Stress, Anxiety and Depression among a Cohort of Health Sciences Undergraduate Students: The Prevalence and Risk Factors

Supporting Mental Health Well-Being in the Most Vulnerable Future Nurses

AIM

The aim of the study was to explore relationships between perceived faculty support and prevalence of severe/extremely severe depression, anxiety, and stress levels among undergraduate baccalaureate nursing students.

BACKGROUND

Emerging research supports nursing students suffering from extreme psychological distress. Educational success and mental health wellness are influenced by external support.

METHOD

A mixed-methods design was used for this descriptive, cross-sectional study. A national convenience sample of 1,163 undergraduate baccalaureate nursing students completed the Depression, Anxiety and Stress Scale-21, Perceived Faculty Support Scale, and a demographic questionnaire. Emerging themes in the qualitative data were identified.

RESULTS

Nearly 54 percent of nursing students suffered from severe/extremely severe depression, anxiety, or stress. Faculty support was critical to nursing student mental health well-being.

CONCLUSION

This multisite study provides a better understanding of the enormity of psychological distress among undergraduate baccalaureate nursing students and emphasizes the immediate need for faculty to provide necessary support to this vulnerable student population.

Impact of Fear of COVID-19, Depression, Anxiety and Stress on Temporomandibular Disorders in Peruvian Dental Students in the Post-Pandemic Period: A Multivariable Regression Analysis

Background: Dentists, who frequently encounter potentially infected patients, have experienced significant changes worldwide due to the COVID-19 pandemic. The aim of this study was to evaluate the impact of the fear of COVID-19, depression, anxiety and stress on the presence of temporomandibular disorders (TMD), taking into account possible confounding variables, in Peruvian dental students during the post-pandemic period. Methods: This analytical cross-sectional study assessed 607 Peruvian dental students from two regions of Peru. The study utilized the Depression Anxiety Stress Scales-21 (DASS-21), the Fear of COVID-19 Scale (FCV-19S) and the Short Form of the Fonseca Anamnestic Index (SFAI). Possible confounding variables were sex, age, year of study, marital status, place of origin, area of residence, history of mental illness and living with people vulnerable to COVID-19. For the multivariable analysis, we utilized a Poisson regression model with an adjusted robust variance. The significance level was set at p < 0.05. Results: The rates of depression, anxiety, stress, fear of COVID-19 and temporomandibular disorders were 47.0%, 50.4%, 35.9%, 30.6% and 54.2%, respectively. Moreover, the study revealed that students with depression and anxiety were 38% and 75% more likely to have temporomandibular disorders compared to those without depression (APR = 1.38, 95% CI: 1.15-1.66) and anxiety (APR = 1.75, 95% CI: 1.44-2.13), respectively. Similarly, the likelihood of presenting temporomandibular disorders was 55% higher in women than in men (APR = 1.55, 95% CI: 1.28-1.87). Furthermore, we found that stress and fear of COVID-19 did not determine the development of temporomandibular disorders (p > 0.05). Conclusions: Almost half of the dental students experienced depression, anxiety and TMD in the post-pandemic period. In addition, depression and anxiety were influential factors in the occurrence of TMDs, with the female gender being a risk factor. However, factors such as fear of COVID-19, stress, age, year of study, marital status, place of origin, area of residence, history of mental illness or living with people vulnerable to COVID-19 were not significant.

Promoting Nursing Student Mental Health Wellness: The Impact of Resilience-Building and Faculty Support

BACKGROUND

Being aware of elevated levels of student psychological distress by nursing faculty, and subsequently responding to it, may diminish nursing students' experience of negative mental health well-being.

PURPOSE

Relationships between perceived faculty support, resiliency, and the prevalence of depression, anxiety, and stress among undergraduate nursing students were explored.

METHODS

An exploratory mixed-methods design was used for this descriptive, cross-sectional study. The Depression, Anxiety, and Stress Scale-21, Brief Resilience Scale, Perceived Faculty Support Scale, a demographic questionnaire, and open-ended questions were used to collect data. A convenience sample of 989 undergraduate baccalaureate nursing students from across the United States completed the surveys.

RESULTS

Study results revealed resilience strategies and psychological and functional supportive faculty behaviors and actions are substantial predictors of lower depression, anxiety, and stress in undergraduate baccalaureate nursing students.

