Is the mental health of young students and their family members affected during the quarantine period? Evidence from the COVID-19 pandemic in Albania

Self-quarantining, social distancing, and mental health during the COVID-19 pandemic: A multi wave, longitudinal investigation

Social isolation and disconnectedness increase the risk of worse mental health, which might suggest that preventive health measures (i.e., self-quarantining, social distancing) negatively affect mental health. This longitudinal study examined relations of self-quarantining and social distancing with mental health during the COVID-19 pandemic. A U.S. national sample (N = 1,011) completed eight weekly online surveys from March 20, 2020 to May 17, 2020. Surveys assessed self-quarantining, social distancing, anxiety, and depression. Fixed-effect autoregressive cross-lagged models provided a good fit to the data, allowing for disaggregation of between-person and within-person effects. Significant between-person effects suggested those who engaged in more self-quarantining and social distancing had higher anxiety and depression compared to those who engaged in less social distancing and quarantining. Significant within-person effects indicated those who engaged in greater social distancing for a given week experienced higher anxiety and depression that week. However, there was no support for self-quarantining or social distancing as prospective predictors of mental health, or vice versa. Findings suggest a relationship between mental health and both self-quarantining and social distancing, but further longitudinal research is required to understand the prospective nature of this relationship and identify third variables that may explain these associations.

Mental workload, musculoskeletal discomfort and physical activity level in master's degree students in the COVID-19 context: A pilot study

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has led to a change of pedagogical strategies from on-campus to "online" modality (synchronous and asynchronous learning) and may influence the health of university students, including their mental workload.

OBJECTIVE

To identify the association between mental workload, perception of musculoskeletal discomfort (MSD), and the level of physical activity of Masters's students' online learning due to the pandemic.

METHOD

This was a pilot descriptive study with a cross-sectional, quantitative, non-experimental study design. The sample consisted of 20 students. To collect the data, the participants answered a sociodemographic questionnaire, NASA-Task Load Index, International Physical Activity Questionnaire, and the Nordic Musculoskeletal Questionnaire.

RESULTS

The students presented mental workload at medium (45%) and high (55%) levels, with time demands as the most prevalent dimension. In addition, 80% of the students reported experiencing MSD in the last seven days, with the most frequent areas being the neck and lower back. Regarding the level of physical activity, five students had a low level (25%), five students had a medium level (25%), and ten students had a high level (50%) of activity.

CONCLUSION

Most of the students (95%) conduct their master's degree along with maintaining a full-time job. Therefore, the adaptive requirements according to "time demands" is a negative factor because of its contribution to mental workload. Especially in addition to students' perception of musculoskeletal discomfort, organizational aspects would be fundamental to prevent physical and mental health risks.

Examining the Impact of Assistive Technology on Psychological Health, Family Education, and Curriculum Research in Japan: Insights from Artificial Intelligence

This study aims to analyze the effect of psychological health based on artificial intelligence agent technology on the implementation effect of Japanese family education. By combining mobile agent technology and education thought, the system structure and working mechanism of the education support system of agents are studied to build personalized support for the family education system based on mobile agents. A total of 320 Japanese middle school students were randomly divided into an experimental group and a control group, with 160 cases in each group. The control group received traditional family health education, while the experimental group received mental health education based on the Agent Technology family education system. The basic information and mental health scores of the two groups of students were compared. The results showed that there were no remarkable differences in the number of male and female cases, weight, height, average age, grade, home address, or family situation between groups (p > 0.05). The psychological health level of the experimental group was considerably superior to that of the control group regarding obsessional symptoms, interpersonal tension and sensitivity, depression, anxiety, learning pressure, maladaptation, emotional imbalance, and psychological imbalance (p < 0.05). In summary, compared with traditional family education, family education of the mental health education system based on agent technology can better improve the level of middle school students' mental health, which can improve student forced symptoms, interpersonal tension and sensitivity, depression, anxiety, learning pressure, maladjustment, emotional imbalance, psychological imbalance, and many other psychological states. Furthermore, personalized support for family education systems based on mobile agents has the advantages of autonomy, responsiveness, initiative, and mobility, which provides a new idea for family education.

Investigating the psychological effects of home quarantine during the early peaks of the COVID-19 pandemic: a survey from Iran

We assessed psychological symptoms among individuals who were quarantined during early coronavirus disease 2019 (COVID-19) peaks. This cross-sectional study was performed during April-October 2020 in Iran. We surveyed 100 individuals with COVID-19 patients in their families and 100 others with health conditions associated with a higher risk of developing critical forms of COVID-19 infection, who have completed at least 14 days of home quarantine. Validated Persian versions of the 21-item Depression, Anxiety, and Stress and 22-item Impact of Event Scale-Revised were used to measure the symptoms of depression, anxiety, stress and distress. The rates of stress, anxiety, depression and quarantine-related distress were 46.5, 48.5, 57.0 and 80.5%, respectively; however, they were not significantly different between the contact and no-contact groups. Female sex and being unemployed were significantly associated with quarantine-related distress, P  = 0.007 and P  = 0.018, respectively. Independent risk factors for anxiety were a history of medical comorbidity ( P  = 0.025) and contact with COVID-19 patients ( P  = 0.007). Findings show high prevalence rates of psychological symptoms among quarantined individuals, regardless of whether they had contact with COVID-19 patients or not. Female sex and unemployment were risk factors for quarantine-related distress.

Distance Learning in Nursing Education during the COVID-19 Pandemic: Psychosocial Impact for the Greek Nursing Students-A Qualitative Approach

(1) Background: The COVID-19 pandemic posed a major threat to global health and on the educational field. The purpose of this study is to identify and illustrate the psychosocial adaptation of nursing students to the sudden and exclusive application of distance learning during the COVID-19 pandemic; (2) Methods: A qualitative interview research has been designed. Two focus groups of seven members each and six individual interviews were conducted in a sample of undergraduate nursing students in Greece from 3 March 2021, to 9 April 2021.; (3) Results: A qualitative thematic analysis of the data identified six themes: 1. Challenges; 2. Concerns; 3. Social changes; 4. Negative Emotions; 5. Evaluation; and 6. Teaching strategies.; (4) Conclusions: During its implementation, it identified gaps and weaknesses in the entire academic community. The study of the psychosocial adaptation of the academic community is considered crucial, as it can highlight the individual difficulties in distance learning and contribute to the improvement of the methods of its the improvement of its methods.

Real time sentiment analysis of natural language using multimedia input

Semantics and Sentiments are parts of our daily speech and expressions that helps to convey the message in the tone intended. The accurate interpretation of emotions and actions is prudent as it expresses the true meaning of the message. This interpretation has been studied extensively in the past two decades, where professionals from various disciplines have pondered this question. Every action and expression-whether it's in a speech, in a video or through some written material-helps the recipient understand the intent behind the message. The primary motive in these studies has been to automate the analysis of these sentiments by teaching the computers to do so, using the audio, video and text-based data that has been collected so far. Machine Learning (ML) and Deep Learning (DL) is the discipline that can help us tackle such a problem which requires analysis and recognition of copious amounts of data. Classification based on these multi-media inputs has seen the application of several common and uncommon ML techniques such as Support Vector Machines (SVMs), Bayesian Networks (BNs), Decision Trees (DTs), Convolutional Neural Networks (CNNs) and K-Means Clustering. These techniques, to a certain level of accuracy, can classify a certain part of a message into a different emotion. Through this research, firstly, a comparison is represented between the previously conducted studies and secondly, a system is developed of our own that enables Real Time Sentiment Analysis and helps a user assess his/her day-to-day attitude and get appropriate recommendations for the same.

