The Impact of COVID-19 Pandemic on Italian University Students' Mental Health: Changes across the Waves

Resilience of University Students During the Coronavirus Disease 2019 Pandemic and Results of a Pilot Positive Psychotherapy Intervention Study

Objective

University students were significantly affected by the 2019 coronavirus disease pandemic, with significant impacts on their mental health, resilience skills, and life skills. The primary aim of this study was to evaluate these parameters by focusing on the experiences of 472 university students as well as examining correlations between mental states, resilience, and life skills. The secondary aim was to conduct a pilot study of a 10-week psychoeducation program that uses positive psychotherapy to improve resilience skills.

Methods

The first phase of this research project was designed as a quantitative and correlative study, while the second phase was designed as a quasi-experimental model. Data collection tools used in the first phase included the Sociodemographic Information Form, Life Skills Scale (LSS), Symptom Checklist (SCL90R), and Brief Resilience Scale (BRS). The Resilience Scale for Adults (RSA) was used in the second phase. The sample group for the first phase was 472 university students from several university institutes in Cyprus, while the quasi-experimental group consisted of 33 psychology students from the University of Cyprus.

Results

The average mental symptoms score for students based on SCL90R was 1.10 ± 0.70, showing they have psychological symptoms and grievances. Significant negative correlations were found between the BRS general score and the LSS general and SCL90R scores (all P = .001). The model was found to be significant and could explain 18.5% of the effect according to the predictive status of LSS and SCL90R scores in BRS scores.

Conclusion

In conclusion, this study provides vital insights into the mental well-being of university students during the pandemic. The findings reveal a concerning prevalence of psychological symptoms and distress among students, indicating a significant impact of the COVID-19 crisis on their mental health. This research also demonstrated the effectiveness of targeted interventions. The positive changes in resilience skills and reduced mental health symptoms observed after the 10-week study period highlight the importance of proactive approaches. This study underscores the urgent need for accessible mental health resources and tailored support mechanisms for university students, especially during times of crisis. Addressing these issues is crucial for fostering a resilient and mentally healthy student population.

Assessment and Psychometric Properties of the 21-Item Depression Anxiety Stress Scale (DASS-21) among Portuguese Higher Education Students during the COVID-19 Pandemic

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.

Prevalence rate trends of borderline personality disorder symptoms and self-injurious behaviors in college students from 2017 to 2021

The current study examines the prevalence rates of borderline personality disorder (BPD) symptoms and nonsuicidal self-injury (NSSI) behaviors amongst college students over a five-year period, including pre- and during the COVID pandemic. Online prescreener surveys were completed by undergraduate students (n = 12,756) attending a large Southern Plains University every semester from Spring of 2017 to Spring of 2021. The percentage of students with NSSI history and significant BPD symptoms were visualized by semester to examine trends over time. A series of logistic regressions and negative binomial regressions were conducted on NSSI history and BPD symptoms to examine whether the endorsement rates have been increasing over time and to compare before and during COVID pandemic. There was an increasing trend of NSSI rates and significant BPD symptoms over time for all sexes. Furthermore, there was a steeper increase in BPD symptoms specifically in female students over the last five years. Additionally, there was a significant increase in odds of elevated BPD symptoms and NSSI behaviors in the college students enrolled during the COVID pandemic compared with pre-COVID. Overall, there has been an increasing trend in BPD symptoms and NSSI rates over the last few years, including during the COVID pandemic.

Impact of COVID-19 Pandemic on Well-Being, Social Relationships and Academic Performance in a Sample of University Freshmen: A Propensity Score Match Evaluation Pre- and Post-Pandemic