CONCLUSIONS

Investments in faculty development to support nursing student resilience may reduce the degree of negative mental health well-being that students exhibit related to nursing education and promote their successful transition to nursing practice.

Exploring predictors of perceived stress: a cross-sectional study among nursing students during their clinical practice

Background

Clinical practice is a demanding academic activity for nursing students, and a variety of factors can affect this perception. This study aimed to investigate the predictors of perceived stress among Indonesian nursing students during their clinical practice.

Methods

From September to November 2022, this cross-sectional investigation was carried out. Five questionnaires, including the socio-demographic, the PSS, the GHQ, the CBI, the MSPSS and the RSES, were completed by 208 participants. With significance set to p < 0.05, the Pearson correlation and multiple linear regression analysis were carried out.

Results

Coping strategies (r = 0.20, p < 0.01), overall health (r = 0.50, p < 0.01), social support (r = -0.34, p < 0.01) and self-esteem (r = -0.51, p < 0.01) were all substantially linked with perceived stress. Furthermore, age (β = -0.22, p < 0.001), coping style (β = 0.22, p < 0.001) and self-esteem (β = -0.42, p < 0.001) substantially predicted perceived stress among nursing students.

Conclusion

The study's findings revealed strong relationships between perceived stress and general health, coping mechanisms, self-esteem and social support. These results can be utilised as evidence to help educators and other stakeholders develop programmes that effectively manage stress among nursing students during their clinical rotations.

Exploring the Relationship Between Stress and Satisfaction During Clinical Training Among Respiratory Therapy Students: A Nationwide Cross-Sectional Survey

Background

Although clinical training is an important component of healthcare education, it is nevertheless a significant source of stress for students. There is limited information on stress and satisfaction perceived by clinical-level undergraduate students studying respiratory therapy (RT) in Saudi Arabia.

Methods

A descriptive, cross-sectional study design with an online questionnaire was employed to conduct this study. Data collection occurred during the academic year 2022-2023 among RT students throughout Saudi Arabia. Patricians responded to demographic questions, the Students Stress Scale and Students Professional Satisfaction questionnaires. Descriptive, inferential, and correlational statistics were used to analyze the collected responses.

Results

A total of 1001 undergraduate RT students completed the online survey. RT students and interns had an overall moderate to high stress level (mean (SD); 3.55 (0.49)), while satisfaction was perceived as mild to moderate (mean (SD): 2.56 (0.65)). In addition, 38% of the study participants have considered quitting the RT program. Female students showed higher stress levels in the following domains: inadequate knowledge and training, adverse and embarrassing experiences, clinical supervision, patients' pain, and Education-reality conflict (p<0.005) compared to male students. Additionally, students who considered quitting the RT program revealed higher stress levels in all domains (p<0.005). There were negative correlations between satisfaction and stress domains: inadequate knowledge and training (r = -0.32; p = 0.001), adverse and embarrassing experience (r = -0.31; p = 0.025), close supervision (r = -0.24; p = 0.001), insufficient hospital resources (r = -0.30; p 0.002), patients' pain and suffering (r = 0.28; p = 0.04), and education - reality conflict (r = -0.30; p = 0.001).

Conclusion

During clinical training, respiratory therapy students experience moderate to high-stress levels and low satisfaction. There need to be tailored interventions to reduce stress and intention to quit and increase students' clinical experience satisfaction.

Risk Factors in Depression and Anxiety Disorders from the Framework of Developmental Psychopathology

Depression and anxiety disorders are among the most prevalent psychiatric disorders that negatively affect individuals’ life in many ways. Understanding how these highly comorbid emotional disorders develop and persist might guide prevention, intervention, and treatment studies. Some common vulnerability factors underlie depression and anxiety disorders. Developmental psychopathology deals with these vulnerabilities and risk factors from a lifetime perspective. The aim of this review is to present the risk factors associated with depression and anxiety from the perspective of developmental psychopathology. For this purpose, we discussed genetic and biological factors, temperament, negative childhood experiences, family and peer relationships, and some cognitive and emotional factors as risk factors. Also, we discussed how these risk factors lead to depression and anxiety disorders. This review emphasizes that some common transdiagnostic risk factors underlie emotional disorders and highlights the importance of a developmental psychopathology perspective to understand the developmental pathways of depression and anxiety disorders.