Psychological disorders among Spanish Nursing students three months after COVID-19 lockdown: A cross-sectional study

The COVID-19 pandemic had a notable impact on the psychological well-being of a large part of the population, putting them at risk of developing depressive symptoms, different levels of anxiety disorders, and posttraumatic stress disorder (PTSD). One group considered to be at high risk are Nursing students; they were affected as learning strategies changed and clinical practices were cancelled. This study attempts to assess the psychological impact COVID-19 pandemic had on Nursing students and to explore the sociodemographic differences that can be risk factors for mental health disturbance. The psychological impact was evaluated using the Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). The study took place 4 months after the state of alarm was declared over in Spain. From a total sample of 304 Nursing students, 26.7%, 39.8%, and 15.5% showed PTSD, anxiety, and depression symptoms, respectively. Severe levels of psychological impact have been associated with being a female, a smoker, and feeling fear and stress. Having a relative test positive has been linked to lower anxiety levels while being afraid or stressed to higher anxiety levels. Being a female, co-habit with friends and feeling stress have been associated with higher depression levels.

Are COVID-19's restrictive measures associated with people's quality of life and the prevalence of anxiety and depression in Kinshasa in the Democratic Republic of Congo?

BACKGROUND

The spread of COVID-19 and the economic repercussions of several restrictive measures have worsened the lives of the Congolese and caused panic, fear, and anxiety. No study has yet examined the effect COVID-19's restrictive measures had on the quality of life in the Congo.

AIMS

The purpose of this study is to determine if the restrictive measures of COVID-19 are associated with the quality of life and the prevalence of anxiety and depression in Kinshasa.

METHODS

A cross-sectional survey was conducted in seventeen Kinshasa municipalities. N=100 adults over the age of 18 were recruited (41 females, 58 males and 1 prefer not). Social Contacts Assessment (SCA), Time Use Survey (TUS), Manchester Short Assessment of quality of life (MANSA), Health status EQ-5D-3L, UCLA Loneliness Scale; Patient Health Questionnaire (PHQ-9); General Anxiety Disorder (GAD-7) and COVID-19 related questions were utilized. We conducted descriptive statistics and multiple regression analyses.

RESULTS

suggest that depression and anxiety are more prevalent (PHQ-9 and GAD-7 scores were 9.1 (SD=6.8) and 8.5 (SD=6.1) respectively). Negative associations were found between the quality of life and living alone (B=-0.35, p=0.05) and mental health decline due to COVID- 19 (B=-0.30, p=0.04). Those who described themselves as less lonely reported a higher quality of life (B=0.34, p=0.03).

CONCLUSIONS

Living alone is associated with a lower quality of life. This study fills a gap in the literature on public health in the DRC and low- and middle-income countries.

COVID-19 e saúde mental

A pandemia de COVID-19 e as medidas de distanciamento social trouxeram implicações psicossociais para toda a comunidade universitária. Diante disso, o objetivo deste estudo é identificar fatores associados a sinais de ansiedade, depressão e estresse em uma comunidade universitária em regime de distanciamento social, durante a emergência sanitária. Por meio de estudo observacional de corte transversal com caráter quantitativo exploratório, realizado entre abril e maio de 2020, com uso da Escala de Depressão, Ansiedade e Estresse (DASS-21), foi obtida amostra on-line de 1.796 indivíduos. Os resultados de regressão quasi-Poisson demonstram que histórico de distúrbio mental, piora do estado emocional e dificuldades financeiras estão associados a altos escores dos três desfechos. Ainda, praticar atividade que proporciona bem-estar e possuir computador em casa estão associados negativamente a escores altos de depressão. Assim, mudanças do ensino presencial para o remoto podem ter implicações negativas na saúde mental de comunidades universitárias. 

Resilience and Experience of the COVID-19 Pandemic among Italian University Students: A Mixed-Method Study

A vast amount of literature has highlighted that restrictions imposed by the COVID-19 pandemic, such as lockdowns and the resulting interruption of face-to-face academic activities, strongly disrupted students' daily routine and undermined their well-being. Through a mixed method approach, this study was aimed at investigating the association between students' experience of the health emergency and their resilience levels during the first pandemic outbreak. Between April and May 2020, 421 Italian university students attending Health Sciences, Humanities, and Political Sciences courses completed the Resilience Scale for Adults (RSA), provided narratives about the emergency by answering an open-ended question, and filled out a demographic questionnaire. Results showed that narratives about community/society issues were by far the most recurrent ones across disciplinary areas, while a significantly higher percentage of students from Humanities focused on study/university. Health Sciences students were more likely to provide narratives concerning social commitment, and they reported significantly higher resilience levels than Humanities students. A higher percentage of students with moderate resilience focused their narratives on the study/university domain, compared to students with high resilience. Findings suggest the importance of supporting students' resilience to counterbalance their academic concerns in both times of crisis and ordinary times.

Latent Profile Analysis of Positive Solitude During the Recurrent Outbreak of COVID-19

The current study aimed to identify latent profiles of positive solitude during the recurrent outbreak of COVID-19 among Chinese adults. A total of 902 adults from China completed the questionnaires. We found five different profiles of positive solitude: low positive solitude group, medium-low positive solitude group, quietness positive solitude group, medium-high positive solitude group, and high positive solitude group. Positive and negative affect were significantly different from the five profiles. In addition, gender had different effects on different positive solitude profiles. The results of the study provide a new perspective to understand the positive solitude of Chinese adults during the recurrent outbreak of COVID-19 by using the people-centered approach.

Decreased Hospital Visits and Increased Mortality Rate in Emergency Department during the COVID-19 Pandemic: Evidence from Albania

Objective:

To investigate the hospital visits and mortality rate during the COVID-19 in emergency department of Vlora regional hospital in Albania and to compare with the three previous years (2017–2019).

Methods:

Secondary data of patients that visited emergency department of Vlora Regional hospital Albania (largest hospital in the south of the country), since January 1, 2017 till December 31, 2020. This is a retrospective study. We used the hard copy of the patients’ health register records. The data extraction was conducted during March 2021 till June 2021. Eligible were all patients admitted and recorded in the registry of the emergency department. The causes of admission were categorized in 14 different disease categories. All registered patients admitted to the Vlora regional hospital were included in the study.

Results:

Study population included 44,917 patients during 2017–2020. Mean age of patients was 51.5 years, while 53.6% were females. The highest number of patients was in 2017 (n=12,407) and the lowest in 2020 (n=9,266). Increase of patients presented with cardiovascular, psychiatric and renal/urinary tract was observed in 2020 in comparison to 2019. Patients decreased over time with an average annual percent decrease of 7% (p-value=0.22). Joinpoint analysis revealed that mortality rate increased over time with an average annual percent increase of 34.3% (95% confidence interval=42.7% to 214.8%, p-value=0.27).

