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Liu Y, Ren Y, Liu C, Chen X, Li D, Peng J, Tan L, Ma Q. Global burden of mental disorders in children and adolescents before and during the COVID-19 pandemic: evidence from the Global Burden of Disease Study 2021. Psychol Med 2025; 55:e90. [PMID: 40098477 PMCID: PMC12080646 DOI: 10.1017/s0033291725000649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 02/15/2025] [Accepted: 02/24/2025] [Indexed: 03/19/2025]
Abstract
BACKGROUND Childhood and adolescence are vulnerable periods for mental disorders, and the COVID-19 pandemic has exacerbated mental health challenges in this population. We aimed to estimate changes in the global burden of mental disorders among children and adolescents before and during the pandemic. METHODS Using data from the Global Burden of Diseases Study 2021, we analyzed incidence, prevalence, and years lived with disability (YLDs) for mental disorders in individuals aged 5-24. Annual percent changes in age-standardized rates were calculated, and a Bayesian age-period-cohort model estimated the expected and additional burden based on pre-pandemic trends. RESULTS In 2021, an estimated 123.0 million new cases of mental disorders were reported among children and adolescents, with an 11.8% average annual increase in the age-standardized incidence rate during the pandemic. Anxiety disorders, which previously ranked third, became the leading cause of nonfatal disability (12.9 million [8.0-19.3] YLDs), while depressive disorders rose to fourth place (10.9 million [6.8-16.5] YLDs). The burden grew in most regions, especially among females, those aged 15-24, and in high sociodemographic index (SDI) areas. Based on pre-pandemic data, we estimated an additional burden of 795.0, 165.9, and 622.8 new cases per 100,000 population for total mental disorders, anxiety disorders, and depressive disorders globally in 2021, respectively. Spearman correlation analysis showed a significant positive correlation between additional burden and SDI levels. CONCLUSIONS These findings highlight the increased burden of mental disorders among children and adolescents during the pandemic, emphasizing the need for targeted post-pandemic mental health support.
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Affiliation(s)
- Yubo Liu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Yijun Ren
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Chenxi Liu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoli Chen
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Danlei Li
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Jia Peng
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Liao Tan
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Qilin Ma
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
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Meneo D, Curati S, Russo PM, Martoni M, Gelfo F, Baglioni C. A Comprehensive Assessment of Bedtime Routines and Strategies to Aid Sleep Onset in College Students: A Web-Based Survey. Clocks Sleep 2024; 6:468-487. [PMID: 39311226 PMCID: PMC11417809 DOI: 10.3390/clockssleep6030031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 08/06/2024] [Accepted: 08/25/2024] [Indexed: 09/26/2024] Open
Abstract
College students often experience sleep-wake alterations. Different factors can contribute to insomnia symptoms in this population. The present study aims at investigating pre-sleep behaviours and strategies used to aid sleep onset in young college students and their association with insomnia symptoms. A total of 548 Italian college students (mean age = 23.48 years, range = 19-30 years, 80.5% female) completed a web-based survey on pre-sleep behaviours and sleep-onset facilitators, insomnia symptoms and sleep hygiene, anxiety and depression, and coping strategies. The use of electronic devices at bedtime and as a sleep-onset facilitator was predominant. Students using specific behaviours as sleep-onset facilitators were characterised by more psychological difficulties and poorer sleep. In multivariable linear regression analysis, the frequency of using medications and melatonin, regardless of motivations, was associated with higher insomnia symptoms. The use of specific sleep-onset facilitators positively correlated with the severity of insomnia symptoms. Many students engage in behaviours that are considered sleep-interfering and that are often employed in an attempt to facilitate sleep onset without benefits. Overall, the motivational factors behind pre-sleep behaviours need to be addressed in preventive programs targeting young college students.
