Two years COVID-19 pandemic: Development of university students' mental health 2020-2022

No particularly negative impact of the Covid-19 pandemic on the mental health of individuals with higher levels of childhood trauma

Background

Initial studies suggest that individuals with a history of traumatic life experiences, particularly childhood trauma, may be more susceptible to increased mental health problems in the wake of the COVID-19 pandemic.

Methods

The present cross-sectional study compared the mental health status of three cohorts of university students before (2016), at the beginning (2020) and at the end (2022) of the COVID-19 pandemic. The students in each cohort were divided into two groups: those with self-reported moderate/severe childhood trauma (n = 126) and those with no/mild childhood trauma (n = 438).

Results

Across all cohorts, students with moderate/severe childhood trauma consistently reported higher levels of psychological and physical stress compared to individuals with no/mild childhood trauma experiences. However, only the no/mild childhood trauma group exhibited an increase in mental health problems (i.e., heightened depressive symptoms and greater subjective impairment due to physical and psychological symptoms) during the COVID-19 pandemic. Furthermore, within the no/mild childhood trauma group, students in the 2022 cohort reported significantly higher psychological distress compared to those surveyed in 2020. In contrast, mental health scores among students with moderate/severe childhood trauma remained unchanged across the pre-pandemic and pandemic cohorts.

Conclusions

The findings of this study do not support the hypothesis that the COVID-19 pandemic disproportionately exacerbated mental health problems in individuals with a history of moderate to severe childhood trauma. Instead, our results suggest that the pandemic's impact on mental health was more pronounced in students with no or only mild childhood trauma.

"Loneliness is killing me?!": the subjective emotional experience of loneliness during the COVID-19 pandemic: results of a cross-sectional study in patients with a psychiatric disorder

PURPOSE

During the COVID-19 pandemic, an increase in loneliness as well as mental health issues was detected. However, research on the association between loneliness and mental disorders is sparse. The aim of this study was to examine loneliness and associated social and emotional factors in patients with a psychiatric disorder and to investigate potential predictors of loneliness.

METHODS

Participants were N = 230 patients currently receiving psychiatric treatment at the Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Germany. A cross-sectional survey included questionnaires on loneliness, life satisfaction, need to belong, interpersonal trust, stress, and resilience.

RESULTS

Most participants (n = 91, 39.6%) suffered from depression, followed by anxiety disorder (n = 43, 18.7%). Significantly higher loneliness levels compared to norm samples were detected in all three loneliness questionnaires (all p <.05), and overall n = 128 (57.7%) reported to feel lonely. In addition, participants reported lower life satisfaction, lower interpersonal trust, and lower resilience than the general population (all p <.05). No significant differences in loneliness levels between different psychiatric diagnoses were revealed. It was found that lower satisfaction with life, lower interpersonal trust and lower resilience were significantly associated with higher loneliness (all p <.05).

CONCLUSION

This study underlines the importance to continue research on loneliness in people with mental disorders after the COVID-19 pandemic since the majority of patients reported to feel lonely. Further, tailored therapy-accompanying interventions to prevent loneliness in patients with a psychiatric disorder should be designed and evaluated to meet patients' diverse needs e.g., through online programs.

TRIAL REGISTRATION

German Clinical Trial Registration: DRKS00023741 (registered on April 6, 2021).

Constellations of Depressive Symptoms, Substance Use, and Risky Sexual Behavior Among Higher Education Students: A Moderated Mediation Analysis of Mask-Wearing Practice During COVID-19

Mental health and substance use emerged as critical factors associated with health risk behaviors during the COVID-19 pandemic, and its importance has only grown in the post-pandemic period, particularly among priority groups like higher education students. To enhance our understanding of how mental health and substance use factors interact with preventive measures like mask-wearing to affect risky sexual behaviors (RSBs), our study examined the associations between depressive symptoms, substance use, and RSBs among college and university students in the United States. We specifically aimed to assess the impact of mask-wearing on the association between depressive symptoms, binge drinking and marijuana use, and RSBs during the pandemic. Data were collected through nonprobability sampling from 835 students at five universities via an online survey conducted between July and August 2020. Using the PROCESS macro, we analyzed the mediating effects of binge drinking and marijuana use on the association between depressive symptoms and RSBs (Model 4), as well as the moderating effect of mask-wearing on the association between depressive symptoms, binge drinking and marijuana use, and RSBs. Our findings revealed that mask-wearing significantly moderated the combined association between depressive symptoms, marijuana use, binge drinking, and RSBs. As we navigate the post-pandemic period, it is crucial for existing programs addressing health risk behaviors to consider the direct and indirect associations between mental health and substance use. Understanding these protective and health risk behaviors is essential for informing targeted prevention and intervention efforts in the post-pandemic landscape.