Conclusions:

The number of patients visiting emergency department decreased while mortality rate increased. Educating and raising awareness of patient to seek medical assistance should be a key objective of health policy makers and health personnel.

Mental health of university students during the pandemic. Threats to their mental health and proposals for university student support in Poland

Purpose

The article is an application report. It focuses on the mental health difficulties currently experienced by university students in relation to the COVID-19 pandemic, which may have a significant impact on the study process. The work also presents examples of support implemented at higher education institutions during the pandemic, aimed at maintaining and strengthening students' mental health.

Views

Mental health is closely related to physical/somatic health, among other things, in terms of health behaviour and immuno-logical processes. Thus, any physical, life-threatening and therefore life-altering illness has a potentially negative impact on an individual's overall mental health. A pandemic such as COVID-19 in 2020 is a potential additional risk factor for mental health that is not yet well understood. Pandemic-related changes such as remote learning, reduced interpersonal contact, the uncertainty surrounding this pandemic of unknown magnitude, as well as its dynamic and often surprising course may have an impact on the functioning of young people and their daily activities, including studying.

Conclusions

It is essential to monitor mental health in different population groups, including students-young adults, specifically in relation to the threat of SARS-CoV-2 coronavirus infection, prevention activities and the treatment of COVID-19 patients. It is important to introduce parallel activities to support students' mental health, in line with the sanitary regime, e.g. by using new technologies.

Impact of COVID-19 shocks, precarity and mediating resources on the mental health of residents of share housing in Victoria, Australia: an analysis of data from a two-wave survey

OBJECTIVES

COVID-19 lockdown measures have challenged people's mental health, especially among economically vulnerable households. The objective of this study was to investigate the impact of exposure to COVID-19 shocks (defined as job loss, living cost pressures and changing housing conditions throughout the lockdown period) and double precarity (defined as precarity in housing and employment) on mental health outcomes for members of share households as well as the mediating effects of a range of resources.

DESIGN

We conducted a two-wave survey of occupants of share housing in June and October 2020 during a prolonged period of population lockdown. Research design involved fixed effects ordered logit regression models to assess the mental health consequences of baseline precarity and COVID-related shocks.

SETTING

Victoria, Australia.

PARTICIPANTS

We surveyed 293 occupants of share houses (mean age 34 SD 11.5, 56% female). Members of share houses (where individuals are unrelated adults and not in a romantic relationship) are more likely to be young, casually employed, visa-holders and low-income.

OUTCOME MEASURES

We measured household composition, housing and employment precarity, access to government support, household crowding, social networks and COVID-19 shocks. We used a self-reported measure of mental health.

RESULTS

Those exposed to COVID-19 shocks reported a 2.7 times higher odds of mental health deterioration (OR 2.7, 95% CI 1.53 to 4.85). People exposed to double precarity (precarity in both housing and employment) reported 2.4 times higher odds of mental health deterioration (OR 2.4, 95% CI 0.99 to 5.69). Housing inadequacy and lack of access to sufficient government payments explained 14.7% and 7% of the total effect of double precarity on mental health, respectively.

CONCLUSIONS

Results indicate that residents of group households characterised by pre-existing precarity were vulnerable to negative mental health effects during lockdown. Access to sufficient government payments and adequate housing buffered this negative effect.

Depression and anxiety among nursing students during the COVID-19 pandemic in Tohoku region, Japan: A cross-sectional survey

Aim

Restrictions such as physical distancing and online learning for college students were implemented due to the COVID‐19 pandemic. Owing to this, students may experience psychological distress from social isolation and loneliness. Nursing students are subjected to an exacerbated level of distress during the pandemic due to their role as health professionals. Therefore, the present study aimed to investigate the level of anxiety and depression among Japanese nursing students, according to their perceived vulnerability to COVID‐19.

Methods

A total of 281 college students (104 nursing students and 177 other college students) responded to a web‐based anonymous questionnaire survey from 18 August to 31 October 2020. The Hospital Anxiety and Depression Scale was used to evaluate anxiety (HADS‐A) and depression (HADS‐D). Perceived vulnerability to COVID‐19 was assessed using the Perceived Vulnerability to Disease Scale.

Results

In both groups of students, the prevalence of both anxiety (30.5% in nursing students; 69.5% in others) and depressive symptoms (31.1% in nursing students; 68.9% in others) were remarkably high. There were no significant differences in anxiety and depression between nursing and other students after adjusting for perceived vulnerability to COVID‐19 plus socio‐demographic characteristics and stress coping styles. Perceived vulnerability and its interactions with nursing did not show a significant association with either depression or anxiety.

Conclusion

This study highlights the need for greater support and preventive strategies for mental health problems for college students during the COVID‐19 pandemic regardless of perceived vulnerability.

Correlation between Positive Orientation and Control of Anger, Anxiety and Depression in Nursing Students in Poland, Spain and Slovakia during the COVID-19 Pandemic

(1) This study analysed the relationship between positive orientation and subjective control of anger, anxiety and depression in nursing students in Poland, Spain and Slovakia during the pandemic. (2) The survey was carried out by the diagnostic survey method in a group of 756 nursing students in Poland, Spain and Slovakia. The empirical data were gathered using an original survey questionnaire, the Positive Orientation Scale and the Courtauld Emotional Control Scale. (3) It was shown that the positive orientation level in Polish students was significantly lower than in students in Spain (p < 0.0001) and Slovakia (p < 0.0001). Low results for positive orientation were obtained in nearly half (47.18%) of the respondents in the Polish sample, whereas it was 34.18% and 31.18% in the Spanish and Slovak samples, respectively (p < 0.0001). A positive orientation was the most important predictor of emotional control among the nursing students at all the sites (p < 0.0001). (4) Positive orientation has been shown to have a significant impact on emotional control in nursing students during the pandemic. Therefore, it is important to carefully monitor students’ mental health during the pandemic to determine the demand for psychological and emotional support.

Assessment of COVID-19 Fear in Five European Countries before Mass Vaccination and Key Predictors among Nurses and Nursing Students

Background: Levels of fear have increased since the COVID-19 pandemic outbreak. The absence of a safe and effective vaccine for mass-vaccination deteriorates this situation, which has a significant impact on mental health. This study aimed to assess the feelings of fear among nurses and nursing students in five European countries. Methods: A multicenter cross-sectional study was conducted in five European countries (Greece, Albania, Cyprus, Spain, and Kosovo) before the start of mass vaccination in Europe. Data collection was conducted in December 2020–January 2021 using an online questionnaire for nursing students and professional nurses. Fear of COVID-19 Scale (FCV-19S) was used for measuring levels of fear. IBM SPSS version 21.0 was used for statistical analysis. Results: The study population included 1135 nurses and 1920 nursing students from Kosovo (n = 1085), Spain (n = 663), Greece (n = 534), Albania (n = 529), and Cyprus (n = 244). According to multivariable analysis, females (OR = 2.53, 95% CI = 1.89–3.15), married (OR = 0.86, 95% CI = 0.24–1.48), nurses (OR = 0.87, 95% CI = 0.28–1.45) and those with a chronic disease (OR = 0.86, 95% CI = 0.11–1.62) were more fearful of COVID-19. Conclusions: It is important to decrease fear in the population of nurses who are at the frontlines of the pandemic. The provision of appropriate education and training activities for nurses and students to manage their stress levels is of high importance. Future studies should focus on levels of fear after the administration of several safe and effective vaccines worldwide.

