The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis

Prevalence of mental disorder symptoms among university students: An umbrella review

This umbrella review synthesizes data on the prevalence of mental disorder symptoms among university students worldwide. A systematic search of seven databases (inception-July 23, 2023) followed PRISMA guidelines. We included meta-analyses assessing the prevalence of mental disorder symptoms, evaluating methodological quality with AMSTAR-2. A random-effects meta-analysis was conducted, along with meta-regression and subgroup analyses for moderators (percentage of females, publication date, healthcare-related degrees, COVID-19 pandemic). We included 1,655 primary studies from 62 meta-analyses, encompassing 8,706,185 participants. AMSTAR-2 ratings classified 35 % of meta-analyses as low quality and 65 % as critically low. Pooled prevalence estimates were: depression-mild (35.41 %, CI=33.9-36.93) and severe (13.42 %, CI=8.03-19.92; k=952; n=2,108,813); anxiety-mild (40.21 %, CI=37.39-43.07) and severe (16.79 %, CI=7.21-29.29; k=433; n=1,579,780); sleep disorders (41.09 %, CI=35.7-46.58); eating disorders (17.94 %, CI=15.79-20.20); gambling disorder (6.59 %, CI=5.52-7.75); post-traumatic stress disorder (25.13 %, CI=20.55-30.02); stress (36.34 %, CI=29.36-43.62); and suicide-related outcomes (ideation past 12 months: 10.76 %, CI=9.53-12.06; lifetime ideation: 20.33 %, CI=16.15-24.86; suicide attempt past 12 months: 1.37 %, CI=0.67-2.29; lifetime attempt: 3.44 %, CI=2.48-4.54). Meta-regression analyses identified statistically significant moderators of prevalence such as healthcare academic degrees and the pandemic in the case of depression and studies with more females in the case of sleep disorders. This is the most comprehensive synthesis on the prevalence of mental disorder symptoms in university students, providing crucial insights for clinicians, policymakers, and stakeholders.

Differentiating anxiety profiles in medical students: a latent profile analysis

Previous studies have confirmed a high prevalence of anxiety among medical students. The present study aimed to identify distinct medical student anxiety profiles to develop targeted interventions. A cross-sectional study was conducted with 735 medical students (346 males and 389 females) recruited voluntarily from mainland China. Latent profile analysis (LPA) was applied to explore profiles of various types of anxiety, including test anxiety, academic anxiety, social anxiety, career choice anxiety, general anxiety, and trait anxiety. The results showed that LPA yielded four profiles, comprising 17.14, 20.82, 21.50, and 40.54% of the sample respectively. Specifically, Class 1 (17.14%) showed the highest levels of multiple types of anxiety, particularly the highest level of general anxiety. Class 2 (20.82%) and Class 3 (21.50%) showed moderate levels of anxiety, but they displayed different patterns across various types of anxiety except for social anxiety. Class 4 (40.54%) displayed the lowest levels of anxiety across all types. These profiles differed in academic status and depression. Further, the multinomial logistic regression analysis showed that the high-anxiety group (Class 1) was more likely to be elder students, with lower sports frequency and a higher degree of self-handicapping. These results call for the need to move beyond linear relations among global constructs to address the complexity of anxiety coping and highlight the importance of customized intervention for these heterogeneous groups.

Comparing the psychological impact of the Shanghai lockdown on local and non-local college students: an explanatory sequential mixed method approach

PURPOSE

In 2022, the Shanghai municipal government enforced strict COVID-19 lockdown measures. Lockdown experiences for college students varied. Local students normally returned home and had familial support while non-local students relied more on institutional support when quarantining in dormitories. The difference could profoundly impact their access to necessary material resources and emotional support, affecting their mental health. This study compared the psychological effects of the Shanghai Lockdown on local and non-local college students using an explanatory-sequential mixed methods design.

METHODS

Quantitative analyses of data from 327 college students examined local and non-local students' mental health outcomes during the lockdown. Follow-up qualitative interviews (N = 12) contextualized their sources of stress and group differences.

RESULTS

Higher prevalences of probable anxiety (34.6%), depression (45.1%), and poor subjective mental well-being (65.4%) are found among non-local students compared to local students (23.7% anxiety, 29.4% depressive symptoms, and 47.9% poor well-being). Suicidal ideation was higher among local students (8.6% prevalence difference). Being a non-local college student was associated with increased odds of probable anxiety, depression, and poor well-being. Interviews identified group differences such that non-local students received more school support (i.e., food and financial) and perceived emotional support but faced poorer quarantine living environments compared to local peers.

CONCLUSIONS

Non-local college students were more vulnerable to the impact of lockdown. Our findings also provide insights into the impact of familial versus institutional support on student mental health during times of crisis.

Novel insight into prediction model for sleep quality among college students: a LASSO-derived sleep evaluation

Background

Sleep disturbance has become a significant concern among college students, as it can lead to various mental and physical disorders. This study aims to provide a fresh perspective by developing and validating a predictive model for sleep quality among college students.

Methods

Data from 20,645 college students in Fujian Province, China, collected between 5th April and 16th April 2022, were analyzed. Participants completed the Pittsburgh Sleep Quality Index (PSQI) scale, a self-designed general data questionnaire, and a sleep quality influencing factor questionnaire. Multinomial logistic regression, LASSO regression, and Boruta feature selection methods were utilized to select relevant variables. The data were then divided into a training-testing set (70%) and an independent validation set (30%) using stratified sampling. Six machine learning techniques, including artificial neural network (ANN), decision tree, gradient-boosting tree, k-nearest neighbor, naïve Bayes, and random forest, were developed and validated. Finally, an online sleep evaluation website was established based on the best-fitting prediction model.

Results

The mean global PSQI score was 6.02 ± 3.112, with a sleep disturbance prevalence of 28.9% (defined as a global PSQI score > 7). The LASSO regression model identified eight predictors: age, specialty, respiratory history, coffee consumption, staying up late, prolonged online activity, sudden changes, and impatient closed-loop management. Among the evaluated models, the ANN demonstrated superior performance with an area under the receiver operating characteristic curve (AUC) of 0.713 (95% CI: 0.696-0.730), accuracy of 0.669 (95% CI: 0.669-0.669), sensitivity of 0.682 (95% CI: 0.699-0.665), specificity of 0.637 (95% CI: 0.665-0.610). Decision curve analysis and clinical impact analysis further confirmed the model's clinical utility.

Conclusions

This study developed a prediction model for sleep disturbance among college students using a LASSO regression and ANN, incorporating eight predictors. The model can serve as an intuitive and practical tool for predicting sleep quality and supporting effective management and healthcare on college campuses.

Predicting the Deviation from the Standard Study Period and Dropout Intentions Through Depression Severity and Social Integration Among University Students in Germany: A Longitudinal Analysis

Mental health problems among university students have become a growing concern for higher education institutions. Students experiencing mental health issues, with depression being the most prevalent disorder, tend to take longer to graduate and have a higher risk of dropping out of university. This study examines the predictive values of depression severity (Patient Health Questionnaire Depression-PHQ-9), use of psychosocial counseling, and social integration on the deviation from the standard study period and dropout intentions. A total of 3300 students at the University of Kassel, Germany were surveyed at baseline in March 2022; 1744 students provided an email address and gave permission to contact them individually for the follow-up survey in March 2023. After eliminating dropouts and questionnaires with a lot of missing values, the final sample consisted of 500 students who participated at both time points. Longitudinal data were used for descriptive, correlational, and multiple linear regression analyses. Multiple linear regression analyses revealed a significant adverse predictive value of the PHQ-9 (β = -0.082; p < 0.05) on the deviation from the standard study period. The analyses found significant positive predictive values of the PHQ-9 (β = 0.190; p < 0.001) and examination grades (β = 0.108, p < 0.05) on dropout intentions. Furthermore, this study could not confirm significant predictive values of difficulties with interaction with fellow students and lecturers on dropout intentions. The results highlight the role of health promotion, psychosocial counseling, and social networks for students with depressive symptoms. Concluding, a networked approach at universities involving students, lecturers, counseling services, and health management is recommended.

Changes in network centrality of anxiety and depression symptoms associated with childhood trauma among Chinese college students

BACKGROUND

Childhood trauma is strongly linked to anxiety and depression, significantly increasing the risk of negative outcomes in adulthood. This study employed network analysis to investigate the complex interplay of anxiety and depression symptoms among Chinese college students, focusing on identifying the core symptoms most directly affected by childhood trauma and those exerting the greatest influence on others.

