Anxiety and depressive symptoms in college students during the late stage of the COVID-19 outbreak: a network approach

AbstractMental health problems are common in college students even in the late stage of the coronavirus disease 2019 (COVID-19) outbreak. Network analysis is a novel approach to explore interactions of mental disorders at the symptom level. The aim of this study was to elucidate characteristics of depressive and anxiety symptoms network in college students in the late stage of the COVID-19 outbreak. A total of 3062 college students were included. The seven-item Generalized Anxiety Disorder Scale (GAD-7) and nine-item Patient Health Questionnaire (PHQ-9) were used to measure anxiety and depressive symptoms, respectively. Central symptoms and bridge symptoms were identified based on centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. The strongest direct relation was between anxiety symptoms “Nervousness” and “Uncontrollable worry”. “Fatigue” has the highest node strength in the anxiety and depression network, followed by “Excessive worry”, “Trouble relaxing”, and “Uncontrollable worry”. “Motor” showed the highest bridge strength, followed by “Feeling afraid” and “Restlessness”. The whole network was robust in both stability and accuracy tests. Central symptoms “Fatigue”, “Excessive worry”, “Trouble relaxing” and “Uncontrollable worry”, and critical bridge symptoms “Motor”, “Feeling afraid” and “Restlessness” were highlighted in this study. Targeting interventions to these symptoms may be important to effectively alleviate the overall level of anxiety and depressive symptoms in college students.

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Inadequate Mental Health Literacy and Insufficient Physical Activity Potentially Increase the Risks of Anxiety and Depressive Symptoms in Chinese College Students

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.753695 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xuexue Huang ◽

Xiaoqing Wang ◽

Jie Hu ◽

Yanni Xue ◽

Yanyan Wei ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

College Students ◽

Depressive Symptoms ◽

Health Literacy ◽

Mental Health Literacy ◽

Mental Health Problems ◽

Anxiety Symptoms ◽

Chinese College Students ◽

Insufficient Physical Activity

Objective: The present study aimed to examine the interactive associations between physical activity and mental health literacy with anxiety and depressive symptoms in Chinese college students.Methods: A cross-sectional study was conducted from May to July 2020. A total of 7,512 students were recruited from two medical colleges in Hefei and Anqing city in Anhui Province, China. Physical activity, mental health literacy, anxiety and depressive symptoms were measured by self-reported validated instruments. Analyses were conducted with logistic regression models.Results: The prevalence of anxiety and depressive symptoms was 8.6% and 16.4%, respectively. Insufficient physical activity was significantly associated with depressive symptoms (OR = 1.359, 95%CI 1.184–1.561) and anxiety symptoms (OR = 1.492, 95%CI: 1.237–1.799). Inadequate mental health literacy was significantly associated with depressive symptoms (OR = 3.089, 95%CI: 2.607–3.662) and anxiety symptoms (OR = 3.675, 95%CI: 2.861–4.721). Low physical activity rank (OR = 1.438, 95%CI: 1.151–1.798) was significantly related with depressive symptoms but not anxiety symptoms. The students who had inadequate mental health literacy and insufficient physical activity had the highest risks of depressive symptoms (OR = 5.049, 95% CI: 3.649–6.987) and anxiety symptoms (OR = 5.270, 95% CI: 3.338–8.321).Conclusion: These finding indicated that Chinese college students having insufficient physical activity and inadequate mental health literacy are at risk of exhibiting anxiety and depressive symptoms. Early intervention programs for college students with mental health problems should be considered to enhance their mental health literacy and to increase their physical activities.

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Job Dissatisfaction Mediated the Associations Between Work Stress and Mental Health Problems

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.711263 ◽

2021 ◽

Vol 12 ◽

Author(s):

Dan Qiu ◽

Ruiqi Li ◽

Yilu Li ◽

Jun He ◽

Feiyun Ouyang ◽

...