Meta-analytic evidence of depression and anxiety in Eastern Europe during the COVID-19 pandemic

OBJECTIVE

To perform a systematic and meta-analysis on the prevalence rates of mental health symptoms including anxiety and depression during the COVID-19 pandemic in the general population in Eastern Europe, as well as three select sub-populations: students, general healthcare workers, and frontline healthcare workers.

DATA SOURCES

Studies in PubMed, Embase, Web of Science, PsycINFO, and medRxiv up to 6 February 2021.

ELIGIBILITY CRITERIA AND DATA ANALYSIS

Prevalence rates of mental health symptoms in the general population and key sub-populations during the COVID-19 pandemic in Eastern Europe. Data were pooled using a random-effects meta-analysis to estimate the prevalence rates of anxiety and depression.

RESULTS

The meta-analysis identifies and includes 21 studies and 26 independent samples in Eastern Europe. Poland (n = 4), Serbia (n = 4), Russia (n = 3), and Croatia (n = 3) had the greatest number of studies. To our knowledge, no studies have been conducted in eleven Eastern European countries including Hungary, Slovakia, and Slovenia. The pooled prevalence of anxiety in 18 studies with 22 samples was 30% (95% CI: 24-37%) pooled prevalence of depression in 18 studies with 23 samples was 27% (95% CI: 21-34%).

IMPLICATIONS

The cumulative evidence from the meta-analysis reveals high prevalence rates of clinically significant symptoms during the COVID-19 pandemic in Eastern Europe. The findings suggest evidence of a potential mental health crisis in Eastern Europe during the ongoing COVID-19 pandemic. Our synthesis also reveals a relative lack of studies in certain Eastern European countries as well as high heterogeneities among the existing studies, calling for more effort to achieve evidence-based mental healthcare in Eastern Europe.

COVID-19 and Youth Psychopathological Distress in Umbria, Central Italy: A 2-Year Observational Study in a Real-World Setting

INTRODUCTION

Adolescents and young adults represent a vulnerable population in the context of the Coronavirus disease 2019 (COVID-19) pandemic. The present retrospective study aims to investigate the pandemic's psychological impact on adolescents and young adults by analyzing data from an outpatient mental health service dedicated to youths in Umbria, central Italy.

MATERIALS AND METHODS

The clinical charts of subjects aged 14-24 who first accessed the service in the timeframe between March 1st, 2019, and February 28th, 2021, were reviewed. Subjects were divided into two subgroups according to the period of time when they accessed the service (pre-COVID-19 vs. during- COVID-19 outbreak). Bivariate analyses were performed using the Chi-square test and the Welch's t-test. A secondary analysis was performed considering only subjects suffering from psychiatric disorders. Furthermore, data concerning individuals who were already followed by the service before the pandemic were analyzed by the McNemar's test and the t-paired test to assess changes in treatment features.

RESULTS

The number of new accesses during the pandemic period remained stable. After the emergency onset, youths accessing the service showed a higher prevalence of anxiety disorders (p = 0.022). During the COVID-19 period, services were more frequently delivered by using a digital mental health approach (p = 0.001). Psychopharmacological treatment was more frequently prescribed among subjects that were referred to the service after the pandemic onset (p = 0.033). As for substance use, a highly significant reduction in opioid use was observed (p = 0.003). Family therapy was delivered less frequently in the during-COVID-19 subgroup, especially in the subpopulation of subjects suffering from psychiatric disorders (p = 0.013). When considering subjects referred to the service in the pre-COVID-19 period, the number of interventions provided to this population increased after the pandemic outbreak (p = 0.038).

CONCLUSION

In the context of the COVID-19-related public health crisis, youths represent an at-risk population for which pathways to care should be reinforced, and targeted interventions, including psychosocial treatments, should be implemented.

Mental Health and Loneliness in University Students During the COVID-19 Pandemic in Germany: A Longitudinal Study

The COVID-19 pandemic and its preventive measures had adverse consequences for mental health. However, knowledge of mental health trajectories across the pandemic is limited. This study investigated the mental health levels and changes among university students during the pandemic and lockdown in Germany, as well as their associated factors. We surveyed students' mental health (N = 363, 68% female) with the patient health questionnaire (PHQ-8) and the generalized anxiety disorder scale (GAD-7) during the first easing phase (July 2020; time 1) and the second lockdown (November 2020; time 2). Cut-off scores from the GAD-7 and PHQ-8 were used to determine clinically relevant symptoms and to define trajectory groups. Sociodemographic and pandemic-related data were assessed (e.g., coping with academic life, social contacts) as well as loneliness, stress, repetitive negative thinking, quality of life, and perceived social support. Paired t-test, multiple regression, and repeated-measures ANOVA were applied. Means and prevalence rates for symptoms of depression (38.8%) and anxiety (25.6%) did not differ between time 1 and time 2, and most students were asymptomatic on the PHQ-8 (44.4%) and the GAD-7 (56.3%) across the pandemic. Feelings of loneliness significantly increased from time 1 to time 2, d = -0.30, [-0.47, -0.13], with higher symptom levels in symptomatic groups at time 2 and greater increases in the asymptomatic groups. Levels of stress, repetitive negative thinking, quality of life, and social support did not differ during the pandemic. At time 1, loneliness and repetitive negative thinking were associated with anxiety and depressive symptoms. Anxiety and depressive symptoms were prevalent among students, and increased levels of loneliness during the pandemic were associated with elevated symptoms and differing trajectories. Further research using representative and larger samples should determine the long-term impact of the pandemic on mental health and loneliness to identify vulnerable students and offer adequate support.

Post-secondary Student Mental Health During COVID-19: A Meta-Analysis

The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.

Impact of COVID-19 pandemic on mental health, risk perception and coping strategies among health care workers in Albania - evidence that needs attention

Background

The COVID-19 pandemic impacted health care workers in many ways including mental health. This impact is usually underestimated in particular in developing countries.

Objectives

The study aims to assess the level of anxiety, depression, risk perception, and coping strategies of Albanian healthcare workers during the COVID-19 pandemic and to identify associated factors.

Methods

A cross-sectional online study was conducted from April to May 2020 by recruiting health care personnel through the snowballing method. Data collection was carried out through social media using the Generalized Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9) by Google forms. Participants were recruited from all health care sectors including doctors, nurses, etc. working in both the public and private sectors.