Depression, Anxiety and Stress Associated With Fear of COVID-19 in Peruvian Dental Students: A Multivariate Analysis With 12 Sociodemographic Factors

Aims and Objectives

Excessive fear of coronavirus disease 2019 (COVID-19) in dental students could cause mood disorders, especially if there are factors in the environment that generate feelings of anxiety or uncertainty. The aim of this study was to evaluate the fear of COVID-19 and its association with depression, anxiety, and stress in Peruvian dental students according to their sociodemographic factors.

Materials and Methods

This analytical, observational, and cross-sectional study was conducted in 398 dental students of a public university in the Peruvian capital during April 2021 to July 2021. The Depression, Anxiety and Stress Scale-21 items was used to diagnose depression, anxiety, and stress. The Fear of COVID-19 Scale was used to detect fear of COVID-19. The Pearson's chi-square test was used for statistical analysis. In addition, a logit model using odds ratio (OR) was performed to evaluate depression, anxiety, and stress of students with the associated factors: fear of COVID-19 and 12 sociodemographic variables (gender, age group, marital status, year of study, origin, companion, living with vulnerable people, history of mental illness, history of COVID-19, loss of close relatives due to COVID-19, occupation, and area of residence). A significance level of P < .05 was considered. In addition, predictive models were developed for the variables depression, anxiety, and stress, considering all possible significant causes.

Results

The prevalence of fear of COVID-19, depression, anxiety, and stress was 19.6%, 36.2%, 40.7%, and 19.6%, respectively. According to the adjusted logit model, students who had fear of COVID-19 had OR = 2.74 (95% confidence interval [CI]: 1.62-4.64), OR = 5.59 (95% CI: 3.14-9.97), and OR = 3.31 (95% CI: 1.88-5.83) for developing depression, anxiety, and stress, respectively. In addition, those who reported history of mental illness were four times more likely to develop depression (OR = 4.02, 95% CI: 1.96-8.25) and anxiety (OR = 4.50, 95% CI: 2.06-9.82), whereas those living with people vulnerable to COVID-19 were twice as likely to develop stress (OR = 2.06, 95% CI: 1.16-3.66).

Conclusion

The highest prevalence of mood disorders among dental students was anxiety. In addition, those who were afraid of COVID-19 had three times the probability of developing depression and stress, and five times the probability of developing anxiety. On the other hand, the most influential factor in the development of depression and anxiety was history of mental illness, whereas the factor of living with vulnerable people was the most influential factor in the development of stress.

Symptoms of depression, anxiety and stress in health students and impact on quality of life

OBJECTIVE

to evaluate the association between quality of life and presence of symptoms of depression, anxiety, and stress in college students in the health area.

METHOD

cross-sectional study that included 321 students from undergraduate courses in the health area. Quality of life was measured using the World Health Organization scale, abbreviated version, in the physical, psychological, social relations and environment domains, and symptoms were assessed by the depression, anxiety and stress scale. Multivariate analysis was performed using robust linear regression to evaluate the association between quality of life and symptoms.

RESULTS

a negative association was observed between the quality of life and depression symptoms in all domains, while anxiety symptoms showed a negative association in the environment domain, and stress symptoms had a negative association in the psychological domain. Symptom severity was unfavorably associated with quality of life, that is, the greater the symptom severity, the lower the mean scores in all domains.

CONCLUSION

symptoms of depression, anxiety, and stress were prevalent and had a negative impact on students' quality of life, especially in the presence of depressive symptoms. The decrease in scores was significantly associated with the severity of symptoms.

Musculoskeletal disorders among undergraduate radiography students during work integrated learning in Kwazulu-Natal, South Africa

BACKGROUND

Musculoskeletal disorders (MSDs) are a group of painful muscle, tendon, and nerve disorders. These disorders are common among healthcare students, including those studying radiography. However, there is a paucity of current literature on the prevalence of MSDs among undergraduate radiography students attending Work Integrated Learning (WIL). To date, no study has been conducted to determine the risk factors for developing MSDs among radiography students in the Kwazulu-Natal province, therefore this study was necessary.

OBJECTIVE

The aims of the study were to determine the prevalence of MSDs and to identify the risk factors associated with MSDs among undergraduate radiography students attending WIL within hospitals in the eThekwini Municipality, Kwazulu-Natal.

