Prevalence of depression among university students in low and middle income countries (LMICs): a systematic review and meta-analysis

A comprehensive review and advanced biomolecule-based therapies for osteoporosis

BACKGROUND

The prevalence of osteoporosis (OP) on a global scale is significantly elevated that causes life threatening issues. The potential of groundbreaking biomolecular therapeutics in the field of OP is highly encouraging. The administration of biomolecular agents has the potential to mitigate the process of bone demineralization while concurrently augmenting the regenerative capacity of bone tissue, thereby facilitating a personalized therapeutic approach. Biomolecules-based therapies showed promising results in term of bone mass protection and restoration in OP.

AIM OF REVIEW

We summarized the recent biomolecular therapies with notable progress in clinical, demonstrating the potential to transform illness management. These treatments frequently utilize different biomolecule based strategies. Biomolecular therapeutics has a targeted character, which results in heightened specificity and less off-target effects, ultimately leading to increased patient outcomes. These aspects have the capacity to greatly enhance the management of OP, thus resulting in a major enhancement in the quality of life encountered by individuals affected by this condition.

Effects of Landscape Characteristic Perception of Campus on College Students' Mental Restoration

Emerging evidence underscores the beneficial effects of campus green spaces (CGSs) on student well-being and recovery. Previous research has predominantly examined the independent roles of landscape characteristics and preferences in mental restoration. However, limited studies have explored the complex interrelationships among restorative effects, landscape characteristics, preferences, and place-bonding factors, particularly within the context of CGSs. To address this gap, this study developed a validated campus landscape perception scale comprising three dimensions (perception of natural characteristics, perception of artificial characteristics, spatial perception) and 20 related indicators. In the second phase, the scale was used to investigate the influence mechanism of perceived campus landscape characteristics on mental restoration. A total of 36 CGSs across six higher education institutions in Nanjing were selected, representing diverse spatial types. The restoration experiences of 759 participants were measured using psychological indicators when viewing these landscapes. With the help of deep learning techniques, landscape elements were integrated with perceptual factors for partial least squares (PLS)-based statistical analysis. Our findings indicate that the natural and spatial dimensions significantly influence mental restoration, whereas the artificial dimension does not directly impact psychological health. Nevertheless, all dimensions indirectly enhance mental restoration through landscape preference and perceived restorativeness. The study also revealed the moderating effect of objective landscape elements on the relationship between the perception of landscape characteristics and landscape preference. This study confirms the positive role of perceived campus landscape characteristics in fostering mental restoration among students and elucidates the intricate pathway of influence, namely "perception of landscape characteristics → landscape preference → perceived restorativeness → mental restoration". These findings offer new insights into the complex processes of environmental restoration, where psychological and physical factors are intertwined. Finally, theoretical and managerial implications for improving landscape planning in restoration research are proposed.

Moderating effects of insomnia on the association between urinary phthalate metabolites and depressive symptoms in Chinese college students: focus on gender differences

OBJECTIVES

To investigate the rates of depressive symptoms in college students, explore the relationship between urinary phthalate metabolites and depressive symptoms and their gender differences, and further explore the moderating role of insomnia in this association.

METHODS

A total of 1 179 college students were recruited from 2 universities in Hefei and Shangrao cities from April to May 2019. The depressive symptoms and insomnia of college students were investigated by the Patient Health Questionnaire 9 and Insomnia Severity Index. The high-performance liquid chromatography-tandem mass spectrometry was adapted to determine the concentration of urinary phthalate metabolites. The generalized linear model was used to analyze the relationship of phthalate metabolites with depressive symptoms. Moderating analysis was used to examine whether insomnia moderated the relationship of phthalate metabolites with depressive symptoms.

RESULTS

The rates of mild depression, and moderate depression and above in college students were 31.9% and 9.2%, respectively. The phthalate metabolites exhibited a median and mean concentration spanning from 2.98 ∼ 156.55 ng/mL and 6.12 ∼ 205.53 ng/mL. The generalized linear model results showed that monobutyl phthalate (MBP) (β = 1.160, 95%CI: 0.423 ∼ 1.896) and low molecular weight phthalate (LMWP) (β = 1.230, 95%CI: 0.348 ∼ 2.113) were positively correlated with depressive symptoms, and MBP (β = 1.320, 95%CI: 0.453 ∼ 2.187) and LMWP (β = 1.396, 95%CI: 0.351 ∼ 2.440) were positively correlated with depressive symptoms only in female college students after stratified by gender. Furthermore, insomnia has a positive moderating role between MBP, LMWP, and depressive symptoms and has a sex-based difference.

CONCLUSIONS

This study suggests that there is a positive association of phthalate metabolites with depressive symptoms among Chinese college students, as well as insomnia plays a positive moderating role in this association.

Longitudinal Interactions between Problematic Internet Gaming and Symptoms of Depression Among University Students: Differentiating Anhedonia and Depressed Mood

BACKGROUND/OBJECTIVE

This study examines the interplay between problematic internet gaming (PIG) and depressive symptoms among university students, specifically anhedonia and depressed mood. Prior studies lacked distinction between these symptoms and had limited follow-ups.

METHOD

The three-wave longitudinal study analyzed data from 1,720 university students (with an average age of 20 years and 49 % being female) using a random intercept cross-lagged panel model, which distinguished between-person and within-person effects.

RESULTS

At the between-person level, PIG was positively associated with two depressive symptoms. At the within-person level, PIG positively predicted future anhedonia. Besides, depressed mood positively predicted future PIG.

CONCLUSIONS

Our results have identified PIG as a risk factor for anhedonia and depressed mood as a risk factor for PIG among university students.

Longitudinal Relations among Self-Compassion, Self-Esteem, and Depressive Symptoms in College Students: Disentangling the Within-Person Process from Stable Between-Person Differences

Although previous studies have shown that self-compassion is associated with self-esteem and depressive symptoms, little is known about the intra-individual processes and the temporal dynamics of these variables. This study used a longitudinal design to explore the association between self-compassion, self-esteem and depressive symptoms among 5785 college students (aged 17-22 years; Mage = 18.63, SD = 0.88; 48.2% females). The participants were assessed six times in a six-month interval over three years. The random intercept cross-lagged panel models (RI-CLPMs) were used to disentangle within-person processes from stable between-person differences. Results of RI-CLPMs indicated that at the within-person level, self-compassion can positively predict subsequent self-esteem and negatively predict subsequent depressive symptoms, and vice versa. Self-esteem played a longitudinal mediating role in the prediction from self-compassion to depressive symptoms at the within-person level. These results indicate that cultivating self-compassion in college students is crucial as it can bolster their self-esteem and alleviate depressive symptoms.

University students who were men who had sex with men (MSM) in Sichuan, China had a higher prevalence of insomnia and probable depression than their non-MSM counterparts: mediation via emotional dysregulations

BACKGROUND

Men who have sex with men studying in universities (MSM-US) frequently face multiple sexual minority stressors that potentially lead to maladaptive emotional regulations and mental problems. This study compared the prevalence of depression/insomnia between MSM-US and non-MSM male university students (NUS) and hypothesized that the potential differences would be mediated via emotional dysregulation styles (rumination and catastrophizing).

METHODS

The study design was a cross-sectional study. NUS were recruited from a university-based survey using cluster sampling in three universities in China from June to October 2018, while MSM-US from the same university-based survey and the other community-based survey using convenience sampling. The effective samples size was 2,531 (292 MSM-US and 2,239 NUS). Structural equation modeling (SEM) was performed.

RESULTS

MSM-US had significantly higher prevalence of both probable depression (55.1% versus 35.7%; OR = 4.85, 95% CI: 3.38-6.94) and moderate-to-severe clinical insomnia (17.3% versus 4.1%; OR = 2.21, 95% CI: 1.73-2.83) than NUS. MSM-US were also more likely than NUS to use emotional dysregulation styles (rumination/catastrophizing), which were correlated with probable depression/insomnia (r = 0.17 to 0.31). In the SEM, the differences in depression/insomnia between MSM-US and NUS were partially mediated by the latent variable of emotional dysregulation (rumination and catastrophizing), with effect sizes of 55.0% for probable depression and 33.6% for insomnia, respectively.