The COVID-19 pandemic has impacted freshmen, compromising their mental health, lifestyles, and academic performance. There are few studies that have investigated changes in the health status and lifestyles of freshmen before and after the pandemic. The aims of this study were: (1) to carry out a pre-post-COVID-19 pandemic comparison between two freshmen samples, in order to detect differences in their socio-demographic characteristics and in some clinical variables; (2) to assess the effect of the COVID-19 pandemic on the social and academic lives of the second sample of freshmen. The samples recruited in 2019 and 2022, matched by propensity score procedure (N = 553), were mostly female (57.3% vs. 55.3%); the mean age was 22.9 and 20.9 years, respectively. The freshmen recruited after the pandemic had less psychological distress and substance use than freshmen recruited before the pandemic. Seventy-eight percent of the freshmen stated that the pandemic had an impact on their social relationships. This effect was greater for females and Italian students. Forty-seven percent reported that the pandemic has worsened their academic performance, while 60% stated that pandemic has improved their grades. The results of this study can provide valuable insights into the impact of the pandemic on freshmen, in order to implement interventions to mitigate the consequences of the pandemic in some subgroups of this target population.

Sociodemographic and educational factors associated with mental health disorders in medical students of clinical years: A multicenter study in Peru

OBJECTIVE

To identify sociodemographic and educational factors associated with mental health disorders in Peruvian medical students in clinical years.

METHODS

Cross-sectional study. We surveyed students from 24 Peruvian medical schools. We defined negative perception of educational environment as having a Dundee Ready Educational Environment Measure score below 100 points; we defined anxiety and depression as having more than 4 points on the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scales, respectively. Poisson regression with robust variance was used to assess the association between negative perception of educational environment and mental health alterations.

RESULTS

Among the 808 participants, the prevalence of anxiety and depression symptoms was 77.6% and 67.3%, respectively. Negative perception of the educational environment was 31.6%. The factors associated with anxiety were being male (PR = 0.95, 95% CI:0.91-0.98), previous medical condition (Prevalence ratios PR = 1.10, 95% CI:1.05-1.16), previous diagnosis of coronavirus disease 2019 (PR = 0.93, 95% CI: 0.93-0.94), being from highlands (PR = 1.11, 95% CI: 1.05-1.16), studying at a national university (PR = 0.90, 95% CI: 0.88-0.92), and negative perception of the educational environment (PR = 1.04, 95% CI: 1.03-1.05), while factors associated with depression were being male (PR = 0.94, 95% CI: 0.93-0.95), previous medical condition (PR = 1.12, 95% CI: 1.08-1.17), type of university (national) (PR = 0.95, 95% CI: 0.95-0.96), and negative perception of the educational environment (PR = 1.11, 95% CI: 1.07-1.16).

CONCLUSION

We found evidence that during the COVID-19 pandemic anxiety and depression are prevalent among Peruvian medical students. Sociodemographic factors and negative perception of educational environment were associated with the presence of these conditions.

The impact of Covid-19 pandemic on modification of medical teaching in Italy: A narrative review

During the first wave of Covid-19 in Italy, there was a problem with University. Universities couldn't do face-to-face (FTF) lessons and started to do online lessons (OL). This study investigates the impressions of students, teachers, and institutions during the first wave situation. A search was conducted on the main international databases, and only studies conducted in Italy starting during the Covid-19 pandemic are considered. 9 studies tell about the impressions of students about OL lessons, and 10 studies speak about medical resident's situation and teacher's impressions. Studies about students give conflicting results, teachers are generally satisfied with the contents, but agree on the difficulty of not having relationships with students. Medical residents have reduced significantly the clinical and surgical practice, sometimes increasing the research. In the future, it is indispensable to create a system that guarantees the efficacy of FTF lessons for practice, it is still low in sanitary and medical courses in Italy during the pandemic period.

Speech Emotion Recognition Using Attention Model

Speech emotion recognition is an important research topic that can help to maintain and improve public health and contribute towards the ongoing progress of healthcare technology. There have been several advancements in the field of speech emotion recognition systems including the use of deep learning models and new acoustic and temporal features. This paper proposes a self-attention-based deep learning model that was created by combining a two-dimensional Convolutional Neural Network (CNN) and a long short-term memory (LSTM) network. This research builds on the existing literature to identify the best-performing features for this task with extensive experiments on different combinations of spectral and rhythmic information. Mel Frequency Cepstral Coefficients (MFCCs) emerged as the best performing features for this task. The experiments were performed on a customised dataset that was developed as a combination of RAVDESS, SAVEE, and TESS datasets. Eight states of emotions (happy, sad, angry, surprise, disgust, calm, fearful, and neutral) were detected. The proposed attention-based deep learning model achieved an average test accuracy rate of 90%, which is a substantial improvement over established models. Hence, this emotion detection model has the potential to improve automated mental health monitoring.