Keyword(s):

Mental Health ◽

Logistic Regression ◽

Depressive Symptoms ◽

Path Analysis ◽

Work Stress ◽

Mental Health Problems ◽

Health Problems ◽

Anxiety Symptoms ◽

Job Dissatisfaction ◽

Working Adults

Objective: This study aimed to explore the relationships and the underlying mechanisms between work stress and mental health problems, and potential mediation effects through job dissatisfaction in a working population.Methods: A large population-based study among workers in China was conducted. The self-reported scales of assessing job dissatisfaction and work stress were included in the questionnaire. Generalized Anxiety Disorder-2 and Patient Health Questionnaire-2 were used for assessment of mental health. Univariate logistic regression was conducted to test the associations between work stress and mental health. Path analysis was conducted to test the proposed mediation model.Results: Of the 6,190 included employees, 27.72% reported that they perceived work stress, 14.84% of them reported that they were not satisfied with their work, 5.01% of the employees reported depressive symptoms, and 3.75% of the employees reported anxiety symptoms. The results of univariate logistic regression showed that employees who perceived work stress were more likely to report anxiety symptoms (adjusted odds ratio (AOR) = 2.78; 95% CI: 2.03–3.79) or depressive symptoms (AOR = 1.61; 95% CI: 1.22–2.12). The path analysis showed that work stress was positively associated with job dissatisfaction. Job dissatisfaction mediated the relationship between work stress and mental health problems among Chinese working adults.Conclusion: This study suggests the importance of psychosocial work environment for mental health among Chinese working adults. Work dissatisfaction is a stressor that may induce negative consequences on the mental health among Chinese workers. Interventions to help workers with stress management may be beneficial for their mental health.

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Depressive Symptoms, Help-Seeking, and Barriers to Mental Healthcare Among Healthcare Professionals in Lithuania

Acta medica Lituanica ◽

10.15388/amed.2020.28.1.3 ◽

2021 ◽

Vol 28 (1) ◽

pp. 3

Author(s):

Daniel Rogoža ◽

Robertas Strumila ◽

Eglė Klivickaitė ◽

Edgaras Diržius ◽

Neringa Čėnaitė

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Help Seeking ◽

Healthcare Professionals ◽

Mental Health Problems ◽

Mental Healthcare ◽

Health Problems ◽

Poor Mental Health ◽

Work Related ◽

Patient Health

Background: Previous research suggests that healthcare professionals (HCPs) experience high levels of work-related psychological distress, including depressive symptoms. Due to the stigma of mental health problems and other barriers, HCPs are likely to be hesitant to seek appropriate mental healthcare. We aimed to explore these phenomena among HCPs in Lithuania.Methods: A web survey inquiring about depressive symptoms, help-seeking, and barriers to mental healthcare was conducted. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). 601 complete questionnaires were included in the analyses. The barriers to help-seeking were identified using the inductive content analysis approach. Descriptive, non-parametric, and robust statistical analysis was performed using SPSS software.Results: Most of the respondents have reported depression-like symptoms over the lifetime, although only about a third of them sought professional help. Of those, roughly half preferred a private specialist. The stigma and neglect of mental health problems were the most common barriers to help-seeking. Around half of the HCPs believed that seeking mental healthcare can imperil their occupational license. About a quarter of the HCPs screened positive for clinically relevant depressive symptoms. Statistically significant differences in the PHQ-9 score were found between categories of healthcare specialty, marital status, religious beliefs, workplace, and years of work as a HCP. Fewer years of work and younger age were associated with the higher PHQ-9 score.Conclusions: Our findings suggest that HCPs in Lithuania may be inclined not to seek appropriate mental healthcare and experience poor mental health, although stronger evidence is needed to verify these findings.

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Resilience Moderates Negative Outcome from Stress during the COVID-19 Pandemic: A Moderated-Mediation Approach

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186461 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6461 ◽

Cited By ~ 4

Author(s):

Audun Havnen ◽

Frederick Anyan ◽

Odin Hjemdal ◽

Stian Solem ◽

Maja Gurigard Riksfjord ◽

...

