The correlation between lifestyle health behaviors, coping style, and mental health during the COVID-19 pandemic among college students: Two rounds of a web-based study.
During the last months of 2019, worldwide attention has focused on a pandemic of COVID-19, and the pandemic spread rapidly, becoming a public health emergency of international concern. The Chinese government has quickly taken quarantine measures and the drastic measures incurred to curtail it, which could have harmful consequences for everyone's behavior and mental health.
This study aimed to investigate the correlation of influencing factors and mental health symptoms among Chinese college students according to two rounds of surveys during the COVID-19 pandemic.
This study was divided into two stages of cross-sectional investigation. In February 2020 and May 2020, two cross-sectional surveys were conducted on college students in the above areas by means of cluster sampling. From February 4 to February 12, 2020, 14,789 college students completed the first round of online study from 16 cities and universities in 21 in China, excluding participants who completed the questionnaire, and finally included 11,787 college students. After 3 months, we also conducted a large-scale questionnaire survey based on the first study area to observe the behavioral changes and psychological symptoms of college students within 3 months. Using the convenience sampling method, a survey on the cognitive and psychological status of COVID-19 among college students was conducted in 21 universities in 16 regions in May 2020. The regions among the two surveys are divided into Wuhan (District 1), neighboring Hubei (District 2), first-tier cities, namely, Beijing, Shanghai and Guangzhou (District 3), and other provinces (District 4).
(1) In the first survey, the average age of the participants was 20.51 ± 1.88 years. One-third of the college students were male. In total, 25.9 and 17.8% of college students reported depression and anxiety symptoms, respectively. College students, who reported higher ST, lower PA, higher soda beverage and tea beverage intake, have Chinese herbal medicine and vitamin drinking, and decreased frequency of diet had higher depression and anxiety symptoms. Moreover, infection risk, perceived resistance to COVID-19, concerns about physical symptoms, family/friends directly/indirectly contacted with confirmed cases, and seeking psychological counseling had significant associations with anxiety and depression symptoms. (2) In the second round of surveys, 6803 males (41.7%) and 9502 females (58.3%) had a mean age of 20.58 ± 1.81 years. The prevalence of depressive symptoms and anxiety symptoms during COVID-19 was 30.7 and 23.9%, respectively. (3) In both surveys, college students who reported having higher ST, lower PA, higher soda beverage and tea beverage intake, Chinese herbal medicine and vitamin drinking, and decreased frequency of diet also had higher depression and anxiety symptoms. Coping styles with COVID-19 partially mediate the association between some related lifestyle behaviors and anxiety and depression. The results of the conditional process model analysis support our hypothesis that lifestyle behaviors, and coping styles are both predictors of anxiety and depression symptoms, with both direct and indirect effects moderated by gender level. In logistic regression analysis, the correlation of depression and anxiety in the second rounds of the survey was higher than that in the first survey. In two surveys, there was a correlation between lifestyle health behaviors and coping style, gender and mental health.
Our findings demonstrated that the prevalence of anxiety and depression in the two rounds of surveys was different, and the prevalence in the second round was higher than that in the first round, as well as that in the two rounds of surveys. All survey identified that unhealthy lifestyle behaviors were positively associated with depression and anxiety symptoms. Compared with the emerged city of risk areas, other pandemic regions have a lower risk of mental health problems. The survey findings complement each other. Lifestyle health behaviors and coping style alleviated mental health symptoms. COVID-19-related social stressors were positively associated with mental health symptoms. The study also suggests that at the beginning of the pandemic, the effective management of college students' mental health problems, corresponding coping measures and maintaining a good lifestyle play a key role in the prevention and control of other cities. Understanding the college students' lifestyle behaviors during COVID-19 lockdown will help public health authorities reshape future policies on their nutritional recommendations, in preparation for future pandemics.
Zhang Y
，Tao S
，Qu Y
，Mou X
，Gan H
，Zhou P
，Zhu Z
，Wu X
，Tao F
... -
《Frontiers in Public Health》
Psychological responses and factors associated with depression and anxiety in entry personnel under quarantine during pandemic in China.