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Affiliation(s)
- Debora Meneo
- Department of Human Sciences, Guglielmo Marconi University, Via Plinio, 44, 00193 Rome, Italy; (D.M.)
| | - Sara Curati
- Department of Human Sciences, Guglielmo Marconi University, Via Plinio, 44, 00193 Rome, Italy; (D.M.)
| | - Paolo Maria Russo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Monica Martoni
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Francesca Gelfo
- Department of Human Sciences, Guglielmo Marconi University, Via Plinio, 44, 00193 Rome, Italy; (D.M.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Chiara Baglioni
- Department of Human Sciences, Guglielmo Marconi University, Via Plinio, 44, 00193 Rome, Italy; (D.M.)
- Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany
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Negash S, Horn J, Heumann E, Stock C, Zeeb H, Pischke CR, Matos Fialho PM, Helmer SM, Niephaus Y, Mikolajczyk R. University Students' Financial Situation During COVID-19 and Anxiety and Depressive Symptoms: Results of the COVID-19 German Student Well-Being Study (C19 GSWS). Psychol Res Behav Manag 2024; 17:2271-2285. [PMID: 38860194 PMCID: PMC11162964 DOI: 10.2147/prbm.s453694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/17/2024] [Indexed: 06/12/2024] Open
Abstract
Background The COVID-19 pandemic has had a major impact on students' financial situation as well as on their mental health. Aim To examine the reported change in the financial situation of German university students before and across two time points of the COVID-19 pandemic and to evaluate its associations with anxiety and depressive symptoms. Methods We used data from the cross-sectional COVID-19 German Student Well-being Study conducted at five German universities (N = 7203). Linear regression models were used to analyze associations between a reported change in financial situation and anxiety and depressive symptoms. Results Twenty-eight percent of the participants reported to have a worsened financial situation at the time of the survey compared to the time prior to the pandemic. A worsened financial situation at the time of the survey as compared to prior to the pandemic was associated with higher levels of anxiety and depressive symptoms reported in all three depression and anxiety scales [a 1.46 point increase on the CES-D 8 scale (95% confidence interval (CI): 1.19; 1.73), a 0.37-point increase in PHQ-2 (95% CI: 0.28; 0.46), and a 0.45-point increase in GAD-2 (95% CI: 0.35; 0.55)]. An improved financial situation, on the other hand, was associated with lower levels of anxiety and depressive symptoms. As for the second change, comparing the current financial situation with the situation during the first wave of the pandemic, the associations with anxiety and depressive symptoms were broadly similar. Conclusion Our findings suggest that students are a vulnerable population in need of mental and financial support during times of crisis. Future research is needed to obtain insights into potential long-term effects of the pandemic on students' mental health.
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Affiliation(s)
- Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Eileen Heumann
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Christiane Stock
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Paula M Matos Fialho
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Stefanie M Helmer
- Institute of Public Health and Nursing Research, Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Yasemin Niephaus
- Department of Social Sciences, University of Siegen, Siegen, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Laranjeira C, Querido A, Sousa P, Dixe MA. Assessment and Psychometric Properties of the 21-Item Depression Anxiety Stress Scale (DASS-21) among Portuguese Higher Education Students during the COVID-19 Pandemic. Eur J Investig Health Psychol Educ 2023; 13:2546-2560. [PMID: 37998067 PMCID: PMC10670895 DOI: 10.3390/ejihpe13110177] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/20/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
The COVID-19 pandemic has caused substantial disruptions in the lives of higher education students, with detrimental repercussions for academic performance and overall mental health. Therefore, we aimed to evaluate the prevalence of depression, anxiety, and stress symptoms among Portuguese higher education students during the first wave of the coronavirus pandemic and investigate DASS-21's psychometric characteristics and whether it functions effectively during a pandemic. A convenience sampling procedure was used to recruit 1522 participants (75.1% women and 79.2% undergraduate students) for this cross-sectional research. Participants completed an e-survey created using DASS-21. The results revealed a considerable prevalence of symptoms of depression [≥10] (N = 434, 28.5%), anxiety [≥7] (N = 551, 36.2%), and stress [≥11] (N = 544, 35.7%). Confirmatory factor analysis (CFA) revealed the scale's three-factor structure, which matched the three DASS-21 subscales. Subsequently, the heterotrait-monotrait (HTMT) correlation ratio evaluated the scale's discriminant validity, which was relatively good. Cronbach's alpha measured the internal consistency of the DASS subscales, which was excellent (Cronbach's α > 0.90). DASS-21 was shown to be a reliable and appropriate measure for assessing students' mental health. Furthermore, DASS-21 is recommended for use by academics and healthcare professionals in measuring students' psychological distress. Further validation studies of this scale are needed with larger and more representative samples.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (A.Q.); (M.A.D.)