Somatic and psychological distress among Russian university students during the COVID-19 pandemic

OBJECTIVE

Previous studies highlighted a high prevalence of mental health issues among students during the COVID-19 pandemic, but there is no evidence from Russia. This study was aimed to examine the prevalence of somatic and psychological distress among Russian university students.

METHOD

The cross-sectional study was conducted in March-April 2021. The participants were university students from several regions of Russia (N = 1236). The Patient Health Questionnaire-15 and Depression, Anxiety, and Stress Scales-21 were used to measure the somatic and psychological distress.

RESULTS

The prevalence of somatic burden, depression, anxiety, and stress was 72.2%, 54.7%, 63.4%, and 55.4%, respectively. Somatic burden, anxiety, and stress were more frequently observed in females and students with experience of COVID-19 disease compared to males and students without experience of COVID-19 disease.

CONCLUSIONS

These data illuminate the high prevalence and potential risk factors for somatic and psychological distress among Russian university students and determine the importance of psychoeducation and preventive measures in the Russian university environment.

Prevalence and risk factors of self-reported psychotic experiences among high school and college students: A systematic review, meta-analysis, and meta-regression

BACKGROUND

Adolescents are at high risk of incident psychopathology. Fleeting psychotic experiences (PEs) that emerge in young people in response to stress may be warning signs that are missed by research that fails to study stressed populations, such as late high school and college/university students. Our aim in this systematic review was to conduct a meta-analysis that estimates prevalence rates of PEs in students, and to assess whether these rates differ by gender, age, culture, and COVID-19 exposure.

METHOD

We searched nine electronic databases, from their inception until January 31, 2022 for relevant studies. We pooled the estimates using the DerSimonian-Laird technique and random-effects meta-analysis. Our main outcome was the prevalence of self-reported PEs in high school and college/university students. We subsequently analyzed our data by age, gender, population, country, culture, evaluation tool, and COVID-19 exposure.

RESULTS

Out of 486 studies retrieved, a total of 59 independent studies met inclusion criteria reporting 210' 024 students from 21 different countries. Nearly one in four students (23.31%; 95% CI 18.41%-29.05%), reported having experienced PEs (heterogeneity [Q = 22,698.23 (62), p = 0.001] τ²  = 1.4418 [1.0415-2.1391], τ = 1.2007 [1.0205-1.4626], I²  = 99.7%, H = 19.13 [18.59-19.69]). The 95% prediction intervals were 04.01%-68.85%. Subgroup analyses showed that the pooled prevalence differed significantly by population, culture, and COVID-19 exposure.

CONCLUSION

This meta-analysis revealed high prevalence rates of self-reported PEs among teen and young adult students, which may have significance for mental health screening in school settings. An important realization is that PEs may have very different mental health meaning in different cultures.

Understanding the role of stress, personality and coping on learning motivation and mental health in university students during a pandemic

The aims explored the associations between stress, personality and coping on student mental health and compared defensive-pessimism and optimism as influences on learning motivation. Most research construes ‘stress’ as ‘distress’, with little attempt to measure the stress that enhances motivation and wellbeing. Undergraduate psychology students (N = 162) were surveyed on student and pandemic-related stressors, personality, support, control, mental health and learning motivation. Overall, adverse mental health was high and the lack of motivation acute. While positive ratings of teaching and optimistic thinking were associated with good mental health, context control was key. Adverse ratings of teaching quality lowered learning motivation. Support and conscientiousness bolstered learning motivation and conscientiousness buffered against the adverse impact of stress on motivation. Openness was associated with the stress involved in learning. For those anxious-prone, defensive-pessimism was as effective as optimism was in stimulating learning motivation. Developing context control, support and strategies linked to personality could bolster student resilience during and post Covid-19.

