Risk and protective factors associated with mental health status in an Italian sample of students during the fourth wave of COVID-19 pandemic

Abstract

Background It is well known that the COVID-19 pandemic has caused a global health crisis, especially for young people. However, most studies were conducted during the first waves of the pandemic. Few Italian studies specifically attempted to broadly assess young people’s mental health status during the fourth wave of the pandemic. Methods This study aimed at evaluating the mental health status among a group of Italian adolescents and young adults during the fourth wave of the COVID-19 pandemic. 11,839 high school students and 15,000 university students (age range 14–25) were asked to complete a multidimensional online survey, of which 7,146 (26,6%) agreed to participate. The survey also included standardized measures for depression, anxiety, anger, somatic symptoms, resilience, loneliness and post-traumatic growth. Two separate clusters were identified through cluster analysis. Random forest, classification tree and logistic regressions analyses were applied to identify factors associated to a good or a poor level of mental health and, thus, to define students’ mental health profiles. Results Overall, the students in our sample showed high levels of psychopathology. The clustering methods performed identified two separate clusters reflecting groups of students with different psychological features, that we further defined as "poor mental health" and "good mental health". The random forest and the logistic regressions found that the most discriminating variables among those two groups were: UCLA Loneliness Scale score, self-harm behaviors, Connor-Davidson Resilience Scale-10 score, satisfaction with family relationships, Fear of COVID-19 Scale score, gender and binge eating behaviors. The classification tree analysis identified students’ profiles, showing that, globally, poor mental health was defined by higher scores of loneliness and self-harm, followed by being of female gender, presenting binge eating behaviors and, finally, having unsatisfying family relationships. Conclusions The results of this study confirmed the major psychological distress caused by the COVID-19 pandemic in a large sample of Italian students, and provided further insights regarding those factors associated with a good or poor mental health status. Our findings suggest the importance of implementing programs targeting aspects that have been found to be associated to a good mental health.

Impact of the COVID-19 Pandemic on the Use of Antidepressants by Young Adults in the ASL TO4 Regione Piemonte (Italy)

“…Interestingly, in line with previously cited studies on the Italian population [18][19][20][21][22][23], we found no changes in AD use comparable to young adults in other age groups, supporting the hypothesis that this subgroup of individuals had needed medication to treat their psychological distress during the lockdown periods and/or after the reopening phase. This evidence supports the association between younger age and lower levels of mental health during the COVID-19 pandemic [24][25][26][27][28][29][30][31][32][33][34][35][36]. We can also speculate that the increase in the use of ADs by young adults in the ASL TO4 Regione Piemonte may be related to prescriptions for the treatment of post-COVID-19 depression.…”

“…In this respect, the association between younger age and lower levels of mental health during the COVID-19 pandemic has been documented. In particular, young adults have been found to experience high rates of loneliness, anxious and depressive symptoms, stress, and sleep disturbances [24][25][26][27][28][29][30][31][32][33][34][35][36]. Whether these changes were associated with a parallel change in AD consumption needs to be better understood.…”

Adolescent Mental Health during the COVID-19 Pandemic: The Interplay of Age, Gender, and Mental Health Outcomes in Two Consecutive Cross-Sectional Surveys in Northern Italy

“…Gender has emerged as the most important factor in predicting mental health problems in adolescents. Females were more affected across all outcome variables, and increasing age was a significant factor for all outcomes in the female subgroup [ 69 , 70 , 71 , 72 ]. Age, however, was not a significant predictor of anxiety symptoms in boys.…”