Depression is Associated with Moderate-Intensity Physical Activity Among College Students During the COVID-19 Pandemic: Differs by Activity Level, Gender and Gender Role

Physical Activity and Mental Health After COVID-19 Recovery: Age and Sex Differences

(1) Background: The relationship between physical activity (PA) and mental health remains a topic of significant interest, particularly in populations recovering from COVID-19. This study aimed to examine the differences in PA levels and mental health parameters (anxiety, depression, and stress) across sex and age groups following COVID-19 recovery; (2) Methods: The sample of participants (n = 288) was selected using a random sampling method and consisted of participants of different ages and both sexes. Participants' self-reported PA was assessed using the International Physical Activity Questionnaire (IPAQ), while the Depression, Anxiety, and Stress Scale (DASS) was used to measure negative emotional states. The influence of COVID-19 recovery on PA and mental health (depression, anxiety, stress) was analyzed using MANOVA and follow-up univariate tests by age and sex. Statistical significance was set at p < 0.05, with SPSS (v23.0) used for data analysis; (3) Results: A statistically significant difference was observed between the initial and final measurements in PA levels (Wilk's Lambda = 0.95; p = 0.000) and mental health (Wilk's Lambda = 0.96; p = 0.000) with older individuals-particularly women-demonstrating improved PA levels and better mental health outcomes. In contrast, younger women exhibited a decline in both domains, with increased anxiety, depression, and stress symptoms. While younger men showed increased PA, their mental health parameters were slightly elevated, though still within normal ranges; (4) Conclusions: Our findings suggest that older individuals were better adapted to post-COVID challenges due to maturity and life experience, while younger populations may require additional support. The study underscored the complexity of the PA-mental health relationship and highlighted the need for further research, particularly among younger individuals recovering from COVID-19.

Higher Levels of Serum Leptin Are Linked with a Reduction in Gait Stability: A Sex-Based Association

Gait stability prevents falls and injuries during physical activities. Muscle strength, aging, and co-existing chronic diseases are factors that affect gait stability. Leptin is an adipokine with pro-inflammatory properties. Several reports demonstrated an association between serum leptin and a reduction in muscle strength. Given the above relationships, we hypothesized that serum leptin could be associated with gait stability. To test this, 146 apparently healthy university students were recruited. Data collection involved anthropometric measurements, physical activity (PA) data, gait parameters, and serum leptin levels. A gait instability index was derived from the percentages of double support time and walking asymmetry (WA) collected from smartphones. Females demonstrated higher leptin levels and WA despite a lower body mass index (BMI). Lower PA levels were also observed among females. Leptin levels were negatively correlated with WA, step count, and vigorous PA (p < 0.05). These correlations remained significant following correction for leptin by BMI. Using logistic regression, a higher leptin-to-BMI ratio was associated with high gait instability (OR = 9.97, 95%CI: 4.17-23.84, p < 0.001). After stratification by sex, this association was only evident among females (OR = 6.09, 95%CI: 1.04-35.56, p = 0.045). These findings suggest a sex-based association between serum leptin and gait stability among apparently healthy students.

Physical Activity Levels and Women's Mental Health After COVID-19 Infection

BACKGROUND

The aim of this research is to investigate the associations between physical activity and mental health parameters (depression, anxiety, and stress) among women who have recovered from COVID-19; Methods: This research involved two measurements: the initial test, conducted 2-to-4 weeks post-COVID infection, and the final test, performed 14-to-16 weeks after the virus's activity. The sample consisted of women (n = 190) aged 20 to 60 (47.60 ± 11.1, 47.60 ± 11.1, mean ± Std.Dev.) who were infected with COVID-19. To assess the level of physical activity, a longer version of the IPAQ questionnaire was used. Self-assessment of mental health was determined by a longer version of the DASS questionnaire; Results: The t-test analysis revealed significant differences in mental health and physical activity levels between the initial and final measurements. After three months, subjects showed lower mental health scores (indicating improvement) and higher Metabolic Equivalent of Task (MET) values across all physical activity domains, with moderate physical activity showing the greatest increase. The regression analysis showed that at the initial measurement, there was no statistically significant association of physical activity with mental health parameters. Three months after the initial measurement, regression analysis showed that there was a statistically significant association of physical activity with anxiety (F = 3.97; p = 0.000) and depression (F = 3.34; p = 0.001) but not with stress (F = 1.67; p = 0.106); Conclusions: This research revealed that higher levels of physical activity improved mental health in post-COVID-19 women, with varying effects on anxiety and depression depending on the activity domain.

Socioeconomic and clinical risk factors associated with moderate intensity physical activity before and during the COVID-19 pandemic

Although moderate intensity physical activity (MIPA) improves general mental health, morbidity, and mortality, the COVID-19 pandemic may have adversely impacted individuals' ability to engage in MIPA. We examined the extent of socioeconomic factors, body mass index, anxiety/depression, and cancer diagnosis associated with MIPA before and during the COVID-19 pandemic. Multivariable logistic regression models were conducted on 4,551 U.S. adults aged 18-64 years using nationally representative samples from the 2019 and 2020 Health Information National Trends Survey datasets. The prevalence of MIPA before the pandemic was higher (77.07%) than during the pandemic (76.21%). Before the COVID-19 pandemic, lower odds of MIPA were observed for individuals with fair/poor health (OR = 0.24, 95% CI = 0.27, 0.63), obesity (OR = 0.51, 95% CI = 0.33, 0.79), anxiety/depression (OR = 0.60, 95% CI = 0.42, 0.85), or a cancer diagnosis (OR = 0.56, 95% CI = 0.32, 0.98). During the pandemic, lower odds were observed among those with obesity (OR = 0.44, 95% CI = 0.28, 0.70), anxiety/depression (OR = 0.61, 95% CI = 0.43, 0.86), less than high school education (OR = 0.33, 95% CI = 0.16, 0.70), or family income of $20,000 - $34,999 (OR = 0.42, 95% CI = 0.24, 0.74). There was a decline in MIPA during the pandemic, with certain subgroups, such as individuals of lower socioeconomic and physical and mental health status, less likely to engage in MIPA. This study highlights the need for concerted physical activity educational strategies aimed at improving access to and utilization of MIPA within subgroups to reduce MIPA disparities, particularly among disadvantaged groups during pandemics.