METHODS

The research conducted was a quantitative study with a descriptive design that targeted radiography students attending WIL within the hospital of eThekwini, KwaZulu Natal. The research questionnaires about the prevalence of MSDs and associated risk factors were given to the students who consented to participate in the study. The data were analysed using Microsoft Excel and SPSS version 23.

RESULTS

In total, 144 questionnaires were utilised for statistical analysis, the number of females (76.4%) was higher than men (23.6%). The majority of the participants were aged between 20 to 24 years year old (81.3%). The results further showed a significantly high prevalence of MSDs among the radiography students (92.4%). The most common areas of pain reported by the participants were the lower back (79.7%), neck (72.2%) and upper back (54.1%). The statistically significant risk factors for MSDs among students were bending (p =0.038.), stress (p= 0.028) and depression (p=0.032).

CONCLUSION AND RECOMMENDATIONS

The study showed that the prevalence of MSDs is high among undergraduate radiography students during WIL. To prevent the recurrence of MSDs among students, it is recommended that the faculty of health sciences and the radiography department design and implement suitable interventions, such as an educational program/training on ergonomics practice.

Structural Relationships between Environmental Factors, Psychological Health, and Academic Performance in Medical Students Engaged in Online Learning during the COVID-19 Pandemic

As a result of the COVID-19 outbreak and the enforced quarantine, universities in Malaysia were required to switch to an online class format. The resulting changes in the environmental factors of students may have had an impact on their psychological health and academic performance. This study aimed to determine the effects of environmental factors and the psychological health of students and examine their structural relationship with academic performance. A cross-sectional design with an online self-reported questionnaire was adopted, and the study was conducted among 207 undergraduate medical students at the Health Campus of Universiti Sains Malaysia. The environmental factors were measured using the lighting-noise-temperature scale and technology scale, while psychological health was assessed using the short version of the General Health Questionnaire and academic performance was determined based on Grade Point Average. Descriptive statistics and structural equation modeling were used for analysis of the data. No significant relationship was found between environmental factors and academic performance, or between environmental factors and psychological health. Nonetheless, the hypothesized structural model provided scientific evidence of an inverse relationship between psychological health and academic performance. These findings could be helpful for academics, health policymakers, and health educators in terms of understanding and promoting psychological wellbeing among university students, as well as improving their academic performance.

Steps toward a resilient future nurse workforce

INTRODUCTION

The psychosocial needs of nursing students are a pressing matter as mental health disorders may affect nursing students' journeys as professional nurses.

LITERATURE REVIEW

Psychological distress and burnout in nurses are threats to worldwide health care, as the stress associated with the COVID-19 pandemic could lead to an unstable future global nurse workforce.

DISCUSSION

Resiliency training can positively impact nurse stress, mindfulness, and resilience, as resilient nurses are better able to manage their response to stress and adversity which will contribute to positive patient outcomes.

IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE

Educating faculty on resilience will aid nurse educators to create new student instructional approaches to improve mental health wellness.

CONCLUSIONS

Supportive faculty behaviors, self-care techniques, and resilience-building infused throughout the nursing curriculum may promote the effective transitioning of students into practice, providing the necessary foundation for improving workplace stress management and increasing longevity and satisfaction in the profession.

Targeted Primary and Secondary Preventive Strategies for Depression among Malaysian Pharmacy Students

The global depression burden has remained a challenge throughout the pre- and post-pandemic era. The pandemic effect has led to the spiraling of mental disorders among young people who will be the next generation of leaders. This study aims to identify university students’ sociodemographic, psychosocial and academic backgrounds and performance associated with depression symptoms for the development of primary and secondary preventive strategies for mental health. A cross-sectional study was conducted using an online questionnaire distributed to 19 institutions in Malaysia offering a Bachelor of Pharmacy degree program. The self-rated Depression Anxiety Stress Scale (DASS-42) was used to assess depression symptoms. Pearson’s chi-square test and Fisher’s exact test were used to assess the investigated variables with depression symptoms. Independent T-test and one-way ANOVA were used to compare means of depression score across variables. Binary logistic regression was employed to examine the relationship between the investigated variables and depression symptoms. A total of 610 pharmacy students participated, of which 47% (n = 289/610) were having depression symptoms. Students who smoke nicotine and those who have separated parents, family history of mental illness, and poor academic performance were associated with depression symptoms (p < 0.05). Differences in geographical areas, race and religion also showed significant associations with depression symptoms. Parental marital status, poor academic performance, history of mental illness and comorbidities were statistically predicting depression symptoms (p < 0.05). Primary preventive strategies allowing students to harness healthy coping skills for stress, nicotine-free campaigns and a holistic curriculum are warranted. Secondary measures on mindfulness and compassion skills activities to benefit students who experienced early life crises are highly recommended. Enforcing these targeted strategies in collaboration with health and social sectors should be the primary agenda of universities to ensure their uptake.