CONCLUSIONS

Depression and insomnia were prevalent among male university students in Sichuan, China. Furthermore, MSM-US were at increased risk than NUS for both mental problems; emotional dysregulation partially explained such differences. Future studies are warranted to confirm the findings, develop tailored interventions to address general and MSM-specific stressors and reduce rumination and catastrophizing, and examine whether similar patterns exist in other sexual minority groups.

Transition and trend analysis of the burden of depression in China and different income countries: Based on GBD database and joinpoint regression model

BACKGROUND

Depression is a leading cause of disability and poor health worldwide and is expected to rank first worldwide by 2030. The aim of this study is to analyze the transition and trend of depression burden in China and various income-level countries by utilizing the Global Burden of Disease (GBD) database and the Joinpoint regression model. This analysis seeks to comprehend the variations in the burden of depression across different income regions and evaluate their developmental patterns.

METHODS

Based on the GBD 2019 open dataset, this study extracted data on YLD (Years Lived with Disability), DALY (Disability-Adjusted Life Years), and incidence related to depression. The analysis focused on the period between 1990 and 2019, covering global data and distinguishing between high-income, upper-middle-income, lower-middle-income, low-income countries, and China. We utilized the Joinpoint regression model to fit the spatiotemporal trend changes among different income-level countries. Pairwise comparisons were conducted to examine the parallelism and to determine if the differences in trend changes among various regions were statistically significant.

RESULTS

From 1990 to 2019, the age-standardized YLD and DALY for depression female were higher than that in male. The YLD total change rate of depression men was higher than that of women. China exhibited the largest disparity in total YLD change rates between genders, reaching 0.08. During 1990 to 2019, the incidence of depression in 2005-2019 increased among females in middle to high-income countries, low-income countries, and China as compare to that of 1990-2005. Notably, China shown the most increase the incidence rate of females (from -0.4 % to 0.84 %). China experienced the most significant change in the YLD of depression during this period (AAPC = 0.45, 95 % CI = 0.41, 0.48, P < 0.01). China's YLD/Incidence rate was higher compared to the global, HICs, UMCs, LMCs, and LICs. In China, the YLD/incidence rate of depression began to rise in 1994, peaking around 2010, and then gradually declining. Since 2010, the growth rate of depression DALYs in China has been higher than the global average, high-income countries, upper-middle-income countries, lower-middle-income countries, and low-income countries. The DALY's AAPC value for the HLCs was the highest (AAPC = 0.24, 95 % CI = 0.22, 0.25, P < 0.01). The UMCs, in comparison to other regions, incidence rate had the highest AAPC value (AAPC = 0.48, 95 % CI = 0.46, 0.50, P < 0.01).

CONCLUSIONS

Given the significant variations in the burden of depression across countries with different income levels, future strategies aimed at reducing the burden of depression should adopt tailored and differentiated approaches according to each country's specific needs and developmental stages.

Mentalized Affectivity, Helicopter Parenting, and Psychopathological Risk in Emerging Adults: A Network Analysis

Emerging adulthood represents a critical stage characterized by heightened risks for anxiety, depression, and somatization symptoms development. Research has shown that difficulties in emotional identification, expression, and processing, as well as dysfunctional parenting styles, may exacerbate symptoms in emerging adults. The present study aimed at examining the interplay between mentalized affectivity (i.e., emotional identification, processing, and expression), helicopter parenting, and psychopathological risk in 913 Italian cisgender emerging adults (M = 24.34, SD = 2.81; 71.20% assigned female at birth), using network analysis. The results indicated moderate to strong associations between psychopathological symptoms, with emotional processing difficulties significantly associated with general anxiety, depression, and, to a lesser extent, somatization. Additionally, increased degrees of helicopter parenting from mothers were linked to increased psychopathology and higher emotional processing difficulties. These findings emphasize the importance of addressing the interconnection between symptoms and emotional processing to prevent and treat psychopathological risks in emerging adults. Moreover, interventions targeting intrusive and overprotecting parenting behaviors may promote well-being among emerging adults.

Depression and Substance Use Among Brazilian University Students During the COVID-19 Pandemic

The prevalence of depression and substance use changed significantly during the COVID-19 pandemic. The present study explored the association between the use of psychoactive substances and depression in Brazilian university students. This cross-sectional study was conducted between 2021 and 2022. A sample of 1271 students were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Hierarchical multivariate logistic regression models were used to assess the association between tobacco use, alcohol consumption, illicit substance use, and depression. Among the participants, 424 (33.4%; 95%CI 30.7-36) screened positive for depression (PHQ-9 ≥ 10). Alcohol was the most consumed substance. Recent use of illicit substances was associated with depression (adjusted odds ratio [aOR] 1.59; CI 1.02-2.50). The pattern of moderate or high-risk tobacco use (aOR 2.11; CI 1.31-3.42), alcohol use (aOR 3.40; CI 2.29-5.06), and illicit substances (aOR 1.82; CI 1.15-2.89) were associated with higher chances of depression in adjusted models. Findings highlight the importance of implementing support for mental health among university students. These policies are crucial for addressing maladaptive behaviors, such as substance use, and for mitigating psychological distress, such as depression, which has been exacerbated during the pandemic.

Female education ban by the Taliban: A descriptive survey study on suicidal ideation, mental health, and health-related quality of life among girls in Afghanistan

BACKGROUND

Following the Taliban's resurgence, Afghan girls were probited from attending school and university, likely causing adverse psychological effects. Therefore, the present study investigated depression, suicidal ideation, and quality of life (QoL) among Afghan girls banned from education by the Taliban.

METHODS

A survey study assessed depression, suicidal ideation, and QoL among 426 females prohibited from attending secondary schools, high schools, and universities by the Taliban. The study used the CES-D 20 Scale to assess depression, and the WHOQOL-Bref Questionnaire to assess QoL. Associations between variables were tested with chi-square tests, and predictors of QoL were analyzed through multivariate regression analysis.

RESULTS

Among the 426 participants, 87.6% exhibited depression symptoms and 49.8% reported suicidal thoughts. Significant predictors of overall QoL included monthly family income (B = 0.147, P = 0.001), recent others' behavior toward participants (B = -0.247, P < 0.001), physical illness (B = 0.110, P = 0.011), experiencing a recent traumatic event (B = 0.108, P = 0.015), depression (B = -0.159, P < 0.001) and suicidal ideation (B = -0.187, P < 0.001).

CONCLUSIONS

In Taliban-ruled Afghanistan, the results indicated that female students who have been prohibited from studying in classes have a high prevalence of depression and suicidal ideation. Having depression and suicidal ideation significantly predicted decreased quality of life among female students.

Specific emotion regulation difficulties mediate the relationship between personal distress and depressive symptoms in medical students

Several studies indicate a link between personal distress and vulnerability to depression. The literature also suggests that personal distress is associated with emotion dysregulation and that emotion dysregulation plays a role in depression. However, which of the various emotion regulation difficulties mediates the relationship between personal distress and depression remains unexplored. This study therefore aims to investigate the mediating role of specific emotion regulation difficulties in the relationship between personal distress and depression. Of the 702 initially recruited participants, 635 completed a survey comprising the Interpersonal Reactivity Index, the Difficulties in Emotion Regulation Scale, and the Beck Depression Inventory. A mediation analysis was used to explore which emotion regulation difficulties mediate the relationship between personal distress and depression. Over a quarter (27%) of participants reported moderate-severe depression symptoms. Difficulties in accessing adaptive emotion regulation strategies and in having a clear understanding about one's own emotions partly mediated the relationship between personal distress and depression symptoms. Our results are the first to indicate that personal distress is linked to depression risk through specific emotion regulation difficulties in medical students. They also highlight possible modifiable skills that could be targeted by prevention intervention.

