Depression, anxiety and suicidal behaviour among college students: Comparisons pre-COVID-19 and during the pandemic

The path of ideological and political education in fulfilling the function of psychological nurturing

Introduction

The risk of college students facing psychological problems, such as stress, anxiety, and depression, has increased, which may have a negative impact ontheir academic performance and overall well-being, especially after the outbreakof the pandemic.

Methods

This paper summarizes the potential psychological issues thatuniversity students may face and the corresponding coping measures. Basedon this, a theoretical model of ideological and political education to enhancepsychological education was established.

Results

There was a total of 446 participantsin the study, with a mean age of 21.4 years and 44.6 per cent male. With 406 valid survey responses, the theoretical model was examined using the structuralequation modeling method. The results showed that education and teaching, practical activities, counseling services, prevention and intervention, and multilevelplatforms are effective measures to protect the psychological health ofuniversity students.

Discussion

Based on the insights gained from this study, policies canbe implemented to help university students improve their mental health andinspire higher education institutions to prioritize psychological education.

College leadership decisions and experiences during the COVID-19 pandemic: an elite interview study

OBJECTIVE

This study at a US Native American-serving Nontribal Institution (NASNTI) deeply analyzed collegiate leadership's responses and experiences during the first year of the COVID-19 pandemic.

PARTICIPANTS

Elite interviews were conducted between April and June 2021 with the college president, provost, dean of student engagement, human resources director, and chief of police. Interviewees were purposively selected due to their positions of authority.

METHODS

Each one-hour interview used a semi-structured guide for standardization and was conducted either virtually or in-person while following COVID-19 protocols. The general inductive method was used to identify nodes and categories within the transcripts.

RESULTS

Six nodes (conceptual domains) and 18 categories were identified. Though there was variability in interviewee emphasis, the respondents described the motivations, drivers, and sentiment behind their decision-making in a transparent way.

CONCLUSIONS

NASNTI leadership reported being able to navigate the pandemic by emphasizing transparency and engaging students, while working alongside the community.

Suicidal behaviour among the university students in the UK: A systematic review

Introduction

Identifying risk factors would help consider suicide prevention in any specific population. We aimed to assess suicidal behaviour among university students in the UK.

Methods

An extensive keyword search was conducted through PubMed, Cochrane, CINHAL Plus, PubMed Central, Web of Science, Trip database, and Science Direct, following the PRISMA guidelines to identify different publications. The search strategy for the literature review was based on the Population Exposure Outcome framework. Critical appraisal utilised the CASP tool for cohort studies and the AXIS tool for cross-sectional studies, resulting in 14 included studies. A narrative synthesis was performed.

Results

Postgraduate and undergraduate students used different suicidal methods such as poisoning, jumping, hanging, drowning, and suffocating, with jumping most preferred by male students. The predisposing factors of suicide among university students included: mental health problems (depression, psychological stress, psychosis, mania, neuroticism, financial anxiety, imperfect parents' connection with students), sexual orientation with risk of suicide among non-heterosexual students due to lowered self-esteem from feeling disregarded, disrespected and insufficient attention from the surrounding. Suicidal behaviour was high among unmarried students, male and unemployed female students, and students with childhood experiences such as physical abuse, family violence, emotional abuse, neglect, and physical punishment-gender, with females seeking more services from general hospitals with more suicide attempts in older females. High risk was also noted in males, with increased risk in white students compared to black students.

Conclusion

The review highlighted that students with previous mental health problems, a history of experiencing sexual abuse in childhood, bad relationships with their mother, disrespect and disregard in the community due to sexual identity are the major contributing factors for suicide among university students in the UK.

The relationship between academic stress and depression among college students during the COVID-19 pandemic: a cross-sectional study from China

BACKGROUND

The COVID-19 pandemic is a global public health crisis. During the COVID-19 pandemic, mental health has attracted great attention. However, there is a lack of research on the relationship between academic stress and depression in Chinese college students and its mechanisms. Therefore, this study investigated the mechanisms of coping style, sleep quality, and interpersonal relationship in academic stress and depression among college students.