Probable Bruxism and Psychological Issues among Dental Students in Serbia during the COVID-19 Pandemic

The COVID-19 pandemic has drastically changed the routine way of life, having consequences in many segments of life, including dental practice and education. The aim of this study was to evaluate the frequency of probable bruxism in a sample of dental students in Serbia and to estimate the potential association between psychological factors related to the COVID-19 pandemic and the presence of bruxism. A cross-sectional study included 178 dental students in Serbia, who were interviewed using a specially-designed self-administered online questionnaire, which consisted of three sections, and after that, a clinical examination for the presence of bruxism symptoms in the oral cavity. Psychological status was evaluated using the Depression, Anxiety and Stress Scale-21 (DASS-21) and the Fear of COVID-19 Scale (FCV-19S). Saliva samples were taken to analyze salivary cortisol levels. The prevalence of probable bruxism was 34.8%. Respondents with probable bruxism had significantly higher DASS-21 and FCV-19S scores and mean values of salivary cortisol compared to non-bruxers. A history of COVID-19 infection, high stress, and fear of COVID-19 scores were associated with the presence of probable bruxism. The findings suggest that the COVID-19 pandemic has had a great psychological impact and impact on the presence and worsening of bruxism symptoms in a sample of dental students in Serbia.

Prevalence of depression and anxiety, and attitudes toward seeking help among first-year pharmacy, medical, and nursing students at a Nigerian university

INTRODUCTION

The first year of university study tends to be particularly challenging and exhausting, especially for students in health sciences. This study aimed to explore the prevalence of anxiety and depression among first-year pharmacy, medicine, and nursing students at a Nigerian university as well as their attitudes toward seeking professional support.

METHODS

This study was a cross-sectional descriptive survey among all first-year pharmacy, medicine, and nursing students. Paper-based self-administered questionnaires were used, and they included the Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Attitudes Toward Seeking Professional Psychological Help Scale. Descriptive statistics, Chi-square test, and Pearson correlation were used for data analysis.

RESULTS

The study included 522 students (89% response rate). The prevalence of depression among participants was 71.8%, while the prevalence of anxiety was 61.7%. Only 24.9% of the participants expressed willingness to seek professional psychological help. Attitudes toward getting professional care was inversely related to the prevalence of depression (r = -0.155, P = .01) and anxiety (r = -0.098, P = .05). Age, smoking, alcohol intake, and dietary habits were associated with the occurrence of depression and anxiety. No demographic variables were related to the participants' attitudes toward seeking professional care.

CONCLUSIONS

Depression and anxiety symptoms were very common among health science freshmen. However, the vast majority of students were unwilling to seek help. Students' attitudes toward seeking treatment are influenced by the prevalence of depression and anxiety. Therefore, educational interventions on mental health promotion are recommended.

Examining anxiety and stress regarding virtual learning in colleges of health sciences: A cross-sectional study in the era of the COVID-19 pandemic in Saudi Arabia

Background

Stress and anxiety are relatively common, particularly in females and college students. Stress can impact students' overall performance and their physical and mental health. The COVID-19 pandemic has affected all aspects of life and is associated with high levels of psychological distress. It has considerably affected the education sector, not only locally but worldwide, forcing a shift in the education system from on-site to virtual learning. This cross-sectional study was undertaken to evaluate the prevalence of anxiety and stress regarding virtual learning among health sciences college students in the Kingdom of Saudi Arabia (KSA) after introducing blended virtual classes and exams and in-person laboratory training. The study was carried six months after the COVID-19 outbreak.

Methodology

Participants were recruited by convenient sampling and snowballing strategies. Our study was conducted between November 18 and December 6, 2020. Questionnaires were employed; they included the General Anxiety Disorder-7 (GAD-7) scale and focused on the participants' attitudes toward virtual learning. The present research was validated by a pilot study, followed by implementing some amendments.