Psychological distress, health-promoting lifestyle and sociodemographic factors in Honduran university students: a structural equation model

This study sought to analyze an explanatory model on the relationship among sociodemographic factors, health-promoting lifestyle behaviors and psychological distress (depression, anxiety and stress) in college students. This is an observational, analytical and cross-sectional study conducted on a national sample of 4203 students who entered a macro university in Honduras in 2021, 2022 and 2023. We used a sociodemographic survey, the Health-Promoting Lifestyle Profile (HPLP-II) and the Depression, Anxiety and Stress Scales (DASS-21). Univariate analysis and a multivariate structural equation model were conducted. The average HPLP-II score was 117.45 (± 23.41), and the average DASS-21 score was 20.06 (± 14.16). The multivariate model showed a good data fit (comparative fit index = 0.951; Tucker-Lewis index = 0.957; root mean square error of approximation = 0.067 [90% CI = 0.067-0.068]). Results indicate that being a woman (β = 0.11; p < 0.001) and being enrolled in biological and health sciences (β = 0.09; p < 0.001) significantly predict HPLP-II scores. Furthermore, being a woman (β = 0.17; p < 0.001), age (β = 0.10; p < 0.001) and having pre-existing medical conditions (β = 0.16; p < 0.001) significantly explain part of the variance of DASS-21. A significant reverse relationship between health-promoting behavior and psychological distress was shown (r = -0.36; p < 0.001). This study identifies protective and risky sociodemographic factors linked to health-promoting lifestyle behaviors and psychological distress. Our findings have implications for developing comprehensive intervention policies and strategies to promote health in higher education settings.

The U-shape Association between Population Agglomeration and Individual Depression: the Role of Dialect Diversity

Depression is a relevant mental illness affecting hundreds of millions of people worldwide. As urbanization accelerates, agglomeration of populations has altered individual social network distances and life crowding, which in turn affects depressive prevalence. However, the association between depression and population agglomeration (PA) remains controversial. This study aims to explore whether and how PA could influence individual depression. Based on the China Health and Retirement Longitudinal Study (CHARLS) 2018, the empirical results showed that there was a U-shaped association between PA and individual CES-D scores. As PA increases, the risk of depression first decreases and then increases. CES-D was lowest at moderate aggregation. Dialect diversity (DD) was positively related to the incidence of individual depression. The higher the DD, the higher the risk of depression. Meanwhile, DD also played a moderating role in the association between PA and individual depression. Our observations suggest that the optimistic level of agglomeration for individual mental health is within 1500 to 2000 persons per square kilometer.

Association between Current Substance Use, Healthy Behaviors, and Depression among Ukrainian College Students

Depression is a pervasive issue among college students worldwide, yet there is a significant gap in the literature regarding its prevalence and coping strategies in the Ukrainian context. The present study aims to fill this gap by investigating how substance use and health-promoting behaviors relate to depressive symptoms among Ukrainian college students. Health-promoting behaviors are an important strategy to prevent depression, whereas substance use can contribute to depression or make it harder to manage. Given the substantial psychosocial problems and stressors related to the ongoing war in Ukraine and the limited availability of mental health services for college students, it is important to understand how we can encourage college students to keep themselves mentally healthy. A cross-sectional study was conducted among college students on 10 campuses in 2018. Almost 16% of participants met a cut-off for depression. Female students and those who were older reported significantly higher depressive symptoms. Participants were more likely to report depressive symptoms if they were more often involved with alcohol and cannabis use, were older, and engaged in fewer health-promoting behaviors. Tobacco use was not significantly associated with depressive symptoms. Our findings suggest a moderate prevalence of depressive symptoms in our study population. We recommend implementing balanced public health interventions that address risk factors (such as substance use) while also promoting protective behaviors and can be tailored to the specific cultural and environmental context of the region.

Substitutions of physical activity and sedentary behavior with negative emotions and sex difference among college students

BACKGROUND

A growing number of studies have found that physical activity (PA) benefits mental health, and sedentary behavior (SB) increases the risk of psychological symptoms, but it remains unclear whether substituting the duration of different activities may affect the association, and whether sex difference exists among college students.

METHODS

A longitudinal survey was conducted in three colleges in Anhui province, China. A total of 8049 participants validly answered the questionnaire, which included demographic variables, PA, SB and negative emotions (depressive, anxiety, and stress symptoms).

RESULTS

Substituting 30 min per day of SB with equivalent walking was associated with lower scores of depressive symptoms. Stress symptoms were reduced when SB was substituted by moderate intensity PA (MPA) and walking. Substituting 30 min per day of MPA in place of walking and SB was associated with an amelioration of depressive and stress symptoms in females, and a reallocation of 30 min walking was associated with lower depressive and stress symptom scores when SB was replaced in males.

CONCLUSIONS

Replacing SB with walking and MPA ameliorates the depressive and stress symptoms in young adults. The results suggest a reallocation of time from SB or walking to MPA in females while from SB to walking in males may markedly reduce the depressive and stress symptoms in college population.

The moderating role of stigma in the relationship between depression and resilience: results of a cross-sectional study in university students

Background/objective

Depression is a growing concern in university students and resilience has shown to play a protective role. The impact of stigma is still under-explored, with reference to its moderating role between depression and resilience. The present study investigate such a relationship among Italian university students.

Methods

A cross-sectional design was applied in a simple of 1,912 students to examine the interrelationships between depression (Patient Health Questionnaire-9), resilience (Nicholson McBride Resilience questionnaire), and stigma (Stigma-9). Correlation, predictor, and moderation analyses were applied in RStudio.

Results

A negative correlation was found between depressive symptoms and resilience (r = -0.455, p < 0.001). A positive correlation was found between depressive symptoms and stigma (r = 0.207, p < 0.001). Lower levels of resilience and higher levels of stigma were significant predictors of depressive symptoms [F(df, n) = 190.8(3, 1884), p < 0.001, R2 = 0.236]. The moderation analysis showed a weakening of resilience protective effect against depression as stigma levels increase [F(df,n) = 186.7(3,1908), p < 0.001, R2 = 0.226].

Conclusion

Stigma influences the relationship between depression and resilience. Anti-stigma interventions and programs empowering resilience, should be implemented in university settings to protect students from depression.

Variations in anxiety and emotional support among first-year college students across different learning modes (distance and face-to-face) during COVID-19

College students with more emotional support experience lower levels of anxiety and other psychosocial and behavioral problems. During the COVID-19 pandemic, the emotional well-being of college students was additionally challenged by an abrupt shift to distance learning followed by a return to face-to-face classes. In this exploratory study, we compared the levels of perceived emotional support and anxiety among incoming first-year undergraduate students, prior to starting classes, which included different learning modes in five semesters of instruction from 2021-2023 (three distance semesters and two face-to-face semesters). Data from 8659 undergraduate students were extracted from a Mexican state university database, corresponding to students' responses collected during new student orientation week. Participants were students in the arts and humanities (9.7%), social and legal sciences (38%), life and health sciences (28.9%), and engineering and architecture (23.4%). Anxiety levels were measured with the GAD-7 scale, and emotional support was measured using a subscale of the PERACT-R (To go through with resilience) inventory. Comparisons of emotional support and anxiety scores among semesters revealed highly significant differences with small effect sizes. Anxiety levels increased significantly with mean average of 6.65 SD(5.52) during the baseline measure to the highest in 2022-2 to 7.53 SD(5.3) and Emotional Support decreased systematically each semester from baseline mean = 8.03 SD(2.0) to the lowest 7.52 SD(1.8) in 2022-2. The results show that a return to face-to-face classes was associated with increased anxiety levels, whereas levels of emotional support systematically decreased across the five semesters. MANOVA analysis revealed significant differences in anxiety and emotional support scores between semesters, with peaks during the learning mode semester that students returned to face-to-face classes after distance learning even after adjusting for gender. Given that the effect of emotional support on anxiety may be related to success in future educational and professional activities, it is important to develop interventions to restore and increase college students' emotional support levels and develop anxiety management strategies.