The Relationship between Physical Activity and Psychosocial Well-Being during and after COVID-19 Lockdown

The COVID-19 pandemic was an extremely critical event that had a major impact on the physical and mental health of the world's population. The aim of the present work is to investigate whether physical activity plays a protective role in well-being both during the lockdown and afterwards, also assessing the role played by self-efficacy and perception of the risk of contracting COVID-19, as well as past behavior. To this end, two studies were conducted, the first close to lockdown (N = 1061; 76.3% females; mean age = 37.3-range: 18-80) and the second 2 years later (N = 562; 71.0% females; mean age = 33.2-range: 18-76). Descriptive and correlational analyses were performed, along with structural equation modelling. The results confirm the hypothesis of a positive impact of physical activity on emotional well-being alone during lockdown and on more general psychosocial well-being 2 years later. This result showed that physical activity during the pandemic represented an avoidance strategy from the psychological distress that COVID-19 was generating, whereas 2 years later, it represents a proactive strategy aimed at generating a positive mental health condition. These results provide a better understanding of the role physical activity plays in well-being by representing a resource for protecting as well as promoting the mental health of individuals.

Temporal dynamics in mental health symptoms and loneliness during the COVID-19 pandemic in a longitudinal probability sample: a network analysis

Figuring out which symptoms are central for symptom escalation during the COVID-19 pandemic is important for targeting prevention and intervention. Previous studies have contributed to the understanding of the course of psychological distress during the pandemic, but less is known about key symptoms of psychological distress over time. Going beyond a pathogenetic pathway perspective, we applied the network approach to psychopathology to examine how psychological distress unfolds in a period of maximum stress (pre-pandemic to pandemic onset) and a period of repeated stress (pandemic peak to pandemic peak). We conducted secondary data analyses with the Understanding Society data (N = 17,761), a longitudinal probability study in the UK with data before (2019), at the onset of (April 2020), and during the COVID-19 pandemic (November 2020 & January 2021). Using the General Health Questionnaire and one loneliness item, we computed three temporal cross-lagged panel network models to analyze psychological distress over time. Specifically, we computed (1) a pre-COVID to first incidence peak network, (2) a first incidence peak to second incidence peak network, and (3) a second incidence peak to third incidence peak network. All networks were highly consistent over time. Loneliness and thinking of self as worthless displayed a high influence on other symptoms. Feeling depressed and not overcoming difficulties had many incoming connections, thus constituting an end-product of symptom cascades. Our findings highlight the importance of loneliness and self-worth for psychological distress during COVID-19, which may have important implications in therapy and prevention. Prevention and intervention measures are discussed, as single session interventions are available that specifically target loneliness and worthlessness to alleviate mental health problems.

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

Purpose

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

Methods

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

Results

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

Conclusion

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

The effect of Bafa Wubu of Tai Chi on college students' anxiety and depression: A randomized, controlled pilot study

Objective: This pilot study aimed to explore the mechanism of the effects of Bafa Wubu of Tai Chi (BWTC) on anxiety and depression in college students using resting-state functional magnetic resonance imaging (RS-fMRI). Methods: Eighteen college students (5 males and 13 females) with anxiety and depression met the study criteria and were randomly divided into an experimental group (aged 24.20 ± 4.07 years) and a control group (aged 22.50 ± 5.95). The experimental group received an eight-week BWTC intervention five times/week for 60 min/session. The control group maintained normal daily life without any exercise intervention. These students were assessed using RS-fMRI scans, the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS). Spearman correlation analysis was used, and statistical significance was defined as a two-sided p-value of <0.05. Results: After the intervention, the SAS and SDS scores of the BWTC group significantly reduced (p = 0.002; p = 0.001). Compared with the control group, the fALFF values of the right middle frontal gyrus, orbital part (Frontal_Mid_Orb_R) (p = 0.043), right inferior occipital gyrus (Occipital_Inf_R) (p = 0.003), and right middle temporal gyrus of the temporal pole (Temporal_Pole_Mid_R) (p = 0.003) in the BWTC group increased significantly; the fALFF values of the left middle frontal gyrus (Frontal_Mid_L) (p = 0.001) and right supplementary motor area (Supp_Motor_Area_R) (p = 0.010) in BWTC group decreased significantly. The fALFF values of Frontal_Mid_Orb_R were significantly positively correlated with the SDS score (r = 0.852, p = 0.015) and the fALFF values of Frontal_Mid_L were significantly negatively correlated with the SAS score (r = -0.797, p = 0.032). Conclusion: In this pilot study with college students, BWTC alleviated anxiety and depression, potentially through modulating activity in the Frontal_Mid_L and Frontal_Mid_Orb_R, respectively.

Impact of Online-Delivered eHealth Literacy Intervention on eHealth Literacy and Health Behavior Outcomes among Female College Students during COVID-19

This study examined the effects of a novel online-delivered eHealth literacy intervention to improve eHealth literacy and positive health behaviors among female college students during COVID-19. Female college students taking a physical education class were allocated to either an online-based eHealth literacy intervention group (n = 62) or a physical education class (n = 58). Weekly two-hour sessions were implemented through Zoom videoconferencing over six weeks. We measured eHealth literacy, exercise self-schemata, and health behavior outcomes (eating, sleep, and exercise) before and after the intervention. A two-way repeated measures ANOVA was conducted to examine within- and between-group differences in all outcomes. The ANOVA (2 × 2) for the interaction effect of group and time showed a statistical significance in eHealth literacy and cognitive-emotional exercise self-schemata. There was a marginally significant interaction effect for exercise but none for eating and sleep. This was the first trial to examine the impact of the online eHealth literacy intervention on eHealth literacy and health behavior outcomes for college students during COVID-19. Preliminary findings indicated that the intervention showed promising effectiveness for improving eHealth literacy and promoting health behaviors among female college students.

Associations between sedentary behavior and negative emotions in adolescents during home confinement: Mediating role of social support and sleep quality

BACKGROUND

Prolonged periods of sedentary behaviour, for instance, engendered by home confinement in Shenzhen city, has led to negative mental health consequences, especially in adolescents. Previous research suggests, in general, that sedentary behavior can increase negative emotions. However, the specific mechanism driving the relationship between sedentary behavior and negative emotions is still relatively unclear. Social support and sleep quality might partly explain the effect of sedentary behavior on negative emotions. Thus, the current study aimed to examine the associations between sedentary behavior and negative emotions, and to investigate if social support and sleep quality mediate such a relationship.