METHODS

Data were collected from December 2020 to January 2021 from 2,266 college students at 16 institutions in southwestern and eastern coastal China. Depression, anxiety, and childhood trauma were assessed using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Childhood Trauma Questionnaire-28, respectively. Separate symptom networks were constructed for participants with and without childhood trauma experiences. Central indices were employed to identify the central symptom within each network. The accuracy and stability of the networks were then evaluated. Finally, a network comparison test was used to analyze differences in network properties between the trauma and non-trauma groups.

RESULTS

Loss of Energy and Worry too much were the central symptoms in the non-trauma group, while anhedonia and nervousness were the central symptoms in the trauma group. There was a significant difference in the global strength of the network between the trauma group and the non-trauma group (pFDR< 0.01), but no significant difference in the distribution of edge weights between the two networks (pFDR =0.14). Anhedonia, Suicide ideation and Feeling afraid in the trauma group showed increased network centrality compared with the non-trauma group.

CONCLUSIONS

This study demonstrates the profound impact of childhood trauma on the central symptoms of anxiety and depression in college students. Further research is warranted to investigate the specific pathways through which these symptoms develop, with the goal of developing targeted interventions for this vulnerable population.

Long-term sickness absences based on mental disorders by socioeconomic group - trends of prevalence in Finland 2010-2023

BACKGROUND

Long-term sickness absences (LTSA) are often linked to mental disorders. Up-to-date register-based evidence on the prevalence and trends of LTSA based on mental disorders is lacking, as is understanding of socioeconomic differences. This study examines the trends in prevalence of LTSA based on mental disorders in various socioeconomic groups both employed and outside employment.

METHODS

Finnish 18-67 years old non-retired residents were included in yearly study populations for 2010-2023. LTSA prevalence was examined through receipt of compensated sickness allowance. Yearly age-adjusted prevalences of LTSA were calculated for six socioeconomic groups using direct standardization. Adjusting for various covariates, relative risks (RR) between socioeconomic groups in LTSA prevalences were then analysed for 2010 and 2023 using Modified Poisson regression models. All analyses were run separately for both sexes, and for all mental disorders combined, for mood disorders, anxiety disorders, and other mental disorders combined.

RESULTS

The prevalence of LTSA based on mental disorders increased from 2010 to 2023 among all socioeconomic groups and for both sexes, but especially among lower non-manual female employees due to anxiety disorders, and among students and unemployed persons due to mood disorders. Compared to upper non-manual employees, the higher covariate-adjusted relative risks for LTSA based on mental disorders in lower non-manual employees increased slightly during the study period (women: RRs 1,13 to 1,25; men: RRs 1,20 to 1,30). While age-group-standardized trends showed an approximately similar risk for manual workers compared to upper non-manual employees, covariate-adjusted modelling revealed a slightly lower relative risk, most apparent for anxiety disorders (RR in 2023 0,79). Entrepreneurs had a consistently lower relative risk compared to other groups.

CONCLUSIONS

The prevalence of long-term sickness absences due to mood and anxiety disorders have increased among all socioeconomic groups, but register data also reveals group differences in prevalences and trends. Factors related to covid-19 pandemic, intensity of job demands, and buffering resources may explain these differing trends. Employees, but also students and unemployed persons need support to curb the increase in LTSA due to mental disorders.

The inequitable psychological impacts of the COVID-19 pandemic on post-secondary students with preexisting health conditions: A longitudinal study

Objective: Evidence suggests young adults in post-secondary school experienced increased distress during the COVID-19 pandemic, but students' experiences likely varied. Effects may have also changed over time as students adapted. This study examined the mental health of students with and without preexisting health conditions at two points during the pandemic (winter 2020/2021 and spring/summer 2021). Methods: Participants (N = 1465) completed a baseline and follow-up questionnaire assessing their health history, depressive symptoms, anxiety symptoms, stress, and COVID-19-related worry and perceived vulnerability of severe infection. Results: At both time points, students with preexisting health conditions reported greater distress than those without preexisting health conditions. Stress increased from time 1 to time 2 for all students, and participants with preexisting health conditions significantly increased in their COVID-19 perceived vulnerability of severe infection over time. Conclusions: Findings highlight the need for additional and ongoing mental health supports for vulnerable students throughout the pandemic.

Using conservation of resources theory to explain university students' anxiety, depression, and learning experience during COVID-19

Objectives: During the second COVID-19 pandemic wave in Israel, we examined COVID-19-specific stressors and academic and financial challenges as potential risk factors for anxiety and depression among university students in Israel. Based on conservation of resources (COR) theory, we hypothesized that the threat of resource loss within the personal domain, academic challenges, and financial concerns would increase the likelihood of experiencing anxiety and depression. Participants: We sampled 18,686 students who responded to an online questionnaire. Methods: Data collection occurred from September 6 to November 8, 2020. Anxiety and depression were assessed by the GAD-7 and PHQ-9, respectively. We conducted multiple hierarchical logistic regression analyses predicting depression and anxiety symptoms at the clinical level. Results: Greater positive learning experiences were associated with a 38% reduction in the odds of experiencing depression (OR 0.62, 95% CI 0.59-0.65). Conclusions: Developing integrated services for students addressing their mental health during disasters is necessary.

Resilience, Stress, and Mental Health Among University Students: A Test of the Resilience Portfolio Model

In recent years, post-secondary students' mental health has become an important public health concern. However, studies examining protective factors of mental health among students and during challenging times are limited. Guided by the strength-based Resilience Portfolio Model and following a group of undergraduates (N = 1004) throughout the 2020/2021 academic year, this study examined multiple domains of resilience internal assets and external resources and simultaneously tested multiple protective mechanisms for student mental health using structural equation modelling. Results provided support for insulating effects: both internal assets such as emotion regulation and external recourses such as social network supportiveness and cultural fit in university (i.e., perceived congruity between students' personal and cultural selves and their university environment) were associated with reducing academic stress which in turn promoted student mental health at the end of the academic year. There was also support for additive effects: greater cultural fit in university was also directly related to better end-of-year student mental health. As cultural fit in university was associated both directly and indirectly with student mental health, creating an inclusive university community may help reduce student academic stress, lower student psychological distress and improve student subjective well-being.

Gasotransmitter-Nanodonor for Spatial Regulation of Anxiety-Like Behavior and Bone Metastasis

Anxiety is highly prevalent among cancer patients, significantly impacting their prognosis. Current cancer therapies typically lack anxiolytic properties and may even exacerbate anxiety. Here, a gasotransmitter-nanodonors (GND) system is presented that exerts dual anxiolytic and anti-tumor effects via a "tumor-brain axis" strategy. The GND, synthesized by co-embedding Fe2⁺ and S2⁻ ions along with glucose oxidase (GOx) within bovine serum albumin (BSA) nanoparticles (FSG@AB), enables the controlled release of the gasotransmitter hydrogen sulfide (H₂S) in the acidic tumor microenvironment. H₂S and GOx synergistically deplete tumor energy sources, resulting in robust anti-tumor effects. Meanwhile, H₂S generated at the tumor site is transported through the bloodstream to the anterior cingulate cortex (ACC) in the brain, where it modulates neuronal activity. Specifically, in the ACC, H₂S upregulates glutamate transporter 1 (GLT-1), which reduces extracellular glutamate levels and attenuates the hyperactivity of glutamatergic neurons, thereby alleviating anxiety-like behavior. This study proposes a GND system that targets both oncological and psychiatric dimensions of cancer through the "tumor-brain axis" strategy, resulting in improved therapeutic outcomes.

Multidimensional social support and associations between COVID-19 stress and depressive/anxiety outcomes among Hispanic/Latinx and White first-year college students

Objective: The COVID-19 pandemic has led to greater depression and anxiety among college students. Social support may alleviate this risk. We examined how social support from family, friends, and romantic partners may influence internalizing psychopathology outcomes associated with COVID-19-related stressful events. Participants: Participants were first-years (N = 425, 34.8% Hispanic/Latinx, 74.9% female) enrolled in a United States public university. Methods: Participants completed an online survey in Fall of 2020. Linear regression models examined associations between COVID-19 stressors, social support, depressive and anxiety symptoms, and differences between White and Hispanic/Latinx students. Results: Reported COVID-19 stressors were associated with elevated depressive and anxiety symptoms and higher among Hispanic/Latinx students. Family and friend support were negatively associated with both internalizing outcomes. Partner support was negatively associated with depression and more predictive among White students whereas friend support was for Hispanic/Latinx students' anxiety. Conclusions: These findings demonstrate the importance of social connectedness during the COVID-19 pandemic.

