Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China

Abstract

Background The COVID-19 pandemic has made unprecedented impact on the psychological health of university students, a population vulnerable to distress and mental health disorders. This study investigated psychiatric symptoms (anxiety, depression, and traumatic stress) during state-enforced quarantine among university students in China (N = 1912) through a cross-sectional survey during March and April 2020. Results Psychiatric symptoms were alarmingly prevalent: 67.05% reported traumatic stress, 46.55% had depressive symptoms, and 34.73% reported anxiety symptoms. Further, 19.56% endorsed suicidal ideation. We explored risk and protective factors of psychological health, including demographic variables, two known protective factors for mental health (mindfulness, perceived social support), four COVID-specific factors (COVID-19 related efficacy, perceived COVID-19 threat, perceived COVID-19 societal stigma, COVID-19 prosocial behavior) and screen media usage. Across symptom domains, mindfulness was associated with lower symptom severity, while COVID-19 related financial stress, perceived COVID-19 societal stigma, and perceived COVID-19 threat were associated with higher symptom severity. COVID-19 threat and COVID-19 stigma showed main and interactive effects in predicting all mental health outcomes, with their combination associated with highest symptom severity. Screen media device usage was positively associated with depression. Female gender and COVID-19 prosocial behavior were associated with higher anxiety, while COVID-19 self-efficacy associated with lower anxiety symptoms. Conclusions Findings suggest high need for psychological health promotion among university students during the COVID-19 pandemic and inform an ecological perspective on the detrimental role of stigma during an emerging infectious disease outbreak. Interventions targeting multi-level factors, such as promoting mindfulness and social support at individual and interpersonal levels while reducing public stigma about COVID-19, may be particularly promising. Attending to the needs of disadvantaged groups including those financially impacted by COVID-19 is needed.

Anxiety and Gastrointestinal Symptoms Related to COVID-19 during Italian Lockdown

“…They are under constant stress due to the duration of their study plan characterized by higher work overload with physical and mental exhaustion. Recent studies conducted among medical students clearly report their psychological status concerning the present pandemic [17][18][19].…”

Editorial: Psychological Distress Among University Students

“…In these times, we have also to consider the impact of the novel coronavirus disease of 2019 (Covid-19) pandemic, that aroused fears and anxiety globally, leading to an upsurge in the incidence and severity of mental health problems (Granieri et al, 2020;Serafini et al, 2020;Xiong et al, 2020). Indeed, covid-19 pandemic caused a massive interruption in the lives and education of university students worldwide, entailing prolonged school closure, transition to internet-based learning, and social isolation from peers during state-enforced quarantine (Bourion-Bédès et al, 2021;Sun et al, 2021). In particular, worries, isolation from social networks, a lack of interaction and emotional support from friends, as well as physical isolation were associated with negative mental health trajectories among university students (Husky et al, 2020;Meda et al, 2021).…”

Survey of German medical students during the COVID-19 pandemic: attitudes toward volunteering versus compulsory service and associated factors

“… 22 It is well known that perceived societal stigma has a negative impact on mental health. 23 The societal stigma of infectious diseases is not completely new. It has also been noted in the context of HIV among gay and bisexual men.…”

“… 24 25 Similar experiences of stigmatisation might be associated with COVID-19 today, recently published data revealed a tendency of COVID-19 stigmatisation. 23 In the past, it has been assumed that extensive information campaigns and goal-oriented lessons in medical schools would overcome this kind of discrimination. 25 Nevertheless, a considerable proportion of medical students and physicians still demonstrate their fears when interacting with patients with HIV.…”

“… 29 Furthermore, students felt not only anxious about COVID-19 but also vulnerable. 23 The anxieties are enhanced in volunteers working on the pandemic’s front lines. It seems to be important for medical students to have the opportunity to discuss such concerns with supervisors.…”