Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China

The role of fortitude, loneliness, and depression in the association between risk perception of contracting COVID-19 and life satisfaction: serial mediation analysis

Recently, the COVID-19 pandemic has been found to have a negative impact on both physical wellbeing and mental health. Increased risk perception of contracting the virus has been associated with adverse psychological outcomes and reduced life satisfaction. However, susceptibility to psychological distress is influenced by personality-related characteristics. This study focuses on fortitude as a potential protective factor. The aim of this study is to investigate the parallel and serial mediating roles of fortitude, loneliness, and depression in the relationship between risk perception and life satisfaction. The participants were young adults ( N = 337) who have completed five self-report questionnaires: University of California Los Angeles Loneliness Scale, Centre for Epidemiological Studies Depression Scale, Fortitude Questionnaire, Satisfaction with Life Scale, and COVID-19 Risk Perception Scale. Descriptive statistics were generated, and structural equation modelling was used to examine the parallel and serial mediating roles of loneliness, depression, and fortitude. Positive associations were found between risk perception and loneliness and depression, and fortitude was found to mediate the relationship between risk perception and life satisfaction, between loneliness and life satisfaction, and between depression and life satisfaction. The overall serial mediation was also found to be significant, thereby supporting the hypothesis that those who perceive themselves to be at a risk of contracting COVID-19 have higher loneliness scores, which in turn is associated with higher depression scores. These findings confirm that fortitude is a salient protective factor and suggest that improving the perception of the ability to manage the risk of infection can enhance psychological wellbeing.

Lifestyle in Undergraduate Students and Demographically Matched Controls during the COVID-19 Pandemic in Spain

Few studies have used a multidimensional approach to describe lifestyle changes among undergraduate students during the COVID-19 pandemic or have included controls. This study aimed to evaluate lifestyle behaviors and mental health of undergraduate students and compare them with an age and sex-matched control group. A cross-sectional web survey using snowball sampling was conducted several months after the beginning of COVID-19 pandemic in Spain. A sample of 221 students was recruited. The main outcome was the total SMILE-C score. Students showed a better SMILE-C score than controls (79.8 + 8.1 vs. 77.2 + 8.3; p < 0.001), although these differences disappeared after controlling for covariates. While groups did not differ in the screenings of depression and alcohol abuse, students reported lower rates of anxiety (28.5% vs. 37.1%; p = 0.042). A lower number of cohabitants, poorer self-perceived health and positive screening for depression and anxiety, or for depression only were independently associated (p < 0.05) with unhealthier lifestyles in both groups. History of mental illness and financial difficulties were predictors of unhealthier lifestyles for students, whereas totally/moderate changes in substance abuse and stress management (p < 0.05) were predictors for the members of the control group. Several months after the pandemic, undergraduate students and other young adults had similar lifestyles.

Demographics, Socioeconomic Status, Social Distancing, Psychosocial Factors and Psychological Well-Being among Undergraduate Students during the COVID-19 Pandemic

The COVID-19 pandemic impacted on academic routine because of the social distancing measures. This study examined the relationships of sociodemographic characteristics, social distancing aspects and psychosocial factors on psychosocial well-being among undergraduate students during the social distancing period due to COVID-19. A web-based survey was conducted of undergraduate students at a public university in Brazil (n = 620). Demographics, socioeconomic status (SES), social distancing factors, negative affectivity (DASS-21), sense of coherence (SOC-13), social support and psychosocial well-being (GHQ-12) were measured. The direct and indirect links between was variables was tested using structural equation modelling. The estimated model showed that greater social support, higher sense of coherence and lower negative affectivity were directly associated with better psychological well-being. Female gender, higher SES, not working during the social distancing period and availability of online modules were indirectly associated with psychological well-being through psychosocial factors. Working during the social distancing period and availability of online modules mediated the link of age, gender, SES with psychological well-being. Our findings suggest the need to provide psychological support, online teaching and financial aid to undergraduate students during the social distancing period due to COVID-19 pandemic to improve their psychological well-being.

Prevalence and predictors of anxiety, depression and stress among university students during the period of the first lockdown in Germany

BACKGROUND

The COVID-19 pandemic exacerbates the risk for mental health issues of university students. The aims of the study were to investigate the prevalence of anxiety, depression and stress among university students during the period of the first lockdown in Germany, and the associations of possible risk and protective factors with all three outcome variables.

METHODS

A total of 2.548 university students were included in the study. The study took place during the period of the first lockdown in Germany. Multiple hierarchical regression analyses were conducted to explore the role of demographic variables, personality traits, psychological capital variables, mindfulness, COVID-19 related variables, and coping strategies on anxiety, depression and stress.