University Students with Current Suicidal Ideation and Perceived Changes during the COVID-19 Pandemic: A Qualitative Study

INTRODUCTION

Mental health problems seemed to have increased among university students during the COVID-19 pandemic. To deepen our understanding of the pandemic's effects in this population, we conducted qualitative research to investigate any perceived changes in students during the pandemic, differentiating the sample based on the presence or absence of current suicidal ideation (SI).

METHODS

A wide sample of Italian university students (n = 1,214) completed an online questionnaire during the COVID-19 pandemic, March 2020-June 2021. We conducted a computer-assisted content analysis of an open-ended question about the perceived changes that occurred to them during the pandemic.

RESULTS

(1) Four thematic clusters were identified: "The psychological impact of the pandemic," "New ties and new loneliness," "An uncertain forethought" and "Discovering the value of relationships." (2) In subjects characterized by severe SI, the state of confinement at home was related to the most intense emotional states and worries. (3) Students with severe SI were different from the others, in particular using the lemma "panic," which was the only psychological state specifically associated with this group.

CONCLUSIONS

Students with current severe SI experienced higher level of psychological distress and suffering compared to the other groups during the pandemic.

Changes of college students' psychological stress during the COVID-19 pandemic in China: A two-wave repeated survey

COVID-19 has posed unprecedented challenges to the mental health of college students worldwide. We examined the trends in students' stress levels during and after China's first wave of COVID-19 outbreaks by analyzing their demographics, behavior, mental health status, career confidence, and Chinese Perceived Stress Scale (CPSS) scores. Our findings indicate an increase in students' stress levels since the COVID-19 onset, with more students experiencing higher stress levels after the first outbreak than during it (OR = 2.03, 95% CI 1.79, 2.30). Several factors were identified as being associated with higher CPSS scores, including higher class levels, residence in rural or town areas, low family income, and lack of familiarity with COVID-19, among others. Our study highlighted the urgency of developing and implementing effective strategies to cope with students' stress during and after a global pandemic.

Emotional growth mindsets and stress controllability buffer the link between stress intensity and anxiety symptoms: An ecological momentary assessment study

Anxiety is highly prevalent among adults. Evidence suggests that perceived stress controllability and emotional growth mindsets are associated with decreased anxiety. However, whether these positive factors synergistically contribute to reducing the impact of stress on anxiety remains unclear, especially within everyday stress contexts. Multilevel models were used to investigate how perceived stress controllability and emotional growth mindsets interacted to mitigate the adverse impact of daily stress on anxiety, differentiating within- and between-person effects. Overall, 198 participants completed ecological momentary assessments of perceived stress intensity and controllability, emotional growth mindsets, and anxiety four times daily over 10-12 consecutive days. The within-person analyses showed that high emotional growth mindsets buffer the link between perceived stress intensity and anxiety. More importantly, the between-person and cross-level results suggested that the synergistic effect of emotional growth mindsets and perceived stress controllability maximally buffered the correlation between perceived stress intensity and anxiety. Additionally, these results highlighted that the positive association between perceived stress intensity and anxiety was most pronounced among participants with low emotional growth mindsets and perceived stress controllability. These findings further support a synergistic intervention approach that emphasizes anxiety alleviation through enhanced perceived stress controllability and the development of emotional growth mindsets.

Sleep quality and associated factors in Latin American medical students: a cross-sectional and multicenter study

BACKGROUND

Existing literature has not stablished the factors associated with sleep quality, which requires further research in the context of the mental health of future medical professionals. This study aimed to determine the prevalence and factors related to sleep quality in Latin American medical students during the COVID-19 pandemic.

METHODS

Cross-sectional multicenter analytic study of secondary data analysis in Latin American medical students. The sampling was non-probabilistic snowball sampling. Sleep quality (Pittsburgh questionnaire) and its association with psychosocial-academic variables, depressive symptoms (PHQ-9 questionnaire), anxious symptoms (GAD-7 questionnaire), resilience (abbreviated CD-RISC questionnaire), eating disorder (EAT-26 questionnaire), physical activity (IPAQ questionnaire-short version), tobacco and alcohol consumption (ASSIST questionnaire) and burnout syndrome (Maslash questionnaire) were assessed. Prevalence ratios and 95% confidence intervals were estimated.

RESULTS

Of 2019 medical students, the prevalence of poor sleep quality was 62.2% (95%CI: 60.00%-64.28%). In the multiple regression model, factors that were positively associated with poorer sleep quality were female sex (PR: 1.13), moderate risk of smoking (PR: 1.08), the presence of moderate to severe depressive symptoms (PR: 2.19 and PR: 2.14, respectively), as well as moderate and severe anxiety symptoms (PR: 1.21 and PR: 1.22, respectively). On the other hand, factors that were negatively associated with poorer sleep quality were having received training on COVID-19 (PR: 0.95), having a history of COVID-19 (PR: 0.80), and having a high level of resilience (PR: 0.86).

CONCLUSION

It was found that 62.2% of students had poor sleep quality. Factors such as female sex, moderate risk of smoking, and depressive and anxious symptoms were associated with poor sleep quality, while COVID-19 training, history of the disease, and a high level of resilience were linked to better quality. These findings are key for public health, as poor sleep quality affects physical and mental health and academic performance, underscoring the importance of intervening on these factors to improve student well-being.

Battling Sleep Disturbances and Academic Procrastination in Undergraduates: A Pilot Study on Acceptance and Commitment Therapy vs. Motivational Interviewing

OBJECTIVES

This pilot study aimed to preliminarily assess the effectiveness of Acceptance and Commitment Therapy (ACT) vs. Motivational Interviewing (MI) in battling sleep disturbances and academic procrastination among Malaysian undergraduates.

METHOD

In this single-blind, quasi-experimental study, thirty undergraduate students were randomly assigned to either six online therapist-led Acceptance and Commitment Therapy (ACT) sessions (n = 15) or six online therapist-led Motivational Interviewing (MI) sessions (n = 15). The Tuckman Procrastination Scale, Pittsburgh Sleep Quality Index, and Psy-Flex were administered at baseline, the end of session 3, session 6, and one-month follow-up.

RESULTS

Participants in both groups showed significant improvement in academic procrastination, sleep disturbances, and psychological flexibility(p < .001, η2 = .62), with outcomes improved progressively after three sessions, six sessions, and at the one-month follow-up. There was no statistically significant difference between the effectiveness of ACT and MI.

CONCLUSIONS

This novel study provides preliminary support for the application of ACT and MI in reducing academic procrastination and sleep disturbances concurrently among undergraduates, with a greater number of sessions leading to better outcomes.The comparable effectiveness of both therapies implies possible flexibility in clinical practice, enabling practitioners to select an intervention based on factors like student preferences, therapist expertise, and resource availability. Future studies should explore the mechanisms and moderating factors influencing the effectiveness of these interventions through well-designed randomized controlled trials (RCTs) with larger sample sizes.

Health and health literacy among social work students in Germany: A cross-sectional health survey

A university is a living environment that can influence people's health. This study aims to analyze health and health literacy of Bachelor of Social Work (BSW) students in comparison with students in other study programs. A survey was conducted among all students at the University of Kassel regarding their health and health literacy. The survey evaluated general health status, disability, and health literacy. In this study, BSW students had an adverse health status compared to other students. Only 66.9% of the BSW students rated their general health as very good or good (vs. 79.7% in other study programs). BSW students are also more likely to be moderately or severely limited in daily activities due to chronic health conditions than students in other study programs. In contrast, health literacy levels differ little between BSW students and other students. This study highlights the need for health (literacy) promotion in social work studies.