METHOD

During home confinement due to the COVID-19 Omicron variant outbreak, 1179 middle and high school students in Shenzhen were invited to voluntarily complete an e-questionnaire, including the 21-item Depression Anxiety Stress Scale (DASS-21), the short form of the International Physical Activity Questionnaire (IPAQ-SF), the Social Support Rating Scale (SSRS) and the Pittsburgh Sleep Quality Index (PSQI). Data from 1065 participants were included in the analysis.

RESULTS

We observed significant sex-related and demografic-related differences in emotional (e.g., anxiety, stress and social support) and other outcome variables (e.g., sitting duration and PSQI score). Furthermore, sedentary behavior, social support, and sleep quality were associated with negative emotions (p < .01), even after controlling for sex, age, only-child case, body mass index, and metabolic equivalent level. In addition, social support and sleep quality partially mediated the association between sedentary behavior and negative emotions.

CONCLUSION

The findings of the current study suggest that social support and sleep quality partially mediate the relationship between sedentary behavior and negative emotions in middle and high school students during home confinement in Shenzhen city.

Associations among Self-Reported Mental Health, Physical Activity, and Diet during the COVID-19 Pandemic

Background: Understanding the relationship between physical activity, diet, and mental health during the COVID-19 pandemic may help inform resources encouraging healthy lifestyle choices during the time of an increased threat to health and wellbeing. Aim: Our objective was to examine how self-rated mental health was associated with engagement in physical activity and consumption of fruits and vegetables during the COVID-19 pandemic. Methods: The study utilized cross-sectional survey data from adults (≥18 years of age) living, working, and/or receiving healthcare in Arkansas (n  =  754). Multivariable regression models were used to examine the associations between self-rated mental health and the number of days respondents engaged in 30 min of physical activity and the number of days respondents consumed five or more servings of fruits and vegetables. Results: Respondents who reported somewhat poor/poor mental health reported engaging in at least 30 min of physical activity fewer days per week (β  =  -.77, p  =  .018) compared with those reporting excellent mental health, after controlling for sociodemographic factors and self-rated health. The significant association observed in the first two models between mental health and number of days consuming five or more servings of fruits and vegetables became non-significant after inclusion of self-rated health. Conclusion: The relationship between mental health and physical activity and diet reaffirms a need for healthcare providers to promote the importance of maintaining both a healthy physical activity level and a nutrient-rich diet in the face of challenging circumstances, such as a global pandemic.

The Potential of Exerkines in Women's COVID-19: A New Idea for a Better and More Accurate Understanding of the Mechanisms behind Physical Exercise

The benefits of physical exercise are well-known, but there are still many questions regarding COVID-19. Chow et al.'s 2022 study, titled Exerkines and Disease, showed that a special focus on exerkines can help to better understand the underlying mechanisms of physical exercise and disease. Exerkines are a group of promising molecules that may underlie the beneficial effects of physical exercise in diseases. The idea of exerkines is to understand the effects of physical exercise on diseases better. Exerkines have a high potential for the treatment of diseases and, considering that, there is still no study of the importance of exerkines on the most dangerous disease in the world in recent years, COVID-19. This raises the fundamental question of whether exerkines have the potential to manage COVID-19. Most of the studies focused on the general changes in physical exercise in patients with COVID-19, both during the illness and after discharge from the hospital, and did not investigate the basic differences. A unique look at the management of COVID-19 by exerkines, especially in obese and overweight women who experience high severity of COVID-19 and whose recovery period is long after discharge from the hospital, can help to understand the basic mechanisms. In this review, we explore the potential of exerkines in COVID-19 by practicing physical exercise to provide compelling practice recommendations with new insights.

The relationship between Chinese college students' mate preferences and their parents' education level

Parents have an influence on the formation of their children's mate preferences. This research conducted two studies to test the relationship between parents' education level and the gender role characteristics (masculinity and femininity) of ideal mate for college students, and the moderating role of urban-rural residence on this relationship. In study 1, 1,033 participants (627 females) reported their explicit attitude toward gender role characteristics for an ideal mate via the Chinese Sex Role Inventory-50. In study 2, we recruited 130 participants (66 females) and used an implicit association test to measure their implicit attitude. Regression-based analyses showed that the higher education level of parents was significantly associated with female students' mate preferences with high-femininity but low-masculinity traits. For male students, the higher education level of parents was associated with their explicit (not implicit) preferences of mates with high-masculinity but low-femininity traits. The significant moderating effect of urban-rural residence was observed in explicit preference, with the different patterns in gender groups. In conclusion, parents with higher educational attainment might bring up children who are more likely to embrace a partner with non-traditional gender roles (e.g., androgynous individuals, feminine men or masculine women).

Physical activity and mental health in sports university students during the COVID-19 school confinement in Shanghai

Background

In 2022, Shanghai was seriously affected by the coronavirus disease 2019 (COVID-19) pandemic. The government implemented citywide static management for 2 months, as well as all universities in Shanghai, which changed the normal learning and living style of sports students and led to a decline in physical activity level. As the physical activity has a strong correlation with mental health, this study aimed to investigate the current state of physical activity (PA) and mental health of the students in Shanghai University of Sport. It will try to reveal the correlation between PA and depressive symptoms, anxiety symptoms, fear of COVID-19 and smartphone addiction.

Methods

A cross-sectional survey was conducted on a random sample of 400 students who came from six different majors in May 2022 at the Shanghai University of Sport. Respondents completed the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Chinese version of the 9-item Patient Health Questionnaire (PHQ-9), the Chinese version of the Generalized Anxiety Disorder Scale (GAD-7), the Chinese version of the COVID-19 Fear Scale (FCV- 19S), and the Smartphone Addiction Scale (SAS-SV). Demographics, PA, depressive symptoms, anxiety symptoms, fear of COVID-19, and smartphone addiction were compared. A binary logistic regression model was used for the further analysis.

Results

A total of 376 college students were included in the final analysis. Binary logistics analysis showed that moderate physical activity (MPA) was negatively correlated with depression (OR = 0.95, 95%CI = 0.93-0.98), anxiety (OR = 0.97, 95%CI = 0.95-0.99), fear of COVID 19(OR = 0.99, 95%CI = 0.98-0.99)and smartphone addiction (OR = 0.94, 95%CI = 0.9-0.98) (all P < 0.05). Sedentary behavior was positively correlated with smartphone addiction (OR = 1.01, P < 0.01, 95%CI = 1.001-1.004).