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André—66–68, Campus 5, Polytechnic University of Leiria, 2410-541 Leiria, Portugal;
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Ana Querido
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (A.Q.); (M.A.D.)
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André—66–68, Campus 5, Polytechnic University of Leiria, 2410-541 Leiria, Portugal;
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal
| | - Pedro Sousa
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André—66–68, Campus 5, Polytechnic University of Leiria, 2410-541 Leiria, Portugal;
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Polo A, Av. Bissaya Barreto, 3004-011 Coimbra, Portugal
| | - Maria Anjos Dixe
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (A.Q.); (M.A.D.)
- Centre for Innovative Care and Health Technology (ciTechCare), Rua de Santo André—66–68, Campus 5, Polytechnic University of Leiria, 2410-541 Leiria, Portugal;
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Ford A, Heidke P, Kurup C, Wirihana L, Kroll J, Calleja P. Factors influencing Australian nursing and midwifery students COVID-19 vaccination intentions. Vaccine X 2023; 14:100352. [PMID: 37519775 PMCID: PMC10372303 DOI: 10.1016/j.jvacx.2023.100352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
Background Vaccination for COVID-19 has become a cornerstone management plan for many countries. Australian state governments made vaccinations mandatory for all healthcare workers. Despite evidence on the important role vaccines hold in preventing or decreasing serious disease, there have been many nurses and midwives who have demonstrated vaccine hesitancy. This hesitancy has also been present in undergraduate nursing and midwifery students. The aim of this study was to explore factors influencing Australian nursing and midwifery students' intentions towards receiving the COVID-19 vaccine; identify the barriers and facilitators to obtaining the COVID-19 vaccine; and understand students' perceptions of mandating the COVID-19 vaccine and identify any impact on their studies.. Methods Cross-sectional mixed method study utilising an online survey platform. Data were analysed using binomial and multinomial logistic regression through Statistical Package for the Social Sciences. A content analysis was completed for the qualitative data. Results There were 715 participants and 556 who completed the survey in full. Nurses made up the majority of participants (n = 409), 133 participants were midwives and 30 were in dual nursing/midwifery programs. Education and communication were identified as two major factors that facilitate vaccine acceptance. Conclusions Vaccines are integral in the prevention of contracting COVID-19 or reducing the severity of the symptoms. However, many nursing and midwifery students have shown reluctance towards getting vaccinated. The mandate to be vaccinated to attend clinical placement has led to the inability of some students to complete their course. The findings from this study are valuable in informing the future COVID-19 vaccination strategies and improving vaccine acceptance. COVID-19 remains a global health risk and therefore further research is needed of vaccine acceptance amongst the future health workforces. It is crucial knowledge for policy makers and healthcare services as they plan for any future pandemics and implement Australia's national vaccine strategy.
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Affiliation(s)
- Abigail Ford
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
| | - Penny Heidke
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
| | - Chanchal Kurup
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
| | - Lisa Wirihana
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
| | - Jeremy Kroll
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
- Motivation of Health Behaviours Lab, Appleton Institute, CQUniversity Psychology Wellness Centre, 554-700 Yaamba Road, Norman Gardens, 4701, Building 32/Lower Ground 32, Australia
| | - Pauline Calleja
- School of Nursing, Midwifery and Social Sciences, CQUniversity Australia, 160 Ann Street, Brisbane, QLD 4000, Australia
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