Keyword(s):

Depressive Symptoms ◽

Indirect Effect ◽

Moderated Mediation ◽

Anxiety Symptoms ◽

Stress Exposure ◽

Mediation Analyses ◽

Symptoms Of Depression ◽

Moderated Mediation Model ◽

Treatment And Prevention ◽

Patient Health

Resilience refers to an individual’s healthy coping abilities when encountering adverse life events. The COVID-19 pandemic represents a situation with a high amount of stress exposure, which in turn may be associated with negative emotional outcome like depressive symptoms. The current study investigated if resilience moderated the effect of stress on symptoms of depression and if anxiety symptoms mediated this association. An adult sample of community controls completed the Perceived stress scale 14 (PSS-14), the Resilience scale for adults (RSA), the Patient health questionnaire 9 (PHQ-9) and the Generalized anxiety disorder 7 (GAD-7). Independent samples t-test, correlation analyses and moderated mediation analyses were conducted. The results showed that resilience moderated the relations between stress and anxiety symptoms (β = −0.131, p < 0.001) as well as between stress and depressive symptoms (β = −0.068, p < 0.05). In support of a moderated mediation model, resilience moderated the indirect effect of stress on depressive symptom, as confirmed by the index of moderated mediation (IMM = −0.036, p < 0.001; [95% BCa: −0.055, −0.020]). The high resilience subgroup was less affected than the low resilience subgroup by the effect of stress exposure symptoms of depression, mediated by anxiety. The study shows that stress exposure is associated with symptoms of depression, and anxiety mediates this association. Level of resilience differentiates the direct and indirect effect of stress on depression. Knowledge about the effect of stress in response to a pandemic is important for developing treatment and prevention strategies for stress, depression and health-related anxiety.

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Prevalence and Risk Factors of Anxiety, Depression, and Sleep Problems Among Caregivers of People Living With Neurocognitive Disorders During the COVID-19 Pandemic

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.590343 ◽

2021 ◽

Vol 11 ◽

Author(s):

Qiuxuan Li ◽

Haifeng Zhang ◽

Ming Zhang ◽

Tao Li ◽

Wanxin Ma ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Prevalence Rate ◽

Mental Health Problems ◽

Sleep Problems ◽

Health Problems ◽

Neurocognitive Disorders ◽

Anxiety Symptoms ◽

Increased Risk ◽

Anxiety Depression

Objectives: To estimate the prevalence of anxiety, depression, and sleep problems among caregivers of persons living with neurocognitive disorders (PLWND) during the COVID-19 pandemic in China and investigate whether the COVID-19-related experiences were associated with the presence of anxiety, depression, and sleep problems.Methods: From March 1 to 31, 2020, 160 caregivers of PLWND participated in an online cross-sectional survey on the prevalence of anxiety, depression, and sleep problems. The 7-item Generalized Anxiety Disorder Scale (GAD-7) was administered to measure anxiety symptoms, and the 2-item Patient Health Questionnaire (PHQ-2) was used to assess depressive symptoms. Questions on sleep duration and sleep quality enquired about sleep problems. Six items were used to explore the COVID-19-related experiences, including community-level infection contact and the level of exposure to media information. We computed the prevalence rate of anxiety, depressive symptoms, and sleep problems. Univariate and multivariate logistic regression analyses were performed to investigate factors associated with these mental health problems.Results: The prevalence rate of anxiety, depression, and sleep problems were 46.9%, 36.3%, and 9.4%. Approximately 55 participants (34.4%) presented with two or more mental health problems. Women had a higher risk of developing anxiety symptoms (OR, 5.284; 95% CI, 2.068–13.503; p = 0.001). Having a mental disorder (OR, 5.104; 95% CI, 1.522–17.114; p = 0.008) was associated with an increased risk of depressive symptoms. Caregivers who preferred to access positive information (OR, 0.215; 95% CI, 0.058–0.793; p = 0.021) was associated with decreased risk of sleep problems.Conclusion: Anxiety and depressive symptoms were common among caregivers of older adults with dementia or mild cognitive impairment during the COVID-19 pandemic. Being female was an independent risk factor for experiencing anxiety symptoms. Preexisting mental disorders increased the risk of depressive symptoms among caregivers, while caregivers who prefer to access positive media information decreased sleep problems.