Changes in Rates of Special Considerations in Higher Education Applications Pre- and During the COVID-19 Pandemic in Victoria, Australia

BACKGROUND AND AIMS

Since the onset of the COVID-19 pandemic, a significant rise in mental ill health has been observed globally in young people, particularly those in their final years of secondary school. Students' negative experiences coincide with a critical transitional period which can disrupt milestones in social and educational development. This study aimed to use innovative population-level data to map the impact of the pandemic on students entering higher education.

METHODS

Pre-pandemic (2019/2020) and pandemic (2020/2021) tertiary education application data were obtained from the Victorian Tertiary Admissions Centre. Prevalence of applications for special consideration related to mental ill health were compared between cohorts across various geographical areas and applicant demographic subgroups. Relative risk regression models were used to understand the role of different risk factors.

RESULTS

Rates of mental health-related special consideration applications increased by 38% among all applications (pre-pandemic: 7.8%, n = 56 916; pandemic: 10.8%, n = 58 260). Highest increases were observed among students in areas with both extended and close-quarter lockdown experiences, and areas impacted by 2019/2020 black summer bushfires. The increases were higher among Year 12 students and students with other special consideration needs (e.g., physical condition, learning disability). Slightly higher increases were observed in areas with higher socio-economic status, which may potentially be related to inequality in mental health service access.

CONCLUSION

As consequences of mental health difficulties and academic disruption in youth can be long lasting, it is critical to establish a mental health support framework both in and outside of higher education to facilitate young people's recovery from the pandemic.

The Road to Recovery: A Two-Year Longitudinal Analysis of Mental Health Among University Students During and After the COVID-19 Pandemic

Longitudinal research into the impact of COVID-19 on university students' mental health beyond the pandemic is lacking. This study aims to address the gap in the literature by tracking the mental health of university students over a two-year period, spanning the COVID-19 pandemic and its aftermath. A two-year longitudinal study surveyed a sample of university students (n = 302) three times between May 2020 and May 2022. Students' psychological distress, generalised anxiety, flourishing, and personal wellbeing were assessed at each time point. It was found that students' psychological distress levels spiked in May 2021 (T1) during the first year of the pandemic but reverted back to similar levels seen in May 2020 (T0) at the two-year follow-up (T2). While generalised anxiety gradually improved, both students' psychological distress and generalised anxiety remained considerably worse than pre-pandemic norms obtained in other studies. Students' flourishing scores remained very low, while their life satisfaction and state happiness improved slightly between May 2021 (T1) and May 2022 (T2). These findings clearly demonstrate that students' mental health is still in crisis, even after the COVID-19 pandemic. More needs to be done to support students beyond the pandemic generally, including this particularly unique cohort of students who endured unprecedented challenges for prolonged periods, and who are now transitioning into the working world. Practical implications and recommendations are discussed.

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

BACKGROUND

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

AIMS

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Sociodemographic, economic, and academic factors linked with resilience in university students during covid-19 pandemic: a Brazilian cross-sectional study

BACKGROUND

Resilience is a crucial factor in students' mental health, playing an important role in their successful adaptation to the academic environment. However, there is a lack of understanding about resilience and its associated factors in students from different undergraduate courses. This study aimed to describe the resilience profile of undergraduate students from various courses in Brazil and identify sociodemographic, economic, and academic factors associated with resilience.