Understanding university students' attitudes and preferences for internet-based mental health interventions

Internet-based interventions are recognised as a practical approach to address mental health issues. The acceptance and utilisation of such interventions are closely linked to user attitudes and preferences. This study aims to examine the predictors of university students' attitudes towards internet-based interventions. Additionally, it seeks to elucidate students' preferences regarding crucial features of these interventions, such as the format, delivery mode, content type, and structural components, to understand better what makes these interventions appealing and practical for university students. A total of 273 university students (comprising 68 % females and 32 % males) participated in the study. The data collection instruments employed were the Personal Information Form, Internet-Based Intervention Preference Survey, E-therapy Attitude Measure (ETAM), Digital Literacy Scale, Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 (GAD-7). The data were analysed utilising descriptive statistics, Pearson correlation analysis, and multiple linear regression analysis. The multiple regression analysis revealed digital literacy as a predictive factor for attitudes towards internet-based interventions. Demographic variables, such as age and gender, and psychological variables, such as depression and anxiety levels, were found not to be associated with attitudes towards these interventions. While students are actively seeking mental health information online, a significant majority remain unaware of internet-based interventions. They show a preference for interventions offering greater human interaction, including face-to-face guidance and video content featuring people. Participants favour completing one or two sessions of the intervention weekly. Desired features of internet-based interventions include self-assessment scales, relatable characters, voice relaxation exercises, practical daily life activity tasks, and weekly reminders throughout the process. In conclusion, initiatives aimed at enhancing digital literacy levels could foster more positive attitudes towards internet-based interventions among students. Developers creating Internet-Based Interventions (IBI) for university students should consider these preferences.

Prevalence of depressive tendencies among college students and the influence of attributional styles on depressive tendencies in the post-pandemic era

Introduction

Depression symptoms are prevalent globally, including China, with a notable impact on college students. This study aims to not only estimate the prevalence of depressive tendencies and attributional styles among college students in the post-pandemic era but also explore the relationship between the two factors. The findings of this study can provide new insights into early intervention and support services for individuals exhibiting tendencies toward depression.

Methods

The survey was administered to college students from various academic backgrounds at a specific university in southern Jiangxi Province by employing two scales to investigate depressive tendencies and attributional styles. Depressive tendency was evaluated using the Patient Health Questionnaire-9 (PHQ-9), while the attributional styles were assessed using the Multidimensional-Multiattributional Causality Scale (MMCS). Univariate analysis and multiple logistic regressions were conducted to identify the related factors of depressive tendency.

Results

A relatively high (48.9%) prevalence of depression among college students was found in this study. College students with higher grades (OR = 1.574, 95%CI: 1.369-1.810), profession of medicine and allied health sciences (OR = 1.779, 95%CI: 1.203-2.629), experiencing higher study stress (OR = 2.006, 95%CI: 1.601-2.514), and having poor physical condition (OR = 1.527, 95%CI: 1.247-1.869) were identified as risk factors for depressive tendency. The correlation between higher grades and increased learning pressure, coupled with poorer physical condition, heightens the vulnerability of college students to depression. Moreover, the more they attribute these experiences to achievement effort (OR = 0.897, 95%CI: 0.828-0.972), achievement ability (OR = 0.903, 95%CI: 0.838-0.972), and affiliation context (OR = 0.919, 95%CI: 0.860-0.982), the less likely they are to develop depression.

Conclusion

In the group of college students, especially those in higher grades, profession of medicine and allied health sciences or experiencing high learning pressure and poor physical condition, emphasizing the significance of their mental well-being becomes crucial. Offering suitable support and assistance is essential. Additionally, fostering the cultivation of positive attributional and coping strategies by attributing difficulties to controllable factors and instilling a belief in their ability to overcome challenges can help reduce the risk of depression.

The impact of problematic mobile phone use and the number of close friends on depression and anxiety symptoms among college students

Background

Psychological problems often occur in college students, with the most common ones being depression and anxiety symptoms. Exploring the risk factors that influence depression and anxiety symptoms in college students is essential to promote their physical and mental health.

Objective

This study aimed to investigate the independent and interaction effects of problematic mobile phone use (PMPU) and the number of close friends (NCFs) on depression and anxiety symptoms and the comorbidity of these symptoms among college students.

Methods

A cross-sectional survey was conducted in Huainan, Anhui Province, and Suzhou, Jiangsu Province in China from October to December 2022. Data from 7,617 college students were collected. The Patient Health Questionnaire and Generalized Anxiety Disorder-7 were used to evaluate depression and anxiety symptoms. The PMPU data were collected by the Mobile Phone Addiction Type Scale. Multinomial logistic regression models were performed to examine the associations of PMPU and NCFs with depression and anxiety symptoms and their interaction effects.

Results

PMPU and lack of close friends significantly increased the risk of depression and anxiety symptoms and the comorbidity of these symptoms in college students (p < 0.001). In addition, the effects of PMPU and lack of close friends on depression and anxiety symptoms in college students were interactive (p < 0.001). No significant sex differences were found.

Conclusion

PMPU and lack of close friends are important risk factors for depression, anxiety, and the comorbidity of these symptoms in college students in China.

Interventions for Strengthening General Self-Efficacy Beliefs in College Students: An Integrative Review

OBJECTIVE

To assess the evidence regarding the effectiveness of interventions aimed at strengthening self-efficacy beliefs in college students.

METHODS

Integrative Review conducted on the Lilacs, PubMed, CinahL, Cochrane Collaboration Databases, Scopus, and PsycInfo databases. The methodological quality of the studies was assessed using tools proposed by the Joanna Briggs Institute, and the results were analyzed descriptively.

RESULTS

Out of the 10 selected studies, six demonstrated that interventions aimed at strengthening self-efficacy were effective (Levels of Evidence II and III), and four revealed contrary results (Levels of Evidence I and II). Programs aimed at enhancing self-efficacy should include content on positive mental health, psychoeducation strategies, cover a period of eight to twelve weeks, and consider the completion of homework assignments.

CONCLUSION

The synthesis of evidence pointed to pathways for building an effective self-efficacy strengthening program to be implemented in universities.

Prevalence of mental disorders in South Asia: A systematic review of reviews

Mental disorders are increasing in South Asia (SA), but their epidemiological burden is under-researched. We carried out a systematic umbrella review to estimate the prevalence of mental disorders and intentional self-harm in the region. Multiple databases were searched and systematic reviews reporting the prevalence of at least one mental disorder from countries in SA were included. Review data were narratively synthesised; primary studies of common mental disorders (CMDs) among adults were identified from a selected subset of reviews and pooled. We included 124 reviews. The majority (n = 65) reported on mood disorders, followed by anxiety disorders (n = 45). High prevalence of mental disorders and intentional self-harm was found in general adult and vulnerable populations. Two reviews met our pre-defined criteria for identifying primary studies of CMDs. Meta-analysis of 25 primary studies showed a pooled prevalence of 16.0% (95% CI = 11.0-22.0%, I 2 = 99.9%) for depression, 12.0% (5.0-21.0%, I 2 = 99.9%) for anxiety, and 14.0% (10.0-19.0, I 2 = 99.9%) for both among the general adult population; pooled estimates varied by country and assessment tool used. Overall, reviews suggest high prevalence for mental disorders in SA, but evidence is limited on conditions other than CMDs.

Depression Among University Students in Jordan After the COVID-19 Pandemic: A Cross-Sectional Study

Background

University students encounter stressors that make them more susceptible to depression than the general population. Depression negatively impacts mental and physical health. Our study assessed the prevalence of depression among university students in Jordan and its associated predictors after the COVID-19 pandemic.

Methods

We conducted this cross-sectional online survey study in the first quarter of 2022 by sending an online questionnaire to university students aged 18 years and older. This study assessed the symptoms of depression using the Patient Health Questionnaire-9 (PHQ-9). Binary logistic regression analysis was used to identify associated predictors of depression.

Results

A total of 535 university students participated in this study. The mean depression score for the study participants was 13.9 (SD: 7.1) out of 27, representing a moderate level of depression. Among the participants, 26.2% had moderate, 19.3% had moderately severe, and 25.8% had severe depression. Students who drink three or more cups of coffee per day, have had an evaluation of their psychological state by specialists before, and have been diagnosed with any mental illness were more likely to have a higher depression score compared to others (p<0.05). On the other hand, students who were aged 24 years and older and those who practiced regular exercise were less likely to have a higher depression score compared to others (p<0.05).

Conclusion

We found a high prevalence of depression among university students in Jordan. This result is vital for decision-makers to implement a plan to prevent and manage this mental health issue.