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Depressive symptoms are associated with cigarette smoking among tuberculosis patients in Botswana

10.1101/2021.09.14.21263357 ◽

2021 ◽

Author(s):

Alexandria Jones-Patten ◽

Qiao Wang ◽

Keneilwe Molebatsi ◽

Thomas E. Novotny ◽

Kamran Siddiqi ◽

...

Keyword(s):

Depressive Symptoms ◽

Cigarette Smoking ◽

Statistical Significance ◽

Median Number ◽

Cross Sectional Study ◽

Anxiety Symptoms ◽

Depression And Anxiety ◽

Cross Sectional ◽

Health Clinics ◽

Patient Health

AbstractBackgroundResearchers have increasingly recognized the adverse effects of smoking on tuberculosis (TB) outcomes. Smoking may be a maladaptive coping mechanism for depression and anxiety among TB patients; however, this association has not yet been investigated.Design/MethodsWe conducted a cross-sectional study among newly diagnosed TB patients between January and December 2019 in Gaborone, Botswana, and evaluated factors associated with cigarette smoking. Using the Patient Health Questionnaire-9 and the Zung Self-Rating Anxiety scale, we collected depression and anxiety scores, respectively; scores of ≥10 indicate depression and scores of ≥36 indicate anxiety. We performed Poisson regression analyses with robust variance to examine whether depression and anxiety were associated with smoking.ResultsOne hundred and eighty participants with TB were enrolled from primary health clinics. Among all enrollees, depression was reported in 46 (27.1%) participants, while anxiety was reported in 60 (44.4%) participants. Overall, 45 (25.0%) participants reported current smoking, and the median number of cigarettes per day was 10. Depressive symptoms were associated with a higher prevalence of smoking (aPR: 1.82; 95% CI = 1.11, 3.01) after adjusting for sex, HIV status, food insecurity, anxiety, and income. The association between anxiety symptoms and cigarette smoking did not reach statistical significance (aPR 1.26; 95% CI: 0.78-2.05).ConclusionsWe found the association between depressive symptoms and smoking among TB patients in Botswana to be significant and the association between anxiety symptoms and cigarette smoking insignificant. Future studies should further investigate these associations when addressing TB care.

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Mental health condition of college students compared to non-students during COVID-19 lockdown: the CONFINS study

BMJ Open ◽

10.1136/bmjopen-2021-053231 ◽

2021 ◽

Vol 11 (8) ◽

pp. e053231

Author(s):

Julie Arsandaux ◽

Ilaria Montagni ◽

Mélissa Macalli ◽

Nathalie Texier ◽

Mathilde Pouriel ◽

...

Keyword(s):