RESULTS

Results showed on average mild depressive and anxiety symptoms, and moderate perceived stress among the students. Alarmingly, 35.9% of the students showed a moderate-to-severe level of depression, 27.7% reported moderate to severe symptoms of anxiety, and 25.1% perceived high stress. Mindfulness and optimism were the most relevant protective factors against depression, anxiety and stress, whereas COVID-related stressors (e.g., worries about study and financial problems, being stressed by the Corona-pandemic and media reporting, quarantine experience) as well as personal characteristics (e.g., neuroticism, older age, being female) were risk factors for increasing mental health issues and/ or stress.

CONCLUSION

The pandemic has negatively affected the mental health of students. The results emphasize the importance of both professional help for students with mental health problems and effective prevention programs on university campuses that promote coping skills, and mental health during the current pandemic.

EU27 Higher Education Institutions and COVID-19, Year 2020

COVID-19 forced higher education institutions to reinvent themselves. The (usually) face-to-face education has swapped to distance contingency education. This change brought about numerous challenges that impose adjustments in several dimensions, such as pedagogical strategies and the dependence on teaching platforms and computer systems-and, above all, the new relationship between the various actors (students, teachers, and management staff). All the sudden changes, combined with uncertainty concerning what was happening, created several strategies and options. This paper has the main purpose of analyzing the scientific production on higher education of EU27 academic institutions during the 2020 COVID-19 pandemic in journals indexed in Clarivate Analytics' Web of Science and Elsevier's Scopus. The sample is composed of 22 articles in total. The results show that the articles were published in 19 journals; their main focuses are Higher Education, COVID-19, and distance learning. In our database, we find several types of concerns, which shows that HEIs have a wide range of dimensions. We intend this article to be an instrument, not only to identify what was done in 2020, but to point out clues for the future.

Impact of online education on fear of academic delay and psychological distress among university students following one year of COVID-19 outbreak in Bangladesh

OBJECTIVES

Extreme fear of academic delay (FAD) and psychological distress among students have arisen as great public health concerns worldwide due to the devastating actions of coronavirus disease 2019 (COVID-19). The precise aim of this study was to assess the impact of ongoing online education on current university students' FAD and psychological stress symptoms following one year of calamitous COVID-19 outbreak in Bangladesh.

METHODS

A cross-sectional web-based survey was conducted from March 15 to 30, 2021, for data collection through a snowball simple sampling technique among Bangladeshi University students, where a total of 1,299 respondents (age: ≥ 18 years) responded in the questionnaire. After obtaining informed consent from the participants, we evaluated the association of various sociodemographic factors and the effects of current e-Learning activities on FAD and subsequent psychological distress among university students in Bangladesh. After excluding the partial responses (n = 177), we analyzed the clean data sheet (n = 1,122) by three consecutive statistical methods: univariate, bivariate, and multivariate analyses.

RESULTS

Alarmingly, near 60% of the current students exerted extreme FAD and were suffering from severe stress. Besides, 78.1% of students having severe FAD were severely psychologically stressed. Logistic regression analyses revealed that the students of the female gender, rural area, lower-income families, and who suffered from the highest FAD were more significantly (p < 0.05) stressed than their reference groups.

CONCLUSION

The current analysis demonstrates that most Bangladeshi university students are battling with the unrivaled trend of FAD and facing severe psychological stress symptoms, which must be alleviated by the concerted efforts of the Government, Universities, and educationalists.

Global prevalence of mental health issues among the general population during the coronavirus disease-2019 pandemic: a systematic review and meta-analysis

To provide a contemporary global prevalence of mental health issues among the general population amid the coronavirus disease-2019 (COVID-19) pandemic. We searched electronic databases, preprint databases, grey literature, and unpublished studies from January 1, 2020, to June 16, 2020 (updated on July 11, 2020), with no language restrictions. Observational studies using validated measurement tools and reporting data on mental health issues among the general population were screened to identify all relevant studies. We have included information from 32 different countries and 398,771 participants. The pooled prevalence of mental health issues amid the COVID-19 pandemic varied widely across countries and regions and was higher than previous reports before the COVID-19 outbreak began. The global prevalence estimate was 28.0% for depression; 26.9% for anxiety; 24.1% for post-traumatic stress symptoms; 36.5% for stress; 50.0% for psychological distress; and 27.6% for sleep problems. Data are limited for other aspects of mental health issues. Our findings highlight the disparities between countries in terms of the poverty impacts of COVID-19, preparedness of countries to respond, and economic vulnerabilities that impact the prevalence of mental health problems. Research on the social and economic burden is needed to better manage mental health problems during and after epidemics or pandemics. Systematic review registration: PROSPERO CRD 42020177120.