Evolving Mental Health Dynamics among Medical Students amid COVID-19: A Comparative Analysis of Stress, Depression, and Alcohol Use among Medical Students

Background and Objectives: The ongoing COVID-19 pandemic has posed an array of new challenges for medical students worldwide. Amidst academic rigors, students are confronted with unique stressors, potentially affecting their mental health and substance use. This study aimed to investigate the multifaceted effects of depression, alcohol use, and stress on medical students and discern how these factors have been amplified by the pandemic's circumstances, and to identify predictors of mental distress during the COVID-19 pandemic period. Materials and Methods: Two online anonymous and cross-sectional surveys were conducted at the University of Medicine and Pharmacy "Iuliu Hatieganu" in Romania among medical students in 2018 and in 2022. Data were gathered via online questionnaires distributed through closed student groups on social media platforms, with a total of 1061 participants, to investigate stress, depression, alcohol and drug use, and the impact of the pandemic and online education on mental health, maintaining anonymity and ethical approval. The Medical Student Stress Questionnaire (MSSQ) was employed to measure different aspects of stress, the Beck Depression Inventory (BDI) provided insights into the participants' depressive symptoms, and for the assessment of alcohol consumption habits, the Alcohol Use Disorders Identification Test (AUDIT) was utilized. Results: Our findings showed a significant decrease in mean depression scores (13.81 vs. 11.56, with p < 0.001) from 2018 to 2022. In 2018, students scored significantly higher in the overall stress-related domains. Additionally, being female, facing financial constraints, and being in pre-clinical years emerged as predictors of heightened academic-related stress and depressive symptoms. Students who had experienced the loss of a family member due to COVID-19 exhibited a statistically significant rise in their average BDI score and current anxiety levels. Conclusions: The pandemic, despite introducing new stressors, may have indirectly fostered an increased focus on students' mental health, leading to more refined support mechanisms. Specialized interventions, taking into account gender and financial problems, are needed to address the multifaceted challenges faced by medical students. Our study highlights the ongoing need to nurture both the academic and emotional strength of future medical practitioners.

Prevalence of depression among students at Ethiopian universities and associated factors: A systematic review and meta-analysis

BACKGROUND

Depression is the most common cause of disability in the world, which affects 350 million people. University students struggle to cope with stressors that are typical of higher education institutions as well as anxiety related to education. Although evidence indicates that they have a high prevalence of depression, no reviews have been done to determine the prevalence of depression among students at Ethiopian universities comprehensively.

METHODS

Without regard to time constraints, PubMed, Scopus, and EMBASE were investigated. A manual search for an article reference list was also conducted. The Meta XL software was used to extract relevant data, and the Stata-11 meta-prop package was used to analyze it. The Higgs I2 test was used to test for heterogeneity.

RESULTS

A search of the electronic and manual systems resulted in 940 articles. Data were extracted from ten studies included in this review involving a total number of 5207 university students. The pooled prevalence of depression was 28.13% (95% CI: 22.67, 33.59). In the sub-group analysis, the average prevalence was higher in studies having a lower sample size (28.42%) than studies with a higher sample; 27.70%, and studies that utilized other (PHQ-9, HADS); 30.67% higher than studies that used BDI-II; 26.07%. Being female (pooled AOR = 5.56) (95% CI: 1.51, 9.61), being a first-year (pooled AOR = 4.78) (95% CI: 2.21, 7.36), chewing khat (pooled AOR = 2.83) (95% CI: 2.32, 3.33), alcohol use (pooled AOR = 3.12 (95% CI:3.12, 4.01) and family history of mental illness (pooled AOR = 2.57 (95% CI:2.00, 3.15) were factors significantly associated with depression.

CONCLUSION

This systematic review and meta-analysis revealed that more than one-fourth of students at Ethiopian universities had depression. More efforts need to be done to provide better mental healthcare to university students in Ethiopia.

Depression prediction based on LassoNet-RNN model: A longitudinal study

Depression has become a widespread health concern today. Understanding the influencing factors can promote human mental health as well as provide a basis for exploring preventive measures. Combining LassoNet with recurrent neural network (RNN), this study constructed a screening model ,LassoNet-RNN, for identifying influencing factors of individual depression. Based on multi-wave surveys of China Health and Retirement Longitudinal Study (CHARLS) dataset (11,661 observations), we analyzed the multivariate time series data and recognized 27 characteristic variables selected from four perspectives: demographics, health-related risk factors, household economic status, and living environment. Additionally, the importance rankings of the characteristic variables were obtained. These results offered insightful recommendations for theoretical developments and practical decision making in public health.

Prevalence of common mental disorders among medical students in China: a systematic review and meta-analysis

Background

The prevalence of mental distress is common for medical students in China due to factors such as the long duration of schooling, stressful doctor-patient relationship, numerous patient population, and limited medical resources. However, previous studies have failed to provide a comprehensive prevalence of these mental disorders in this population. This meta-analysis aimed to estimate the prevalence of common mental disorders (CMDs), including depression, anxiety, and suicidal behaviors, among medical students in China.

Methods

We conducted a systematic search for empirical studies on the prevalence of depression, anxiety, suicide attempt, suicide ideation, and suicide plan in Chinese medical students published from January 2000 to December 2020. All data were collected pre-COVID-19. The prevalence and heterogeneity estimations were computed by using a random-effects model and univariate meta-regression analyses.

Results

A total of 197 studies conducted in 23 provinces in China were included in the final meta-analysis. The prevalence data of depression, anxiety, suicide attempt, suicide ideation, and suicide plan were extracted from 129, 80, 21, 53, and 14 studies, respectively. The overall pooled crude prevalence for depression was 29% [38,309/132,343; 95% confidence interval (CI): 26%-32%]; anxiety, 18% (19,479/105,397; 95% CI: 15%-20%); suicide ideation, 13% (15,546/119,069; 95% CI: 11%-15%); suicide attempt, 3% (1,730/69,786; 95% CI: 1%-4%); and suicide plan, 4% (1,188/27,025; 95% CI: 3%-6%).

Conclusion

This meta-analysis demonstrated the high prevalence of CMDs among Chinese medical students. Further research is needed to identify targeted strategies to improve the mental health of this population.

Depression and Its Associated Factors among Undergraduate Engineering Students: A Cross-Sectional Survey in Thailand

BACKGROUND

Depression is a common mental health problem that can affect everyone at different stages of development. Though the prevalence rate of depression among university students is rising, exploration among engineering students is limited. The aim of the study was to examine the prevalence of depression and its associated factors of among engineering students in Thailand.

METHODS

A total of 346 students participated in this study. All completed the outcome inventory depression subscale (OI-D) to evaluate the level and prevalence of depression. Other variables assessed included social skills, learning styles, relationship satisfaction, interpersonal difficulty, alcohol use, internet addiction, and neuroticism. Correlation and regression analyses were applied to test the association between sociodemographic and psychosocial factors and depression.

RESULTS

Of the 346 students with the mean age of 20.25 (SD, 1.33), 52.31% were male. Based on the OI-D, 35.3% of participants exhibited symptoms indicative of major depression. Multiple regression showed that only neuroticism, interpersonal difficulties, social skills, and self-esteem appeared to be the significant predictors of depression.

CONCLUSION

The prevalence of depression among engineering students in Thailand was unexpectedly high compared with the prevalence of depression among engineering students in some other countries. Intra- and interpersonal factors were found to be associated with depression. Further study on identifying these risk factors should be encouraged.

Prevalence and factors associated with depression and suicidal ideation among French students in 2016: A national study

Depression is one of the leading causes of morbidity worldwide and increases the risk of suicide. Students are known as a population at risk for depression. This study aimed to evaluate the prevalence of 12 months major depressive episode (MDE) and suicidal thoughts in French students and investigate associated factors. A questionnaire was sent by email to a representative sample of the French student population between April 28th and June 27th 2016. MDE was assessed using the Composite International Diagnostic Interview Short Form (CIDI-SF). The response rate was 18.7% (N= 18,875). Prevalence of 12 months MDE was 15.8%, and suicidal thoughts was 9%. Factors associated with MDE were being a woman, study field (law/eco, human/social sciences, and medical), having failed midterms exams or dropout, refusal or stop social scholarship, and subjective financial difficulties. Factors associated with suicidal thoughts were study field (human/social sciences), having failed midterms exams or dropout, and important subjective financial difficulties. The use of CIDI-SF allows comparison with the 2017 French national study, and showed more MDE in students than in the general population. This is the only national study on French students before COVID 19 pandemic.