Results

410 questionnaires were included in the analysis. Most participants were nurses (59.3%), female (78.5%), and belonged to the age group 26–40 years (46.3%). Mild levels of anxiety were expressed in 26.9% of participants while 7.2% of them expressed moderate levels. 23.1% and 12.1% of participants expressed respectively mild and moderate depression levels. High levels of risk perception were found. A statistical association was found between occupation (p = 0.011), gender (p = 0.031), providing care for COVID-19 patients (p = 0.011), and the availably of mental health support in the workplace. Poor coping strategies were reported among participants.

Conclusions

Mental health support should be a priority of the healthcare system in particular for young health care workers caring for COVID-19 patients. It can improve the mental health status of health care workers and their family members, impacting the quality of care provided.

The Impact of COVID-19 on Mental Health: Psychosocial Conditions of Students with and without Special Educational Needs

Given the pandemic-induced school lockdown in Germany in the spring of 2020, COVID-19 evidently had a negative impact on child and adolescent mental health and wellbeing. However, there is no evidence regarding the specific problems of students with special educational needs in emotional and behavioral disorders (E/BD) during or after the school lockdown. Thus, this study bridges the gap. A sample of 173 students across Germany was included in the analysis. The students were rated by their teachers in an online survey via a standardized teacher-report form for emotional and behavioral problems and competencies, as well as perceptions of inclusion. Several student- and teacher-level predictors were applied in a stepwise regression analysis. The results showed that the school lockdown marginally impacted E/BD, with small differences between student groups. The strongest predicting variable was students’ psychosocial situation. Hence, the psychosocial situation of students should be monitored by teachers and school psychologists to provide sufficient support during lockdown.

Prevalence of Anxiety in Dental Students during the COVID-19 Outbreak: A Meta-Analysis

Background: Since the onset of the COVID-19 pandemic, the psychological state of university students has been a cause for concern. In particular, odontology students have experienced symptoms of anxiety due to the closure of universities and the suspension of clinical training. Methods: Medline via PubMed was searched for studies on the prevalence of anxiety in dental undergraduates, published from 1 December 2019 to 1 August 2021. Results: A total of fifteen studies were included in this review. Our results show a prevalence of anxiety of 35% reported by dental students, which was independent of gender, response rate or methodological quality. The only significant finding was a lower prevalence of anxiety in studies located in Europe compared to those located in other continents. Conclusions: The results suggest dental students are experiencing significant levels of anxiety during this COVID-19 pandemic and that there seem to be differences between students from different regions of the world. Therefore, it is important to help dental students psychologically as the pandemic situation continues.

Factors influencing nursing students' intention to accept COVID-19 vaccination: A pooled analysis of seven European countries

BACKGROUND

Experiencing the third wave of COVID-19 pandemic, high vaccination coverage by a safe and effective vaccine globally would be a great achievement. Acceptance of vaccination by nursing students is an important issue as they play a decisive role as future professionals in educating patients, counselling, and guiding them to the right clinical decision.

OBJECTIVES

To explore the intention of nursing students to get vaccinated for SARS-CoV-2 infection and the factors acting either as motivators or as barriers towards vaccination.

DESIGN

A multicenter cross-sectional design.

PARTICIPANTS

In total 2249 undergraduate nursing students participated.

METHODS

The study was conducted in 7 universities in participating countries (Greece, Albania, Cyprus, Spain, Italy, Czech Republic, and Kosovo) through a web survey. Data was collected during December 2020-January 2021 in all countries.

RESULTS

Forty three point 8% of students agreed to accept a safe and effective COVID-19 vaccine, while the acceptance was higher among Italian students. The factors for intention to get vaccinated were male gender (p = 0.008), no working experience in healthcare facilities during the pandemic (p = 0.001), vaccination for influenza in 2019 and 2020 (p < 0.001), trust in doctors (p < 0.001), governments and experts (p = 0.012), high level of knowledge (p < 0.001) and fear of COVID-19 (p < 0.001).

CONCLUSIONS

Understanding of factors that influence students' decision to accept COVID-19 vaccination could increase the acceptance rate contributing to a management of the pandemic.

Impact of the COVID-19 Pandemic on Higher Education: Characterizing the Psychosocial Context of the Positive and Negative Affective States Using Classification and Regression Trees

Our aim is to analyze the extent to which the psychosocial aspects can characterize the affective states of the teachers, administrative staff, and undergraduate and postgraduate students during the quarantine. A questionnaire was answered by 1,328 people from the community of the Universitat de Barcelona (UB), Spain. The survey was partially designed ad hoc, collecting indicators related to sociodemographic variables, the impact of COVID on the subjects or in their personal context, the psychosocial context of coexistence and perceived social support, characteristics related to the physical context during the quarantine, and labor conditions. Additionally, it included two validated instruments: the Survey Work-Home Interaction-Nijmegen for Spanish Speaking Countries (SWING-SSC) validated in Spanish and PANAS, the Positive and Negative Affect Schedule. Classification and Regression Trees (CART) were performed to identify which variables better characterize the participants' level of positive and negative affective states. Results according to groups showed that students are the ones who have suffered the most as a result of this situation (temporary employment regulation, higher scores in negative work-home and home-work interaction, lower scores in positive home-work interaction, and negative effects of teleworking). Additionally, they reported a higher mean score in interpersonal conflict and worse scores with regard to negative affective states. Based on sex, women were the ones whose environment was shown to be more frequently affected by the pandemic and who exhibited more negative effects of teleworking. In general terms, participants with the highest scores in negative affective states were those who perceived an increase in conflict and a high negative effect from work spilling over into their personal lives. On the contrary, participants with the highest levels of positive affective states were those with medium to low levels of negative home-work interaction, over 42.5 years old, and with medium to high levels of positive work-home interaction. Our results aim to help higher education to reflect on the need to adapt to this new reality, since the institutions that keep pace with evolving trends will be able to better attract, retain, and engage all the members of the university community in the years ahead.

Social Support and Dietary Habits as Anxiety Level Predictors of Students during the COVID-19 Pandemic

The COVID-19 pandemic is a public health emergency concern and a challenge to students' mental health due to changes in education and social isolation. The aim of this research was to expand knowledge about the relations that shape the level of anxiety amongst men and women who are studying during the pandemic in terms of the relations towards their sense of social support and their nutritional behaviors. A State-Trait Anxiety Inventory was used to measure anxiety level, alongside supplementary questions such as the feeling of support from close ones, concentration of attention on nutrition during the pandemic and externally derived factors (university, specialization). Analysis of the regression was applied to the examination of the dependency between the anxiety level (in both forms of its occurrence-as state-anxiety and as trait-anxiety). We observed that the pandemic situation affected a level of state-anxiety above average (mean value of 46-48 points) even when students felt social support. Nutrition habits and chosen education type are associated with trait-anxiety level, which was also elevated (mean values of 49-50 points). Chosen factors had a partial influence on the anxiety level of students, therefore their mental health should concern shaping positive nutrition habits and social support.

Impact of the COVID-19 Pandemic on the Mental Health of College Students: A Systematic Review and Meta-Analysis

Background

The coronavirus disease (COVID-19) pandemic has been spreading and brought unprecedented psychological pressure on people across the entire globe since December 2019.