The impact of the COVID-19 epidemic on students’ mental health: A cross-sectional study

Background

The COVID-19 pandemic is currently one of the biggest public health threats for people’s mental health. A particularly endangered group were students, who became highly affected by measures of social distance due to their active lifestyle. Therefore, the aim of this paper is to assess the level of self-reported stress, anxiety and depression of the student population in Serbia, in relation to demographic characteristics, living and studying conditions, students’ activities during the epidemic, potential coronavirus infection and general, mental and physical health.

Methods

We conducted a cross-sectional study of 580 undergraduate medical students from the University of Belgrade during the 2020/2021 school year. Mental health data were collected using the Depression Anxiety Stress Scales (DASS-21). Both bivariate and multivariate logistic regression analysis were used to examine the association between independent variables with the dependent variable mental health.

Results

Women made up the majority of the sample with 80.3%. A total of 64.5%, 66.8% and 66.7% of students between the ages of 21 and 30 had severe depressive symptoms, severe degree of anxiety, and a severe degree of stress, respectively. Women almost twice as often (OR = 1.89) assessed their anxiety as severe and almost two and a half times more (OR = 2.39) perceived stress as severe compared to men. Students who lived with their families during studies two and a half times (OR = 2.57) more often assessed their stress as severe, compared to students who lived alone. Fifth- and sixth-year students were less likely to rate depression and anxiety as serious than the first-year students.

Conclusions

Medical students reported their health as severely impaired in terms of depression, anxiety and stress reactions. The results indicate the need to launch a mental health program in the form of counseling and emotional support to students affected by the pandemic.

Remote Working and Home Learning: How the Italian Academic Population Dealt with Changes Due to the COVID-19 Pandemic Lockdown

The COVID-19 pandemic introduced changes in people’s lives that affected their mental health. Our study aimed to explore the level of psychological distress in the academic population during the lockdown period and investigate its association with the new working or studying conditions. The study sample included 9364 students and 2159 employees from five Italian universities from the study IO CONTO 2020. We applied linear regression models to investigate the association between home learning or remote working conditions and psychological distress, separately for students and employees. Psychological distress was assessed using the Hospital Anxiety and Depression Scale (HADS). In both students and employees, higher levels of distress were significantly associated with study/work–family conflicts, concerns about their future careers, and inadequacy of equipment; in employees, higher levels of distress were significantly associated with a lack of clarity on work objectives. Our results are in line with previous research on the impact of spaces and equipment in remote working/studying from home. Moreover, the study contributes to deepening the association between well-being and telework–family conflict, which in the literature is still equivocal. Practical implications require academic governance to promote sustainable environments both in remote and hybrid work conditions, by referring to a specific management by objectives approach.

Will the Effects of COVID-19 on Commuting and Daily Activities of the University Students Be Maintained? Evidence from a Small Town in Sicily

As many studies have already shown, the COVID-19 pandemic has had a great impact on the daily routines of people all over the world. University students form one of the most affected groups of people, since they have had to interrupt many of the activities that they usually perform, and have also had to get used to a new way of learning (e-learning). An important question that now arises is whether the changes that were identified within the pandemic period are to be maintained when the risk of being infected is eliminated. To this end, 537 university students of the Kore University of Enna, Italy, were surveyed. Their responses are analyzed descriptively, and an ordinal regression model is being developed to shed more light on the likelihood of retaining changes related with to transport mode choice. The results show that the likelihood of retaining all the changes when commuting and during daily activities is very high, demonstrating such willingness from the participants. Moreover, it has been shown that public transport has increased the probability of people being negatively affected by the pandemic in the long-term, and opportunities appear for increasing the modal share of active modes.