Conclusion

There was an association between the presence of MPA and depressive symptoms, anxiety symptoms, fear of COVID-19, smartphone addiction, and sedentary behavior associated with smartphone addiction levels. Clarifying the causal relationship between PA and mental health will require further research.

Mental Health Risk Factors and Coping Strategies among Students in Asia Pacific during COVID-19 Pandemic-A Scoping Review

The impact of COVID-19 has forced higher education institutes to go into lockdown in order to curb the situation. This sudden change caused students within the institutions to forgo traditional face to face classroom settings and to attend immediate online classes. This review aims to summarize the evidence of the social demographic mental health impacts of the COVID-19 pandemic on students in higher education institutes within the Asia Pacific region and identify the coping mechanisms adopted during these times. A systematic literature search was conducted using three databases (PubMed, Google Scholar, and Scopus), out of which 64 studies met the inclusion/exclusion criteria. The findings revealed that the social demographic groups most at risk were female students, those who were in the final years of their studies (i.e., students who were almost graduating), and postgraduate students as well as students studying medical fields (nursing, dental, medicine, health sciences etc.). The majority of the studies identified that students were relying on mobile devices and extended screen time to cope with the pandemic. Having proper social support, be it through a network of friends or positive family cohesion, can be a good buffer against the mental impacts of COVID-19. Students in higher education institutes are at risk of mental consequences due to COVID-19. By reducing their screen time, finding a healthier coping system, increasing the availability of support within the family and community, as well as actively engaging in beneficial activities students may be able to alleviate general negative emotions, specifically during the pandemic.

Assessing Knowledge, Preventive Practices, and Depression Among Chinese International Students and Local Korean Students in South Korea During the COVID-19 Pandemic: An Online Cross-Sectional Study

Depression among university students and international university students is an increasing problem globally. This study aimed to clarify the differences on the conditions and determinants of the knowledge, preventive practices and depression of the Chinese international students and local Korean students in South Korea during the COVID-19 pandemic. An online cross-sectional questionnaire including general demographic characteristics, COVID-19-related knowledge, preventive practice, and the Patient Health Questionnaire (PHQ-9) was applied from March 23 to April 22, 2020. A total of 533 university students (171 Chinese international students and 362 local South Korean students) were included in the study. The majority of both Chinese international students and local South Korean students had a good comprehension of COVID-19. Chinese international students in South Korea showed better preventive practice than local Korean students, while the proportion of moderate to severe depression of Chinese international students was relatively higher (28.07%) than that of local Korean students (22.38%). Determinants of depression of Chinese international students in South Korea were information satisfaction, likelihood of survival after infection, symptoms of a cough and feelings of discrimination, while for local Korean students were gender, educational level, family, suspected symptoms, self-assessed physical health status, COVID-19 detection, population contact history and online sources of information. These results could be used as a reference for decreasing the depressive symptoms among the university students.

Lifestyle, Physical Activity and Dietary Habits of Medical Students of Wroclaw Medical University during the COVID-19 Pandemic

The new disease COVID-19, induced by SARS-CoV-2, causes acute respiratory infection. Many countries, including Poland, began to set a variety of different restrictions to reduce the spread of the virus. Most students had problems with online lessons. The study was conducted among second year medicine students of the Medical University of Wroclaw, and after the entire process of verification 200 respondents were accepted. The research consisted of completing the same anonymous online questionnaires twice in March and October 2020. This finally allowed for a critical assessment of the impact of the pandemic and its restrictions on the students’ daily lives. During the online classes, low levels of physical activity persisted (p = 0.718), whereas time spent sitting increased (p < 0.001). Despite positive changes in declared snacking (p = 0.061), we observed significant drops in the index of healthy diet (p = 0.001) and nutritional knowledge (p < 0.001) as well as an increase in the consumption of fast-food (p < 0.001) and energy drinks (p = 0.019). Reduced nutritional knowledge can cause a decrease in attention to healthy food preparation and much more frequent consumption of fast-food.

The Impact of Physical Activity on Mental Health during COVID-19 Pandemic in China: A Systematic Review

The outbreak and spread of novel coronavirus disease (COVID-19) in 2019 was a public health emergency of global concern. As an important health behavior, physical activity (PA) and its impact on mental health have been increasingly explored during the epidemic period. The keywords and references were searched on PubMed, Web of Science, Scopus, Cochrane Library, EBSCO, and CNKI since the inception of an electronic bibliographic database until October 2021. A total of 2979 articles were identified, of which 23 were eligible for inclusion to examine the relationship between PA and mental health during the COVID-19 epidemic. Residents with regular PA, high-intensity PA, and PA duration of 30-60 min or more per day were associated with a lower risk of anxiety, depression, and negative emotions. In contrast, residents with no exercise and physical inactivity were more likely to have anxiety, depression, sleep disturbances, and lower subjective well-being. In addition, the dose-response curve between PA and negative emotions indicated a U-shaped relationship, and there were urban-rural differences in the relationship between emotional status and the levels of PA in adolescents. The findings have significant implications for addressing mental health issues during the current pandemic and future pandemics. Future studies adopting an experimental study design, conducting objective PA measures, and focusing on the vulnerable subpopulations are warranted to further explore the association of PA on mental health during the COVID-19 pandemic.

Global research on syndemics: a meta-knowledge analysis (2001-2020)

BACKGROUND

Syndemics or synergies of cooccurring epidemics are widely studied across health and social sciences in recent years.

METHODS

We conducted a meta-knowledge analysis of articles published between 2001 to 2020 in this growing field of academic scholarship.

RESULTS

We found a total of 830 articles authored by 3025 authors, mostly from high-income countries. Publications on syndemics are gradually increasing since 2003, with rapid development in 2013. Each article was cited more than 15 times on average, and most (n = 604) articles were original studies. Syndemics research focused on several areas, including HIV/AIDS, substance abuse, mental health, gender minority stressors, racism, violence, chronic physical and mental disorders, food insecurity, social determinants of health, and coronavirus disease 2019. Moreover, biopsychosocial interactions between multiple health problems were studied across medical, anthropological, public health, and other disciplines of science.

CONCLUSIONS

The limited yet rapidly evolving literature on syndemics informs transdisciplinary interests to understand complex coexisting health challenges in the context of systematic exclusion and structural violence in vulnerable populations. The findings also suggest applications of syndemic theory to evaluate clinical and public health problems, examine the socioecological dynamics of factors influencing health and wellbeing, and use the insights to alleviate health inequities in the intersections of synergistic epidemics and persistent contextual challenges for population health.