METHODS

This study has data from a cross-sectional multicenter study involving undergraduate students from eight Federal Institutions of Higher Education in Minas Gerais, Brazil. The dependent variable was resilience, measured using the Connor-Davidson Resilience Scale (CD-RISC) 10-item version, with sociodemographic, economic, and academic factors considered independent variables. Data was collected virtually via a self-administered questionnaire between October 2021 and February 2022 (during the covid-19 pandemic). Independent samples t-tests and ANOVAs were conducted to compare resilience scores between independent variables, and Tukey's post-hoc test was performed when necessary. Multiple linear regression was performed to create three models.

RESULTS

8,650 undergraduate students were included in this study. The average score on the resilience scale was 19.86 ± 8.15, with a normal distribution. The respondents ranged from 18 to 71 years old, averaging 23.9 ± 6.33. Being female, not having a religious belief, having low per capita family income, having had a decrease in the family income, not being heterosexual, or having the head of the family with a low education level were the main factors associated, individually, with low resilience scores in the sociodemographic and economic multiple linear regression model constructed. Being from linguistics, letters and arts courses, being enrolled in fewer subjects, or being from UFMG were the main factors associated, individually, with low resilience scores in the academic multiple linear regression model constructed.

CONCLUSIONS

The study's findings revealed that sociodemographic, economic, and academic variables were significantly associated with resilience scores in undergraduates from Minas Gerais during the covid-19 pandemic. These findings can help universities develop target strategies to promote students' resilience and reduce the risk of poor mental health among this population.

Innovating Social-Emotional Learning to Enhance Positive Engagement of Youth With Social Media: A Comprehensive Review of Why and How

The rising mental health burden among youth, exacerbated by excessive social media use and other risks associated with digital engagement, necessitates urgent and innovative preventive solutions. The existing research supports the notion that smartphones and social media significantly impact youth mental health, advocating for age restrictions to mitigate worsening psychological distress in the young.This comprehensive narrative literature review synthesizes research on the dual role of social media in shaping well-being among youth and explores how social-emotional learning (SEL) programs can be adapted to encourage a healthy relationship with digital platforms. Innovating SEL programs by incorporating educational techniques such as Problem-Based Learning, Inquiry-Based Learning, and Project-Based Learning inculcates real-world problem-solving and holds significant promise for fostering self-realization and self-regulation among the youth. By inculcating skills related to mindful technology use within SEL programs, students can learn to navigate social media and other technology related risk factors in a way that supports their mental health and overall well-being. The goal is to empower students to make informed decisions about technology and social media use, understand its effects on their mood and mental state, and practice techniques that contribute to a healthier, more balanced digital life. This holistic approach not only mitigates the risks associated with digital overuse but also leverages technology as a tool for enhancing personal and social development. Well-designed, innovative programs backed by thorough feasibility studies can help cultivate a generation of emotionally intelligent, resilient, and adaptive learners who can thrive in an increasingly complex digital landscape. Future research should focus on longitudinal studies to assess the long-term effects of these SEL innovations and develop scalable models that can be implemented across various educational settings.

Depressive Symptoms Among Higher Education Students in Germany-A Systematic Review and Meta-Analysis

Objectives

Higher education students in Germany are vulnerable to depressive symptoms. Despite ample evidence, no comprehensive review has recently been conducted. Thus, our systematic review and meta-analysis aims at describing the extent to which students are affected by depressive symptoms.

Methods

We searched three databases for articles reporting the prevalence rates of depressiveness among students in Germany published between 2002 and 2023. Pooled prevalence rates were calculated using random effects models, both for the overall sample and for subgroups categorized by gender, study setting, assessment instrument, and whether the study was conducted before or during the COVID-19 pandemic.

Results

The search yielded 992 records. After screening, 60 articles remained for data extraction. About one out of five students (21.1%) exhibits depressive symptoms. Pooled prevalence rates differ between subgroups, with higher rates during the COVID-19 pandemic than before (30.6% versus 18.0%) and with females being more affected than their male counterparts (29.0% versus 23.1%).

Conclusion

This review underlines the urgency with which the mental health of students should be addressed at the (higher educational) policy level.

Clinical Trial Registration: PROPSPERO, Identifier CRD42022384066.

