The psychological impact of the COVID-19 epidemic on college students in China.
TL;DR: Having relatives or acquaintances infected with COVID-19 was a risk factor for increasing the anxiety of college students and economic effects, and effects on daily life, as well as delays in academic activities, were positively associated with anxiety symptoms.
Abstract: A COVID-19 epidemic has been spreading in China and other parts of the world since December 2019. The epidemic has brought not only the risk of death from infection but also unbearable psychological pressure. We sampled college students from Changzhi medical college by using cluster sampling. They responded to a questionnaire packet that included the 7-item Generalized Anxiety Disorder Scale (GAD-7) and those inquiring the participants' basic information. We received 7,143 responses. Results indicated that 0.9% of the respondents were experiencing severe anxiety, 2.7% moderate anxiety, and 21.3% mild anxiety. Moreover, living in urban areas (OR = 0.810, 95% CI = 0.709 - 0.925), family income stability (OR = 0.726, 95% CI = 0.645 - 0.817) and living with parents (OR = 0.752, 95% CI = 0.596 - 0.950) were protective factors against anxiety. Moreover, having relatives or acquaintances infected with COVID-19 was a risk factor for increasing the anxiety of college students (OR = 3.007, 95% CI = 2.377 - 3.804). Results of correlation analysis indicated that economic effects, and effects on daily life, as well as delays in academic activities, were positively associated with anxiety symptoms (P < .001). However, social support was negatively correlated with the level of anxiety (P < .001). It is suggested that the mental health of college students should be monitored during epidemics.
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TL;DR: Predictive models revealed that the greatest protector for symptomatology was spiritual well-being, while loneliness was the strongest predictor of depression, anxiety and PTSD.
Abstract: The pandemic caused by Covid-19 has been an unprecedented social and health emergency worldwide. This is the first study in the scientific literature reporting the psychological impact of the Covid-19 outbreak in a sample of the Spanish population. A cross-sectional study was conducted through an online survey of 3480 people. The presence of depression, anxiety and post-traumatic stress disorder (PTSD) was evaluated with screening tests from 14 March. Sociodemographic and Covid-19-related data was collected. Additionally, spiritual well-being, loneliness, social support, discrimination and sense of belonging were assessed. Descriptive analyses were carried out and linear regression models compiled. The 18.7% of the sample revealed depressive, 21.6% anxiety and 15.8% PTSD symptoms. Being in the older age group, having economic stability and the belief that adequate information had been provided about the pandemic were negatively related to depression, anxiety and PTSD. However, female gender, previous diagnoses of mental health problems or neurological disorders, having symptoms associated with the virus, or those with a close relative infected were associated with greater symptomatology in all three variables. Predictive models revealed that the greatest protector for symptomatology was spiritual well-being, while loneliness was the strongest predictor of depression, anxiety and PTSD. The impact on our mental health caused by the pandemic and the measures adopted during the first weeks to deal with it are evident. In addition, it is possible to identify the need of greater psychological support in general and in certain particularly vulnerable groups.
935 citations
TL;DR: High rates of negative mental health outcomes in the Italian general population 3 weeks into the CO VID-19 lockdown measures and different COVID-19 related risk factors are found.
Abstract: Background The psychological impact of the COronaVIrus Disease 2019 (COVID-19) outbreak and lockdown measures on the Italian population are unknown. The current study assesses rates of mental health outcomes in the Italian general population three to 4 weeks into lockdown measures and explores the impact of COVID-19 related potential risk factors. Methods A web-based survey spread throughout the internet between March 27th and April 6th 2020. Eighteen thousand one hundred forty-seven individuals completed the questionnaire, 79.6% women. Selected outcomes were post-traumatic stress symptoms (PTSS), depression, anxiety, insomnia, perceived stress, and adjustment disorder symptoms (ADS). Seemingly unrelated logistic regression analysis was performed to identify COVID-19 related risk factors. Results Endorsement rates for PTSS were 6,604 (37%), 3,084 (17.3%) for depression, 3,700 (20.8%) for anxiety, 1,301 (7.3%) for insomnia, 3,895 (21.8%) for high perceived stress and 4,092 (22.9%) for adjustment disorder. Being woman and younger age were associated with all of the selected outcomes. Quarantine was associated with PTSS, anxiety and ADS. Any recent COVID-related stressful life event was associated with all the selected outcomes. Discontinued working activity due to the COVID-19 was associated with all the selected outcomes, except for ADS; working more than usual was associated with PTSS, Perceived stress and ADS. Having a loved one deceased by COVID-19 was associated with PTSS, depression, perceived stress, and insomnia. Conclusion We found high rates of negative mental health outcomes in the Italian general population 3 weeks into the COVID-19 lockdown measures and different COVID-19 related risk factors. These findings warrant further monitoring on the Italian population's mental health.
897 citations
Cites background from "The psychological impact of the COV..."
...This latter bias could have affected also two other large web-based surveys in China, that reported on samples with a 64.7% and 67.3% proportion of woman (12, 13)....
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...Furthermore, cultural, social, and health care system differences between China and Italy could explain differences in reported mental health outcomes....
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...A study on 7,143 medical students in China (22) found severe anxiety rates, assessed as GAD≥15, to be 0....
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...Compared to another large web-based survey from China on 52,730 respondents that evaluated peritraumatic stress-related symptoms, we found similar rates of PTSS (13)....
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...Concerning the COVID-19 pandemic, a study on 1210 respondents in China found rates of 30% of anxiety and 17% of depression (12)....
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TL;DR: The results of this cross-sectional study suggest that the groups most psychologically affected by the COVID-19 pandemic are women, individuals with previous psychiatric illness, individuals living in urban areas and those with an accompanying chronic disease.