Global research on syndemics: a meta-knowledge analysis (2001-2020)

BACKGROUND

Syndemics or synergies of cooccurring epidemics are widely studied across health and social sciences in recent years.

METHODS

We conducted a meta-knowledge analysis of articles published between 2001 to 2020 in this growing field of academic scholarship.

RESULTS

We found a total of 830 articles authored by 3025 authors, mostly from high-income countries. Publications on syndemics are gradually increasing since 2003, with rapid development in 2013. Each article was cited more than 15 times on average, and most (n = 604) articles were original studies. Syndemics research focused on several areas, including HIV/AIDS, substance abuse, mental health, gender minority stressors, racism, violence, chronic physical and mental disorders, food insecurity, social determinants of health, and coronavirus disease 2019. Moreover, biopsychosocial interactions between multiple health problems were studied across medical, anthropological, public health, and other disciplines of science.

CONCLUSIONS

The limited yet rapidly evolving literature on syndemics informs transdisciplinary interests to understand complex coexisting health challenges in the context of systematic exclusion and structural violence in vulnerable populations. The findings also suggest applications of syndemic theory to evaluate clinical and public health problems, examine the socioecological dynamics of factors influencing health and wellbeing, and use the insights to alleviate health inequities in the intersections of synergistic epidemics and persistent contextual challenges for population health.

Effects of Weight-Related Self-Stigma and Smartphone Addiction on Female University Students' Physical Activity Levels

Physical inactivity is a common health problem in female college students, and factors such as weight self-stigma and smartphone addiction may negatively impact physical activity in this population. The aim of the current study was to investigate the associations between these variables and identify the moderating effects of smartphone addiction between weight stigma and physical activity. Using a cross-sectional study, information on the level of physical activity in the past week, weight-related self-stigma, and smartphone addiction, as well as demographics, were collected via an online survey from 391 female college students in Taiwan. Participants in two groups of moderate to high and low physical activity were compared using a zero-order bivariate correlation in terms of independent variables. A moderated mediation model using Model 14 in the Hayes’ PROCESS macro with 1000 bootstrapping resamples was applied to assess moderation effects. There were significant differences in terms of weight status, smartphone addiction, and weight stigma between active and inactive groups (p < 0.001). All independent variables except for age were positively correlated (0.14 < r < 0.45). Multivariate regression models indicated that weight status was associated with weight stigma (odds ratio [OR] = 9.13, p < 0.001; 95% CI = 6.90, 11.35). Weight status (OR = 0.47, p = 0.03; 95% CI = 0.23, 0.93), weight stigma (OR = 0.96, p = 0.03; 95% CI = 0.922, 0.997), and smartphone addiction (OR = 0.11, p = 0.003; 95% CI = 0.03, 0.47) were associated with physical activity. The moderating role of smartphone addiction on the association between weight stigma and physical activity was also identified (OR = 1.05, p = 0.049; 95% CI = 1.0001, 1.1004). The moderating effect of smartphone addiction on the association between weight stigma and physical activity suggests that designing interventions to address the negative impacts of both weight stigma and smartphone addiction may help to improve physical activity in female college students.

The association between physical activity and mental health during the first year of the COVID-19 pandemic: a systematic review

INTRODUCTION

The Coronavirus disease-19 (COVID-19) pandemic affected countries worldwide and has changed peoples' lives. A reduction in physical activity and increased mental health problems were observed, mainly in the first year of the COVID-19 pandemic. Thus, this systematic review aims to examine the association between physical activity and mental health during the first year of the COVID-19 pandemic.

METHODS

In July 2021, a search was applied to PubMed, Scopus, and Web of Science. Eligibility criteria included cross-sectional, prospective, and longitudinal study designs and studies published in English; outcomes included physical activity and mental health (e.g., depressive symptoms, anxiety, positive and negative effects, well-being).

RESULTS

Thirty-one studies were included in this review. Overall, the studies suggested that higher physical activity is associated with higher well-being, quality of life as well as lower depressive symptoms, anxiety, and stress, independently of age. There was no consensus for the optimal physical activity level for mitigating negative mental symptoms, neither for the frequency nor for the type of physical activity. Women were more vulnerable to mental health changes and men were more susceptive to physical activity changes.

CONCLUSION

Physical activity has been a good and effective choice to mitigate the negative effects of the COVID-19 pandemic on mental health during the first year of the COVID-19 pandemic. Public health policies should alert for possibilities to increase physical activity during the stay-at-home order in many countries worldwide.

Perceived Academic Stress and Depression: The Mediation Role of Mobile Phone Addiction and Sleep Quality

BACKGROUND

Although academic stress is a well-known risk factor for students' depression, little is known about the possible psychological mechanisms underlying this association. In this study, we investigated the prevalence of depression and sleep disturbance among Chinese students, examined the relationship between perceived academic stress and depression, considered if mobile phone addiction and sleep quality is a mediator of this relationship, and tested if mobile phone addiction and sleep quality together play a serial mediating role in the influence of perceived academic stress on depression.

METHOD

A cross-sectional survey was conducted among students from September to December 2018 in Heilongjiang Province, China. The final analysis included 5,109 students. Mobile phone addiction, sleep quality, and depressive symptoms were assessed using the Mobile Phone Addiction Index, Pittsburgh Sleep Quality Index, and Center for Epidemiologic Studies-Depression scales, respectively. The serial mediation model was used to analyse the relationship between perceived academic stress, mobile phone addiction, sleep quality, and depression.

RESULTS

Among all participants, the prevalence of depressive symptoms and sleep disturbance was 28.69 and 27.95%, respectively. High school students showed the highest scores of perceived academic stress (2.68 ± 1.06), and the highest prevalence of depressive symptoms (33.14%) and sleep disturbance (36.47%). The serial mediation model indicated that perceived academic stress was a significant predictor of depression (B = 0.10, SE = 0.02, 95% CI = 0.06 - 0.13). Additionally, mobile phone addiction (B = 0.08, 95% boot CI = 0.06-0.11) and sleep quality (B = 0.27, 95% boot CI = 0.22-0.33) played a mediating role between perceived academic stress and depression. Mobile phone addiction and sleep quality together played a serial mediating role in the influence of perceived academic stress on depression (B = 0.11, 95% boot CI = 0.08-0.14). Furthermore, the indirect effect (i.e., the mediating effect of mobile phone addiction and sleep quality) was significant and accounted for 64.01% of the total effect.