METHODS

The cross-sectional study was conducted from May to June 2022 through face-to-face questionnaires with college students in Anhui Province, China. The questionnaires included sociodemographic information, the Simplified Coping Style Questionnaire, and the Self-Rating Depression Scale. Ordered logistic regression model was used to study the relationship between academic stress and depression of college students during the COVID-19 pandemic through the mechanism analysis of coping style, sleep quality and interpersonal relationship.

RESULTS

Two thousand thirty-three Chinese college students participated in the study, including 1,285 female and 748 male college students, with an average age 19.81 years old (SD = 1.22 years old). The results showed that (1) Academic stress had a significant impact on depression in college students under the background of COVID-19 (p < 0.01); (2) The influence of academic stress on depression had a difference in work experience as student cadres, which showed that college students who had served as student cadres were less affected by academic stress (p < 0.10), college students who had not served as student cadres were greatly affected by the academic stress (p < 0.05); (3) College students' attitudes toward COVID-19 significantly affected depression (p < 0.01); (4) Counselors' concern had a significant impact on college students' depression (p < 0.01); (5) Positive coping style, high quality sleep and good interpersonal relationship were the important mechanisms of the impact of academic stress on college students' depression.

CONCLUSIONS

This study provides new findings for in-depth understanding of the relationship between academic stress and depression among college students in China during the COVID-19 pandemic, which is conducive to the provision of targeted intervention measures for the mental health of college students.

Effects of a stigma reduction intervention on help-seeking behaviors in university students: A 2019-2021 randomized controlled trial

INTRODUCTION

Stigma is one of the most frequently identified help-seeking barriers, but there is a lack of research on the effects of stigma reduction interventions on actual mental health help-seeking behaviors during crucial academic years. This research explores the effects of stigma on university students' mental health care help-seeking behaviors before and during the pandemic.

METHODS

A randomized control trial spanned from 2019 to 2021 at the University of Porto, along five evaluation moments, with students into one control group and two intervention groups-the interventions aimed to reduce depression stigma.

RESULTS

Among the 702 participants (mean age 18.87, 59.4 % female), the intervention groups significantly increased help-seeking behaviors. In 2020, the intervention groups, having reduced stigma, continued to demonstrate to be more prompt to seek mental health help. In 2021, 22 months, the effects of the intervention on help-seeking were no longer significant; however, participants in the intervention groups showed less severe symptomatology.

CONCLUSION

Stigma reduction interventions have a pronounced effect on enhancing help-seeking behaviors among university students, even during times of crisis. This study advocates for prioritizing stigma reduction in academic settings, highlighting its value in promoting mental health access during crucial academic and life challenges.

Twelve-month suicidal ideation, incidence and persistence among college students pre-pandemic and during the pandemic: A longitudinal study

The present study explored whether there had been significant changes in 12-month suicidal thoughts, incidence, and persistence of suicidal ideation among college students prior to and during the COVID-19 pandemic. Data were drawn from the French portion of the World Mental Health International College student Survey Initiative (WMH-ICS), a prospective cohort survey initiated in 2017. Students who completed both the baseline and one-year follow-up surveys were included (n = 1,216). Lifetime suicidal ideation and behaviors and mental disorders were assessed at baseline, and 12-month suicidal ideation and behaviors were also assessed at one-year follow-up. Logistic regressions were used to determine whether the odds of 12-month suicidal ideation at follow-up was associated with COVID-19 pandemic period while adjusting for lifetime psychopathology. No significant change in the odds of 12-month suicidal ideation was observed during the pandemic when compared to pre-pandemic times. Adjusting for prior psychopathology, 12-month suicidal ideation was not significantly associated with pandemic times, nor was incidence or persistence. No evidence of a significant increase in suicidal thoughts during the pandemic was observed. Longer follow-up periods and larger samples are needed in order to determine whether suicidal ideation and behaviors remain stable in the future.