Frequency and perceived effectiveness of mental health providers' coping strategies during COVID-19

There has been an emphasis on understanding the detrimental effects of coronavirus disease (COVID-19) on individuals’ wellbeing. Healthcare workers, including mental health providers, may experience increased emotional and behavioral health concerns to a greater degree than the general public. The objective of the present study was to examine the frequency and the perceived effectiveness of various coping strategies implemented by mental health practitioners during the COVID-19 pandemic, as well as differences across career stages (i.e., trainees versus licensed practitioners [LPs]). Survey data were collected from mental health practitioners (N = 888) assessing the strategies they used to manage COVID-19-associated anxiety/distress and the perceived effectiveness of these strategies. Bonferroni-adjusted chi-square tests and t-tests were conducted to assess differences by career stage. Overall, respondents used various coping strategies, most commonly behavioral strategies such as distraction/engaging in an enjoyable activity (88.63%), spending time with loved ones (77.82%), and exercise (72.64%). Over one-quarter reported using alcohol to cope (28.27%). Respondents generally perceived their coping strategies as somewhat to very effective; no strategies were generally perceived as ineffective. Compared to LPs, trainees were significantly more likely to manage COVID-19-related anxiety/distress using supervision (p < .001) and substances other than alcohol or tobacco (p < .001). There were no significant differences in how effective trainees and LPs perceived each strategy. U.S. mental health practitioners’ use of predominantly behavioral coping strategies, which were generally perceived as effective, during the first months of COVID-19 offers implications for interventions as the pandemic progresses.

Geographic variability in homicide rates following the COVID-19 pandemic

It has been demonstrated in a number of communities that the rates of serious crimes such as homicides and intimate partner violence have increased as a result of lockdowns due to COVID-19. To ascertain whether this is a universal trend the electronic autopsy files at Forensic Science South Australia, Adelaide, Australia, were searched for all homicides occurring between January 2015 and December 2020. There were 92 cases with 17 homicides in 2015 out of a total of 1356 cases (1.3%),18 in 2016 (18/1340 = 1.3%), 23 in 2017 (23/1419 = 1.6%); 14 in 2018 (14/1400 = 1.0%), 15 in 2019 (15/1492 = 1.0%) but in 2020 there were only 5 (5/1374 = 0.4%) (p < 0.02). Thus the incidence of homicides has fallen significantly in South Australia since the beginning of the pandemic. As the occurrence of serious crimes of violence and homicide has not followed a standard pattern in different communities it will be important to evaluate specific populations and subgroups rather than merely relying on accrued national data or extrapolating from one country to another. Pathologists, epidemiologists and health officials will need to specifically monitor local trends to understand more clearly what effects, if any, the pandemic has had on particular subgroups of deaths in order to more clearly understand causal relationships.

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.

Measurement Invariance of the Drivers of COVID-19 Vaccination Acceptance Scale: Comparison between Taiwanese and Mainland Chinese-Speaking Populations

The impacts of novel coronavirus disease-2019 (COVID-19) on human life continue to be serious. To control the spread of COVID-19, the production of effective vaccines is likely to be one of the best solutions. However, vaccination hesitancy may decrease individuals' willingness to get vaccinated. The Drivers of COVID-19 Vaccination Acceptance Scale (DrVac-COVID19S) was recently developed to help healthcare professionals and researchers better understand vaccination acceptance. The present study examined whether DrVac-COVID19S is measurement invariant across different subgroups (Taiwanese vs. mainland Chinese university students; males vs. females; and health-related program majors vs. non-health-related program majors). Taiwanese (n = 761; mean age = 25.51 years; standard deviation (SD) = 6.42; 63.5% females) and mainland Chinese university students (n = 3145; mean age = 20.72 years; SD = 2.06; 50.2% females) were recruited using an online survey between 5 January and 21 February 2021. Factor structure and measurement invariance of the two DrVac-COVID19S scales (nine-item and 12-item) were tested using confirmatory factor analysis (CFA). The findings indicated that the DrVac-COVID19S had a four-factor structure and was measurement invariant across the subgroups. The DrVac-COVID19S's four-factor structure was supported by the CFA results is a practical and valid instrument to quickly capture university students' willingness to get COVID-19 vaccination. Moreover, the DrVac-COVID19S can be used to compare university students' underlying reasons to get COVID-19 vaccination among different subgroups.