CONCLUSIONS

Our research results underscore the need for stakeholders-including family members, educators, and policy makers-to take preventative intervention measures to address depression among Chinese students, especially high school students.

Personalized individual-based exercise prescriptions are effective in treating depressive symptoms of college students during the COVID-19: A randomized controlled trial in China

BACKGROUND

The COVID-19 pandemic has seriously increased depression prevalence among the public, including Chinese college students. However, many exercise cannot be performed as usual under the stay-at-home order. This study was a 12-week three-arm randomized controlled trial using the intention-to-treat principle, aiming to explore and compare the feasibility and effect of individual-based personalized aerobic-exercise and resistance-training prescriptions on depressive symptoms in college students, and conclude with some recommendations for individual-based exercise prescriptions.

METHODS

Eighty-six college students with depressive symptoms were randomized into aerobic-exercise (AE), resistance-training (RT), and wait-list control (WLC) groups. Participants in two experimental groups received 12-week personalized AE and RT prescriptions on their individual situations, respectively. No intervention was implemented on participants in the WLC group. Depressive symptoms and physical activity (PA) were measured by Zung Self-Rating Depression Scale (SDS) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. All data were collected at the baseline, 4, 8, and 12 weeks, and 4-week post-intervention.

RESULTS

At 12 weeks, 72.09% of depressive participants improved to "normal." Participants exhibited a statistical reduction in SDS in all 3 groups (p < 0.05) at 12 weeks compared to baseline. Follow-up assessments showed no significant increase in SDS at 4-week post-intervention compared to 12 weeks (p > 0.05). The independent t-test revealed significantly lower SDS in AE and RT group than in WLC group (p _AE < 0.001 and p _RT < 0.05) at 4, 8, and 12 weeks, and 4-week post-intervention. Furthermore, the PA of participants (including total PA and intensities) in both experimental groups represented a significant improvement at 4-week post-intervention compared to baseline (p < 0.05), while no differences were observed in the PA of participants in the WLC group (p > 0.05).

CONCLUSION

Personalized exercise prescriptions have good feasibility as they can increase adherence to intervention and reduce serious adverse events. Besides, individual-based personalized aerobic-exercise and resistance-training prescriptions result in a similar effect in relieving depressive symptoms and improving physical activity in college students. The individual-based exercise programs performed in 45- to 60- min with progressive moderate-to-vigorous intensity, 3 times/week for at least 12 weeks, may reduce depressive symptoms in college students during the COVID-19.

Individual-level determinants of depressive symptoms and associated diseases history in Turkish persons aged 15 years and older: A population-based study

BACKGROUND

Depressive symptoms are associated with both long-lasting and short-term repetitive mood disorders and affect a person's ability to function and lead a rewarding life. In addition to predisposing genetic causes, other factors such as socioeconomic and demographic factors, and chronic diseases have also been reported to associate with depression. In this study, we analyzed the association between history of chronic diseases and presentation of depressive symptoms amongst Turkish individuals.

METHODS

We employed the 2019 Turkey health survey to analyze data of 11,993 individuals aged 15+ years. Depressive symptoms were assessed using the eight-item Patient Health Questionnaire (PHQ-8) coded with a binary measure, a score of <10 as less depressed and >10 as moderate-severely depressed. A number of sociodemographic characteristics were adjusted for in the analyses. Logistic regression models were used to test the association between chronic diseases and depressive symptoms in the study sample.

RESULTS

Our analysis revealed that 6.24% of the 11,993 participants had reported an episode of depressive symptoms. The prevalence of depressive symptoms in men was 1.85% and in women, it was 2.34 times higher. Participants who had previously reported experiencing coronary heart diseases (AOR = 7.79, 95% CI [4.96-12.23]), urinary incontinences (AOR = 7.90, 95% CI [4.93-12.66]), and liver cirrhosis (AOR = 7.50, 95% CI [4.90-10.42]) were approximately eight times likely to have depressive symptoms. Similarly, participants with Alzheimer's disease (AOR = 6.83, 95% CI [5.11-8.42]), kidney problems (AOR = 6.63, 95% CI [4.05-10.85]), and history of allergies (AOR = 6.35, 95% CI [4.28-9.23]) had approximately seven-fold odds of reporting episodes of depressive symptoms. The odds of presenting with depressive symptoms amongst participants aged ≥ 50 were higher than in individuals aged ≤ 49 years.

CONCLUSION

At individual level, gender and general health status were associated with increased odds of depression. Furthermore, a history of any of the chronic diseases, irrespective of age, was a positive predictor of depression in our study population. Our findings could help to serve as a reference for monitoring depression amongst individuals with chronic conditions, planning health resources and developing preventive and screening strategies targeting those exposed to predisposing factors.

The Changes in Stress Coping, Alcohol Use, Cigarette Smoking and Physical Activity during COVID-19 Related Lockdown in Medical Students in Poland

The ongoing COVID-19 pandemic has significantly limited social contacts, thus contributing to deepening isolation. Therefore, SARS-CoV-2 exerted on humanity not only a physical impact but also a psychological one, often increasing the feeling of stress. The long-term effects of such a state could include the management of depression, so our study aimed to analyze groups of medical students in different periods of the pandemic (at the beginning of the pandemic, after half a year of the pandemic, after one year of the pandemic) in order to assess the impact of this situation on coping with stress. The impact of the pandemic on the development of stress factors such as alcohol consumption and smoking was also studied. The level of physical activity in the context of coping with an uncertain situation was also assessed. The impact of the above-mentioned factors on the behavior of students, including the Mini-COPE questionnaire, AUDIT test, the Fagerström test and the IPAQ questionnaire was analyzed. It has been shown that as the pandemic and the lockdown progressed, patients consumed more often or larger amounts of alcohol, smoked more cigarettes, and levels of physical activity decreased. All these factors may have had some impact on the deterioration of coping with stress among the respondents, which would indicate that the COVID-19 pandemic significantly contributed to an increase in the sense of stress among the students.

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.

Does gender role explain a high risk of depression? A meta-analytic review of 40 years of evidence

BACKGROUND

This meta-analytic review aimed to systematically evaluate associations of depression with multiple gender role dimensions (masculinity, femininity, androgyny, and undifferentiated traits) and to determine potential moderators (participant characteristics, study instruments and sociocultural factors) of the relationship.