A multisite, quasiexperimental trial of a college course to support student mental health during the COVID-19 pandemic

OBJECTIVE

The purpose of this study was to investigate the acceptability, appropriateness, feasibility, and preliminary effectiveness of a three-credit college Wellness and Resilience Course (WRC) for improving student mental health and well-being outcomes in the context of the coronavirus disease 2019 (COVID-19) pandemic.

METHOD

Undergraduate students aged 18-24 years old on five campuses in Western Pennsylvania or West Virginia who had either enrolled in the WRC (n = 81) or were attending university as usual (i.e., not enrolled in the WRC; n = 171) participated in surveys at baseline (beginning of semester), end of semester, and 3-month follow-up during the Spring and Fall 2020 semesters.

RESULTS

Overall, students rated the WRC as acceptable, appropriate, and feasible. From baseline to the end of semester, students who received the WRC reported significant improvements in psychological flexibility (d = 0.30), mindfulness (d = 0.42), distress tolerance (d = 0.36), and use of dysfunctional and adaptive coping skills (d = 0.32), compared with students who did not receive the WRC. At follow-up, all gains remained statistically significant and students who received the WRC additionally reported significant improvements in stress (d = 0.44) and life satisfaction (d = 0.35) compared with students who did not receive the WRC.

CONCLUSIONS

These findings offer preliminary evidence that college courses focused on mental wellness may be an important component of campus strategies to increase universal access to mental health support and skills. This study was registered on clinicaltrials.gov on April 8, 2020.

Prevalence of past-year major depressive episode among young adults between 2005 and 2021: Results from four national representative surveys in France

BACKGROUND

The objectives are to examine time trends in the prevalence of past year major depressive episode (MDE) among young adults, and to identify differences by occupational status comparing students, those employed, and those who are not in employment, education or training (NEET).

METHODS

Data were drawn from the Health Barometer survey, a cross-sectional computer-assisted telephone interview survey on a national representative sample of residents of metropolitan France and conducted approximately every 5 years. The surveys relied on the Composite International Diagnostic Interview-Short Form to determine the presence of DSM-IV past-year major depressive episode. Data from the 2005, 2010, 2017, and 2021 surveys were pooled and respondents aged 18 to 25 were selected (n = 7556) and categorized based on their occupational status: students, those employed, and NEET.

RESULTS

Overall, significant differences in the prevalence of MDE was observed by occupational status: NEET had the highest rate (18.5 %) followed by students (14.3 %) and those employed (11.0 %). The prevalence of MDE among young adults was 10.1 % in 2005, 9.7 % in 2010 and 11.3 % in 2017, reflecting a stable prevalence between 2005 and 2017. The prevalence then nearly doubled in 2021, with 20.9 % of MDE, with a significant increase of 9.6 points between 2017 and 2021.

LIMITATIONS

No assessment of lifetime psychopathology.

CONCLUSIONS

The prevalence of major depression among young adults significantly increased between 2005 and 2021, those at greatest risk are females and those not in employment, education or training. The contribution of pandemic-related factors may be elucidated in future national health surveys.

Mental health in undergraduate students several months into the COVID-19 pandemic compared to before the pandemic

OBJECTIVE

To compare mental health indicators among undergraduates in Fall 2019, before the COVID-19 pandemic, and Fall 2020, when many students returned to campus amidst restrictions on in-person contact.

PARTICIPANTS

Analyses included 26,881 undergraduate students, aged 18-24, from 70 U.S. institutions.

METHODS

Students completed the National College Health Assessment-III survey in Fall 2019 or Fall 2020.

RESULTS

The prevalences of high stress, loneliness, a low flourishing score, and serious psychological distress increased in 2020 compared to 2019. Serious psychological distress increased substantially in 2020 among students not living with family (adjusted prevalence ratio (aPR)=1.36, 95% CI 1.29-1.45) but not among students living with family (aPR = 1.09, 95% CI 0.95-1.26).

CONCLUSIONS

These results suggest prevalences of several indicators of poor mental health were elevated among U.S. undergraduates several months into the pandemic. The pandemic may have had greater impact on mental health among students not living with family.

