COVID-19: A Source of Stress and Depression Among University Students and Poor Academic Performance

A quasiexperimental study of assessing the impact of stress management program on health science students at Kuwait University

The purpose of this research was to study the effectiveness of a stress management program among students at the Health Science Center (HSC), Kuwait University. This study utilized a quasiexperimental research design in which the participants were randomly assigned to one of two groups: (1) the control group or (2) the experimental (intervention) group. The participants received a comprehensive educational seminar relevant to stress management (i.e., a presentation, written hand-outs and a structured home program). The program addressed nine topics pertaining to stress management strategies: breathing and imagery techniques; self-care routines; planning for success; meditation strategies; monitoring mechanisms for coping; seeking help for mental health, exercise and health; cognitive behavioral therapy tips (CBTs); and psychoeducation. The demographic data along with using two validated tools were collected through online google form; the validated tools were: (1) the Perceived Stress Scale and (2) the Depression, Anxiety, and Stress Scale-21. Nonparametric tests, including Wilcoxon signed-rank tests and Kruskal‒Wallis tests, were used to investigate statistically significant differences between the median scores of the control and intervention groups (p values < 0.05). Ninety-eight participants participated in the stress management program (56 participants in the intervention group and 42 in the control group). There was a significant improvement in stress and depression in the intervention group compared with the control group (p values < 0.05). With respect to the value of the stress management program, additional online postintervention survey questions were filled out by the intervention group; 82.1% (n = 46) of the intervention group agreed that the stress management program was useful, and 89.3% (n = 50) agreed that they would recommend that other students utilize this program regularly in the future. In conclusion, in this study, we developed, implemented, and evaluated the effects of a stress management program among HSC students. The program improved HSC students' mental health while reducing their depression and stress levels. Most importantly, the study findings presented here were feasible and could provide important information that can be applied to future studies and used as invaluable mental health resources for students at different university programs. Thus, future studies with larger representative samples and true randomized controlled trials are needed to consolidate our findings concerning the value of such scientifically driven and culturally relevant stress management program.

Psychological stress and depression symptoms in nursing undergraduates: the chain mediating effect of cognitive reappraisal and ruminate thinking

BACKGROUND

Nursing students exhibit a higher incidence of mental disorders. Studies have identified psychological stress contributes to elevated depression symptoms through reappraisal cognitive in nursing students. However, there is little research exploring the knowledge regarding the role of ruminative thinking in mediating the associations between psychological stress and depression symptoms. Guiding by the non-hemostatic model and cognitive control theory, the study aims to investigate the chained mediation of cognitive reappraisal and ruminate thinking between psychological stress and depression symptoms among nursing undergraduates.

METHODS

A total of 1,220 nursing undergraduates were carried out by stratified sampling from July to December of 2023 via online survey. The investigation adopted the Perceived Stress Scale (PSS-10), Emotion Regulation Questionnaire (ERQ), Ruminative Response Scale (RRS), and the Center for Epidemiologic Studies Depression Scale (CES-D) to measure the level of psychological stress, cognitive reappraisal, ruminative thinking and depression symptoms, respectively. Pearson's r was utilized to investigate the interrelationships, and the structural equation model (SEM) was used to clarify the mediation effects among the four variables.

RESULTS

The mean total score of CES-D was 21.57 ± 10.79. SEM analysis proved that psychological stress had a direct positive effect on depression symptoms (β = 0.388). accounting for a substantial 51.52% of the total effect. Cognitive reappraisal and ruminate thinking partially mediated the association between psychological stress and depression symptoms (95% CI: 0.094-0.210), and the mediating effect accounted for 48.48% of the total effect.

CONCLUSIONS

Nursing students exhibited a high prevalence of depression, and cognitive reappraisal and ruminate thinking partially mediated the correlations between psychological stress and depression symptoms. Interventions targeting at consolidating cognitive reappraisal and ruminate thinking are imperative for improving depression.

Mental health and sleep in the post-COVID-19 era among Thai undergraduate students

The purpose of this study was to examine mental health problems and sleep quality among undergraduate students in the post-COVID-19 era, as well as related factors. This cross-sectional study involved 627 undergraduate students from Chiang Mai University in northern Thailand between October and December 2022. Data were collected using a self-administered online questionnaire that included the General Health Questionnaire-12 (GHQ-12), the Center for Epidemiologic Studies-Depression Scale (CES-D), and the Pittsburgh Sleep Quality Index (PSQI). The study found that 57.9% of participants experienced mental health problems (95% CI: 54.0-61.8), 32.2% experienced depression (95% CI: 28.5-35.9), and 68.1% reported poor sleep quality (95% CI: 64.4-71.8). Multiple logistic regression analysis revealed that medical conditions, relationships with family members, relationships with friends or other people, having problems while studying at university, and self-perceived COVID-19 impact score were all associated with mental health problems and poor sleep quality (p < 0.05). Depression was associated with the field of study, relationships with family members, relationships with friends or other people, having problems while studying at university, and self-perceived COVID-19 impact score (p < 0.05). The findings highlight a significant occurrence of poor sleep and mental health issues, including depression, among undergraduate students in the post-COVID-19 era, underscoring the need for ongoing mental health monitoring and interventions to mitigate negative outcomes.