The Role of Sports in Building Resilience: A Machine Learning Approach to the Psychological Effects of the COVID-19 Pandemic on Children and Adolescents

(1) Background: This study evaluated whether physical activity and sports serve as a protective factor in mitigating COVID-19 pandemic long-term consequences. (2) Methods: A survey of 1702 participants (8-18 years) used the Impact of Event Scale (IES), Generalized Anxiety Disorder Scale (GAD-7), and Center for Epidemiological Studies Depression Scale for Children (CES-DC). Participants were categorized based on their engagement in sports, cultural activities, or sedentary behaviors. Statistical analysis included non-parametric tests, CHAID models, and clustering. (3) Results: In total, 65.5% of participants experienced minimal to mild anxiety, and 34.5% reported moderate to severe anxiety. The main predictor of depression is the sample age, followed by the training experience. Depressive symptoms were identified in 71.3% of participants (75.7% adolescents; 64% children). Adolescents with longer training experience (67.6%) showed lower depression compared to those with shorter experience (77.2%). For post-traumatic stress, 38% of children and 46% of adolescents exceeded cut-off scores for significant symptoms, with age and training level identified as key predictors. Among children, sport experience with low weekly frequency was associated with the lowest depression rates (59.5%). (4) Conclusions: Four years after the pandemic, a high percentage of anxiety and depression disorders is observed in the youth population, particularly among adolescents. Sports appear to slightly alleviate this serious condition.

Ecologically recorded sleep patterns, stress, and lifestyle behaviors in college students prior to and during the COVID-19 pandemic

Objective: Beginning in the spring of 2020, college students adapted to a myriad of COVID-19 pandemic-related stressors including personal and family health concerns, social isolation and future uncertainty that affect sleep behavior. We investigated how the pandemic affected ecologically recorded sleep patterns, self-reported stress and lifestyle behaviors in three semester-differentiated cohorts of college students enrolled in a psychology of sleep course. Methods: Students (N = 117) used the SleepScore biomotion sensor system to track sleep patterns and responded to behavior questions during the spring 2018, fall 2020, and spring 2022 semesters. Results: When compared to students in the spring 2018 pre-pandemic semester, students who underwent remote/hybrid learning in the fall 2020 semester displayed improved objective measures of sleep quality that were accompanied by increased deep sleep, fewer disruptions, and decreased time awake during the night, while self-reported stress ratings were unchanged. During pandemic semesters, students also reported decreased time studying, increased napping and screen use and higher ratings of bedroom comfort. Conclusions: Pandemic initiated remote learning and social restrictions may have allowed for healthier sleeping environments that likely contributed to better sleep health and stress resiliency in college students.

College student mental health, treatment utilization, and reduced enrollment: Findings across a state university system during the COVID-19 pandemic

Objective: This study measured the rate of college student mental health concerns and mental health service utilization. The roles of mental health and seeking treatment regarding anticipated enrollment were explored. Methods: One thousand eight hundred thirty-one randomly selected students participated in this online survey. Results: Most students reported clinically significant symptoms (88.3%), and many sought treatment in the past year (28.8%). Most students had favorable attitudes toward telemental health. Barriers to seeking care included a preference for self-management of symptoms (68.8%) and limited time (43.3%). Mental health was the most commonly reported reason for anticipating reduced enrollment (ps < .001), and these individuals were more likely to seek treatment. Conclusions: Past and anticipated use of mental health treatment likely exceeds on-campus capacity. Student mental health and retention are linked, and treatment may support retention. Nontraditional services, including telemental health, could help address increasing symptom severity and demand for services.

Impact of distress and anxiety due to COVID-19 on digital addictions in university students in the third wave period

Abstract

Background

Digital addictions are a major problem worldwide, which has increased considerably during the COVID-19 pandemic. In this scenario, two important impact factors to explain this problem are stress and anxiety because of COVID-19. The objective of this research was to determine the impact of distress and anxiety due to COVID-19 on digital addictions.

Methods

cross-sectional, explanatory study. A total of 802 students from public and private universities residing in the city of Lima and Callao (Peru), with a mean age of 21.68 (SD = 3.11), selected by convenience sampling, participated in the study. The MULTICAGE CAD-4 questionnaire, the distress scale, and the anxiety scale by COVID-19 were applied.

Results

two models examined with structural equation modeling showed good fit indices (CFI and TLI > .95, RMSEA and SRMR < .06). The first model shows that the latent variables distress and anxiety due to COVID-19 have direct effects on digital addictions as a general construct (R 2 = 22%). The second model shows that the exogenous latent variables (stress and anxiety) have direct effects of different magnitudes on each digital technology, so the variance explained on smartphone addiction was higher (R 2 = 25%) with respect to internet (R 2 = 19%) and video game addiction (R 2 = 6%). It was also found that for every male, there are two females with high levels of distress and anxiety. Regarding the problematic use of smartphones and internet, there is a prevalence of 40% regardless of sex; but as for the problematic use of video games, there is a marked difference between males (18.8%) and females (2.7%).

Conclusion

the distress and anxiety caused by COVID-19 have a direct impact in aggravating digital addictions.

A Comprehensive Review of Psychosocial, Academic, and Psychological Issues Faced by University Students in India

Background

University students confront a wide range of issues during their pursuit of education. Understanding these issues is essential for developing effective treatments and support systems.

Purpose

This study aims to delineate the landscape of scholarly literature pertaining to psychosocial, academic, and psychological issues among university students. It further identifies key journals and publishing trends within the fields, thereby significantly contributing to this domain. Additionally, this study outlines the scientific field networks that offer theoretical and conceptual foundations for exploring the psychosocial, academic, and psychological challenges faced by university students. Furthermore, it also intends to systematically categorise various types of problems encountered by university students in India.

Methods

To systematically gather and investigate the problems encountered by students in higher education, this study utilises bibliometric analysis, highlighting topics related to mental health. Data were extracted from Scopus and Web of Sciences databases.

Results

The analysis of the literature yielded 12 overarching categories related to challenges faced by university students: stress, academic stress, depression, anxiety, internet/ smartphone addiction/ gaming disorder, low self-esteem, loneliness, insomnia, suicidal ideations, eating disorders, drug addiction, adjustment issues.

Conclusion

Academic institutions should prioritise student mental health, as it affects academic performance and can lead to psychological disorders. Universities need Guidance and Counselling Cells staffed with professionals to help students manage psychosocial, academic, and psychological challenges.

Risk perception of COVID-19, depressive symptoms and Internet addiction among undergraduates: a longitudinal study

Background

The COVID-19 pandemic has caused serious negative psychological effects worldwide, relatively little research has been performed on the potential enduring effects of COVID-19 on people's emotional health and Internet addiction. This study was to examine the longitudinal associations between risk perception of COVID-19, depressive symptoms, and Internet addiction among Chinese undergraduates.

Methods

We conducted a two-wave longitudinal survey by convenience sampling, a total of 1,153 Chinese undergraduate students completed questionnaires measuring their COVID-19 risk perception and post-traumatic growth (PTG) in December 2022 (T1) via an online survey. Subsequently, 1,008 of the T1 participants (87.42%) completed the depressive symptoms scale and Internet addiction scale 6 months later, in June 2023 (T2).

Results

(1) Risk perception of COVID-19 was significantly and positively predicted depressive symptoms and Internet addiction 6 months later; (2) Depressive symptoms played a mediating role between risk perceptions and Internet addiction; (3) PTG moderated the first-stage link between risk perception and Internet addiction, and this relationship was more robust for low PTG than for high PTG.

Conclusion

These findings advance our understanding of the relationship and mechanisms between risk perception of COVID-19 and Internet addiction, and further support developing interventions to strengthen PTG for mitigating negative outcomes during major crises.

Functional Connectivity Alterations Associated with COVID-19-Related Sleep Problems: A Longitudinal Resting-State fMRI Study

Background

COVID-19 has led to reports of fatigue and sleep problems. Brain function changes underlying sleep problems (SP) post-COVID-19 are unclear.

Purpose

This study investigated SP-related brain functional connectivity (FC) alterations.

Patients and methods

Fifty-five COVID-19 survivors with SP (COVID_SP) and 33 without SP (COVID_NSP), matched for demographics, completed PSQI and underwent rs-fMRI at baseline and 2-month follow-up. Correlations between FC and clinical data were analyzed by Pearson correlation analysis with Gaussian random field (GRF) correction. The repeated-measures analysis of variance (R-M ANOVA) was completed to explore the interaction with time.

Results

At baseline, COVID_SP exhibited elevated FC: right precentral gyrus (PrG) with left lateral occipital cortex (LOcC)/right PrG, left inferior parietal lobule (IPL) with right superior frontal gyrus (SFG), left hippocampus with right inferior frontal gyrus (IFG). Higher FC between left hippocampus and right SFG correlated with PSQI scores. At 2-month follow-up, decreased FC implicated in emotion regulation, executive function, and memory; increased FC in semantics, attention, and auditory-visual processing. The changes in these regions are correlated with the scores of PSQI, GAD, and PHQ. The Repeated-Measures Analysis of Variance (R-M ANOVA) revealed a significant time interaction effect between sleep and various emotion scales. Moreover, the analysis of the functional connectivity between the right PrG and the right PrG as well as that between the left IPL and the right SFG also discovered a significant time interaction effect.