The prevalence of anxiety and depression symptoms (ADS), persistent and chronic ADS among the adult general population and specific subgroups before and during the COVID-19 pandemic until December 2021

BACKGROUND

It is unclear to what extent the prevalence of moderate and severe anxiety and depression symptoms (ADS) is higher during the first 20 months after the COVID-19 outbreak than before the outbreak. The same holds for persistent and chronic ADS among the adult general population and subgroups (such as employed, minorities, young adults, work disabled).

METHODS

Data were extracted from six surveys conducted with the Dutch longitudinal LISS panel, based on a traditional probability sample (N = 3493). Biographic characteristics and ADS (MHI-5 scores) were assessed in March-April 2019, November-December 2019, March-April 2020, November-December 2020, March-April 2021, and November-December 2021. Generalized estimating equations were conducted to examine differences in the prevalence of post-outbreak ADS, persistent and chronic ADS compared to the pre-outbreak prevalence in similar periods. The Benjamini-Hochberg correction for multiple testing was applied.

RESULTS

Among the general population chronic moderate ADS increased significantly but slightly in the period March-April 2020 to March-April 2021 compared to a similar period before the pandemic (11.9 % versus 10.9 %, Odds Ratio = 1.11). In the same period a somewhat larger significant increase in chronic moderate ADS was observed among 19-24 years old respondents (21.4 % versus 16.7 %, Odds Ratio = 1.35). After the Benjamini-Hochberg correction several other differences were no longer significant.

LIMITATIONS

No other mental health problems were assessed.

CONCLUSIONS

The Dutch general population and most of the assessed subgroups were relatively resilient given the limited increase or absence of increases in (persistent and chronic) ADS. However, young adults suffered from an increase of chronic ADS.

Mental health in Europe during the COVID-19 pandemic: a systematic review

The COVID-19 pandemic caused immediate and far-reaching disruption to society, the economy, and health-care services. We synthesised evidence on the effect of the pandemic on mental health and mental health care in high-income European countries. We included 177 longitudinal and repeated cross-sectional studies comparing prevalence or incidence of mental health problems, mental health symptom severity in people with pre-existing mental health conditions, or mental health service use before versus during the pandemic, or between different timepoints of the pandemic. We found that epidemiological studies reported higher prevalence of some mental health problems during the pandemic compared with before it, but that in most cases this increase reduced over time. Conversely, studies of health records showed reduced incidence of new diagnoses at the start of the pandemic, which further declined during 2020. Mental health service use also declined at the onset of the pandemic but increased later in 2020 and through 2021, although rates of use did not return to pre-pandemic levels for some services. We found mixed patterns of effects of the pandemic on mental health and social outcome for adults already living with mental health conditions.

Mental Health of University Students When Returning to Face-to-Face Classes: A Cross-Sectional Study

Depression, anxiety and stress are multifactorial affective disorders that could manifest through a set of symptoms, both physical and psychological, that affect the quality of life and performance of people who suffer from them. In this sense, the present research had the objective of evaluating depression, anxiety and stress in students of the Faculty of Engineering of a Peruvian public university when returning to face-to-face classes. The research was developed under a quantitative approach and is of a non-experimental design of the descriptive cross-sectional type. The sample consisted of 244 students who responded to the Depression, Anxiety and Stress Scale, an instrument with adequate psychometric properties. According to the results, the students presented low levels of depression and anxiety. However, they showed moderate levels of stress. On the other hand, it was found out that the three variables were directly and significantly related. In the same way, it was found that there were statistically significant differences regarding the levels of depression, anxiety and stress related to gender, age group, family responsibilities and professional career. Finally, it was concluded that there were symptoms of depression, anxiety and stress in students of the Faculty of Engineering of a Peruvian public university when returning to face-to-face classes.

Mental health state and its determinants in German university students across the COVID-19 pandemic: findings from three repeated cross-sectional surveys between 2019 and 2021

Background

Students were at an increased risk for elevated mental symptoms during the first year of the COVID-19 pandemic compared to pre-pandemic levels. As universities remained closed much longer than anticipated, the mental burden was expected to persist through the second year of the pandemic. The current study aimed to investigate the prevalence of mental distress from 2019 through 2021 and identify risk factors for elevated mental burden, focusing on gender.

