ABSTRACT
Background: Restrictions on movement and lockdown are measures taken in many nations, in response to the COVID-19 pandemic. University students are additionally burdened by the transition to distance e-learning. The aims of the study were to investigate the prevalence of anxiety and depression in university students and to identify associated risk factors.
Design and Methods: An online questionnaire was administered to 2,009 students in the University of Patras, Greece, during the national lockdown. Socio-demographic, academic data, and the forced disruption of daily life were assessed along with the Greek version of the Hospital Anxiety and Depression Scale.
Results: Anxiety and depression prevalence was 35.8% and 51.2% respectively. Age, school of study, financial status, self-perceived health status, level of satisfaction with the state’s and university’s response and specific aspects in the daily routine were associated with both anxiety and depression scores. At higher odds of both depression and anxiety were students with low income, bad health status, annoyed at staying home and those who encountered difficulties with the online education system. Additional risk factors for depression were studies in humanities and social sciences, and low satisfaction with the university’s response, while for anxiety were studies in agricultural sciences and absence of information about COVID-19.
Conclusions: The proportion of Greek students showing depression and anxiety, during the restrictive measures, is alarming. Mental health in university students should be monitored. Mitigation strategies should focus on specific personal, academic and social variables that have been identified as protective factors.
REFERENCES
Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health 2020;17:1729. DOI: https://doi.org/10.3390/ijerph17051729
Papandreou C, Arija V, Aretouli E, Tsilidis KK Bulló M. Comparing eating behaviours and symptoms of depression and anxiety between Spain and Greece during the COVID-19 outbreak: Cross-sectional analysis of two different confinement strategies. Eur Eat Disorders Rev 2020;28:836-46. DOI: https://doi.org/10.1002/erv.2772
Wu W, Zhang Y, Wang P, et al. Psychological stress of medical staffs during outbreak of COVID-19 and adjustment strategy. J Med Virol 2020;92:1962-70. DOI: https://doi.org/10.1002/jmv.25914
Odriozola-González P, Planchuelo-Gómez A, Irurtia MJ, de Luis-García R. Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Res 2020;290:113108. DOI: https://doi.org/10.1016/j.psychres.2020.113108
National Public Health Organization. Current state of Covid-19 outbreak in Greece and timeline of key containment events. [cited 2020, Apr 10]. Available from: https://eody.gov.gr/en/current-state-of-covid-19-outbreak-in-greece-and-timeline-of-key-containment-events/
King N, Pickett W, McNevin SH, et al. Mental health need of students at entry to university: Baseline findings from the U-Flourish Student Well-Being and Academic Success Study. Early Interv Psychiatry 2021;15:286-95. DOI: https://doi.org/10.1111/eip.12939
Duffy A, Saunders KEA, Malhi GS, et al. Mental health care for university students: a way forward? Lancet Psychiatry 2019;6:885-7. DOI: https://doi.org/10.1016/S2215-0366(19)30275-5
Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020;395:912-20. DOI: https://doi.org/10.1016/S0140-6736(20)30460-8
Wu P, Liu X, Fang Y, et al. Alcohol abuse/dependence symptoms among hospital employees exposed to a SARS outbreak. Alcohol Alcohol 2008;43:706-12. DOI: https://doi.org/10.1093/alcalc/agn073
Voitsidis P, Gliatas I, Bairachtari V, et al. Insomnia during the COVID-19 pandemic in a Greek population. Psychiatry Res 2020;289:113076. DOI: https://doi.org/10.1016/j.psychres.2020.113076
National Public Health Organization. Daily report of epidemiological surveillance of the new coronavirus infection (COVID-19). Data until April 15, 2020, at 15:00 (in Greek), [cited 2020, Sep 15]. Available from: https://eody.gov.gr/wp-content/uploads/2020/04/covid-gr-daily-report-20200415.pdf
Zigmond AS and Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-70. DOI: https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res 2002;52:69-77. DOI: https://doi.org/10.1016/S0022-3999(01)00296-3
Giourou E, Giannopoulou E, Alexopoulou S, et al. Undergraduate students’ anxiety and depression prevalence at the University of Patras, Greece due to academic and other stressors including gender inequality: a cross-sectional study. Eur Psychiatry 2019;56:S120.
Patsali ME, Mousa D-PV, Papadopoulou EVK, et al. University students’ changes in mental health status and determinants of behavior during the COVID-19 lockdown in Greece. Psychiatry Res 2020;292:113298. DOI: https://doi.org/10.1016/j.psychres.2020.113298
Essadek A, Rabeyron T. Mental health of French students during the Covid-19 pandemic. J Affect Disord 2020;277:392-3. DOI: https://doi.org/10.1016/j.jad.2020.08.042
Wang X, Hegde S, Son C, et al. Investigating mental health of US College students during the COVID-19 pandemic: cross-sectional survey study. J Med Internet Res 2020;22:e22817. DOI: https://doi.org/10.2196/22817
Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res 2020;287:112934. DOI: https://doi.org/10.1016/j.psychres.2020.112934
Wang ZH, Yang HL, Yang YQ, et al. Prevalence of anxiety and depression symptom, and the demands for psychological knowledge and interventions in college students during COVID-19 epidemic: A large cross-sectional study. J Affect Disord 2020;275:188-93. DOI: https://doi.org/10.1016/j.jad.2020.06.034
Xiong J, Lipsitz O, Nasri F, et al. Impact of COVID-19 pandemic on mental health in the general population: A systematic review. J Affect Disord 2020;277:55-64. DOI: https://doi.org/10.1016/j.jad.2020.08.001
Salari N, Hosseinian-Far A, Jalali R, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Glob Health 2020;16:57. DOI: https://doi.org/10.1186/s12992-020-00589-w
Lim GY, Tam WW, Lu Y, et al. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci Rep 2018;8:2861. DOI: https://doi.org/10.1038/s41598-018-21243-x
Ludwig AM. Method and madness in the arts and sciences. Creat Res J 1998;11:93-101. DOI: https://doi.org/10.1207/s15326934crj1102_1
Solomou I, Constantinidou F. Prevalence and predictors of anxiety and depression symptoms during the COVID-19 pandemic and compliance with precautionary measures: age and sex matter. Int J Environ Res Public Health 2020;17:4924. DOI: https://doi.org/10.3390/ijerph17144924
Xie L, Luo H, Li M, et al. The immediate psychological effects of Coronavirus Disease 2019 on medical and non-medical students in China. Int J Public Health 2020;65:1445-53. DOI: https://doi.org/10.1007/s00038-020-01475-3
Traunmüller C, Stefitz R, Gaisbachgrabner K, Schwerdtfeger A. Psychological correlates of COVID-19 pandemic in the Austrian population. BMC Public Health 2020;20:1395. DOI: https://doi.org/10.1186/s12889-020-09489-5
Zhang Y, Zhang H, Ma X, Di Q. Mental health problems during the COVID-19 Pandemics and the mitigation effects of exercise: A longitudinal study of college students in China. Int J Environ Res Public Health 2020;17:3722. DOI: https://doi.org/10.3390/ijerph17103722
Sahu P. Closure of Universities due to Coronavirus Disease 2019 (COVID-19): Impact on education and mental health of students and academic staff. Cureus 2020;12:e7541. DOI: https://doi.org/10.7759/cureus.7541
Sinha M, Pande B, Sinha R. Impact of COVID-19 lockdown on sleep-wake schedule and associated lifestyle related behavior: A national survey. J Public Health Res 2020;9:1826. DOI: https://doi.org/10.4081/jphr.2020.1826