NoiBene, a Group Intervention for Promoting Mental Health Among University Students: A Study Protocol for a Randomized Controlled Trial

University students’ mental health has become a public health issue since increasingly students report high levels of psychological distress. Mental health difficulties influence students’ lives, such as academic performance, relationships satisfaction, and quality of life. Moreover, different kinds of obstacles often hinder help-seeking behavior. Such evidence strongly suggests the need to implement prevention and promotion strategies to increase health and well-being in educational contexts. This article presents a study protocol for implementing and evaluating NoiBene, an evidence-based group intervention that aims to promote mental health and well-being, improve a series of transversal competencies (e.g., emotional awareness, commitment to values, assertiveness, goal setting), and decrease dysfunctional transdiagnostic mechanisms (i.e., perfectionism, repetitive thinking, experiential avoidance). A randomized controlled trial will be conducted to evaluate the protocol’s efficacy. Participants will be assigned to one of the three conditions: the NoiBene Group condition (NB-G), the NoiBene guided web-based condition (NB-WB), or the waiting list condition (WLC). The NB-G intervention consists of six face-to-face group meetings, each dedicated to specific issues related to well-being or vulnerabilities. Every meeting includes an explanation of the theoretical contents, individual and group exercises, and role-plays. The NB-WB intervention covers the same topic addressed in the NB-G intervention. In this case, participants carry out a series of online modules, including theoretical explanations, practical exercises, useful activities, and self-monitoring tools. Students will individually meet the Tutor once every 2 weeks. The primary outcome will include an increase in mental health and well-being. Secondary outcomes will include changes in emotional awareness, assertiveness, perfectionism, rumination, worry, self-criticism, experiential avoidance, and academic performance and satisfaction. We expect that participants in both NoiBene conditions will show these outcomes. However, we hypothesized that the NB-G conditions will be more effective than the NB-WB in improving assertiveness. Besides treatment efficacy, we expect that students can benefit from the NB-G or NB-WB differently based on their specific behavioral and motivational patterns. Outcomes will be assessed at pre-, post-intervention and 6-months follow-up. In conclusion, we believe that NoiBene is a promising tool that can improve students’ well-being, and it could have positive implications for preventing mental health disorders among students.

Supportive Therapy to Reduce Anxiety Levels of COVID-19 Nurses in Isolation ICU Room

BACKGROUND: COVID-19 for this year has had a negative impact on life, particularly the psychological impact of anxiety. Anxiety occurs in the general public and in health workers, one of which is a nurse. If anxiety continues, it will affect the quality of life and performance of nurses. Supportive therapy is one of the non-pharmacological treatments to reduce anxiety. AIM: This study was to determine the effectiveness of supportive therapy in reducing the anxiety of COVID-19 nurses in isolation ICU. METHODS: This study used quantitative research with a quasi-experimental design. The researcher wanted to know the effectiveness of a treatment, namely, supportive therapy, against the anxiety of the COVID-19 nurses of isolation ICU room. This study used a pre-post-test one-group intervention method. The therapy mechanism applied 1–4 sessions of supportive therapy by dividing each session into 3 days. Forty respondents participated in this study. The data obtained were analyzed using paired t-test. RESULTS: The results show that 55% of respondents experience moderate anxiety before supportive therapy, and 60% are not anxious after supportive therapy. It is also found that p = 0.000 is considered and lower than the alpha value of 0.05 (0.000 < 0.05). Therefore, there is a statistically significant difference before and after supportive therapy. CONCLUSION: The conclusion that can be drawn is the influence of supportive therapy on reducing anxiety in COVID-19 isolation ICU nurses.

Somatic Symptoms, Anxiety, and Depression Among College Students in the Czech Republic and Slovakia: A Cross-Sectional Study