Conclusion

This study provides insight into the changes in brain function associated with SP after COVID-19. These changes may partially explain the development of SP, and they also changed over time.

Echoes of Strain: A Two-Year Longitudinal Study on the Impact of China's Zero-COVID Policy on College Students' Insomnia and Depressive Symptoms

Purpose

In China, stringent and long-lasting infection control measures, which were called "dynamic zero-COVID policy", have significantly affected the mental health of college students, particularly concerning depressive and insomnia symptoms. This study aims to investigate how depressive and insomnia symptoms evolved among Chinese college students throughout the pandemic, including the beginning and end of the dynamic zero-COVID policy period.

Patients and Methods

We conducted a 2-years longitudinal survey involving 1102 college students, collecting data at three key time points. Depressive symptoms were assessed using the Patient Health Questionnaire-9, and insomnia symptoms were measured with the Youth Self-rating Insomnia Scale-8. Three contemporaneous symptom networks and two cross-lagged panel networks were constructed.

Results

In the current sample, the prevalence of clinically significant depressive symptoms was 6.1%, 8.9%, and 7.7% during the first, second, and third waves, respectively. The prevalence of clinically significant insomnia symptoms was 8.1%, 13.0%, and 14.1%. Over time, the severity of depressive and insomnia symptoms and network density increased, persisting at least one year after the pandemic and control measures ended. "Difficulty initiating sleep" bridged the two disorders, while "anhedonia" played a pivotal role in triggering and sustaining other symptoms.

Conclusion

This study underscores the lasting impact of the evolving zero-COVID policy on depressive and insomnia symptoms among college students, elucidating the underlying interaction mechanisms. There is a pressing need for a more comprehensive evaluation of the implementation of restrictive public policies, taking into account their potential long-term consequences.

Students supporting students: evaluating the impact of the COVID-19 pandemic on resident assistant mental health

OBJECTIVE

To examine the impact of the novel coronavirus SARS-CoV2 (COVID-19) pandemic on Residents Assistants (RA) at a public university in the Midwest.

PARTICIPANTS

Sixty-seven RAs that had been offered an RA position for the '20-'21 academic year.

METHODS

An online cross-sectional survey measuring socio-demographics, stress, and well-being was fielded. MANCOVA models evaluated the impact of COVID-19 on well-being of Current RAs and compared to the non-current RA groups.

RESULTS

Sixty-seven RAs provided valid data. Overall, 47% of RAs had moderate-severe anxiety and 86.3% had moderate-high level of stress. Current RAs perceiving a great impact of COVID on life had significantly more stress, anxiety, burnout, and secondary traumatic stress than those who did not. RAs who started then quit experienced significantly higher secondary trauma compared to Current RAs.

CONCLUSIONS

Further research is needed to better understand the experiences and of RAs and to develop policies and programs to support RAs.

The impact of short-term exposure to criteria air pollutants on sleep disturbance among young adults: A nationwide analysis in 261 Chinese cities

BACKGROUNDS

Evidence concerning the short-term acute effect of air pollution on sleep health is quite limited. This study aims to examine the association between short-term exposure to ambient criteria air pollutants (CAPs) and sleep disturbance among young adults.

METHODS

A nationwide retrospective study was conducted across 261 Chinese cities from 2023 to 2024. Participants' sleep quality was assessed by the Pittsburgh Sleep Quality Index, and air pollutant concentrations were collected during the study period. Distributed lag nonlinear models were utilized to assess the effect of CAPs on sleep disturbance and seven sleep quality components over the seven days preceding the survey (lag 0-7). Stratification analyses involving gender, cigarette smoking, and hazardous drinking behavior were performed.

RESULTS

Of 12,279 young adults, 39% were identified as having sleep disturbances. Increases of 10 μg/m3 in PM2.5, PM10, O3, and NO2 exposure were linked to a heightened risk of sleep disturbance, with the maximum single-day percentage changes being 8.3% (95% confidence intervals: 1.9-15.2%), 10.0% (1.2-19.6%), 6.0% (2.3-9.8%), and 23.6% (4.5-46.0%), respectively. A 10 μg/m3 elevation in PM2.5, PM10, and O3 were associated with 18.4%-34.8% of cumulative increase in sleep disturbance risk. Additionally, a 10 μg/m3 increase in PM2.5 and PM10 concentrations prolonged sleep latency by 3 and 4.8 min, respectively. Each 10 μg/m3 increase in PM10 and O3 shortened sleep duration by 5.4 and 5.7 min. NO2 exposure increased scores on the daytime dysfunction component of the PSQI, resulting in a percentage change of 23.9%. The association between PM2.5, O3, and NO2 exposure and sleep disturbance was stronger in subpopulations with cigarette smoking behavior.

CONCLUSION

Short-term exposure to PM2.5, PM10, O3, and NO2 is significantly associated with sleep disturbance among young adults. Sustained improvements in air quality may help improve sleep health.

Anxiety, depression, and insomnia among medical and non-medical students in Jordan: a cross-sectional study

Background

Depression, the leading cause of disability worldwide, has worsened due to the COVID-19 pandemic, with key risk factors including age, gender, and socioeconomic status. Jordan is experiencing an increase in mental health issues, particularly among children, adolescents, and university students, yet negative attitudes and structural barriers limit access to mental healthcare This study provides a comprehensive analysis of depression, anxiety, and sleep quality among Jordanian undergraduate students.

Methods

This cross-sectional study was conducted between December 2023 and March 2024. The study used the Generalized Anxiety Disorder scale (GAD-7), the Patient Health Questionnaire (PHQ-9), and the Insomnia Severity Index (ISI) to evaluate these mental health factors. Data collection involved a self-administered survey, distributed online and in paper format. Multiple linear regression was utilized to pinpoint significant predictors.

Results

A total of 1181 participants completed the survey, with an average age of 20.43 years. Among the respondents, 74.2% were female, and 35.1% were medical students. Predictors of GAD-7 scores included year of study for medical students, with PHQ-9 scores and male gender serving as negative predictors. For non-medical students, both PHQ-9 and ISI scores positively predicted higher GAD-7 scores. ISI scores were positively influenced by age and PHQ-9 scores for medical students, whereas for non-medical students, age, PHQ-9, and GAD-7 scores were positive predictors.

Conclusion

The study demonstrates that non-medical students experience higher levels of depression, insomnia, and anxiety than their medical counterparts. These findings highlight the necessity for targeted mental health interventions and awareness programs for all undergraduate students.

Self-efficacy and healthy lifestyle behaviors as mediators between COVID-19 care knowledge and health status

The COVID-19 epidemic has affected the psychological well-being and daily life of college students, leading to a decrease in their quality of life. Health status can be influenced by a variety of factors. This study aims to assess the current health status of university students and explore the relationships among COVID-19 care knowledge, self-efficacy, healthy lifestyle behaviors, and health status and how these factors are influenced. Among the 1694 participants, 49.4% were male, 50.6% were female, and 82.2% were freshmen. The results revealed that health status across all dimensions decreased to some extent. COVID-19 care knowledge affected both physical and mental component summaries. The results suggest that improving COVID-19 care knowledge, strengthening self-efficacy, and promoting the development of healthy lifestyle behaviors can positively impact their health status. Here, we explore the health status of college students with COVID-19 infection and the factors and mechanisms that influence it to guide health interventions to better meet the challenges posed by future outbreaks.

Development of the psychopathological vulnerability index for screening at-risk youths: a Rasch model approach

Accumulating research on mental health emphasizes the general factor of psychopathology (p-factor) that unites various mental health issues. This study develops a psychopathological vulnerability assessment for youths, evaluating its psychometric properties and clinical utility. An umbrella review conceptualized multifactor psychopathological vulnerability, leading to a 57-item pool. A total of 11,224 individuals participated in this study. The resulting 22-item psychopathological vulnerability index (PVI) fitted the unidimensional Rasch model, demonstrating a person separation reliability of 0.78 and a Cronbach's alpha of 0.84. Cut-off points of 11 and 5, derived from latent class analysis, were used to distinguish vulnerable and high-protection populations. The PVI's concurrent and predictive hit rates ranged from 36.00% to 53.57% in clinical samples. The PVI concretized the vulnerability-stress model for identifying at-risk youths and may facilitate universal interventions by integrating the theoretical foundations of bifactor S-1 models with key symptoms from network models for theoretically grounded approaches.