Prevalence of depression, anxiety and burnout in medical students at the University of Namibia

Background

There is an increased prevalence of depression, anxiety, and burnout among medical students worldwide with no information from Namibia.

Aim

This study aimed to determine the prevalence and factors associated with depression, anxiety, and burnout among medical students at the University of Namibia (UNAM).

Methods

A quantitative descriptive cross-sectional survey was conducted utilising a specially designed questionnaire for the study and standardised instruments to evaluate depression, anxiety, and burnout.

Results

Of the 229 students in this study, 71.6% were female and 28.4% were male. The prevalence of depression, anxiety, and burnout was 43.6%, 30.6%, and 36.2%, respectively. The prevalence of emotional exhaustion (EX), cynicism (CY), and professional efficacy (EF) was 68.1% (n = 156), 77.3% (n = 177) and 53.3% (n = 122), respectively. In the final regression model, participants with a current psychiatric illness were more likely to screen positive for depression (adjusted odds ratio [aOR] 4.06, confidence interval [CI] 1.28-12.91; p = 0.02) and anxiety (aOR: 3.63, CI: 1.17-11.23; p = 0.03). Emotional exhaustion and cynicism were significantly associated with female gender (EX: aOR, 0.40, CI: 0.20-0.79; p = 0.01) (CY: aOR, 0.42, CI: 0.20-0.91; p = 0.03).

Conclusion

More than one in three medical students at the UNAM were either depressed or burnt out.

Contribution

This is the first study to highlight the mental health needs of medical students at the University of Namibia.

Disaster preparedness in healthcare professionals amid COVID-19 and beyond: A systematic review of randomized controlled trials

BACKGROUND

Disasters like COVID-19 are oftentimes inevitable, which makes disaster preparedness indispensable to global health and social stability. However, there is a dearth of understanding of how well healthcare professionals, who often have to work at the epicenter of disasters as they evolve, are trained to be sufficiently prepared for these crises. To this end, this study aims to examine the characteristics and effectiveness of existing interventions that aim to improve healthcare professionals' disaster preparedness.

METHODS

We searched RCTs that aim to improve healthcare professionals' disaster preparedness in databases including PubMed, PsycINFO, CINAHL and Scopus. Results were screened against the eligibility criteria. The review was registered with PROSPERO (CRD42020192517) and conducted following the PRISMA guidelines.

RESULTS

A total of 7382 articles were screened for eligibility, among which, 27 RCTs, incorporating 35,145, met the inclusion criteria. Review results show that most of the eligible RCTs were conducted in high-income countries. Only two RCTs were developed in disaster contexts that share similarities with COVID-19. Most of the interventions did not address critical disaster coping abilities, such as how can healthcare professionals protect or improve their personal or the general public's mental health amid pandemics. Furthermore, almost half of the disaster preparedness RCTs failed to generate statistically significant outcomes.

CONCLUSIONS

Albeit inevitable, disasters are preventable. Our study results underscore the imperative of designing and developing effective and comprehensive interventions that could boost healthcare professionals' disaster preparedness, so that these frontline workers can better protect personal and public health amid global crises like COVID-19.

Relationship between depression and quality of life among students: a systematic review and meta-analysis

The objectives of this systematic review were to estimate the prevalence of depression and to identify the relationship between depression and quality of life (QOL) among high school and university students. Literature search was performed in the Scopus, Embase, PubMed, Scielo, CINAHL and Web of Science databases, following the PRISMA methodology. The results were presented through descriptive approaches and meta-analysis. Thirty-six studies met the eligibility criteria, and twenty-six were included in the meta-analysis. The prevalence of depressive symptoms was 27% (95% CI 0.21-0.33) among students, being high school and university students was 25% (95% CI 0.14-0.37) and 27% (95% CI 0.20-0.34), respectively, and most studies have shown that depression was associated with low QOL. Among the limitations of the study is the difficulty of generalizing the results found, considering the large sample of health students. New studies should be conducted considering the severity, duration, and patterns of depressive symptoms in high school and university students, to better understand the relationship between depression and QOL.

Factors contributing to depressive symptoms among undergraduate nursing students: A cross-sectional study

AIM

To investigate predictive factors of student's academic year, interest in the field of nursing, stress, self-efficacy, and problem-focused and emotion-focused coping on the depressive symptoms among undergraduate nursing students.

BACKGROUND

As the burden of depression among students has increased worldwide, depressive symptoms have become a standard part of mental health problems in college and university students. Among the various fields of medical sciences, nursing students face more stressors during their study period and are more at risk of suffering depressive symptoms than other students.

DESIGN

A cross-sectional design.

METHODS

A total of 230 undergraduate nursing students from a university in Myanmar were recruited from August to September 2021. The data were collected using standard research instruments, including a Demographic Questionnaire, Student Nurse Stress Index Questionnaire, General Self-efficacy Scale, Brief COPE Inventory, and Center for Epidemiology Studies Depression Scale (CES-D). Descriptive statistics were used to describe the sociodemographic characteristics of the participants. Inferential statistics were used to identify the predictive effect of academic year, interest in the field of nursing, stress, self-efficacy, problem-focused coping, and emotion-focused coping on depressive symptoms, using multiple linear regression analysis.

RESULTS

Academic year, interest in the field of nursing, stress, self-efficacy, and problem-focused and emotion-focused coping accounted for 31.5% of the variance of depressive symptoms (F(8, 221) = 12.704, p < .001) with an R² = .315. Stress was the factor that most influenced student's depressive symptoms (β = .407, p < .001). Self-efficacy (β = -.244, p < .001) and emotion-focused coping (β = .199, p < .05) were also critical factors contributing to depressive symptoms among undergraduate nursing students.

CONCLUSIONS

The results of this study provide insight and knowledge about depressive symptoms and factors that can contribute to depressive symptoms among undergraduate nursing students. Results suggest that nurse educators and community mental health nurses should focus on reducing stress, increasing self-efficacy, and enhancing proper coping strategies among students to prevent depressive symptoms.

Pre- and Post-Pandemic (COVID-19) Mental Health of International Students: Data from a Longitudinal Study

Purpose

International students are highly vulnerable to the risk of mental health worsening before and during the pandemic (COVID-19). This study investigated international students' mental health pre- and post-pandemic (COVID-19).

Methods

It is a longitudinal study, and data were collected online, pre-pandemic (N = 470) and during the pandemic (N = 420). Using a random sampling technique, a self-administered questionnaire was used to measure mental health, including depression and anxiety.

Results

Findings show that international students' mental health was good in pre-pandemic. Meanwhile, international students were found to be more depressed and anxious during the pandemic. Findings also investigated that in the pre-pandemic phase, young students' and mainly females' mental health was worsened.

Conclusion

This study concluded that students' mental problems are alarming, so the university should provide psychological services for the student's mental health. Post-pandemic is leaving long-lasting psychological effects and will require further investigation.

Designing interventions to ameliorate mental health conditions in resource-constrained contexts: some considerations

Health interventions, including those directed at ameliorating symptoms of mental disorders, can contribute significantly to realising the goal of sustainable development. The Strategic Development Goal of ensuring healthy lives and well-being for all, at all ages, pertains all health conditions, including those affecting mental health. Considering the low ratio of researchers to the population of many low- and middle-income countries, there is a specific need to build capacity for research so as to ensure good quality data so that social policies can be data-informed. This article outlines four considerations for trial investigators assessing the effectiveness of mental health interventions in low- and middle-income countries, namely, task sharing, scaling up, structural barriers, and the transformation imperative. Task sharing is an arrangement in which non-specialist health workers receive training and supervision to screen for and diagnose mental disorders and intervene with persons affected by them. Scaling up a proof of concept is appropriate when trials yield positive results showing effectiveness of the intervention. Structural barriers such as transport difficulties, long waiting times in clinics, food insecurity, competing demands on people’s time, childcare concerns, and poor health literacy play an important role in driving health behaviours and should be considered in intervention design. Transformation of the cadre of researchers to include those from oppressed and marginalised groups will yield investigators who are able to frame research questions and develop methodologies that reflect the lived realities of these communities.

[Existential youth depressions]

OBJECTIVE

To determine the clinical and psychopathological features of existential depression in youth.