Results

A total of 418 health sciences college students, aged 18-27 (M = 20.88, SD = 1.97), participated in the study. Our analysis indicated that more than half the sample (51.44%) reported a risk of moderate to severe GAD. Anxiety was recognized more frequently in women (72.09%) than in men (27.91%). Interestingly, our Χ2 analysis revealed an association between marital status and anxiety, with a higher risk of GAD found in single people (compared with married). In addition, we found that the risk of anxiety increased in junior students (1st-3rd year) compared to senior students (4th-6th year).

Conclusion

Our study highlights the need to establish gender-based tailored mental health support systems that provide preventive measures. The study findings also recommend that institutions develop programs and platforms that safely support students to interact and seek guidance, particularly those at higher risk of stress, such as females and first-year students. Overall, our study underlines the need to pursue an understanding of the complicated nature of anxiety disorders..

COVID-19 mental health prevalence and its risk factors in South East Asia

With the record surge of positive cases in Southeast Asia, there is a need to examine the adverse mental effects of COVID-19 among the under-researched countries. This study aims to synthesize the extant literature reporting the effects of COVID-19 pandemic on the psychological outcomes of people in Southeast Asia, and its risk factors. A scoping review was adopted targeting articles published in PubMed, Google Scholar and Scopus from January 2020 to March 30, 2021. Articles were screened using predetermined eligibility criteria, resulting in 26 papers. Elevated prevalence of adverse mental effects was noted in most of the countries as the pandemic progressed over time, with Malaysia and Philippines reporting higher prevalence rates. Mental decline was found to be more profound among the general population compared to healthcare workers and students. Dominant risk factors reported were age (younger), sex (females), education (higher), low coping skill and social/family support, and poor reliability in COVID-19 related information. Adverse mental effects were noted among population, healthcare workers and students in most of the Southeast Asian countries. Intervention and prevention efforts should be based at community-level and prioritize young adults, females, and individuals with dire financial constraints.

Faculty supportive behaviors and nursing student mental health: a pilot study

OBJECTIVES

Relationships between perceived faculty support and prevalence of depression, anxiety, and stress among undergraduate nursing students were explored.

METHODS

A mixed method design was used for this descriptive, cross-sectional pilot study. Depression, Anxiety and Stress Scale-21 (DASS-21), Perceived Faculty Support Scale (PFSS), a demographic questionnaire, and open-ended questions were used to collect data.

RESULTS

Nursing students experienced moderate depression and stress, and severe anxiety. Perceived faculty support was moderate. An inverse correlation between select perceived faculty supportive behaviors and depression, anxiety, and stress was evident. Student stressors were related to faculty actions. The theme being attentive to student stress emerged from the qualitative data.

CONCLUSIONS

Symptoms of poor mental health among undergraduate nursing students are prevalent and represent a significant public health concern among nursing students. Nurse educators must develop psychological and functional supportive behaviors to promote mental health during nursing students' transition throughout the nursing program and beyond.

Body dysmorphic disorder and depression among male undergraduate students in a Malaysian University

INTRODUCTION

Body dysmorphic disorder (BDD) and depression have been reported to be both prevalent among young people worldwide, resulting in serious implications in their quality of life and social functioning. This is worrying especially in men where mental disorders are often overlooked and under-researched. This study aims to determine the proportion of male university students with symptoms suggestive of body dysmorphic disorder and depression, as well as their perception on their body image.

METHODS

In this cross-sectional study, 1,308 male students between the aged of 17-26 years in a private university in Malaysia via self-administered online questionnaire comprising the Patient Health Questionnaire (PHQ)-9, the Body Dysmorphic Disorder Questionnaire (BQQD) and the Body Self-Image Questionnaire (BSIQ), in addition to their sociodemographic parameters. Data analyses were performed with Mann Whitney test, chi square test and Fisher's exact test.

RESULTS

3.3 and 54.2% of the students had symptoms suggestive of BDD and depression respectively, with up to 9.02% of the students reporting having moderate to severe depression. There was a significant association between BDD symptoms and students staying alone, whilst depression was significantly associated with studying in the rural campus. Furthermore, a significant association was demonstrated between presence of BDD and depression symptoms. Most of the students were dissatisfied with their whole body, especially their height.

CONCLUSION

The proportion of BDD and depression symptoms among male students in our university is quite high. Universities and the public health sector should develop better support service targeting male university students.

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.