Mental Health ◽

College Students ◽

Depressive Symptoms ◽

Perceived Stress ◽

Health Condition ◽

Anxiety Symptoms ◽

Secondary Outcome ◽

Mental Health Condition ◽

Online Questionnaire ◽

Suicidal Thoughts

ObjectivesTo estimate the effect of student status on mental health condition during COVID-19 general lockdown in France.DesignCross-sectional analysis comparing students and non-students recruited in the same study.SettingParticipants of the web-based CONFINS study implemented during the general lockdown in France in spring 2020.Participants2260 participants (78% women) including 1335 students (59%).Primary and secondary outcome measuresThrough an online questionnaire, participants declared if they have experienced suicidal thoughts, coded their perceived stress on a 10-points scale and completed validated mental health scales (Patient Health Questionnaire-9 for depressive symptoms, Generalised Anxiety Disorder-7 for anxiety symptoms) during the last 7 days. The effect of college student status on each mental health condition was estimated using multivariate logistic regression analyses. Stratified models for students and non-students were performed to identify population-specific factors.ResultsStudent status was associated with a higher frequency of depressive symptoms (adjusted OR (aOR)=1.58; 95% CI 1.17 to 2.14), anxiety symptoms (aOR=1.51; 95% CI 1.10 to 2.07), perceived stress (n=1919, aOR=1.70, 95% CI 1.26 to 2.29) and suicidal thoughts (n=1919, aOR=1.57, 95% CI 0.97 to 2.53). Lockdown conditions that could be potentially aggravating on mental health like isolation had a higher impact on students than on non-students.ConclusionsCollege students were at higher risk of mental health disturbances during lockdown than non-students, even after taking into account several potential confounding factors. A close follow-up and monitoring of students’ mental health status is warranted during lockdown periods in this vulnerable population.

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Mental health problems and correlates among 746 217 college students during the coronavirus disease 2019 outbreak in China

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796020000931 ◽

2020 ◽

Vol 29 ◽

Author(s):

Z. Ma ◽

J. Zhao ◽

Y. Li ◽

D. Chen ◽

T. Wang ◽

...

Keyword(s):

Mental Health ◽

Social Support ◽

College Students ◽

Depressive Symptoms ◽

Mental Health Problems ◽

Acute Stress ◽

Health Problems ◽

Senior Year ◽

Increased Risk ◽

The Impact

Abstract Aims Coronavirus disease 2019 (COVID-19) pandemic is a major public health concern all over the world. Little is known about the impact of COVID-19 pandemic on mental health in the general population. This study aimed to assess the mental health problems and associated factors among a large sample of college students during the COVID-19 outbreak in China. Methods This cross-sectional and nation-wide survey of college students was conducted in China from 3 to 10 February 2020. A self-administered questionnaire was used to assess psychosocial factors, COVID-19 epidemic related factors and mental health problems. Acute stress, depressive and anxiety symptoms were measured by the Chinese versions of the impact of event scale-6, Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively. Univariate and hierarchical logistic regression analyses were performed to examine factors associated with mental health problems. Results Among 821 218 students who participated in the survey, 746 217 (90.9%) were included for the analysis. In total, 414 604 (55.6%) of the students were female. About 45% of the participants had mental health problems. The prevalence rates of probable acute stress, depressive and anxiety symptoms were 34.9%, 21.1% and 11.0%, respectively. COVID-19 epidemic factors that were associated with increased risk of mental health problems were having relatives or friends being infected (adjusted odds ratio = 1.72–2.33). Students with exposure to media coverage of the COVID-19 ≥3 h/day were 2.13 times more likely than students with media exposure <1 h/day to have acute stress symptoms. Individuals with low perceived social support were 4.84–5.98 times more likely than individuals with high perceived social support to have anxiety and depressive symptoms. In addition, senior year and prior mental health problems were also significantly associated with anxiety or/and depressive symptoms. Conclusions In this large-scale survey of college students in China, acute stress, anxiety and depressive symptoms are prevalent during the COVID-19 pandemic. Multiple epidemic and psychosocial factors, such as family members being infected, massive media exposure, low social support, senior year and prior mental health problems were associated with increased risk of mental health problems. Psychosocial support and mental health services should be provided to those students at risk.

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Risk Factors for Anxiety and Depressive Symptoms in Doctors During the Coronavirus Disease 2019 Pandemic

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.687440 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lanying He ◽

Jian Wang ◽

Lijuan Zhang ◽

Feng Wang ◽

Weiwei Dong ◽

...