MATERIAL AND METHODS

53 male patients (16-25 years old) with diagnosis F31.3, F31.4, F32, F33 with existential themes of depressive experiences were studied by clinical and psychopathological method.

RESULTS

The axial symptom of existential was over-value ideas about the meaninglessness of their own and human life with ideas of self-abasement, insolvency, low value, imperfection of society, which in most of the studied cases (79.2%) was accompanied by various degrees of severity suicidal thoughts and intentions. Three varieties were identified: with the prevalence of reflections on the meaninglessness of life (39.6%); with the prevalence of neurotic religiosity (28.3%); with an existential philosophical interpretation (32.1%).

CONCLUSION

As a result of the study, the heterogeneity of existential depressions, a significant role of psychogenic factors in their formation were revealed, as a high suicidal risk. Existential depressive states differed in duration, severity of depressive symptoms, high frequency of non-suicidal self-neglect and suicidal risk.

Bullying victimization and suicide attempts among adolescents in 41 low- and middle-income countries: Roles of sleep deprivation and body mass

Background

Suicide is the fourth leading cause of death for adolescents, and globally, over 75% of completed suicides occur in low- and middle-income countries (LMICs). Bullying has been proven to be closely related to suicide attempts. However, further understanding of the mechanisms underlying the relationship between bullying and adolescents' suicide attempts is urgently needed.

Methods

We used data from the Global School-based Student Health Survey (GSHS) (2010-2017) from 41 LMICs or regions. This study was based on questions assessing bullying victimization, suicide attempts, sleep deprivation, and body mass. Chi-square tests were used to explore the correlations among the main variables. The mediating role of sleep deprivation and the moderating role of body mass index (BMI) were analyzed using PROCESS.

Results

The results showed a positive association between bullying victimization and suicide attempts. Sleep deprivation partially mediated the relationship between the frequency of being bullied and suicide attempts. In addition, sleep deprivation played a full or partial mediating role in the relationship between different types of bullying and suicide attempts. BMI moderated the relationships between the frequency of being bullied and suicide attempts, between being made fun of about one's body and sleep deprivation, and between sleep deprivation and suicide attempts.

Conclusion

Being bullied has a positive effect on suicide attempts, which is mediated by sleep deprivation and moderated by body mass. The results of this study are consistent with the stress-diathesis model of suicide, suggesting that being bullied is one of the stressors of suicide in adolescents, while sleep deprivation and body mass are susceptibility diatheses of suicide. The results are conducive to identifying adolescents at a high risk of suicide, suggesting that there is a need to pay more attention to bullied adolescents, especially their sleep quality and body mass, and design effective intervention measures to improve the current situation of adolescent suicide in LMICs.

Probable depression and its correlates among undergraduate students in Johannesburg, South Africa

BACKGROUND

Depression is associated with high rates of morbidity and mortality. Globally, depression is higher among university students than the general population-making it a significant public health problem. Despite this, there is limited data on the prevalence in university students in the Gauteng province, South Africa. This study determined the prevalence of screening positive for probable depression and its correlates among undergraduate students at the university of the Witwatersrand, Johannesburg, South Africa.

METHODS

A cross-sectional study, using an online survey was conducted among undergraduate students at the University of the Witwatersrand in 2021. Patient Health Questionnaire (PHQ-2) was used to assess the prevalence of probable depression. Descriptive statistics was computed and conducted bivariate and multivariable logistic regression to identify factors associated with probable depression. Age, marital status, substance use (alcohol use, cannabis use, tobacco use, and other substance use) were included in the multivariable model apriori determined confounders and other factors were only added if they had a p-value <0.20 in the bivariate analysis. A p-value of 0.05 was considered statistically significant.

RESULTS

The response rate was 8.4% (1046/12404). The prevalence of screening positive for probable depression was 48% (439/910). Race, substance use, and socio-economic status were associated with odds of screening positive for probable depression. Specifically reporting white race (adjusted OR (aOR) = 0.64, 95% CI: 0.42, 0.96), no cannabis use (aOR = 0.71, 95% CI: 0.44-0.99), higher spending power in the form of having the most important things but few luxury goods (aOR = 0.50, 95% CI: 0.31, 0.80) and having enough money for luxury goods and extra things (aOR = 0.44, 95% CI: 0.26-0.76) were associated with lower odds of screening positive for probable depression.

DISCUSSION

In this study, screening positive for probable depression was common among undergraduate students at the University of the Witwatersrand, Johannesburg, South Africa and associated with sociodemographic and selected behavioral factors. These findings call for strengthening the awareness and use of counselling services among undergraduate students.

The role of ghrelin peptide among a sample of Egyptian patients with first episode of major depressive disorder

Background

Major depressive disorder (MDD) is a prominent psychiatric disorder that significantly reduces living quality and increases the risk of suicide. Ghrelin influences the central nervous system (CNS) and impacts reward, inspiration, and signaling pathways in addition to acting as an appetite signal. This case-controlled comparative study focused on the association between serum ghrelin levels and MDD. The study was done during September 2021 and March 2022 on 25 people with MDD and 25 healthy controls. SCID-1 and the Ham-D 17 scales were used to evaluate the cases. The GHQ scale was used to evaluate the controls. The serum ghrelin levels of all samples were determined. The findings were presented, and statistically analyzed to perform an accurate assessment.

Results

There were 50 subjects: 25 cases of MDD and 25 healthy matched controls with non-statistically significant difference to cases as regard gender, marital status, residence, education, age, height, weight and body mass index (BMI). Total serum ghrelin levels among our cases showed a mean value of 4.152, while the controls showed markedly low values, with a mean value of 0.436, showing a statistically significant difference between both groups with p < 0.001. Furthermore, Post Hoc analysis by least significant difference showed a significant difference between mild-severe and moderate-severe groups, although there was no statistically significant difference between mild and moderate groups.

Conclusions

There was a significant indirect correlation between serum ghrelin level and severity of the illness. Further investigations via longitudinal studies and on larger samples are recommended to settle specific causal paths between the two variables.

Different Effects of Perceived Social Support on the Relationship between Perceived Stress and Depression among University Students with Borderline Personality Disorder Symptoms: A Multigroup Mediation Analysis

Background: While perceived social support can mediate the relationship between perceived stress and depression, little is known about the differences between individuals with high and low borderline personality disorder symptoms (BPDS). This study aimed to investigate the associations among perceived stress, perceived social support, and depression, and compare low and high levels of BPDS. Methods. This cross-sectional analysis was a secondary analysis of data from the SI-Bord study. University students across Thailand completed a screening instrument for borderline personality disorder, the Perceived Stress Scale (PSS), the Revised Thai Multi-dimensional Scales of Perceived Social Support (MSPSS), and the Patient-Health Questionnaire (PHQ)-9. Mediation analysis using PROCESS was applied to test the direct and indirect effects of perceived stress on depression. Multigroup mediational analysis was adopted to compare low and high levels of BPDS. Results. The mean age of the 330 participants was 20.27 (SD, 1.4) and 80% were female. Significant correlations were observed between the PSS, MSPSS, and PHQ scores, with greater magnitude among the high-level BPDS group (p < 0.001). A significant direct effect on perceived stress and a significant indirect effect on depression through perceived social support were noted. Of all the sources of social support, only the significant others variable significantly differed between the two groups (p < 0.05). Conclusion. Perception of social support had a significant mediating role in perceived stress and depression. The magnitude of associations was remarkably high for individuals with high BPDS compared to those with low BPDS. Unlike those with low BPDS, all sources of social support were significant mediators between the two groups.

Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis

BACKGROUND

To evaluate the global prevalence of depression and anxiety symptoms among college students and potential associated factors.

METHODS

PubMed and Web of Science were searched from their inception to March 28, 2021. Random-effects models were used to calculate the pooled prevalence of depression and anxiety. Subgroup analyses were conducted to explore potential heterogeneity. Egger's and Begg's test were used to assess publication bias.

