The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis

Deng, Jiawen; Zhou, Fangwen; Hou, Wenteng; Silver, Zachary; Wong, Chi Yi; Chang, Oswin; Drakos, Anastasia; Zuo, Qi; Huang, Emma

doi:10.1016/j.psychres.2021.113863

Cited by 314 publications

(342 citation statements)

References 132 publications

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“…The prevalence of psychological distress amongst students in Southeast Asia (20%), although deriving from a limited number of studies, compares favourably to that in Spain (50%) [51], a meta-analysis performed on studies from China, Iran, India, Brazil and the UAE (28% pooled prevalence of anxiety) [55] and a further meta-analysis from 31 countries performed by Deng et al (anxiety 32%, depression 34%, insomnia 33%) [56].…”

Section: Comparison Of Results With Previous Studiesmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of the Mental Health Symptoms during the Covid-19 Pandemic in Southeast Asia

Pappa

Chen

Barnett

et al. 2021

Preprint

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Aims: The Covid-19 pandemic has had a substantial impact on the mental health of the general public and high-risk groups across the globe. Southeast Asia, one of the first regions to be affected by the outbreak, is of particular interest given its proximity and close links to China, experience with recent epidemics (i.e. SARS), and the variable course of the outbreak in the region thus far. The aim of this study was to systemically review and assess the prevalence of anxiety, depression and insomnia symptoms in the general adult population, frontline and general healthcare workers (HCWs), and adult students in Southeast Asia during the course of the first year of the Covid-19 pandemic. Methods: Several literature databases (PubMed, Embase, PsycINFO, Web of Science, and medRxiv) were systemically searched for articles published up to February 2021. Two reviewers independently evaluated all the relevant studies using pre-determined criteria and assessed the risk of bias for each included study. The prevalence rates of mental health symptoms were estimated using a random-effect meta-analysis model. Results: In total, 32 samples from 25 studies with 20,352 participants were included. Anxiety symptoms was assessed in all 25 studies and depressive symptoms in 15 studies with pooled prevalence rates of 22% and 16% respectively. Only two studies evaluated insomnia, whose prevalence was estimated to be 19%. The overall prevalence of mental health disorders was similar amongst frontline HCWs (18%), general HCWs (17%), and students (20%) whilst being noticeably higher in the general population (27%). Conclusions: The results indicate that a considerable proportion of participants report the presence of anxiety, depression and insomnia symptoms. However, the pooled prevalence rates in Southeast Asia are significantly lower than those reported in other meta-analyses from other areas such as China and Europe. This meta-analysis may provide valuable evidence for more targeted identification of mental health needs and guide future research of long-term outcomes. Keywords: meta-analysis; Covid-19; mental health; pandemic; general population; healthcare workers; students; anxiety; depression; insomnia

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Section: Comparison Of Results With Previous Studiesmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of the Mental Health Symptoms during the Covid-19 Pandemic in Southeast Asia

Pappa

Chen

Barnett

et al. 2021

Preprint

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“…The scale was validated in Chinese university students with a clinically significant cutoff point of 10 ( 33 ). The majority of studies among medical students or students' mental health during the COVID-19 pandemic only presented results on mild to severe depressive symptoms using five as the cutoff point ( 3 , 9 , 12 , 16 , 34 ). For a better comparison with previous research and policy attention for subclinical symptoms, we used two cutoff points, namely a PHQ score ≥5 for mild to severe depressive symptoms and a PHQ score ≥10 for moderate to severe depressive symptoms.…”

Section: Methodsmentioning

confidence: 99%

“…We used a sample size calculation for the logistic regression ( 39 ). According to previous research on the prevalence of depressive symptoms among medical students or college students ( 3 , 9 ), we set P x = 0 = 0.27, P x = 1 = 0.40. Then, we assumed a detectable odds ratio (OR) of 1.2, α = 0.05, power = 0.8.…”

Section: Methodsmentioning

confidence: 99%

“…The COVID-19 pandemic has influenced the mental health status of college or university students. A meta-analysis showed that approximately one-third of college or university students had depressive or anxiety symptoms ( 9 ). Different testing procedures, dates, scales, or the cutoff points of scales may result in varied prevalence rates ( 9 ), such as 12% in Greece ( N = 1,104) ( 10 ) and nearly half in France ( N = 619) ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