METHODS

Of 4481 initially identified records in three electronic databases, 58 studies published 1978 to 2021 were included for meta-analysis.

RESULTS

(1) Association of depression and gender role is moderated by study year and human development indices. (2) Masculinity is a protective factor for depression, while this dominance has declined as life expectancy increases. (3) A negative, weak but significant association between depression and femininity is observed in women, and college students, which starts to emerge with the gradual increase in the national education and income index from 1990 to 2019. (4) Androgynous individuals reported the lowest level of depression as compared with other gender role orientations (masculine, feminine, and undifferentiated trait group). This disparity is becoming more extreme with life expectancy and per capita income index increases.

LIMITATIONS

English-language studies were only included in this review.

CONCLUSIONS

Androgyny might be the most ideal gender role protecting both women and men from depression.

Changes in Physical Activity and Sedentary Behavior in Chinese Young Adults during the COVID-19 Pandemic: A Repeated-Measure Study throughout One Year

Though we know physical activity (PA) decreased while sedentary behavior (SB) increased compared to that before the COVID-19 pandemic, little is known about subsequent changes in PA and SB throughout one year in the post-pandemic era. This study aimed to examine the changes in PA and SB in a sample of Chinese young adults using a four-wave repeated-measure design during the pandemic. A total of 411 participants provided self-reported data of sociodemographic characteristics (e.g., sex, age), PA, and SB. Nonparametric tests and generalized estimating equations were conducted. Results revealed significant changes in moderate to vigorous PA (MVPA), light PA (LPA), and SB. The MVPA of Wave 1, 2, and 3 was significantly less than that of Wave 4 (p < 0.001); the LPA of Wave 1 and 2 was significantly less than that of Wave 4; the SB of Wave 1 was significantly more than that of Wave 4 (p < 0.05). Being female was the only predictor of changes in MVPA (Beta = −0.311, p< 0.001). Being female (Beta = 0.115, p = 0.003) and perceived family affluence (Beta = −0.059, p< 0.001) were predictors of changes in SB. As such, PA was less, while SB was more during the early stages of the pandemic. With the progress of the pandemic stages, health behaviors in young adults have been gradually improved. Sex and perceived family affluence were two important factors in predicting health behaviors. Our results can inform efficient policies or interventions in the COVID-19 era and future similar public health events.

Gender Self-Perception and Psychological Distress in Healthcare Students during the COVID-19 Pandemic

The aim of this study was to analyze university Health Sciences students’ self-perception regarding gender stereotypes, and to explore whether there was any association between gender stereotypes and clinical/socio-demographic variables. Methods: This cross-sectional study was conducted with a sample of 252 university students who completed a self-administrated online questionnaire (18.3% males, 81.7% females). We evaluated the self-perception of gender stereotypes as determined using the BSRI-12 questionnaire and explored the association of this measure with the impact of perceived stress measured using a modified scale (PSS-10-C) as well as anxiety and depression according to scores on the Goldberg scale (GADS). Results: According to the students’ self-perception of gender stereotypes, 24.9% self-perceived themselves as feminine, 20.1% as masculine, 24.9% as androgynous, and 30% as undifferentiated. The degree determines self-identification with gender stereotypes. Nursing and Occupational Therapy are studied mostly by women, 28.4% and 45%, respectively, while Physiotherapy is studied mainly by men (71.2%). Females indicated more anxiety (75.7%) and depression (81.7%) than males (52.9% and 67.3%, respectively). In contrast, males developed more stress (88.5%) than females (74.1%). Conclusions: University degree, anxiety, depression, and stress determined self-identification with gender stereotypes. The results of this study indicate that gender roles influence the possibility of developing mental disorders and should be taken into account in future studies.

Moving Forward: Understanding Correlates of Physical Activity and Sedentary Behaviour during COVID-19-An Integrative Review and Socioecological Approach

Population-level physical activity (PA) and sedentary time/behaviour estimates represent a significant public health issue exacerbated by restrictions enforced to control COVID-19. This integrative review interrogated available literature to explore the pandemic's impact on correlates of such behaviours in adults (≥18 years). Five electronic databases were systematically searched in January 2021. Data extracted from 64 articles were assessed for risk-of-bias using the Mixed Methods Assessment Tool, with correlates identified, coded, and themed via thematic analysis. A socioecological model of during-pandemic PA was conceptualized and mapped to the Capability, Opportunity, Motivation, and Behaviour (COM-B) model of behaviour change mechanisms, which illustrates influences over five levels: Individual (biological)-general health; Individual (psychological)-mental health, cognition, motivation, and behaviour; Social-domestic situation, sociodemographic factors, support, and lifestyle choices; Environmental-resources and area of residence; and Policy-COVID-19-related rules. For sedentary time/behaviour, individual level factors, namely general and mental health, may be important correlates. Neither age or sex were clearly correlated with either behaviour. As we transition into a new normal, understanding which behaviour mechanisms could effectively challenge physical inactivity is essential. Targeting capability on a psychological level may facilitate PA and limit sedentary time/behaviour, whereas, on a physical level, maximizing PA opportunities could be crucial.

Us and the Virus

Abstract. From a social psychological perspective, the COVID-19 pandemic and its associated protective measures affected individuals’ social relations and basic psychological needs. We aim to identify sources of need frustration (stressors) and possibilities to bolster need satisfaction (buffers). Particularly, we highlight emerging empirical research in which social psychological theorizing can contribute to our understanding of the pandemic’s social consequences: Loneliness, social networks, role conflicts, social identity, compliance, trust, reactance, and conspiracy beliefs. We highlight directions for future social psychological research as the pandemic continues.

Well-being and its relationship with sports and physical activity of students during the coronavirus pandemic

The main goal of this correlational study is to examine the changes in the amount and type of physical activity of students of various study programs during the coronavirus pandemic. Furthermore, the motives for these changes as well as their relationship with general well-being are investigated. Therefore, 243 students (sport science, humanities, natural sciences) answered questions concerning (a) the amount and type of their physical activity before and during the pandemic, (b) their well-being and (c) their optimism/pessimism. The main result of the study is that the type and the motives for sports and physical activity changed for the study participants during the coronavirus pandemic: Team sports and swimming decreased, while individual sports and physical activity not associated with a sports club/business and with digital media increased. In this study the difference in sports and physical activity seemed to be related to well-being, especially for the students of sport science and humanities. To conclude the study indicated that a change occurred in the type of sports and physical activity as well as change in the motives for physical exercise in students during the pandemic.