University students' sleep during the COVID-19 pandemic in the State of Hawai'i

Objectives: This study assessed undergraduates' sleep in Hawai'i during the COVID-19 pandemic and whether demographic characteristics, health locus of control, substance use and campus features related to sleep outcomes. Implications are considered for programs to support students' sleep and health during pandemic conditions. Participants: About 1,288 undergraduate students from six universities in Hawai'i. Methods: Surveys assessing sleep, emotional wellbeing, ethnicity, body mass index, locus of health control, and substance use. Results: Students' reported increased sleep time but decreased sleep quality during the pandemic. Sleep disruption related to anxiety, depression, ethnicity, substance use, BMI, health locus of control, class rank, and whether students lived at home. All campuses were associated with disrupted sleep, regardless of size, location, religious affiliation, term structure, or method of instruction. Conclusions: In response to public health crises, such as the COVID-19 pandemic, all Hawai'i universities should screen students for sleep disruption, emotional adjustment, social isolation and substance misuse. Programs to promote sleep and behavioral health appear particularly warranted for graduating seniors, Pacific Islanders, students with high BMI, and students who commute to college.

Evaluating the mental health of international students in the U.S. during the COVID-19 outbreak: The case of University of Florida

Objective: The study aims to capture the emotional challenges faced by international students due to the changes in U.S. visa regulations during the COVID-19 outbreak. Participants: 165 international students from University of Florida participated in the study. Methods: We conducted a cross-sectional online survey using previously validated questionnaire tools (PHQ-9 and GAD-7). The collected data was quantitatively analyzed through different statistical approaches, including ANOVA, Independent Sample t-Test, and Binary Logistic Regression. Results: 18.8% of our study sample had a moderately severe to severe depressive status, and 20.6% of the study sample had severe anxiety. Additionally, there was a statistically significant difference in the depression and anxiety scores based on gender. Conclusions: Our findings addressed the importance of taking serious measures when emotionally impactful political issues arise to prevent the development of mental illnesses among international students at U.S. institutions of higher education.

The evaluation of depressive, anxiety symptoms and sleep disturbance in college students post- pandemic era across UAE: a multicentric survey

The COVID-19 epidemic has had a significant worldwide impact, requiring measures such as quarantine, social isolation, and the closing down of educational institutions, increasing concerns about student safety. This study evaluated the mental health and sleep status of 201 college students in the UAE after the epidemic. The sample consisted primarily of females (72.1%) and students aged 21-23 years (42.3%), with the majority residing in Dubai (62.7%). The findings revealed unsettling levels of insomnia risk and significant gender variations in emotional states, with females displaying higher degrees of distress. These findings underscore the negative consequences of the pandemic on student well-being and the importance of having access to mental health care, as well as calling for specialized treatments to address the individual needs of various student groups.

Perceived Causes of Sleep Problems in Higher Education Students: An Exploratory Study

The major purpose of the present study was to explore higher education students' perceptions of the causes of their sleep problems. The data were drawn from a previous cross-sectional online survey, from which only the questions relevant to this study were selected, including items on sleep disturbances and their causes. The participants included 1519 full-time students (76% women), aged 18-30 years (M = 20.9, SD = 2.3); 95.3% were single and studying for a Bachelor's degree (75.2%) across diverse fields of study. Overall, 30% of the students reported suffering from insomnia, 17.8% met the criteria for clinical insomnia (according to the Insomnia Severity Index), and 12.5% reported being dissatisfied with their sleep. The most significant perceived causes of sleep difficulties were stress (85%), academic problems (67%), and general worries (56.5%). Other causes included affective/love problems (28.4%), family issues (27.5%), changes in sleeping habits (25.9%), financial problems (13.7%), transition to higher education (10.4%), pain (7.1%), and general illness (5.5%). These findings may have important implications for interventions aimed at improving sleep health among higher education students.

Cross-country comparison of depressive symptoms and social-emotional aspects in university students from Brazil and Germany during the COVID-19 pandemic: results from two cross-sectional surveys

BACKGROUND

The COVID-19 pandemic negatively affected students' mental health, increasing pre-existing psychosocial vulnerabilities. University students worldwide have presented differences in their mental health status; however, cross-country studies comparing students' mental health during the pandemic are lacking.

AIMS

To investigate potential differences between university students from Brazil and those from Germany with respect to (a) depressive symptoms and alcohol and drug consumption, (b) social and emotional aspects (loneliness, self-efficacy, perceived stress, social support and resilience) and (c) attitudes towards vaccination.

METHOD

Two online cross-sectional studies were conducted with university students during the COVID-19 pandemic in Brazil (November 2021 to March 2022) and in Germany (April to May 2022). Depressive symptoms, alcohol consumption, loneliness, self-efficacy, perceived stress, social support, resilience, sociodemographic information and attitudes towards vaccination were assessed. Data were analysed using univariate and bivariate models.

RESULTS

The total sample comprised N = 7911 university students, with n = 2437 from Brazil and n = 5474 from Germany. Brazilian students presented significantly more depressive symptoms and suicidal thoughts, higher levels of perceived stress, higher frequency of drug or substance consumption, and lower levels of perceived social support and resilience than German students, whereas German students presented higher levels of loneliness than Brazilian students. A more favourable opinion towards vaccinations in general was found among Brazilian students compared with German students.

CONCLUSIONS

In both countries, low-threshold (online) counselling targeting university students is needed. The differences between the samples could indicate country and/or cultural differences which justify further research in this area.

TikTok use versus TikTok self-control failure: Investigating relationships with well-being, academic performance, bedtime procrastination, and sleep quality

With the global rise of TikTok popularity, the research on how TikTok use may affect its users is still limited. We aimed to contribute to this research by taking a novel approach: distinguishing between general TikTok use (duration and frequency) and TikTok self-control failure. We expected that using TikTok when it conflicts with other important goals or tasks (TikTok self-control failure) would be more strongly and negatively linked to well-being, academic performance, bedtime procrastination, and sleep quality as compared to general TikTok use. We tested our expectations in two samples: adolescents (N1 = 249) and university students (N2 = 222) during the COVID-19 pandemic lockdown. We found interesting relationships between TikTok use, TikTok self-control failure, and the outcome variables. However, our hypothesis was confirmed in both studies only for bedtime procrastination. We argue that this might be because bedtime procrastination could be a more 'proximal' outcome variable compared to the other tested variables. The present research offers empirical data useful for discussions regarding the potential negative effects of TikTok use on young people. It also shows that differentiating between general measures of social media use (i.e., duration and frequency) and a measure of social media self-control failure might provide more detailed insights into the relationships between variables of interest for media researchers.

Sleep health, its intraindividuality, and perceived stress in college students during the COVID-19 pandemic

Objective: To describe the changes in sleep health domains and examine the associations between the repeated measures and intraindividual variability (IIV) of these domains and perceived stress. Participants: A diverse racial and ethnic group of first-year college students (N = 23, 78.3% female, aged 17-18) attending in-person classes during the COVID-19 pandemic. Methods: Sleep health domains were determined using 7-day wrist actigraph and daily sleep diaries, and perceived stress scale was completed at 1-month intervals across 3 months. Results: Sleep timing, regularity, and alertness during daytime demonstrated statistically significant changes between three timepoints. Greater stress was associated with more irregularity (B = 2.25 [.87-3.62], p < .001), more dissatisfaction in sleep (B = .04 [.02-.19], p < .01), alertness during daytime (B = .18 [.05-.31], p < .001), and greater IIV (ie, fluctuations) in sleep satisfaction (B = .083 [.02, .15], p < .01). Conclusion: These findings offer insights for future researchers to facilitate intervention development to promote mental and sleep health among college students.