Methods

We analyzed three cross-sectional online surveys among students at the University of Mainz, conducted in 2019 (n = 4,351), 2020 (n = 3,066), and 2021 (n = 1,438). Changes in the prevalence of depressive symptoms, anxiety, suicidal ideation, and loneliness were calculated using Pearson's chi-square tests and analyses of variance. Multiple linear regressions yielded associated risk factors.

Results

The proportion of students with clinically relevant depressive symptoms was significantly higher during the pandemic (38.9% in 2020, and 40.7% in 2021), compared to pre-pandemic (29.0% in 2019). Similarly, more students reported suicidal ideation and generalized anxiety during the pandemic with a peak in the second pandemic year (2021). The level of loneliness was significantly higher in 2020, compared to 2019, and remained at a high level in 2021 (p < 0.001, η p 2 = 0.142). Female and diverse/open gender, being single, living alone, and being a first-year student were identified as risk factors associated with mental burden during the pandemic.

Discussion

Mental burdens remained elevated among students through the second year of the pandemic and were associated with socio-demographic risk factors and pandemic-related concerns. Future research should monitor recovery and evaluate the need for psychosocial support.

The contribution of childhood adversities to the persistence of severe role impairment among college students: a follow-up study

PURPOSE

While the association between childhood adversities (CAs) and negative mental health outcomes is robustly supported throughout the epidemiological literature, little is known about their contribution to the persistence of role impairment. The present study aims to investigate the association of three facets of CAs with the persistence of severe role impairment among college students using a follow-up design.

METHODS

Data were drawn from the French portion of the World Mental Health International College Student Initiative. Students who completed both the baseline and 1-year follow-up surveys were included (n = 1,188). Exposure to 12 types of CAs before the age of 18 was assessed at baseline, and 12-month role impairment and 12-month mental disorders were assessed at baseline and follow-up. Logistic regressions estimated associations by jointly using types, number of types, and cumulative frequency of exposure to CAs as predictors.

RESULTS

At baseline, 27.6% of students reported any severe role impairment. Among them, 47.5% reported the persistence of any impairment at one year. In models adjusted for 12-month mental disorders, only the frequency of CAs was associated with the persistence of impairment, namely college-related and other work impairment (aOR = 1.17, 95% CI [1.01, 1.35]).

CONCLUSION

Role impairment is prevalent among college students, and studies are needed to better understand its persistence. Beyond the primary prevention of early stressors, screening for and treating mental health problems during college may help reduce the impact of CAs on the persistence of role impairment.

The associations between body dissatisfaction, exercise intensity, sleep quality, and depression in university students in southern China

Background

In recent years, depression in early adulthood has become an urgent global public health concern. The university years mark a transitional period from adolescence to adulthood. Young people are required to face academic and life pressures independently, which increases the risk of mental health problems in university.

Purpose

The main goal of the current study was to explore the sex differences in depression, body dissatisfaction, sleep quality, and exercise intensity among university students in southern China and to analyze the factors affecting the level of depression among university students.

Methods

In total, 1,258 university students aged 18-23 years were recruited for this study. All participants completed anthropometric measurements, the Self-rating Depression Scale, Physical Activity Rating Scale, and Pittsburgh Sleep Quality Index. Body dissatisfaction levels were measured using sex-appropriate silhouettes.

Results

Compared with young women, young men had higher exercise intensity and sleep quality, whereas young women's body dissatisfaction and depression levels were significantly higher than those of young men. Sleep quality score (β = 0.34, p < 0.01), sex (β = 0.15, p < 0.01), physical activity score (β = -0.14, p < 0.01), and body dissatisfaction (β = 0.14, p < 0.01) were significant predictive factors of the Self-rating Depression Scale score.