COVID-19-Related Stressors and Psychophysical Health Conditions among Italian University Students: A Post Pandemic Insight

The COVID-19 medical emergency has ended worldwide, yet the psychological impact of these years of unprecedented changes on students' lives still needs to be deepened.

METHODS

This study aims to assess and compare COVID-19-related stressors (relationships and academic life; isolation; and fear of contagion) and psychophysical symptoms reported by 637 university students at three times, i.e., April 2020 (n = 197), April 2021 (n = 200), and April 2022 (n = 240). The impact of COVID-19-related stressors on psychophysical symptoms within each time was also tested.

RESULTS

In April 2022, perceived isolation and fear of contagion decreased from the peak registered in April 2021, but stress related to relationships and academic life remained high. An ongoing increase in psychophysical symptoms was found. More than 50% of students reported clinical levels of sleep disorders, depression, psychoticism, and interpersonal sensitivity. In April 2022, students still perceiving stress related to relationships and academic life and isolation were at risk for anxiety, somatization, and sleep disorders. Students still perceiving stress related to fear of contagion were also at risk for depression, obsessive-compulsive symptoms, and psychoticism.

CONCLUSION

The findings emphasized the long-lasting effects of COVID-19-related stress on students' psychophysical health. Interventions must aim at supporting students in dealing with the complex post-pandemic adjustment process.

Long-term effects of combined mindfulness intervention and app intervention compared to single interventions during the COVID-19 pandemic: a randomized controlled trial

Objectives

The study examines the short-, middle-, and long-term effects of a combined intervention (face-to-face mindfulness intervention plus the mindfulness app 7Mind), compared to single interventions (face-to-face mindfulness intervention alone and an intervention via app 7Mind alone). The subgroups were compared with an active control group on mindfulness, mindful characteristics, mental health, emotion regulation, and attentional abilities during the COVID-19 pandemic. Additionally, the study explores whether students' engagement with the app and their formal mindfulness practice at home improves intervention outcomes.

Methods

The study employs a randomized controlled trial approach involving three intervention groups and an active control group, with two follow-ups conducted over 12 months. The study included 177 university students who were randomly assigned to a mindfulness group (n = 42), a mindfulness app group (7Mind app, n = 44), a mindfulness + app group (n = 45), and an active control group (n = 46). The duration of the interventions was 4 weeks. The outcome variables were assessed at pre- and post-intervention, at 4 and 12 months post-intervention.

Results

At post-intervention and during both follow-ups, students in the combined mindfulness intervention did not demonstrate better outcomes compared to students in the single interventions or the active control group across all measures. Additionally, no statistically significant difference was observed between all interventions and the active control groups on any of the measures. However, it is noteworthy that all intervention groups and the active control group exhibited improvement in mindfulness, body awareness, emotion regulation, stress, and attentional abilities over the short, medium, and long term. Moreover, higher app usage in the app groups was significantly associated with increased body awareness. However, greater app use was also correlated with higher stress.

Conclusion

The results suggest that the mindfulness intervention and the mindfulness app were similar to the active control condition (communication training) on the investigated variables in the short, medium, and long term. Furthermore, an increased use of a mindfulness app can negatively affect stress.

Nursing students' emotions, educational concerns, and the impact of study careers and professional futures during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

COVID-19 is a challenge to education systems worldwide. The aim of the study was to explore the impact of COVID-19-pandemic-related emotions and COVID-19-related concern for education on the study careers and professional futures of nursing students.

METHODS

The study was completed between March and June 2023 using a multi-stage sampling design. A total of 1126 nursing students were recruited to complete the questionnaire. The self-administered questionnaire consisted of basic characteristics of the subjects, the COVID-19-pandemic-related emotions scale, the COVID-19-related concern for education scale, and the impact of the COVID-19 on study careers and professional futures scale (SCPFI-19 S). One-way ANOVA/t-test, correlation coefficient analysis, and hierarchical linear regression analysis were used to explore factors influencing changes in study careers and professional futures, and the relationship between COVID-19-pandemic-related emotions and COVID-19-related concern for education.