RESULTS

A total of 64 studies with 100,187 individuals were included in the present meta-analysis. The pooled prevalence of depression and anxiety symptoms among college students was 33.6% (95% confidence interval [CI] 29.3%-37.8%) and 39.0% (95% CI, 34.6%-43.4%), respectively. The highest prevalence of depression symptoms was found in Africa region (40.1%, 95% CI 12.3-67.9%), lower middle-income countries (42.5%, 95% CI 28.6-56.3%), and medical college students (39.4%, 95% CI 29.3-49.6%). For the prevalence of anxiety symptoms, the highest was observed in North America (48.3%, 95% CI 37.4-59.2%), lower middle-income countries (54.2%, 95% CI 35.0-73.4%), medical college students (47.1%, 95% CI 35.1-59.1%) and identified by Beck Anxiety Inventory (BAI) (49.1%, 95% CI 31.0-43.0%). Besides, the prevalence of depression symptoms (35.9%, 95% CI 20.2-51.7%) and anxiety symptoms (40.7%, 95% CI 39.5-42.0%) was higher in studies conducted after the coronavirus disease 2019 (COVID-19) outbreak.

CONCLUSIONS

Our study suggests that a lot of college students experience depression and anxiety symptoms and clarifies factors that are related to these mental disorders. Effective prevention and intervention strategies for mental disorders should be developed among college students.

Prevalence of common mental health problems and associated factors among university students visiting Supara mental health service: A cross-sectional study

Background: Early studies found that the mental health problems rate was relatively high in university students. We aimed to investigate the prevalence of mental problems and associated factors in university students. Methods: We conducted a cross-sectional descriptive study at Supara mental health service in the Faculty of Medicine Vajira Hospital between February 2020 to June 2021. The primary outcome was the prevalence of psychiatric diagnosis according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The secondary assessments included the Patient Health Questionnaire-9 (PHQ-9), 8 items from the Mini International Neuropsychiatric Interview (MINI) to assess suicidal risk (8Q), and the Thai Mental Health Indicator (TMHI-15). The prevalence of mental health problems was presented by frequency and percentage. In addition, multivariable regression analysis was used to identify potential predictors of mental health problems.   Results: A total of 184 participants (62% female; mean age = 22.49 years (SD 3.93) were recruited. The depressive disorders, adjustment disorders, and anxiety disorders rates were 57.1%, 15.2% and 13.6%, respectively. Grade point averages (GPAs) below 3.0 (OR=3.09, 95%CI: 1.17-8.14) and a family history of mental disorder (OR=3.40, 95%CI: 1.10-10.48) were significant associated factors of moderate to severe mental health problems. Detecting and screening these factors may help the university to provide early detection and treatment for students. Conclusions: Depressive disorders were the most common mental health disorders. Females, low GPAs and a family history of mental disorder were predictors of moderate to severe mental health problems.

Prevalence of common mental health problems and associated factors among university students visiting Supara mental health service: A cross-sectional study

Background: Early studies found that the mental health problems rate was relatively high in university students. We aimed to investigate the prevalence of mental problems and associated factors in university students. Methods: We conducted a cross-sectional descriptive study at Supara mental health service in the Faculty of Medicine Vajira Hospital between February 2020 to June 2021. The primary outcome was the prevalence of psychiatric diagnosis according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The secondary assessments included the Patient Health Questionnaire-9 (PHQ-9), 8 items from the Mini International Neuropsychiatric Interview (MINI) to assess suicidal risk (8Q), , and the Thai Mental Health Indicator (TMHI-15). The prevalence of mental health problems was presented by frequency and percentage. In addition, multivariable regression analysis was used to identify potential predictors of mental health problems. Results: A total of 184 participants (62% female; mean age = 22.49 years (SD 3.93) were recruited. The depressive disorders, adjustment disorders, and anxiety disorders rates were 57.1%, 15.2% and 13.6%, respectively. Grade point averages (GPAs) below 3.0 (OR=3.09, 95%CI: 1.17-8.14) and a family history of mental disorder (OR=3.40, 95%CI: 1.10-10.48) were significant associated factors of moderate to severe mental health problems. Detecting and screening these factors may help the university to provide early detection and treatment for students. Conclusions: Depressive disorders were the most common mental health disorders. Females, low GPAs and a family history of mental disorder were predictors of moderate to severe mental health problems.

Prevalence of common mental health problems and associated factors among university students visiting Supara mental health service: A cross-sectional study

Background: Early studies found that the mental health problems rate was relatively high in university students. We aimed to investigate the prevalence of mental problems and associated factors in university students. Methods: We conducted a cross-sectional descriptive study at Supara mental health service in the Faculty of Medicine Vajira Hospital between February 2020 to June 2021. The primary outcome was the prevalence of psychiatric diagnosis according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The secondary assessments included the Patient Health Questionnaire-9 (PHQ-9), 8 items from the Mini International Neuropsychiatric Interview (MINI) to assess suicidal risk (8Q), and the Thai Mental Health Indicator (TMHI-15). The prevalence of mental health problems was presented by frequency and percentage. In addition, multivariable regression analysis was used to identify potential predictors of mental health problems.   Results: A total of 184 participants (62% female; mean age = 22.49 years (SD 3.93) were recruited. The depressive disorders, adjustment disorders, and anxiety disorders rates were 57.1%, 15.2% and 13.6%, respectively. Grade point averages (GPAs) below 3.0 (OR=3.09, 95%CI: 1.17-8.14) and a family history of mental disorder (OR=3.40, 95%CI: 1.10-10.48) were significant associated factors of moderate to severe mental health problems. Detecting and screening these factors may help the university to provide early detection and treatment for students. Conclusions: Depressive disorders were the most common mental health disorders. Females, low GPAs and a family history of mental disorder were predictors of moderate to severe mental health problems.

Prevalence of common mental health problems and associated factors among university students visiting Supara mental health service: A cross-sectional study

Background: Early studies found that the mental health problems rate was relatively high in university students. We aimed to investigate the prevalence of mental problems and associated factors in university students. Methods: We conducted a cross-sectional descriptive study at Supara mental health service in the Faculty of Medicine Vajira Hospital between February 2020 to June 2021. The primary outcome was the prevalence of psychiatric diagnosis according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The secondary assessments included the Patient Health Questionnaire-9 (PHQ-9), 8 items from the Mini International Neuropsychiatric Interview (MINI) to assess suicidal risk (8Q), , and the Thai Mental Health Indicator (TMHI-15). The prevalence of mental health problems was presented by frequency and percentage. In addition, multivariable regression analysis was used to identify potential predictors of mental health problems. Results: A total of 184 participants (62% female; mean age = 22.49 years (SD 3.93) were recruited. The depressive disorders, adjustment disorders, and anxiety disorders rates were 57.1%, 15.2% and 13.6%, respectively. Grade point averages (GPAs) below 3.0 (OR=3.09, 95%CI: 1.17-8.14) and a family history of mental disorder (OR=3.40, 95%CI: 1.10-10.48) were significant associated factors of moderate to severe mental health problems. Detecting and screening these factors may help the university to provide early detection and treatment for students. Conclusions: Depressive disorders were the most common mental health disorders. Females, low GPAs and a family history of mental disorder were predictors of moderate to severe mental health problems.

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.

Childhood maltreatment and depressive symptoms among Chinese college students: A moderated mediation model of adult attachment styles and physical activity

BACKGROUND

Previous research has investigated the independent effects of childhood maltreatment, adult attachment, and physical activity, on depressive symptoms. However, explanatory mechanisms linking childhood maltreatment to current depressive symptoms are poorly understood. This study investigated the mediating role of adult attachment between childhood maltreatment and depressive symptoms among college students and explored the moderating effect of physical activity in the mediating pathway.

METHODS

The data for the present study were gathered in three waves with 6-month lags. A total of 3662 Chinese college students completed anonymous questionnaires concerning demographic variables, childhood maltreatment, and depressive symptoms in Wave 1, adult attachment and physical activity in Wave 2, and depressive symptoms in Wave 3.

RESULTS

Childhood maltreatment and adult attachment were significantly associated with depressive symptoms, identifying a mediating role of adult attachment in the relationship between childhood maltreatment and depressive symptoms, and a moderating role of physical activity between attachment anxiety and depressive symptoms in the mediating pathway.

LIMITATIONS

This study utilized self-reported questionnaires for data collection purposes, which could constitute key study limitations.

CONCLUSIONS

These findings highlight the need to consider early stress factors (childhood maltreatment), social psychological factors (adult attachment), and potential protective factors (physical activity) simultaneously when evaluating the occurrence and development of depressive symptoms.