“…A meta-analysis showed that approximately one-third of college or university students had depressive or anxiety symptoms ( 9 ). Different testing procedures, dates, scales, or the cutoff points of scales may result in varied prevalence rates ( 9 ), such as 12% in Greece ( N = 1,104) ( 10 ) and nearly half in France ( N = 619) ( 11 ). An online survey conducted among 11,787 Chinese college students in February 2020 showed that the prevalence rates of depressive [the Patient Health Questionnaire—nine-item (PHQ-9) ≥ 5] and anxiety [the seven-item Generalized Anxiety Disorder Scale (GAD-7) ≥ 5] symptoms were 25.9 and 17.8%, respectively ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

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The Association Between Social Support, COVID-19 Exposure, and Medical Students' Mental Health

et al. 2021

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Background: The coronavirus disease−2019 (COVID-19) pandemic has halted in-person medical education worldwide. Limited studies have reported on the mental health status of medical students during this public health emergency. This study aimed to explore the association of personal virus exposure, regional epidemic condition, and social support with medical students' depressive and anxiety symptoms during the COVID-19 outbreak in China.Methods: In February 2020, 5,982 medical students (60.0% females, Meanage = 21.7 years, Medianage = 22 years) completed an online survey consisting of demographics, personal virus exposure, the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Social Support Rating Scale.Results: The prevalence rates of mild to severe depressive symptoms and anxiety symptoms were 35.2 and 22.8%, respectively. Multivariate linear regression showed that students with low- or medium-level social support had a higher risk of experiencing depressive or anxiety symptoms than those with high-level social support. COVID-19 exposure was positively associated with mild to severe depressive or anxiety symptoms. Respondents living in provinces with 500–1,000 confirmed COVID-19 cases had an increased risk of experiencing mild to severe depressive symptoms compared with those living in provinces with <100 cases. Other related factors were gender and years of training.Conclusions: Some medical students suffered from a poor psychological status during the COVID-19 outbreak. Low social support was a stronger factor related to poor mental status compared with COVID-19 exposure or the provincial epidemic condition. Thus, we suggest that colleges or universities provide social support and mental health screening.

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Sleep Disturbance and SARS–CoV‐2 Vaccinations in Patients With Chronic Inflammatory Disease

Pawar

Taylor

Yang

et al. 2023

Arthritis Care & Research

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Objective Immunocompromised patients with chronic inflammatory diseases (CID) may have experienced additional psychosocial burden during the COVID‐19 pandemic due to an immunocompromised status. We hypothesized that vaccination will result in improved patient‐reported outcomes (PROs) longitudinally among individuals with CID undergoing SARS‐CoV‐2 vaccination following vaccination regardless of baseline anxiety. Methods Data are from a cohort of individuals with CID from two sites undergoing SARS‐CoV‐2 vaccination. Participants completed three study visits before and after two mRNA vaccine doses, in the initial vaccination series, where clinical data was collected. PROs were measured using the PROMIS‐29 Profile and expressed as T‐scores, with 2 groups stratified by high and low baseline anxiety. Mixed effects models were used to examine longitudinal changes, adjusting for age, gender, and study site. Results The cohort was 72% female with mean ±SD age of 48.1±15.5 years. Overall, sleep disturbance improved following both doses of SARS‐CoV‐2 vaccinations and anxiety decreased after the second dose. Physical function scores worsened but did not meet MID threshold. Stratifying by baseline anxiety, improvement in anxiety, fatigue, and social participation were greater for the high anxiety group. Physical function worsened slightly for both groups and sleep disturbance improved significantly in the high anxiety group. Conclusion Sleep disturbance decreased in a significant and meaningful way in patients with CID upon vaccination. In patients with higher baseline anxiety, social participation increased and anxiety, fatigue, and sleep disturbance decreased. Overall, results suggest that SARS‐CoV‐2 vaccines may improve mental health and wellbeing, particularly among those with greater anxiety.

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The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis

Cited by 314 publications

References 132 publications

A Systematic Review and Meta-Analysis of the Mental Health Symptoms during the Covid-19 Pandemic in Southeast Asia

A Systematic Review and Meta-Analysis of the Mental Health Symptoms during the Covid-19 Pandemic in Southeast Asia

The Association Between Social Support, COVID-19 Exposure, and Medical Students' Mental Health

Sleep Disturbance and SARS–CoV‐2 Vaccinations in Patients With Chronic Inflammatory Disease

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