Anxiety and Gastrointestinal Symptoms Related to COVID-19 during Italian Lockdown

The first case of infection by SARS-CoV-2 (i.e., COVID-19) was officially recorded by the Italian National Health Service on 21 February 2020. Respiratory tract manifestations are the most common symptoms, such as gastrointestinal symptoms (GISs) like nausea or sickness, diarrhea, and anorexia, and psychological effects may be reported in affected individuals. However, similar symptoms may be observed in healthy people as a consequence of an anxiety state. Methods: We analyzed GISs and anxiety state during the COVID-19 lockdown period; from 9 March 2020 to 4 May 2020. A web-based survey consisting of 131 items was administered to 354 students affiliated with the School of Medicine of the University “Magna Graecia” of Catanzaro; Italy. A set of statistical analyses was performed to analyze the relationships among the answers to assess a correlation between the topics of interest. Results: The statistical analysis showed that 54.0% of interviewed reported at least one GISs, 36.16% of which reported a positive history for familial GISs (FGISs). The 354 subjects included in our cohort may be stratified as follows: 25.99% GISs and FGISs, 27.97% GISs and no-FGISs, 10.17% no-GISs and FGISs, 35.87% no-GISs and no-FGISs. Results indicated an anxiety state for 48.9% of respondents, of which 64.74% also presented GISs. In addition, considered dietary habits, we detect the increased consumption of hypercaloric food, sweetened drinks, and alcoholic beverages. Conclusions: The increase of GISs during the lockdown period in a population of medical students, may be correlated to both dietary habits and anxiety state due to a concern for one’s health.

Intolerance of COVID-19-Related Uncertainty and Negative Emotions among Chinese Adolescents: A Moderated Mediation Model of Risk Perception, Social Exclusion and Perceived Efficacy

The uncertainty caused by the COVID-19 pandemic has exacerbated negative emotions, especially among adolescents, who feel unable to tolerate the uncertainty of the epidemic. However, the mechanism by which the intolerance of COVID-19-related uncertainty (COVID-19 IU) affects negative emotions in adolescents remains unclear. This study explored the underlying mechanism from COVID-19 IU to negative emotions using a moderated mediation model in adolescents. In total, 3037 teenagers completed a cross-sectional survey including measures of COVID-19 IU, risk perception, social exclusion, perceived efficacy, and negative emotions. The results showed that COVID-19 IU positively predicted negative emotions and that risk perception and social exclusion mediated this relationship. In addition, both the direct effect of COVID-19 IU on negative emotions and the mediating effect of risk perception on this relationship were moderated by perceived efficacy; in particular, COVID-19 IU had a greater impact on negative emotions among adolescents with lower levels of perceived efficacy. These findings suggest that COVID-19 IU is closely associated with negative emotions among adolescents and that effective measures should be taken to enable adolescents to improve their perceived efficacy and develop a reasonable perception of risk, help them eliminate the stigma of the disease, and strengthen their connections with society.

The Psychological Impact of COVID-19 Pandemic on Graduating Class Students at the University of Gondar, Northwest Ethiopia

INTRODUCTION

A poorly known contagious disease outbreak, like COVID-19, leads to unavoidable stress, fear, and anxiety. During the pandemic, University students suffer from adverse mental health outcomes resulted from the continuous spread of the disease, sensational media reporting, and implementation of social lockdown. Graduating class students are more affected due to cancellation and postponing of anticipated events such as exchange studies and graduation ceremonies. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress among graduating class students.

METHODS

Institution-based cross-sectional study was conducted from November 10 to 30, 2020 at the University of Gondar. A simple random sampling technique was employed to select 350 students. Data were collected using a structured self-administered questionnaire, entered in EPI DATA version 3, analyzed using SPSS version 21, and presented in frequencies, percentages, tables, and graphs. Bivariable and multivariable analysis was investigated using a binary logistic regression model.

RESULTS

The prevalence of stress, anxiety, and depression among graduating class students was 22.2%, 39.6%, and 40.2% respectively. Living in an urban area, living with a family, sedentary lifestyle, unable to practice COVID-19 preventive measures, and having a contact history increases the risk of developing stress. Living in an urban area, substance use, sedentary lifestyle, and fear of infecting family increase the risk of developing anxiety. Students who came from an urban area, live with a family, study non-health departments, had confirmed cases in the family and did not perform physical exercise had higher odds of developing depression.

CONCLUSION

More than one-fifth, more than one-third, and nearly two-fifths of graduating students had stress, anxiety, and depression respectively. It is better to develop effective strategies and interventions, train students about self-protection, and establish a psychological crisis intervention team to minimize the psychological impact of the COVID-19 pandemic.