Mental Health Among First-Year Students Transitioning to University in Australia: A Longitudinal Study

Objectives: Young people attending university for the first time may be at heightened risk of experiencing mental health problems. However, limited research has examined the mental health experiences of this cohort using longitudinal methods. This study aimed to examine mental health symptoms prior to commencing university, estimate changes in symptoms over the course of the first semester of study, and identify factors associated with initial symptom levels and changes. Methods: Australian first-year undergraduate students (N = 340) were recruited via social media and participated in a four-wave online longitudinal study conducted between February and June 2021. Symptoms of depression, anxiety, and psychological distress were assessed at each wave, along with psychosocial and lifestyle factors. Demographic characteristics were assessed at baseline. Results: Latent growth curve models indicated no significant linear change over time for depression (p = .26) or anxiety (p = .83) symptoms. However, a significant effect of time was observed for psychological distress (p = .03), indicating higher distress levels at wave 3 compared to baseline (p = .004). Financial stress, pressure to succeed, difficulty coping, greater loneliness, and more negative social interactions were each significantly associated with higher baseline depression, anxiety, and distress scores. Only greater loneliness and more negative social interactions were found to be associated with a greater increase in depression over time. Conclusion: The findings indicate that transition to university was not generally associated with an increase in poor mental health. However, several factors were associated with poorer mental health immediately prior to university commencement. Assisting students to manage financial distress, facilitating the development of social connections among students with limited social networks and skills training targeting coping and the development of realistic academic expectations may help support student mental health and promote improved wellbeing during transition to university.

Depressive symptoms and its multifaceted associated factors among young men who have sex with men facing the dual threats of COVID-19 and mpox in China

INTRODUCTION

The COVID-19 pandemic has significantly impacted the mental health of human beings since 2020, especially the young people and the pre-existing marginalized groups such as men who have sex with men (MSM). During the COVID-19 pandemic, the multi-country outbreak of mpox in 2022 additionally posed a significant stress on the most-affected communities (i.e., MSM). This study investigated the level of depressive symptoms and its multifaceted associated factors among Chinese young men who have sex with men (YMSM) in this unique period.

METHODS

In September 2022, a large-scale cross-sectional survey was conducted among YMSM aged 18-29 years across six representative provinces in China. Hierarchical regression analysis was performed to test the various types of associated factors of depressive symptoms.

RESULTS

Among the 2493 participants, 65.6 % (n = 1638) reported mild to severe depressive symptoms. The hierarchical regression analysis identified that depressive symptoms was significantly positively associated with unemployment, having substance use in the past 6 months, a higher level of MSM self-stigma, incompletion of COVID-19 vaccination, greater mpox risk perception, and presence of mpox related-like symptoms.

LIMITATIONS

This study used the facility-based sampling method to recruit the participants, which may lead to selection bias.

CONCLUSIONS

Chinese YMSM faced significant mental health challenges during the concurrent epidemics of COVID-19 and mpox, which was associated with their socio-economic status, risk behaviors, stigma, and multiple diseases-related variables. Proactive measures may hold promise as effective strategies for mitigating mental distress among marginalized groups during public health crises.

Videoconferencing During the COVID-19 Pandemic is Associated with Sleep Disruption in Young Adults

Purpose

The COVID-19 pandemic resulted in a shift to working and learning from home and a concomitant rise in the use of virtual communication technology, such as videoconferencing. The current study prospectively examined the association between videoconferencing and sleep in a sample of young adults attending a university during the pandemic. The effects of videoconferencing on health and wellness outcomes and academic performance were also evaluated.

Patients and Methods

Participants completed the core Consensus Sleep Diary and reported engagement in videoconferencing, the use of electronic devices, and physical activity daily for 8 consecutive days. They also completed baseline measures of sleep, communication technology use, physical activity, and mental distress, as well as released their end-of-term GPA. Results were evaluated via multilevel modeling and path analysis.

Results

Participants with a heavier videocall volume lost 17 m of sleep and suffered nearly a 1% reduction in sleep efficiency for each additional hour of videoconferencing compared to those with a lower call volume. They also tended to spend more time awake during the night, have earlier sleep midpoints, and report worse sleep, although those trends did not reach statistical significance. For everyone, including individuals with lower videocall volume, earlier sleep midpoints, lower sleep quality, somewhat shorter sleep, and higher fatigue were reported on days with a relatively high videocall load compared to days with a low videocall load. Increased academic engagement with videoconferencing predicted lower academic performance and higher psychological distress: Both relationships were mediated by sleep. Use of videoconferencing for personal reasons, however, was directly associated with a reduction in distress.

Conclusion

Videoconferencing is an important determinant of sleep and may impact health and wellness as well as academic outcomes in young adults. The effects of virtual communication on sleep and human behavior warrant further study in this and other populations.

Move more today, sleep better tonight? Daily associations between physical activity and sedentary behavior with sleep among young adults with and without insomnia symptoms

OBJECTIVE

At the between-person level, it is well-documented that individuals with more physical activity (PA) and less sedentary behavior (SB) tend to have better sleep outcomes than their peers. However, the associations at the within-person level remain unclear. This study investigated the daily associations between PA and SB with nighttime sleep among young adults with and without insomnia symptoms.

METHODS

Data was collected through activity trackers and online questionnaires for 7 consecutive days among 147 university students, including time spent on moderate to vigorous physical activity (MVPA), light physical activity (LPA), and SB, along with sleep duration, sleep efficiency, and sleep quality. Participants were classified into two subgroups according to the presence of insomnia symptoms, which were determined by a self-reported insomnia scale. Multilevel compositional data analysis was conducted on the total sample, and separately on subsamples characterized by the presence and absence of insomnia symptoms.

RESULTS

In the total sample and subsample without insomnia symptoms, substitutions among MVPA, LPA, and SB were not associated with changes in sleep outcomes at the daily level. However, in the subsample with insomnia symptoms, days with more MVPA or SB and less LPA were associated with higher sleep efficiency, while days with more LPA at the expense of MVPA or SB were associated with lower sleep efficiency.

CONCLUSIONS

For young adults with insomnia symptoms, replacing LPA with MVPA on a given day may improve their sleep efficiency that night.

COVID-19 Pandemic Increases the Risk of Anxiety and Depression among Adolescents: A Cross-Sectional Study in Rural West Bengal, India

About 14% of adolescents experience mental illnesses globally. The rate increased after the COVID-19 pandemic. This study aimed to estimate the prevalence of COVID-related major mental illnesses (depression and anxiety) and their predictors among adolescents. This community-based cross-sectional study was conducted among 350 adolescents aged 10-19 years, recruited from rural communities in West Bengal, India. The study areas included 27 subcenters in the Budge Budge II Block, which comprised 191,709 population and 45,333 households. Data were collected from randomly selected households by trained research assistants through house-to-house interviews. Pretested standardized questionnaires, Patient Health Questionnaire (PHQ) for depression, Generalized Anxiety Disorder (GAD) for anxiety, and a demographic questionnaire were used for data collection. The prevalence of anxiety was 35.7% (125 out of 350), and the prevalence of depression was 30.0% (105 out of 350). Females had significantly higher scores of anxiety (6.67 ± 4.76 vs. 3.42 ± 3.17, respectively, p < 0.001) and depression (5.51 ± 4.99 vs. 3.26 ± 3.86, respectively, p < 0.001) compared to males. Adolescents who had COVID-19 cases or deaths in the family had significantly higher scores of anxiety and depression compared to those who did not have these events. In multivariate analysis, the statistically significant predictors of anxiety were COVID-19 death in the family, COVID-19 cases in the family, female gender, and a lower income group (p < 0.001 for all). For depression, the significant predictors included COVID-19 death in the family, COVID-19 cases in the family, female gender, a lower income group, and a higher age group in adolescents (p < 0.001 for all). Based on the study results, we recommend that immediate attention is needed for adolescents' mental health support and coping with stresses following COVID-19.

The longitudinal mediating role of sleep in associations between COVID-19 stressors predicting mental and physical health outcomes among emerging adult college students

The current study tested a longitudinal mediation model throughout the COVID-19 pandemic focused on whether students' housing instability stress and food/financial instability stress at the beginning of the pandemic in spring 2020 (T1) informed sleep dissatisfaction and duration in fall 2020 (T2) and, in turn, physical and mental health in spring 2021 (T3). Further, we tested whether relations varied based on students' ethnic-racial backgrounds. Participants included 879 Asian, Black, Latine, Multiracial, and White emerging adult college students (Mage = 19.95, SD = 0.33) from a large public university in the mid-Atlantic region of the United States who attended college during the COVID-19 pandemic and completed surveys about their experiences. Findings indicated a significant mediation process, such that T1 housing instability stress predicted greater T2 sleep dissatisfaction and, in turn, less physical health, greater depressive symptoms, and greater anxiety symptoms at T3. Additionally, T1 food/financial instability stress was significantly associated with less T2 sleep duration but was not, in turn, associated with any T3 outcomes. Findings did not vary by students' ethnicity/race. Results highlight that sleep dissatisfaction is an important factor that accounts for relations between COVID-19 stressors predicting mental and physical health outcomes throughout the pandemic.