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

The COVID-19 pandemic and its accompanying infection control measures introduced significant disruptions to the routines of many higher education students around the world. It also deprived them of in-person counselling services and social support. These changes have put students at a greater risk of developing mental illness. The objective of this review is to assess the prevalence of depressive symptoms, anxiety symptoms and sleep disturbances in higher education students during the pandemic. A systematic search of English and Chinese databases was conducted current to January 1^st, 2021. The quality of included studies was evaluated using a modified Newcastle-Ottawa scale. Prevalence of depressive symptoms, anxiety symptoms and sleep disturbances were pooled using random-effects meta-analysis. Eighty-nine studies (n=1,441,828) were included. The pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances was 34%, 32% and 33%, respectively. The prevalence values differ based on geographical regions, diagnostic criteria, education level, undergraduate year of study, financial situation, living arrangements and gender. Overall, the prevalence of depressive symptoms and anxiety symptoms synthesized in this study was higher compared to pre-pandemic prevalence in similar populations. Evidently, mental health screening and intervention should be a top priority for universities and colleges during the pandemic.

Mental Health and Physical Activity in Health-Related University Students during the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic led to increased negative emotional states among students. Physical activity is known to have positive impacts on mental health and well-being. However, due to the closure of gyms and other recreational facilities as a restrictive measure, students' physical activity levels may decrease. This cross-sectional study aimed to determine the prevalence of depression, anxiety, and stress symptoms and physical activity among health-related students during the second partial COVID-19 lockdown. The study included 823 students from the Faculty of Dental Medicine and Health of the University of Osijek in Croatia. The Depression Anxiety Stress Scale-21 (DASS-21) and the Godin-Shephard Leisure Time Questionnaire for Physical Activity (GSLTPAQ) questionnaires were used to assess the prevalence of depression, anxiety, and stress symptoms as well as physical activity. Two-thirds (59.2%) of students in health-related fields were insufficiently active, while the prevalence of depression (50.8%), anxiety (50.9%), and stress (49.9%) symptoms were high. Also, female respondents had significantly higher levels of depression, anxiety, and stress than their male counterparts. Graduate students had higher levels of all three negative emotional states, but only anxiety levels were significant. This study shows that students in health-related fields had reduced physical activity and a high prevalence of negative emotional conditions (depression, anxiety, and stress) during the second partial lockdown. The resulting symptoms were mostly of mild intensity; however, we consider this a significant mental health issue during the COVID-19 pandemic. Hence, it is crucial to control and support students' mental health, especially in more affected female individuals, in order to reduce the pandemic's negative impact.

Prevalence of depressive symptoms among Chinese university students amid the COVID-19 pandemic: a systematic review and meta-analysis

AIMS

Chinese university students are at high risk for depressive symptoms and the ongoing coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the mental health of university students. However, existing studies on depressive symptoms in Chinese university students during the COVID-19 pandemic reported a wide range of prevalence estimates, making mental health planning for this population difficult. The objective of this study was to conduct a systematic review and meta-analysis of surveys that assessed the prevalence of depressive symptoms in Chinese university students amid the COVID-19 pandemic.

METHODS

Major Chinese (CNKI, Wanfang, VIP) and English (PubMed, Embase, PsycInfo) databases and preprint platforms were searched to identify cross-sectional studies containing data on the prevalence of depressive symptoms in Chinese university students during the pandemic. Two authors independently retrieved the literature, evaluated the eligibility of potential studies, assessed the risk of bias (RoB) of included studies, and extracted data. RoB was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

RESULTS

In total, 1177 records were retrieved, and 84 studies involving 1 292 811 Chinese university students during the pandemic were included. None of the included studies were rated as completely low RoB. Statistically significant heterogeneity in the prevalence estimates of included studies was detected (I2 = 99.9%, p < 0.001). The pooled prevalence of depressive symptoms was 26.0% (95%CI: 23.3-28.9%), which was significantly higher in female than in male students (30.8% v. 28.6%, p < 0.001), in postgraduates than in undergraduates (29.3% v. 22.9%, p < 0.001), in students living inside than in those living outside the COVID-19 epicentre (27.5% v. 22.3%, P < 0.001), in students from universities at the epicentre than in those from universities outside the epicentre (26.2% v. 23.1%, p < 0.001), in students who had close contact with COVID-19 than in those who did not (46.0% v. 25.0%, p < 0.001), and in students who had acquaintances or relatives infected with COVID-19 (39.7% v. 24.0%, p < 0.001) than in those who did not. Five sources of heterogeneity were identified from the subgroup analysis: survey period, % of males among the survey sample, scale of depressive symptoms, cutoff score of the scale and level of RoB.

CONCLUSIONS

Over one-fourth of Chinese university students experienced depressive symptoms during the COVID-19 pandemic. Mental health services for this population should include periodic evaluation of depressive symptoms, expanded social support and psychiatric assessment and treatment when necessary. It is also necessary to design depression prevention programmes that target higher-risk cohorts of university students.

Nine Months into the COVID-19 Pandemic: A Longitudinal Study Showing Mental Health and Movement Behaviours Are Impaired in UK Students

Initial studies indicated that student mental health was impaired during the early stages of the pandemic and that maintaining/improving physical activity gave some protection from mental illness. However, as the pandemic persists, these data may not reflect current circumstances and may have been confounded by exam stress. Methods: This study used an online survey to assess the changes in, and associations between, mental health and movement behaviours in 255 UK university students from before the COVID-19 pandemic (October 2019) to 9 months following the UK’s first confirmed case (October 2020). Changes in and associations between mental wellbeing, perceived stress, physical activity, and sedentary behaviour were assessed using a mixed model ANOVA; a multiple linear regression model determined the predictive value of variables associated with Δ mental wellbeing. Results: Mental wellbeing and physical activity decreased (45.2 to 42.3 (p < 0.001); 223 to 173 min/week (p < 0.001)), whereas perceived stress and time spent sedentary increased (19.8 to 22.8 (p < 0.001); 66.0 to 71.2 h/week (p = 0.036)). Δ perceived stress, Δ sedentary behaviour and university year accounted for 64.7%, 12.9%, and 10.1% of the variance in Δ mental wellbeing (p < 0.001; p = 0.006; p = 0.035). Conclusion: The COVID-19 pandemic is having a sustained negative impact on student mental health and movement behaviour.