Conclusion

Low levels of physical dissatisfaction have a positive effect on depression, and high levels of physical activity and quality sleep can also improve depressive symptoms. At the same time, increasing body satisfaction has the effect of increasing physical activity and improving sleep quality. Therefore, there is great potential to prevent and ameliorate depression by reducing body dissatisfaction.

College students' anxiety after returning to school during the COVID-19 epidemic: What should we care

The college students' anxiety during the Coronavirus disease 2019 (COVID-19) epidemic remains unclear. We aimed to evaluate the college students' anxiety after returning to school during the COVID-19 epidemic, to provide reference for the management and nursing care of college students. We conducted a survey from September 15, 2021 to September 30, 2021 investigate the anxiety level of college students. The Self-rating Anxiety Scale was used for anxiety assessment. The Spearman correlation analysis was conducted to evaluate the correlation between students' anxiety and characteristics. Logistic regression analysis was used to explore the influencing factors of concurrent anxiety among college students. A total of 2168 college students were included, the incidence of anxiety was 30.07% in college students during the COVID-19 epidemic. Pearson correlation analyses showed that grade (R = 0.715), main use of computer and mobile phone (R = 0.622), daily exercise (R = 0.735), whether relatives or friends are infected with COVID-19 (R = 0.735) are associated with the anxiety level of college students (all P < .05). Logistic regression analysis indicated that senior year (Odds ratio [OR] = 2.064, 95% confidence interval [CI]: 1.355-3.001), online game (OR = 3.122, 95% CI: 2.562-3.899), relatives or friends are infected with COVID-19 (OR = 2.987, 95% CI: 1.901-3.451) are the independent risk factors of anxiety in college students (all P < .05). Daily exercise (OR = 0.514, 95% CI: 0.205-0.814) was the independent protective factors of anxiety in college students (P = .008). During the COVID-19 epidemic, college students have increased anxiety and there are many influencing factors. Administrators and educators should especially pay attention to the mental health of students with those risk factors to maintain students' physical and mental health.

The study of psychological traits among Chinese college students during the COVID-19 campus lockdown

To investigate the prevalence of interpersonal sensitivity, anxiety, depression symptoms and associated risk factors among a large-scale sample of college students in China during the COVID-19 campus lockdown. The survey was conducted among undergraduate students at a university in eastern part of China in April 2022. The Chi-square test was used to compare the different variable groups and multivariable analysis was performed for the risk factors associated with interpersonal sensitivity, anxiety, and depression symptoms. A total of 12,922 college students were included, with an average age of (20.96 ± 1.66) years. The prevalence of interpersonal sensitivity, anxiety and depression symptoms in this study was 58.1, 22.7, and 46.8%, respectively. Male (OR = 1.16, p &lt; 0.001), 22–23 years (OR = 1.40, p &lt; 0.001), freshman (OR = 1.35, p = 0.002), and non-only child (OR = 1.15, p &lt; 0.001) were positively associated with interpersonal sensitivity. Male (OR = 1.20, p &lt; 0.001), sophomores (OR = 1.27, p = 0.020) and seniors (OR = 1.20, p = 0.027) were positively associated with anxiety symptoms. Compared with female students, male students (OR = 0.89, p &lt; 0.001) were less likely to have depression symptoms. 22–23 years (OR = 1.37, p &lt; 0.001), sophomores (OR = 1.26, p = 0.009) and non-only child (OR = 1.11, p = 0.009) were positively associated with depression symptoms. In addition, college students aged 18–21 years, learning status, skipping breakfast, roommate relationship and sleep quality were associated with interpersonal sensitivity, anxiety and depression symptoms (all p &lt; 0.05). The findings of this study suggest a high prevalence of interpersonal sensitivity, anxiety and depression symptoms among Chinese college students during the COVID-19 campus lockdown. Younger ages, low grades, poor dormitory relationship, negative learning status, skipping breakfast and poor sleep quality were the risk factors for college students’ mental health, which should be concerned by the relevant departments of school during the campus lockdown.