The Differential Impact of Lockdown Measures Upon Migrant and Female Psychiatric Patients - A Cross-Sectional Survey in a Psychiatric Hospital in Berlin, Germany

The COVID-19 pandemic could have major effects on already vulnerable individuals with psychiatric disorders. It is important to assess how different patient groups respond to stress related to the pandemic, and what additional factors influence it, including family-related stress, migration background, and sex. We conducted a survey in a sample of 294 psychiatric patients in a large outpatient clinic in Berlin, measuring level of distress in relation to COVID-19 lockdown as well as family-related distress. We also measured potential influencing factors such as media consumption and medical support. In the migration background group, we found that women had more lockdown related psychological distress than men. This was not apparent in those patients with a German background. We found that females were more strongly affected by family-related distress, particularly those with a migration background. People with PTSD were most strongly affected by family-related distress, whereas people with psychotic disorders and addiction reported the least distress. There were no effects of media consumption. There were no differences in ability to abide by the lockdown related restrictions across diagnoses. Our results support earlier findings on differential vulnerability of diagnostic groups to these stressors. Thus, clinicians can optimize treatment by taking family-related stressors into account particularly for females and people with a migrant background.

Prevalence of posttraumatic stress disorder after infectious disease pandemics in the twenty-first century, including COVID-19: a meta-analysis and systematic review

Pandemics have become more frequent and more complex during the twenty-first century. Posttraumatic stress disorder (PTSD) following pandemics is a significant public health concern. We sought to provide a reliable estimate of the worldwide prevalence of PTSD after large-scale pandemics as well as associated risk factors, by a systematic review and meta-analysis. We systematically searched the MedLine, Embase, PsycINFO, Web of Science, CNKI, WanFang, medRxiv, and bioRxiv databases to identify studies that were published from the inception up to August 23, 2020, and reported the prevalence of PTSD after pandemics including sudden acute respiratory syndrome (SARS), H1N1, Poliomyelitis, Ebola, Zika, Nipah, Middle Eastern respiratory syndrome coronavirus (MERS-CoV), H5N1, and coronavirus disease 2019 (COVID-19). A total of 88 studies were included in the analysis, with 77 having prevalence information and 70 having risk factors information. The overall pooled prevalence of post-pandemic PTSD across all populations was 22.6% (95% confidence interval (CI): 19.9-25.4%, I²: 99.7%). Healthcare workers had the highest prevalence of PTSD (26.9%; 95% CI: 20.3-33.6%), followed by infected cases (23.8%: 16.6-31.0%), and the general public (19.3%: 15.3-23.2%). However, the heterogeneity of study findings indicates that results should be interpreted cautiously. Risk factors including individual, family, and societal factors, pandemic-related factors, and specific factors in healthcare workers and patients for post-pandemic PTSD were summarized and discussed in this systematic review. Long-term monitoring and early interventions should be implemented to improve post-pandemic mental health and long-term recovery.

The Psychological Effect of Internet-Based Mindfulness-Based Stress Reduction on the Survivors of Breast Cancer During the COVID-19

Objective: To examine the efficacy and the role of engagement of an internet-based Mindfulness-based Stress Reduction (iMBSR) for survivors of breast cancer (BC) during the COVID-19 period from January to March in 2020 in China. Methods: 48 survivors of BC were divided into the absentees group and the iMBSR groups according to their attending to the standardized, group-based, 8-week iMBSR. Based on practice time, survivors of BC in the iMBSR were categorized into three subgroups: group 1 (<30 min/day), group 2 (30-60 min/day), and group 3 (>60 min/day). In addition, participants were classified as partial attendees (<4 sessions) and completers (more than 4 sessions) of the iMBSR groups. All participants were evaluated for symptoms of depression, anxiety and insomnia at baseline, mid-intervention, and post-intervention. Results: After an 8-week iMBSR practice, at mid-intervention and post-intervention, participants in iMBSR group had significant improvement in scores and reduction rates of depression, anxiety, and insomnia compared to absentees. Scores of depression and insomnia, reduction rates of depression at post-intervention, scores of anxiety, reduction rates of anxiety and insomnia at mid-intervention and post-intervention, had significant differences among subgroups of practice time. Daily practice time was positively related to reduction rates of depression, anxiety and insomnia at post-intervention in the iMBSR group. Conclusion: Internet-based MBSR showed efficacy in reducing psychological symptoms among survivors of BC. For survivors of BC, iMBSR practice has a potential dose-response efficacy, with a threshold of >30 min daily practice for most optimal symptoms reduction. Trial Registration: Registration number is [ChiCTR2100044309].