Among 746,217 college students surveyed, 45% reported mental health problems during the COVID-19 pandemic.
Prevalence rates of probable , depressive, and were 34.9%, 21.1%, and 11.0%, respectively.
Having relatives or friends infected with COVID-19 was associated with a higher risk of mental health problems, with adjusted odds ratios ranging from 1.72 to 2.33.
Students exposed to media coverage of COVID-19 for 3 or more hours per day were 2.13 times more likely to experience acute stress compared to those with less than 1 hour of exposure.
Low perceived social support was linked to a significantly increased likelihood of anxiety and , with odds ratios between 4.84 and 5.98.
Senior year and prior mental health issues were also significantly associated with anxiety and depressive symptoms.
Simplified
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. , depressive and 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 . 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.
Key numbers
45%
Prevalence of Mental Health Issues
Percentage of students reporting , anxiety, or .
2.13×
Increase
Likelihood of symptoms for students exposed to media >3 h/day vs. <1 h/day.
4.84–5.98×
Social Support Impact
Increased likelihood of anxiety/depression for students with low vs. high perceived social support.
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