Objectives

To synthesize the existing evidence of the prevalence of mental health status during the epidemic and provide the basis for mental health education.

Materials and methods

The literature search was conducted in nine databases from December 2019 to October 2020. The risk of bias for each study was assessed, and the random-effects meta-analysis was used to estimate the prevalence of specific mental health problems. The review protocol was registered in PROSPERO with the registration number CRD42020208619.

Results

About 27 studies were included in the analysis with a total of 706,415 participants combined, and 14 mental health problems were gathered. Meta-analysis showed that the prevalence of depression was 39% (95% CI: 27–51%) and that of anxiety was 36% (95% CI: 26–46%). Subgroup analysis indicated that the prevalence of depression and anxiety varied among nations and due to the survey date. The prevalence of depression (60%, 95% CI: 46–74%) and anxiety (60%, 95% CI: 46–74%) in non-Chinese college students was higher than those in Chinese college students (26%, 95% CI: 21–30% and 20%, 95% CI: 14–26%). The proportion of depression (54%, 95% CI: 40–67%) and anxiety (37%, 95% CI: 26–48%) was higher after March 1 than before it (21%, 95% CI: 16–25% and 19%, 95% CI: 13–25%).

Conclusions

The meta-analysis results presented that the prevalence of depression (39%) or anxiety (36%) among college students greatly increased during the COVID-19 pandemic. In addition, the mental health of college students is affected by the nations and the survey date. It was necessary to take measures to reduce mental health risks during the pandemic.

[Mental health interventions for college and university students during the COVID-19 pandemic: a critical synthesis of the literature]

BACKGROUND

College and university students are a population vulnerable to mental disorders, especially during the COVID-19 pandemic. Their mental health has been affected by confinement, difficulties in the development of academic activities, and the demands of new pedagogical modalities. We aimed to respond to the question: what are the actions around a) promotion and prevention, b) mental symptoms care, and c) pedagogical adaptations that can be developed in order to improve the mental health of college and university students?

METHODS

We conducted a critical synthesis from a systematic review of the literature. A search was made for scientific articles with descriptive, analytical, empirical or evaluative designs, as well as web resources of organisations related to the topic. A synthesis was carried out based on the three aspects of the question by means of a constant comparative method, until the aggregation of actions by similarity in the actors. We anticipated low evidence quality; therefore, a standardised evaluation was not performed.

RESULTS

We explored 68 articles and 99 web resources. After reviewing the full text, 12 scientific articles and 11 web resources were included. As general guidelines, we found that the most frequent suggestion is the design of a specific structured mental health programme within universities, one that should be multidisciplinary, inclusive, dynamic and culturally sensitive. All actions taken by the university should be reported and published periodically so that students and other members of the university community are clear about them. Ideally, it is suggested to keep them until the post-pandemic period and include alumni. Regarding a) promotion and prevention, digital psychoeducation was recommended, with information about healthy lifestyles, common emotional reactions to epidemics, coping strategies and warning signs. Peer participation is suggested as a support strategy, as well as spaces for social interaction that focus not only on academic aspects but also on leisure. Screening for mental symptoms is suggested through frequent submission of online forms or mobile applications. In addition to mental health, it is important to inquire about the degree of satisfaction of basic and technology-related needs. For b) the care of mental symptoms, one of the actions commonly identified was a consulting centre that can provide mental health care by telephone, by technology, and even in person --if required --, with permanent availability with rapid response teams for crisis situations, such as suicidal behaviour and domestic violence. For c) pedagogical adaptations, fluent communication is an indispensable requirement; having clear instructions on academic activities can reduce uncertainty and therefore anxiety. The teaching and pedagogical staff at the institution can offer direct advice (via video calls or online group meetings) to provide support in study habits, degree-specific material and mental health.

CONCLUSIONS

Included resources suggest the creation of a programme that specifically addresses the mental health of students. This synthesis can provide guidelines that facilitate decision-making by the university, without losing sight of the fact that the institution and the student are immersed in a complex context, with circumstances and other actors at various levels that also intervene in mental health. Research is required on the evolution of the mental health situation and the effect of the actions that are being taken.

Mental health interventions for college and university students during the COVID-19 pandemic: A critical synthesis of the literature

BACKGROUND

The aim of the study is to compare the emotional effects of COVID-19 among three different groups, namely: health personnel, medical students, and a sample of the general population.

METHODS

375 participants were recruited for this study, of which 125 were medical students (preclinical studies, 59; clinical studies, 66), 125 were health personnel (COVID-19 frontline personnel, 59; personnel not related with COVID-19, 66), and 125 belonged to the general population. The PHQ-9, GAD-7, and CPDI scales were used to assess the emotional impact. A multinomial logistic regression was performed to measure differences between groups, considering potential confounding factors.

RESULTS

Regarding CPDI values, all other groups showed reduced values compared to COVID-19 frontline personnel. However, the general population, preclinical and clinical medical students showed increased PHQ-9 values compared to COVID-19 frontline personnel. Finally, confounding factors, gender and age correlated negatively with higher CPDI and PHQ-9 scores.

CONCLUSIONS

Being frontline personnel is associated with increased COVID-19-related stress. Depression is associated, however, with other groups not directly involved with the treatment of COVID-19 patients. Female gender and younger age correlated with COVID-19-related depression and stress.

Could the Associations of Changes in Living Arrangement with Mental Disorders Be Moderated or Mediated During COVID-19 Pandemic?

PURPOSE

Changes in living arrangement was one of the most well-established risk factors for mental disorders, but little evidence came from moderating or mediating effect during COVID-19 pandemic. This study aimed to determine whether associations of changes in living arrangement with mental disorders could be moderated or mediated during COVID-19 pandemic.

METHODS

Data were a cross-sectional and international population-based survey data collected as part of theCOVID-19 pandemic. Participants included nationally representative general population probability samples of adults (≥18 years) during COVID-19 pandemic (N=16,784). Main mental measures were reflected by loneliness assessed by UCLA Loneliness Scale Version 3, anxiety assessed by Generalised Anxiety Disorder 2-item, and depressed mood assessed by The Patient Health Questionnaire-2 in the survey. With control variables, all the mediation models were conducted by Stata mode. Potential influencing effects of social contact and social support as moderators were analyzed using Hayes's PROCESS macro.

RESULTS

Among the participants, prevalence of mental disorders was high. Logistic regression indicated that changes in living arrangement had significant associations with anxiety (AOR=1.127, 95% CI: 1.018-1.249) and depression (AOR =1.142, 95% CI: 1.027-1.269). Mediation models indicated that indirect, direct, and total effects of changes in living arrangement on mental disorders through COVID-symptoms; change in alcohol use; and social contact were significant. Indirect, direct, and total effects of changes in living arrangement on loneliness and depression through social support were significant. Moderation analysis indicated that moderation model 1 in AF Hayes Process procedure was accepted.

CONCLUSION

This study indicated that associations of changes in living arrangement with mental disorders could be mediated by COVID-symptoms, changes in alcohol use, social contact, and social support and moderated by social support during COVID-19 pandemic. The finding in this study might provide better understanding of the mechanisms by which social support might contribute to the resolving mental disorders.