Studying in college can be a challenging time for many students, which can affect their mental health. In addition to academic pressure and stressful tasks, another aggravating factor in student life is the ongoing coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to examine the prevalence of anxiety, depression, and somatic symptoms in Czech and Slovak college students during the COVID-19 pandemic and to evaluate possible socio-demographic determinants of mental health problems. A total of 3,099 respondents participated in this cross-sectional study (Czech Republic: 1,422, Slovakia: 1,677). The analyzes included the Patient Health Questionnaire for somatic symptoms (PHQ-15), the Generalized Anxiety Disorder instrument (GAD-7), and the Patient Health Questionnaire for depression (PHQ-9). Socio-demographic factors were gender, age, family structure, marital status, form of study, degree of study, year of study, field of study, distance between home and college, residence, and housing during the semester. Among Czech students, prevalence of somatic complaints, anxiety and depression was 72.2, 40.3, and 52%, respectively. Among Slovak students, prevalence of somatic complaints, anxiety and depression was 69.5, 34.6, and 47%, respectively. During the COVID-19 pandemic, the most severe mental health problems were identified in a non-negligible part of the sample (Czech Republic: PHQ-15 = 10.1%, GAD-7 = 4.9%, PHQ-9 = 3.4%; Slovakia: PHQ-15 = 7.4%, GAD-7 = 3.5%, PHQ-9 = 2.7%). Regarding the differences between the analyzed countries, a significantly higher score in somatic symptoms, anxiety, and depression was identified in the Czech Republic. Significant differences in mental disorders were found in most socio-demographic characteristics. The main results of the logistic regression analysis revealed that risk factors for mental health disorders in Czech and Slovak students were female gender, younger age, third degree of study, and study of Informatics, Mathematics, Information and Communication Technologies (ICT). Especially in the case of these high-risk groups of students, public policies should consider a response to impending problems. The findings are an appeal for a proactive approach to improving the mental health of students and for the implementation of effective prevention programs, which are more than necessary in the Czech and Slovak college environment.

An Internet-Based Multi-Approach Intervention Targeting University Students Suffering from Psychological Problems: Design, Implementation, and Evaluation

Despite the widespread prevalence of mental health problems, most psychological distress remains untreated. Internet-based psychological interventions can be an essential tool for increasing treatment availability and accessibility. The main objective of the MindBlooming project is to design and implement an innovative Internet-based multi-approach treatment for university students suffering from psychological or physical problems. The intervention will focus on symptoms of depression, anxiety, sleep problems, self-destructive thoughts, job- and study-related stress and burnout, and chronic pain. It will be based on different approaches, primarily psychoeducation, Cognitive-Behavioral Treatment (CBT), and third-wave CBT. At the end of the treatment, user satisfaction and usability will be assessed. In addition, two further aims will be evaluating the treatment efficacy through a randomized controlled trial and tuning a predictive model through Machine Learning techniques. The intervention consists of a 7-week treatment on two problematic areas according to each students’ personal needs, identified through an initial assessment. Besides the treatment assigned following the initial screening, participants will also be assigned to a different module to improve their relational skills. The treatment, which can be accessed through a mobile app, consists of psychoeducational videos followed by related exercises. We expect MindBlooming to be a remarkable tool for promoting the mental health of university students.

Gender Differences in COVID-19 Lockdown Impact on Mental Health of Undergraduate Students

Background: Prolonged university closures and social distancing-imposed measures due to the COVID-19 pandemic obliged students to at-home learning with online lectures and educational programs promoting potential social isolation, loneliness, hopelessness, and episodes of clinical decompensation. Methods: A web-based cross-sectional survey was carried out in a university institute in Milan, Northern Italy, to assess the COVID-19 lockdown impact on the mental health of the undergraduate students. We estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) using adjusted logistic regression models. Results: Of the 8,177 students, 12.8% reported depressive symptoms, 25.6% anxiety, 8.7% insomnia, and 10.6% reported impulsive tracts, with higher proportions among females than males. Mental health symptoms were positively associated with caring for a person at home, a poor housing quality, and a worsening in working performance. Among males compared with females, a poor housing quality showed a stronger positive association with depressive symptoms and impulsivity, and a worsening in the working performance was positively associated with depressive and anxiety symptoms. In addition, the absence of private space was positively associated with depression and anxiety, stronger among males than females. Conclusions: To our knowledge, this is the first multidisciplinary consortium study, involving public mental health, environmental health, and architectural design. Further studies are needed to confirm or refute our findings and consequent recommendations to implement well-being interventions in pandemic conditions.