RESULTS

Univariate analysis of variance indicated that residence, willingness, and whether to engage in nursing after graduation were related to SCPFI-19 S (P < 0.05). COVID-19-pandemic-related emotions and COVID-19-related concern for education were significantly and positively associated with SCPFI-19 S (r = 0.566, P < 0.01; r = 0.199, P < 0.01). Stratified multiple regression analysis showed that COVID-19-pandemic-related emotions and COVID-19-related concern for education of nursing students were significant predictors of SCPFI-19 S.

CONCLUSION

Overall, both COVID-19-pandemic-related emotions and COVID-19-related concern for education were significantly correlated with SCPFI-19 S. In future interventions, schools should consider structures and strategies to support students' mental health and educational trajectories during current and future epidemics or similar crises.

International and domestic university students' mental health over the course of the COVID-19 pandemic in Germany: Comparison between 2020, 2021, and 2022

BACKGROUND

The COVID-19 pandemic affected university students' mental health worldwide. International students were presenting high levels of stress, anxiety, and depressive symptoms before the pandemic. This study aimed to investigate (i) differences between various timepoints of the COVID-19 pandemic (2020, 2021, and 2022) in mental health outcomes and social and emotional aspects in domestic and international students, separately, (ii) differences between international and domestic students between the three timepoints on mental health outcomes and social and emotional aspects, and (iii) possible moderation effects of timepoints on mental health outcomes and social and emotional aspects of domestic and international students.

MATERIAL AND METHODS

Data from three cross-sectional anonymous online surveys conducted in German universities were analyzed and compared. Data were collected in 2020, 2021, and 2022, respectively, with a total N = 14,498. Depressive symptoms, hazardous alcohol use, social support, self-efficacy, resilience, perceived stress, and loneliness were assessed through standardized self-report instruments. Differences between domestic and international students in mental health outcomes, and social and emotional aspects across three timepoints were assessed with one-way and two-way ANCOVAs.

RESULTS

Regardless of the timepoint, international students presented more depressive symptoms and perceived stress, lower perceived social support and resilience, but higher levels of self-efficacy and less alcohol consumption compared to domestic students. A significant interaction effect between timepoint and student status emerged only for loneliness.

CONCLUSIONS

International students generally presented poorer mental health outcomes than domestic students. Mental health care and prevention such as low-threshold, online counseling should address university students, especially international students.

The crisis is over, long live the crisis: mental health in emerging adulthood during the course of the COVID-19 pandemic

Introduction

As a multidimensional stressor, the COVID-19 pandemic posed a significant threat to mental health, with studies showing younger age groups to be particularly vulnerable. Thus, this study aimed to monitor mental health, potential risk/protective factors, and pandemic-related variables among young university students during the pandemic.

Methods

Students of the University of Greifswald (M age = 23.0 years, 73.9% female) participated in five cross-sectional online surveys in December 2020 (N = 1,127), March 2021 (N = 760), June/July 2021 (N = 531), December 2021 (N = 1,226), and December 2022 (N = 814). Sociodemographic data, depression and anxiety severity, loneliness, quality of life, coping strategies, resilience, self-esteem, and emotion regulation were measured. First, results from December 2020 were compared to pre-pandemic normative data. Second, the time course during the pandemic was analyzed. Third, linear models were calculated to examine the influence of risk and protective factures on depression and anxiety severity.

Results

Higher levels of depression, anxiety, and loneliness, as well as lower levels of self-esteem, physical and mental health, social relationships and well-being were found in December 2020 compared to pre-pandemic. Levels of depression and anxiety severity peaked in December 2022. Female sex, loneliness, and previous mental treatment showed associations with higher depression and anxiety severity, while higher self-esteem, resilience and use of reappraisal strategies appeared to act as protective factors.

Discussion

The study indicates the pandemic's detrimental impact on students' mental health and quality of life. Identified risk and protective factors provide guidance for tailored prevention and treatment, as well as the design of measures for future pandemics and other crisis.

Differences in Help-Seeking Behavior among University Students during the COVID-19 Pandemic Depending on Mental Health Status: Results from a Cross-Sectional Survey

BACKGROUND

Current evidence suggests that a significant proportion of university students are affected by mental disorders and suicidal ideation. Despite this, a treatment gap exists. Therefore, the present study assessed students' knowledge and past use of on- and off-campus mental health services and help-seeking intentions. Furthermore, resilience was investigated as a potential barrier to help-seeking behavior.