Physical activity and depressive symptoms during the fifth wave of COVID-19 pandemic: Implication for public policy and administrators

Depression is a public mental health problem that can progress to suicidal ideation, literature suggests regular physical activity may ameliorate it. The study assessed the link between physical activity and depression symptoms during the fifth wave of the COVID-19 pandemic and the Academic Staff Union (ASU) strike among undergraduates. Four hundred and eighteen undergraduates were recruited and participated in the study. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Patient Health Questionnaire-9 (PHQ-9) to measure depression severity. The result on PA showed that about one-third of the participants were inactive, above half were moderately active, while a few achieved high PA levels. Above one-fifth of the participants experienced minimal or no depression while a good percent had mild, moderate, moderately severe, and severe depression. Non-parametric tests between PA total score and depression total score with demographic variables were not significant. Spearman's correlation showed a strong negative relationship between PHQ-9 scores and IPAQ-SF scores. This suggests that a high PA level is associated with lower depression symptoms. The COVID-19 pandemic and the ASU strike experiences resulted in increased depression among undergraduates. The university administration needs to formulate an urgent policy to promote PA among undergraduates and provide treatment for the affected students.

Prevalence and correlates of depressive symptoms among matriculated university students in Singapore during Covid-19 pandemic: findings from a repeated cross-sectional analysis

BACKGROUND

Depression is a common issue among university students and has been particularly exacerbated during the COVID-19 pandemic. However, limited research has specifically focused on depression among university entrants.

OBJECTIVES

This study aimed to determine the prevalence of depression severity and identify associated factors during different phases of the COVID-19 pandemic using health screening questionnaires completed by matriculated university students in Singapore.

METHODS

A repeated cross-sectional study was conducted at a public university in Singapore. Data from health screening questionnaires administered in 2020 and 2021, involving 15,630 newly enrolled university students, were analyzed. The questionnaires covered students' sociodemographic information, physical health status, own and family medical history, lifestyle behaviours, and the Patient Health Questionnaire (PHQ-9). The PHQ-9 was used to measure the severity of depressive symptoms, categorizing into moderate to severe depressive symptoms (MSDS), mild depressive symptoms (MDS), or no depressive symptom (NDS). Multinomial logistic regression was used to assess the sociodemographic, physical and behavioural correlates of depression.

RESULTS

The prevalence of MSDS was 1% in both 2020 and 2021, while the rates for MDS were 1.93% in 2020 and 1.64% in 2021. In the 2020 cohort, male freshmen who reported better health had a lower likelihood of experiencing depression. Conversely, students of Malay ethnicity, those majoring in Engineering, those with multiple chronic diseases, monthly alcohol consumers, current smokers, and those with a family history of mental disorder had a higher likelihood of experiencing depression. Moreover, students who lived on-campus in the 2021 cohort were less likely to experience depression than those living off-campus. However, the associations between academic majors, alcohol consumption, and smoking with depression were not significant in the 2021 cohort.

CONCLUSIONS

This study reported a low prevalence of both MSDS and MDS among university entrants in Singapore. The study further identified three categories of factors associated with depression: sociodemographic, physical, and behavioural. This study suggests policy interventions to enhance targeted social support that address each student group's specific requirements and susceptibilities. A more extensive and comprehensive study is warranted to assess the changes in student mental health status post-COVID-19 pandemic.

Effects of the COVID-19 Pandemic on University Students' Mental Health: A Literature Review

This review aims to focus on the effects of COVID-19 on university students' mental health and deepen our understanding of it. The conclusions are based on the review of 32 studies conducted during the pandemic. This review confirms that university students were at high risk for mental health disorders, heightened stress, and increased sleep comorbidities both pre-pandemic and during the pandemic. This literature review confirmed a few universal trends, i.e., increased stress, anxiety, and depression, during the pandemic. The rates of insomnia, obsessive-compulsive disorder, and suicidal ideation also went up. Overall, female students are at a disadvantage in the development of mental health issues. Male students coped better but may be at higher risk for lethality in suicidal ideation. Students with a history of mental health issues and other comorbidities prior to the pandemic had worse outcomes compared to healthy individuals. The study points to a strong positive correlation between fear and increased rates of stress, anxiety, and insomnia. There is also a positive correlation between declining mental health and online learning. A strong negative correlation was present between physical activity and depressive symptoms. These findings are universal across many countries and regions where the studies occurred.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

The positive effects of positive coping on mental health in college students during the COVID-19 campus lockdown

Objectives

Isolation has been an effective method to control the spread of COVID-19 over the past 3 years. However, lifestyle changes may have a negative impact on mental health. To examine the effects of positive coping on mental health in college students during the COVID-19 campus lockdown, this study conducted an online cross-sectional survey.

Methods

In October 2022, following a prolonged campus lockdown of nearly 3 years, 313 university students from a university in Shandong Province, China, were invited to complete an online questionnaire. The questionnaire comprised a self-administered general situation questionnaire, the Simple Coping Style Scale, and the Hospital Depression and Anxiety Scale.

Results

(1) The analysis of variance revealed a significant main effect of coping Style on depression [F(4,300) = 2.446, p = 0.047] during the COVID-19 campus lockdown. A post-hoc test indicated that college students who engaged in study (p = 0.012) or sports (p = 0.027) during their free time had significantly lower depression scores than those who used the Internet. (2) Independent sample t-tests showed significant differences in positive and negative coping styles among college students in terms of depression (t = 6.891, p < 0.001) and anxiety scores (t = 7.745, p < 0.001). (3) Pearson correlation analysis demonstrated a negative correlation between positive coping style and anxiety (r = -0.378, p < 0.001), and between positive coping style and depression (r = 0.427, p < 0.001). Positive correlations were also found between the negative coping style and anxiety (r = 0.155, p = 0.007), and between the negative coping style and depression (r = 0.190, p < 0.001).

Discussion

The study suggested that fostering positive coping in students can mitigate mental health issues during crises, providing a blueprint for university mental health initiatives during epidemics.