Impact of COVID-19 on psychological distress in subsequent stages of the pandemic: The role of received social support

This longitudinal study examined a sample of adult Poles (N = 1245), who were interviewed three times from July 2021 to August 2022, during the later stages of the COVID-19 pandemic. The study had two primary objectives. The first was to assess the impact of the pandemic on psychological distress, measured through symptoms of depression and anxiety. The pandemic's effects were evaluated using three predictors: direct exposure to COVID-19, COVID-19 related stressors, and perceived threats from COVID-19. The second objective was to investigate the role of received social support in coping with the pandemic's hardships. Receipt of social support was measured by both the quantity of help received and the perceived quality of that support. A Latent Growth Curve Model (LGCM) was employed to analyze psychological distress across three waves, controlling for sociodemographic variables, non-COVID life events, coping self-efficacy, and perceived social support. Findings indicated that COVID-19 stressors and COVID-19 threats were strongly and consistently associated with greater psychological distress throughout the study period. The impact of direct COVID-19 exposure was limited. The quantity of received support predicted higher distress, whereas higher quality of received support was linked to better mental health. Crucially, the relationship between the quantity of support and distress was moderated by the quality of support. Effective social support was associated with the lowest distress levels, regardless of the amount of help received. Conversely, receiving large amounts of low-quality support was detrimental to psychological health. In summary, the ongoing psychosocial challenges of COVID-19 significantly eroded mental health, highlighting the importance of support quality over quantity in coping with significant life adversities.

Depressive and anxiety symptoms among university students during the later stages of the COVID-19 pandemic in Germany - Results from the COVID 19 German Student Well-being Study (C19 GSWS)

Introduction

Data on the mental health of university students in Germany during the later stages of the pandemic is still limited. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 1.5 years after the first COVID-19 restrictions and (2) which factors were associated with these outcomes.

Methods

The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 6,996 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analyzed using multivariable logistic regression models.

Results

The mean age of the participants was 23.9 years (SD = 4.8), 67% were female and 31% male. The prevalence for depressive symptoms was 29 and 32% for anxiety. The lack of a trusted person and financial difficulties were associated with anxiety and depressive symptoms. Being worried that someone in one's personal network had become severely ill with COVID-19 and concern about (re)infection with COVID-19 were associated with anxiety symptoms. Those with pre-existing health conditions had an up to 1.98-times higher chance for reporting depressive symptoms (OR, 95% CI: 1.01-3.88) and an up to 2.27-times higher chance for anxiety symptoms, respectively (OR, 95% CI: 1.15-4.46).

Conclusion

Concepts for prevention and counseling to tackle mental health problems in students are needed and programs should take specific stressors in times of crises into account.

Factors associated with dental students' mental health during the COVID-19 pandemic: a longitudinal study

The aim of the present study was to examine the relationships between gender, sense of coherence (SOC), social support, perception of academic environment and mental health of dental students during the coronavirus disease 2019 (COVID-19) pandemic. A longitudinal study involving 65 undergraduates enrolled from the first to sixth semesters in the bachelor dental course of Universidade Federal Fluminense, Brazil, was conducted. Baseline data (2018) included age, gender, SOC, social support, stress control and perception of education environment. Depression, anxiety and stress were assessed at baseline (response rate: 93%) and two-year follow-up (2020; response rate: 37%). Structural Equation Modelling was used to test the relationships between independent variables and depression, anxiety and stress during COVID-19 pandemic. Lower social support (β = -0.15), lower stress control (β = -0.20) and lower SOC (β = -0.39) were directly linked to higher depression (β = 0.22). Female gender (β = 0.22), worse perception of educational environment (β = -0.24) and lower SOC (β = -0.57) directly predicted higher anxiety. Female gender (β = 0.18), lower stress control (β = -0.21), and lower SOC (β = -0.46) directly predicted higher stress. The link between gender and both depression and stress, was mediated by stress control. Social support was indirectly linked to depression and stress via SOC. Perception of educational environment mediated the link between SOC and anxiety. Mental health of dental students during COVID-19 pandemic was influenced by demographic characteristics, perception of educational environment, social support and SOC through both direct and indirect pathways.

Depression, anxiety and coping strategies among Palestinian university students during political violence: a cross sectional study

Background

There are numerous wars and ongoing political violence in Palestine and little is known about how they have affected Palestinian undergraduate students' mental health and coping strategies. This study aimed to assess the prevalence of depression, and anxiety symptoms and coping mechanisms among Palestinian university students during the times of current political violence in Palestine after October 7, 2023.

Methods

A cross-sectional descriptive study design was utilized for a sample of students from 3 universities in Palestine (Al Quds University, Hebron University, and An-Najah University) and 1815 participants responded. Data were collected using self-reported questionnaires, including Hospital Anxiety and Depression Scale (HADS) and Brief COPE scale. Person correlation test, chi-square test, and bivariate analysis were performed to examine the associations between research variables.

Results

The estimated prevalence of depression was 65.9, and 60.9% for anxiety. The logistic regression showed that students from the Arts Faculty, females, and those with working parents were significantly more likely to experience depression and anxiety symptoms. Also, active coping, emotional support, and humor reduced the likelihood of experiencing depression symptoms, while active coping, positive reframing, humor, and acceptance decreased the likelihood of developing anxiety symptoms. Further, the study found that using religion, self-blame, denial, and behavioral disengagement increased the likelihood of depression symptoms while planning, venting, religion, self-blame, denial, and behavioral disengagement increased the likelihood of anxiety symptoms.

Conclusion

The study found that political violence often leads to symptoms of depression and anxiety among undergraduates. Furthermore, the use of maladaptive coping mechanisms increases the likelihood that these symptoms will occur. Providing immediate assistance to university students affected by political violence and conflicts is crucial for their emotional and mental recovery and coping with difficulties.

Examining the Relationship Between Anxiety, Depression, and Gastrointestinal Symptoms Among University Students: A Campus-Wide Survey Analysis

STUDY PURPOSE

This study investigates the relationship between anxiety, depression, and gastrointestinal (GI) symptoms among university students through a comprehensive campus-wide survey.

METHODS

A cross-sectional online survey design was adopted in this study. A total of 437 students from three public medical universities in Saudi Arabia participated in the survey, which assessed anxiety and depression using standardized scales and GI symptoms through a tailored questionnaire.

RESULTS

The findings reveal a significant overlap between mental health disorders and GI symptoms, highlighting that students experiencing high levels of anxiety and depression frequently report GI issues. This correlation underscores the importance of integrated health strategies to address both mental and physical well-being.

CONCLUSION

This study concludes that there is a significant correlation between anxiety, depression, and GI symptoms among university students. This highlights the need for comprehensive and integrated health interventions that address both mental and physical health to improve overall well-being and academic success in this population.

Predicting long-term sleep deprivation using wearable sensors and health surveys

Sufficient sleep is essential for individual well-being. Inadequate sleep has been shown to have significant negative impacts on our attention, cognition, and mood. The measurement of sleep from in-bed physiological signals has progressed to where commercial devices already incorporate this functionality. However, the prediction of sleep duration from previous awake activity is less studied. Previous studies have used daily exercise summaries, actigraph data, and pedometer data to predict sleep during individual nights. Building upon these, this article demonstrates how to predict a person's long-term average sleep length over the course of 30 days from Fitbit-recorded physical activity data alongside self-report surveys. Recursive Feature Elimination with Random Forest (RFE-RF) is used to extract the feature sets used by the machine learning models, and sex differences in the feature sets and performances of different machine learning models are then examined. The feature selection process demonstrates that previous sleep patterns and physical exercise are the most relevant kind of features for predicting sleep. Personality and depression metrics were also found to be relevant. When attempting to classify individuals as being long-term sleep-deprived, good performance was achieved across both the male, female, and combined data sets, with the highest-performing model achieving an AUC of 0.9762. The best-performing regression model for predicting the average nightly sleep time achieved an R-squared of 0.6861, with other models achieving similar results. When attempting to predict if a person who previously was obtaining sufficient sleep would become sleep-deprived, the best-performing model obtained an AUC of 0.9448.