The global COVID-19 pandemic has highlighted critical concerns surrounding mental health. Social isolation measures, such as the quarantine of incoming travelers, are essential public health strategies for the prevention and control of infectious diseases. However, quarantine can lead to adverse psychological outcomes, including feelings of confinement, boredom, perceived scarcity of supplies and information, financial hardship, and social stigma. This study aims to assess the mental states of quarantined individuals, investigate the factors affecting their mental well-being, and examine their coping mechanisms, with the objective of providing recommendations to enhance mental health in anticipation of future outbreaks, such as Disease X.
We surveyed 327 individuals in quarantine from September 22, 2020 to January 9, 2021, collecting general demographic data and information related to COVID-19. Depression and anxiety were assessed using the PHQ-9 and GAD-7 scales, respectively, while stress coping was evaluated with a simplified version of the Cope scale. We analyzed the relationships between independent variables and mental health outcomes.
Among the individuals undergoing entry quarantine, 27.8% reported symptoms of depression, and 20.5% reported symptoms of anxiety. Students were more likely to experience depression compared to those with permanent jobs or no occupation. Significant risk factors for both depression and anxiety included pre-existing health conditions, lack of medical insurance, concerns about shortages of daily necessities during quarantine, and high scores for "guilt and self-blame." Additionally, participants who worried about the impact of the epidemic on their studies or work, and those with high scores for "denial," were more likely to exhibit depressive symptoms. On the other hand, participants who were concerned about potential rejection or discrimination from the outside world after quarantine were more prone to anxiety symptoms.
Attention should be paid to the negative psychological reactions of the entry quarantined personnel, especially those with pre-existing health conditions, those without medical insurance, and students studying abroad. Accurate and effective epidemic dynamic information and preventive and control measures can be provided to the public to prevent fear and stigma against quarantined personnel.
Chen L
，Chu Q
，Xu C
，Zhou F
，Hu X
，Wang Z
，Jin Y
，Lv Y
... -
《Frontiers in Public Health》
Psychological distress associated with COVID-19 quarantine: Latent profile analysis, outcome prediction and mediation analysis.
Mental health of the population during COVID-19 quarantine could be at risk. Previous studies in short quarantines, found mood-related and anxiety symptomatology. Here we aimed to characterize the subtypes of psychological distress associated with quarantine, assess its prevalence, explore risk/protective factors, and possible mechanisms.
Online cross-sectional data (n = 4408) was collected during the Argentine quarantine, between 1st-17th April 2020 along a small replication study (n = 644). Psychological distress clusters were determined using latent profile analysis on a wide-range of symptoms using the complete Brief-Symptom Inventory-53. Multinomial and Elastic-net regression were performed to identify risk/protective factors among trait-measures (Personality and Resilience) and state-measures (COVID-19 related fear and coping-skills).
Three latent-classes defined by symptom severity level were identified. The majority of individuals were classified in the mild (40.9%) and severe classes (41.0%). Participants reported elevated symptoms of Phobic-Anxiety (41.3%), Anxiety (31.8%), Depression (27.5%), General-Distress (27.1%), Obsession-Compulsion (25.1%) and Hostility (13.7%). Logistic-regressions analyses mainly revealed that women, young individuals, having a previous psychiatric diagnosis or trauma, having high levels of trait-neuroticism and COVID-related fear, were those at greater risk of psychological distress. In contrast, adults, being married, exercising, having upper-class income, having high levels of trait-resilience and coping-skills, were the most protected. Mediation analysis, showed that state-measures mediated the association between trait-measures and class-membership.
Quarantine was associated intense psychological distress. Attention should be given to COVID-19-related fear and coping-skills as they act as potential mediators in emotional suffering during quarantine.
Fernández RS
，Crivelli L
，Guimet NM
，Allegri RF
，Pedreira ME
... -
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ResearchGate
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