METHODS

Data were collected between April and May 2022 from N = 5510 students from Saxony, Germany. To compare dependent variables, subgroups were computed according to students' mental health status. Variables were assessed using standardized questionnaires. Chi-square tests were used for comparisons between groups. Multiple regression models were used to investigate the influence of resilience on help-seeking behavior.

RESULTS

Between 34 and 38% (depending on the subgroup) of participants indicated that they were not aware of their universities' psychosocial counseling services. Furthermore, between 17 and 19% of participants indicated that they were not willing to seek help from professional mental health services. Finally, the previously found negative effect of resilience on help-seeking behavior was confirmed.

CONCLUSION

The results showed a lack of awareness regarding universities' mental health services and a treatment gap among university students. Universities and healthcare providers need to educate students about mental health services and how to access them. Further research is needed to elucidate the differential impact of resilience on mental health and help-seeking.

Psychological impact of COVID-19 and determinants among Spanish university students

Background

University students are a vulnerable population and faced a significant psychological impact from the COVID-19 pandemic. Therefore, this study aimed to determine the level of fear of COVID-19 among university students and to evaluate the possible relationship between fear of COVID-19 and socio-demographic, health-related determinants, variables related to the COVID-19 and variables related to the psychological impact of the COVID-19 pandemic.

Methods

We conducted a cross-sectional study between December 2020 and December 2021 on a sample of 950 university students from two universities in southern Spain. Participants completed a form that collected socio-demographic, health-related and COVID-related variables, a validated questionnaire related to the psychological impact of the COVID-19 pandemic and the fear of COVID Scale (FCV-19S). Descriptive, inferential, and multivariable linear regression analyzes were conducted.

Results

The mean FCV-19S score was 14.86 ± 5.16 points. The factors identified as predictors of FCV-19S were being female (p < 0.001), holding religious beliefs (p = 0.04), living in towns with over 10,000 inhabitants (p < 0.01), living with someone vulnerable to COVID-19 (p = 0.02), watching TV to keep informed about COVID-19 (p < 0.01), believing in a low probability of surviving if infected with COVID-19 (p < 0.001), having a higher level of death anxiety (p < 0.001) and suffering from insomnia (p < 0.001).

Conclusion

An average fear of COVID-19 score of 14.86 ± 5.16 points has been found among university students in Spain. These findings can aid in identifying specific factors contributing to fear of COVID-19 and in developing coping strategies to alleviate the stress of the pandemic.

The impact of social connectedness on mental health in LGBTQ + identifying individuals during the COVID-19 pandemic in Germany

BACKGROUND

Recent studies report that LGBTQ + people have experienced high levels of mental health problems during COVID-19-related social distancing. Given the well-established association between social isolation and mental health, the main aim of the current study was to investigate differences in mental health and (perceived) social isolation and social support in LGBTQ + individuals compared to heterosexual, cisgender people and to explore whether the hypothesized higher mental health burden in LGBTQ + individuals is (partly) mediated by (perceived) social isolation or social support.

METHODS

N = 531 participants indicating belonging to the LGBTQ + community and N = 1826 not identifying as LGBTQ + participated in a cross-sectional online survey during the initial COVID-19-related lockdown in Germany. Standardized questionnaires were used to assess depression, anxiety, suicidality, loneliness and social support. Further, perceived social isolation and face-to-face communication during the lockdown were assessed.

RESULTS

LGBTQ + people had higher levels of depression, anxiety and suicidal thought, were lonelier and experienced less social support than non-LGBTQ + identifying individuals. Mediation analysis showed that the higher levels of mental health burden in LGBTQ + people were (partly) mediated by reduced social connectedness. Further face-to-face contact positively affected mental health by reducing feelings of loneliness.

CONCLUSION

Given the high impact of loneliness on mental health, governmental actions should be taken to promote social connectedness particularly among LGBTQ + identifying individuals to ensure that the COVID-19 pandemic does not exacerbate the health inequalities that already exist between LGBTQ+-identifying and heterosexual, cisgender people.