Implications of the COVID-19 Pandemic on the Mental Health and Professional Psychomotor Skills of Dental Students

Purpose

To estimate dental students’ self-perception of mental well-being (MWB) and its effects on their clinical psychomotor skills (CPS) once they (or their family members) get infected with COVID-19.

Materials and Methods

This is a cross-sectional (n =268) study from a public dental college in Riyadh. We collected data on MWB and CPS. An 18-item online survey was used to collect the responses from the participants. The inter-rater reliability for the finalised survey came out to be 0.86.

Results

The participants (54.3%) who were infected with COVID-19 recorded that their CPS were significantly affected (almost 4 times higher) as compared to others (OR= 4.02; P=0.0004). However, 42.2% reported infection control measures at clinics resulted in bringing significant (OR=2.22, P=0.04) psychological upsets, for those who were infected with COVID-19. Participants (45.1%) also reported that they have difficulty in recalling old memories or information due to the COVID-19 pandemic; among them, 46.7% were the ones who (and/or any family member) were exposed to COVID-19.

Conclusion

The study spotlighted the extent of dental students’ MWB and its significant effect on their CPS once (themselves or a family member) infected with COVID-19. Moreover, levels of infection control measures at clinics resulted in psychological upsets for dental students.

Clinical Significance

The issue is fundamental as participants enter the clinical workforce and face the ever-increasing demands of dental practice.

Impacts of the Covid-19 pandemic on the health of university students

The Covid-19 pandemic caused by the novel Sars-CoV-2 coronavirus, has resulted in millions of deaths and disruption to daily life across the globe. University students have been additionally affected by a sudden move to online learning, the closure of campuses and dramatic societal changes that have upended their experiences of higher education. Here we focus on the physical and mental health consequences of the pandemic for this population sector during 2020, and the interdependencies of these impacts. We survey the challenges for infection control on campuses and for monitoring the disease dynamics in student communities. Finally, we explore the psychological and mental health problems that have been exacerbated by the pandemic and evaluate the underlying factors that are most relevant to students.

Association Between Perceived Resilience and Mental Well-Being of Saudi Nursing Students During COVID-19 Pandemic: A Cross-Sectional Study

Purpose: This study investigated the relationship between nursing students' profile variables and their state of mental well-being and resilience during the coronavirus disease-19 (COVID-19) pandemic and how this impacts their understanding of holistic nursing care provision. Design: This study used a cross-sectional design and total enumeration sample (n = 439) from all enrolled nursing students in the College of Nursing of a state-run university. Method: The 10-item Connor-Davidson Resilience Scale (CD-RISC) and 14-item Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) were used to collect data from the participants. A correlational analysis was employed to determine the relationship between the responses of the participants to their profile variables. Findings: There were no significant differences in age, gender, and year level in the 10-item CD-RISC and WEMWBS. Regarding the WEMWBS, the mean total score of those with 61-100% of the allowed units was significantly higher than those with 31-60%. Finally, the CD-RISC scores revealed that participants with a general point average (GPA) of A were significantly higher than those with a GPA of B+ or B. Conclusion: Academically performing students (those with a GPA of B and above) are more resilient. In addition, there is an existing linear relationship between high mental well-being and the ability to pursue higher academic loads.

Awareness and Behaviors Regarding COVID-19 among Albanian Undergraduates

The coronavirus disease 2019 (COVID-19) pandemic has led to the adoption of restriction measures that have had notable consequences on the health and wellbeing of individuals. This survey was carried out on a sample of 905 Albanian undergraduates to assess their knowledge about COVID-19 and their health-related behaviors and communication changes during lockdown. The students were invited to complete a pre-validated questionnaire during lessons. The results show that the majority of the surveyed students were able to answer correctly about the main epidemiological features of the disease. The level of knowledge was proven to be proportional to the students' education level (enrollment year and age). No considerable relationship emerged with respect to diet or smoking. On the other hand, a relevant portion of the sample (37.6%) declared decreased physical activity (PA). Finally, a notable increase in the intensity and frequency of communication with their peers and with their parents was declared by 34.7% and 50.8% of the sample, respectively. Lifestyle variables were found to be mutually related, as were communication outcomes. The participants showed a satisfactory awareness regarding the COVID-19 epidemic. However, the registered reduction in PA may represent a public health issue and should be addressed with adequate policies. The use of electronic media seems to have increased communication habits in this population group.

Anxiety and depression among Kosovar university students during the initial phase of outbreak and lockdown of COVID-19 pandemic

Background and Purpose: Measures taken to prevent COVID-19 infections, aside from causing disruptions in many facets of our daily life, have impeded education, including the higher education process, as never seen before on a global scale. Recent studies have indicated the potential negative impact of the COVID-19 pandemic on the mental health trajectory of university students. Anxiety and depression can seriously hamper students’ quality of life and educational achievement. This study explored anxiety and depression among university students in Kosovo during the lockdown as a result of COVID-19 pandemics. The study was implemented during the initial phase of the pandemic. This study also explored the impact of selected determinants on the reported mental health of students. Methods: In total, 904 university students from the largest public university in Kosovo were enrolled in a web-based cross-sectional study during the early phase of the national lockdown due to the COVID-19 pandemic. Results: The first and second hierarchical regression models indicated that the anxiety and depression scores of students were predicted by gender, knowing someone who was infected with COVID-19, concerns about the potential financial impact of measures taken by governments to respond to the COVID-19 pandemic and excessive information seeking about COVID-19. The third model improved significantly when the variables concerns about family members’ health, concerns about being lonely, problems with online lectures and requests for help from the university related to online lectures were added to the model. Overall, the findings indicated that situational variables associated with measures taken to respond to the COVID-19 pandemic appeared to predict anxiety and depression among students. Conclusion: These findings indicate that universities and public health institutions need to support students, especially the more vulnerable students, in enhancing their skills to cope with mental health problems and distress related to the pandemic and the shift to online learning.

Assessing the Psychological Impact of COVID-19 among College Students: An Evidence of 15 Countries

Mental health issues among college students is a leading public health concern, which seems to have been exacerbating during the COVID-19 pandemic. While previous estimates related to psychological burden among college students are available, quantitative synthesis of available data still needs to be performed. Therefore, this meta-analysis endeavors to present collective evidence discussing the psychological impact of COVID-19 among college students. Bibliographical library databases, including Embase, Medline, CINAHL, Scopus, and PsycINFO, were systematically searched for relevant studies. Titles, abstracts, and full articles were screened, and two reviewers extracted data. Heterogeneity was assessed by I² statistic. The random-effects model was utilized to obtain the pooled estimates of psychological indicators among college students. Location, gender, level of severity, and quality scores were used as moderator variables for subgroup analyses. Funnel plot and Egger linear regression test was used to assess publication bias. Twenty-seven studies constituting 90,879 college students met the inclusion criteria. The results indicated 39.4% anxiety (95% CI: 28.6, 51.3; I² = 99.8%; p-value < 0.0001) and 31.2% depression (95% CI: 19.7, 45.6; I²= 99.8%, p < 0.0001) among college students. The pooled prevalence of stress (26.0%), post-traumatic stress disorder (29.8%), and impaired sleep quality (50.5%) were also reported. College students bear a disproportionate burden of mental health problems worldwide, with females having higher anxiety and depression levels than males. This study‘’s findings underscore the need to develop appropriate public health interventions to address college students’ emotional and psychosocial needs. The policies should be reflective of demographic and socioeconomic differentials.

