognitive and social-cognitive variables. A short version of the Beck Depression Inventory-II, ten images from the Eyes Task, and five memory vignette stimuli were included in the survey. Descriptive, one-way ANOVA, correlation, and logistic regression analyses were conducted.

RESULTS

Half of the student sample reported significant impairment in concentration and learning abilities during DE. Regarding psychological health, 19.7%, 27.1%, and 23.6% of the sample reported mild, moderate, and severe depressive symptoms, respectively. Correlation analyses showed a statistically significant negative association between depression and the overall subjective evaluation of DE (r =  - 0.359; p < 0.000). Changes in one's study context and habits, i.e., studying alone at one's parents' home instead of studying with colleagues or alone in a university "social place" (e.g., the university library), seemed to increase the likelihood of poor academic performance by almost 3 times (O.R. 3.918; p = 0.032). This predictor was no longer statistically significant in the subsequent step when the individual impairment predictors were entered. Learning concentration impairment during DE (O.R. 8.350; p = 0.014), anxiety about COVID-19 contagion for oneself or others (O.R. 3.363; p = 0.022), female gender (O.R. 3.141; p = 0.045), and depressive symptomatology (O.R. 1.093; p = 0.047) were ultimately determined to be the strongest predictors of poor academic performance, whereas the appreciation of DE represented a protective variable (O.R. 0.610; p < 0.000).

CONCLUSIONS

The study showed a negative impact of DE on the mental health of students presenting depressive symptoms and impairment in concentration and learning, the latter identified as the strongest predictors of poor academic performances. The study confirms the emerging need to monitor the impact of DE, which occurred during the 2019/2020 academic year and will continue in the coming months, to refine educational offerings and meet students' psychological needs by implementing psychological interventions based on the modifiable variables that seem to compromise students' psychological well-being and academic outcomes.

The Impact of COVID 19 on University Staff and Students from Iberoamerica: Online Learning and Teaching Experience

(1) Background: The COVID-19 pandemic has created a great impact on mental health in society. Considering the little attention paid by scientific studies to either students or university staff during lockdown, the current study has two aims: (a) to analyze the evolution of mental health and (b) to identify predictors of educational/professional experience and online learning/teaching experience. (2) Methods: 1084 university students and 554 staff in total from four different countries (Spain, Colombia, Chile and Nicaragua) participated in the study, affiliated with nine different universities, four of them Spanish and one of which was online. We used an online survey known as LockedDown, which consists of 82 items, analyzed with classical multiple regression analyses and machine learning techniques. (3) Results: Stress level and feelings of anxiety and depression of students and staff either increased or remained over the weeks. A better online learning experience for university students was associated with the age, perception of the experience as beneficial and support of the university. (4) Conclusions: The study has shown evidence of the emotional impact and quality of life for both students and staff. For students, the evolution of feelings of anxiety and depression, as well as the support offered by the university affected the educational experience and online learning. For staff who experienced a positive professional experience, with access to services and products, the quality-of-life levels were maintained.

Prevalence of depressive symptoms among Chinese university students amid the COVID-19 pandemic: a systematic review and meta-analysis

AIMS

Chinese university students are at high risk for depressive symptoms and the ongoing coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the mental health of university students. However, existing studies on depressive symptoms in Chinese university students during the COVID-19 pandemic reported a wide range of prevalence estimates, making mental health planning for this population difficult. The objective of this study was to conduct a systematic review and meta-analysis of surveys that assessed the prevalence of depressive symptoms in Chinese university students amid the COVID-19 pandemic.

METHODS

Major Chinese (CNKI, Wanfang, VIP) and English (PubMed, Embase, PsycInfo) databases and preprint platforms were searched to identify cross-sectional studies containing data on the prevalence of depressive symptoms in Chinese university students during the pandemic. Two authors independently retrieved the literature, evaluated the eligibility of potential studies, assessed the risk of bias (RoB) of included studies, and extracted data. RoB was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

RESULTS

In total, 1177 records were retrieved, and 84 studies involving 1 292 811 Chinese university students during the pandemic were included. None of the included studies were rated as completely low RoB. Statistically significant heterogeneity in the prevalence estimates of included studies was detected (I2 = 99.9%, p < 0.001). The pooled prevalence of depressive symptoms was 26.0% (95%CI: 23.3-28.9%), which was significantly higher in female than in male students (30.8% v. 28.6%, p < 0.001), in postgraduates than in undergraduates (29.3% v. 22.9%, p < 0.001), in students living inside than in those living outside the COVID-19 epicentre (27.5% v. 22.3%, P < 0.001), in students from universities at the epicentre than in those from universities outside the epicentre (26.2% v. 23.1%, p < 0.001), in students who had close contact with COVID-19 than in those who did not (46.0% v. 25.0%, p < 0.001), and in students who had acquaintances or relatives infected with COVID-19 (39.7% v. 24.0%, p < 0.001) than in those who did not. Five sources of heterogeneity were identified from the subgroup analysis: survey period, % of males among the survey sample, scale of depressive symptoms, cutoff score of the scale and level of RoB.

CONCLUSIONS

Over one-fourth of Chinese university students experienced depressive symptoms during the COVID-19 pandemic. Mental health services for this population should include periodic evaluation of depressive symptoms, expanded social support and psychiatric assessment and treatment when necessary. It is also necessary to design depression prevention programmes that target higher-risk cohorts of university students.