Keyword(s):

Risk Factors ◽

Depressive Symptoms ◽

Mental Health Problems ◽

Depression Scale ◽

Anxiety Symptoms ◽

The Self ◽

Female Sex ◽

Self Rating ◽

Increased Risk ◽

A Minor

Background: The purpose of our study was to investigate the prevalence of anxiety and depressive symptoms and their risk factors among doctors during the coronavirus disease 2019 (COVID-19) pandemic.Methods: A hospital-based survey study was conducted. Anxiety symptoms were assessed using the Self-Rating Anxiety Scale (SAS), and depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Multivariable logistic regression was used to analyze anxiety and depressive symptoms across independent variables.Results: A total of 1,521 doctors were included; 11.11% (169/1,521) of the doctors had anxiety symptoms, and 16.90% (257/1,521) had depressive symptoms. Female sex [adjusted odds ratio (aOR), 1.69; 95% confidence interval (CI), 1.21–2.34; P = 0.002] and having a minor child (aOR, 2.31; 95% CI, 1.50–3.56; P < 0.001) were associated with an increased risk of anxiety symptoms. Female sex (aOR, 1.56; 95% CI, 1.18–2.06; P = 0.002) and having a minor child (aOR, 1.48; 95% CI, 1.06–2.01; P = 0.022) were associated with an increased risk of depressive symptoms. Older age (aOR, 0.97; 95% CI, 0.98–0.99; P = 0.008) was associated with a decreased risk of depressive symptoms.Conclusions: Anxiety and depressive symptoms have been common mental health problems in doctors during the COVID-19 pandemic. We found that female sex, having a minor child, and younger age were major risk factors for the development of anxiety and depressive symptoms among doctors during the COVID-19 pandemic.

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Prevalence and determinants of low social support during pregnancy among Australian women: a community-based cross-sectional study

Reproductive Health ◽

10.1186/s12978-021-01210-y ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Asres Bedaso ◽

Jon Adams ◽

Wenbo Peng ◽

David Sibbritt

Keyword(s):

Social Support ◽

At Risk ◽

Depressive Symptoms ◽

Pregnant Women ◽

Mental Health Problems ◽

Economic Status ◽

Well Being ◽

Cross Sectional Study ◽

Anxiety Symptoms ◽

Cross Sectional

Abstract Background Pregnancy is a time for women in which the need for social support is crucial. Social support reduces stressors and improves the emotional and physical well-being of pregnant women. Women receiving low social support during pregnancy are at risk of substances use, developing mental illness, and adverse birth outcomes. The current study aims to determine the prevalence and determinants of low social support during pregnancy among Australian women. Methods Data were obtained from the 1973–1978 cohort of Australian Longitudinal Study on Women’s Health (ALSWH) and those who report being pregnant (n = 493) were included in the current analyses. Social support was assessed using Medical Outcomes Study Social Support index (MOSS). A logistic regression model was applied to identify determinants of low social support, separately for each MOSS domain. Result The study found that 7.1% (n = 35) of pregnant women reported low social support. Significant determinants of low emotional support were non-partnered (AOR = 4.4, 95% CI: 1.27, 14.99), difficulty managing on available income (AOR = 3.1, 95% CI: 1.18, 8.32), experiencing depressive symptoms (AOR = 8.5, 95% CI: 3.29, 22.27) and anxiety symptoms (AOR = 2.9, 95% CI: 1.26, 7.03). Significant determinants of low affectionate support were suffering from depressive symptoms (AOR = 5.3, 95% CI: 1.59, 17.99), having anxiety symptoms (AOR: 6.9, 95% CI: 2.21, 22.11) and being moderately/very stressed (AOR: 3, 95% CI: 1.17, 7.89). Significant determinants of low tangible support were difficulty managing available income (AOR = 3, 95% CI: 1.29, 6.95), and being depressed (AOR = 2.8, 95% CI: 1.48, 5.34). Conclusion The study revealed that 7.1% of pregnant women reported low social support. Having a mental health problems, being stressed, being from low socio-economic status and being non-partnered were significant determinants of low social support during pregnancy. Maternal health professionals and policymakers can use this information to screen pregnant women at risk of receiving low social support and improve the level of support being provided.

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