Anxiety and depression as predictors of life satisfaction during pre-professional health internships in COVID-19 times: the mediating role of psychological well-being

Due to the emotional impact of COVID-19 on university students, the goal was to explore the relationship between anxiety, depression, psychological well-being, and life satisfaction among pre-professional interns. The research was carried out using an explanatory cross-sectional design, with the participation of 1011 pre-professional interns of 13 health networks from the department of Puno (Peru). Data were collected using the Satisfaction with Life Scale, Generalized Anxiety Disorder Scale-2, Patient Health Questionnaire 2, and the Psychological Wellbeing Scale. The main data analysis was carried out using the R statistical software, and implementing the confirmatory factor analysis technique, which evidenced that the explanatory model provides an acceptable value. Based on the above, a negative relationship between depression and life satisfaction, (β = -.60, p < .001) and a positive relationship between anxiety and life satisfaction (β = .28, p < .001) was shown, in addition to a mediating effect of the psychological wellbeing related to depression and life satisfaction (p < .001). In conclusion, life satisfaction is explained concerning the degree of depression and anxiety, as well as the moderating effect of psychological well-being. Despite that, there is an urgent need to take preventive actions to strengthen the mental health of the pre-professional health interns, who have also been providing support during the COVID-19 pandemic.

Depression and anxiety among online learning students during the COVID-19 pandemic: a cross-sectional survey in Rio de Janeiro, Brazil

Background

The COVID-19 pandemic introduced a global need to explore the potential and challenges of online education.

Objective

To evaluate the presence of depression and anxiety in university students and their level of satisfaction with online learning during the period of social isolation caused by the COVID-19 pandemic.

Method

A cross-sectional design was used to evaluate 152 online learning students from six different university courses: Medicine, Psychology, Law, Engineering, Physiotherapy, and Business. The evaluation of the participants was carried out through an online survey in Rio de Janeiro, Brazil. Also, the Hospital Anxiety and Depression Scale was used to assess participants mental health.

Results

Most of the participants reported emotional impact, followed by learning impact, financial impact, social impact, and technological impact, with a significant difference in the presence of depressive symptoms, but no significant difference in anxiety. The participants presented moderate anxiety levels, with no significant differences between genders, and mild levels of depressive symptoms with significant differences between genders. Also, younger students were more anxious than older students. In addition, female students with less social contact presented more depressive symtoms.

Conclusion

From a clinical perspective, the findings provide insights into mental health among university students during the COVID-19 pandemic. These findings may help in the development of effective screening strategies and in the formulation of interventions that improve the mental health of students.

First-onset major depression during the COVID-19 pandemic: A predictive machine learning model

BACKGROUND

This study longitudinally evaluated first-onset major depression rates during the pandemic in Italian adults without any current clinician-diagnosed psychiatric disorder and created a predictive machine learning model (MLM) to evaluate subsequent independent samples.

METHODS

An online, self-reported survey was released during two pandemic periods (May to June and September to October 2020). Provisional diagnoses of major depressive disorder (PMDD) were determined using a diagnostic algorithm based on the DSM criteria of the Patient Health Questionnaire-9 to maximize specificity. Gradient-boosted decision trees and the SHapley Additive exPlanations technique created the MLM and estimated each variable's predictive contribution.

RESULTS

There were 3532 participants in the study. The final sample included 633 participants in the first wave (FW) survey and 290 in the second (SW). First-onset PMDD was found in 7.4% of FW participants and 7.2% of the SW. The final MLM, trained on the FW, displayed a sensitivity of 76.5% and a specificity of 77.8% when tested on the SW. The main factors identified in the MLM were low resilience, being an undergraduate student, being stressed by pandemic-related conditions, and low satisfaction with usual sleep before the pandemic and support from relatives. Current smoking and taking medication for medical conditions also contributed, albeit to a lesser extent.

LIMITATIONS

Small sample size; self-report assessment; data covering 2020 only.

CONCLUSIONS

Rates of first-onset PMDD among Italians during the first phases of the pandemic were considerable. Our MLM displayed a good predictive performance, suggesting potential goals for depression-preventive interventions during public health crises.