Nursing students, mental health status during COVID-19 quarantine: evidence from three European countries

BACKGROUND

The SARS-CoV2 pandemic obligated most of the European countries to implement strict measures and lockdowns to minimize the spread of the virus. Universities closed and on-line classes started. However, COVID-19 epidemic has significant impact on mental health of population.

AIM

To assess depression level of nursing students (undergraduate and master) in Greece, Spain and Albania during COVID-19 pandemic as well as to identify possible determinants of depression level.

METHODS

A multicenter cross-sectional study was conducted between April and May 2020. An on-line questionnaire was used to collect the data. The Patient Health Questionnaire-9 was used to evaluate the depression levels of nursing students.

RESULTS

Seven hundred and eighty-seven nursing students participated in the study out of which 83.9% were of female gender, 92.9% single and 94.7% lived with others. One third of the nursing student population experienced mild depression, with higher depression levels noted for Spanish students (59.1%) followed by Albanian (34.5%) and Greek (21.8%) students. Multivariate linear regression analysis identified that Spanish students experienced more depression than Greek and Albanian (p < 0.001). Also, decreased age was associated with increased depression.

CONCLUSION

The impact of lockdown and quarantine on nursing students mental health is clear. Provision of university based mental health interventions should be a priority.

Factors associated with psychological distress during the coronavirus disease 2019 (COVID-19) pandemic on the predominantly general population: A systematic review and meta-analysis

BACKGROUND

The Coronavirus Disease 2019 (COVID-19) outbreak has escalated the burden of psychological distress. We aimed to evaluate factors associated with psychological distress among the predominantly general population during the COVID-19 pandemic.

METHODS

We searched PubMed, EMBASE, Scopus, Cochrane Library, PsycINFO, and World Health Organization COVID-19 databases (Dec 2019-15 July 2020). We included cross-sectional studies that reported factors associated with psychological distress during the COVID-19 pandemic. Primary outcomes were self-reported symptoms of anxiety and depression. Random-effects models were used to pool odds ratios (OR) and 95% confidence intervals (CI). The protocol was registered in PROSPERO (#CRD42020186735).

FINDINGS

We included 68 studies comprising 288,830 participants from 19 countries. The prevalence of anxiety and depression was 33% (95% CI: 28%-39%) and 30% (26%-36%). Women versus men (OR: 1.48 [95% CI: 1.29-1.71; I2 = 90.8%]), younger versus older (< versus ≥35 years) adults (1.20 [1.13-1.26]; I2 = 91.7%), living in rural versus urban areas (1.13 [1.00-1.29]; I2 = 82.9%), lower versus higher socioeconomic status (e.g. lower versus higher income: 1.45 [1.24-1.69; I2 = 82.3%]) were associated with higher anxiety odds. These factors (except for residential area) were also associated with higher depression odds. Furthermore, higher COVID-19 infection risk (suspected/confirmed cases, living in hard-hit areas, having pre-existing physical or mental conditions) and longer media exposure were associated with higher odds of anxiety and depression.

INTERPRETATION

One in three adults in the predominantly general population have COVID-19 related psychological distress. Concerted efforts are urgently needed for interventions in high-risk populations to reduce urban-rural, socioeconomic and gender disparities in COVID-19 related psychological distress.

Effect of Covid-19 pandemic on mental health among Albanian people residing in the country and abroad - Implications for mental care

BACKGROUND

Coronavirus disease caused by the novel coronavirus Covid-19 is a current worldwide outbreak. The use of quarantine and isolation proved effective in containing the spread of infection.

OBJECTIVES

The purpose of this cross-sectional study was to assess the mental health of Albanian people residing in the country and abroad during the quarantine period for the Covid-19 pandemic.

DESIGN

This study was carried out from 25th March - 20th April 2020 through a web survey shared on social networks. The goal was to reach at least the minimum sample size for cross-sectional studies. The Patient Health Questionnaire (PHQ-9) was used to assess mental health. Chi-square (χ2) and Fisher -Exact test were used to assess the statistical significance among variables. P values ≤0.05 were considered statistically significant.

RESULTS

715 participants were included in the final analyses (78.41% females and 21.53% males). Most were residents in Albania (80.41%) and the others resided mainly in Italy (6.89%), Greece (3.51%), Germany (2.43%), Kosovo (1.62%) and the UK (1.69%). Statistical association was found between gender, country of residency and measures taken. Summary score of PHQ-9 items was 6.4662. The total score of depression classification shows that 31.82% and 12.90% of participants have respectively mild and moderate depression. Female participants showed the highest score for some items of PHQ-9, p≤0.05.

CONCLUSIONS

Findings suggest that health care professionals should recognize and address mental health problems associated with Covid-19 especially in vulnerable groups. Acting in a timely and proper manner is essential in preventing these problems from becoming chronic.

COVID-19 Related Knowledge and Mental Health: Case of Croatia

Background and Aims: The COVID-19 pandemic has led to radical and unexpected changes in everyday life, and it is plausible that people's psychophysical health has been affected. This study examined the relationship between COVID-19 related knowledge and mental health in a Croatian sample of participants.

METHODS

An online survey was conducted from March 18 until March 23, 2020, and a total of 1244 participant responses were collected (85.5% were women and 58.4% completed secondary education). Measures included eight questions regarding biological features of the virus, symptoms, and prevention, the Hospital Anxiety and Depression Scale, and Optimism-Pessimism Scale. According to the answers given on the questions on COVID-19 related knowledge, participants were divided in two groups: (1) informed and (2) uninformed on each question. They were then compared in the expressed levels of anxiety, depression, pessimism, and optimism. Full vs. partial mediation models with optimism/pessimism as a mediator in the relationship between anxiety/depression and the accuracy of responses for questions about handwashing and ways of transmission were estimated.

RESULTS

Participants who responded correctly on the question about handwashing had higher levels of anxiety, depression, and pessimism than those participants whose answer was incorrect, while participants who answered correctly on the question about the percentage of patients who develop serious breathing problems had higher levels of depression than those who answered incorrectly. Lower levels of anxiety and pessimism were observed in the participants who answered correctly about ways of transmission. Higher levels of pessimism were found in participants who scored incorrectly on questions about the efficiency of antibiotics, most common symptoms, and the possibility of being infected by asymptomatic carriers. Higher levels of knowledge about handwashing were predicted by higher levels of anxiety and pessimism. Higher levels of knowledge about ways of transmission were predicted by lower levels of anxiety and lower levels of pessimism. The examined relationships between anxiety/depression and knowledge were mediated by pessimism.

CONCLUSION

The findings of this study suggest that knowledge about COVID-19 may be useful to reduce anxiety and depression, but it must be directed to the promotion of health behaviors and to the recognition of fake news.