Abstract: Background:The COVID-19 pandemic is having negative effects on societies’ mental health. Both the pandemic and the measures taken to combat it can affect individuals’ mental health.Aims:The purpose...
858 citations
Cites background from "The psychological impact of the COV..."
...Family income stability and living together with parents were found to exhibit a protective effect against anxiety symptoms (Cao et al., 2020)....
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TL;DR: In this article, the authors present the most comprehensive and large-scale study to date on how students perceive the impacts of the first wave of COVID-19 crisis on various aspects of their lives on a global level.
Abstract: The paper presents the most comprehensive and large-scale study to date on how students perceive the impacts of the first wave of COVID-19 crisis in early 2020 on various aspects of their lives on a global level. With a sample of 30,383 students from 62 countries, the study reveals that amid the worldwide lockdown and transition to online learning students were most satisfied with the support provided by teaching staff and their universities’ public relations. Still, deficient computer skills and the perception of a higher workload prevented them from perceiving their own improved performance in the new teaching environment. Students were mainly concerned about issues to do with their future professional career and studies, and experienced boredom, anxiety, and frustration. The pandemic has led to the adoption of particular hygienic behaviours (e.g., wearing masks, washing hands) and discouraged certain daily practices (e.g., leaving home, shaking hands). Students were also more satisfied with the role played by hospitals and universities during the epidemic compared to the governments and banks. The findings also show that students with certain socio-demographic characteristics (male, part-time, first-level, applied sciences, a lower living standard, from Africa or Asia) were significantly less satisfied with their academic work/life during the crisis, whereas female, full-time, first-level students and students faced with financial problems were generally affected more by the pandemic in terms of their emotional life and personal circumstances. Key factors influencing students’ satisfaction with the role of their university are also identified. Policymakers and higher education institutions around the world may benefit from these findings while formulating policy recommendations and strategies to support students during this and any future pandemics.
849 citations
TL;DR: The results indicate the importance of considering social contacts in students’ mental health and offer starting points to identify and support students at higher risk of social isolation and negative psychological effects during the COVID-19 pandemic.
Abstract: This study investigates students' social networks and mental health before and at the time of the COVID-19 pandemic in April 2020, using longitudinal data collected since 2018. We analyze change on multiple dimensions of social networks (interaction, friendship, social support, co-studying) and mental health indicators (depression, anxiety, stress, loneliness) within two cohorts of Swiss undergraduate students experiencing the crisis (N = 212), and make additional comparisons to an earlier cohort which did not experience the crisis (N = 54). In within-person comparisons we find that interaction and co-studying networks had become sparser, and more students were studying alone. Furthermore, students' levels of stress, anxiety, loneliness, and depressive symptoms got worse, compared to measures before the crisis. Stressors shifted from fears of missing out on social life to worries about health, family, friends, and their future. Exploratory analyses suggest that COVID-19 specific worries, isolation in social networks, lack of interaction and emotional support, and physical isolation were associated with negative mental health trajectories. Female students appeared to have worse mental health trajectories when controlling for different levels of social integration and COVID-19 related stressors. As universities and researchers discuss future strategies on how to combine on-site teaching with online courses, our results indicate the importance of considering social contacts in students' mental health and offer starting points to identify and support students at higher risk of social isolation and negative psychological effects during the COVID-19 pandemic.
786 citations
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5,446 citations
TL;DR: The COVID-19 crisis has laid bare the preexisting conditions of modern society: inequality, workers’ rights violations, air pollution, and biodiversity loss, to climate change.
1,534 citations
"The psychological impact of the COV..." refers background or result in this paper
...Finally, social support was negatively correlated with the anxiety of college students, which is consistent with previous findings (Thompson et al., 2016; Chen et al., 2020)....
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...There have been reports on the psychological impact of the epidemic on the general public, patients, medical staff, children, and older adults (Chen et al., 2020; Yang et al., 2020; Li et al., 2020)....
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1,341 citations
"The psychological impact of the COV..." refers background in this paper
...The novel coronavirus (COVID-2019) has spread very rapidly all over China and several other countries, causing an outbreak of acute infectious pneumonia (Bao et al., 2020)....
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...It has been indicated that the increasing number of patients and suspected cases, as well as the increasing number of provinces and countries affected by the outbreak, have elicited public worry about being infected in this outbreak, which has increased anxiety (Bao et al., 2020)....
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TL;DR: The coronavirus disease 2019 (COVID-19) epidemic has now spread across China for over a month, and Xiang and colleagues, claim that the mental health needs of patients with confirmed CO VID-19, patients with suspected infection, quarantined family members, and medical personnel have been poorly handled.
1,244 citations
"The psychological impact of the COV..." refers background in this paper
...The epidemic brought not only the risk of death from the viral infection but also unbearable psychological pressure to people in China and the rest of the world (Xiao, 2020; Duan, 2020)....
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TL;DR: The coronavirus emergency is rapidly evolving, and one can more or less predict expected mental/physical health consequences and the most vulnerable populations, which include: the infected and ill patients, their families, and colleagues; (ii) Chinese individuals and communities; (iii) individuals with pre-existing mental health conditions.
Abstract: In December 2019, cases of life-threatening pneumonia were reported in Wuhan, China. A novel coronavirus (2019-nCoV) was identified as the source of infection. The number of reported cases has rapidly increased in Wuhan as well as other Chinese cities. The virus has also been identified in other parts of the world. On 30 January 2020, the World Health Organization (WHO) declared this disease a ‘public health emergency of international concern.’ As of 3 February 2020, the Chinese government had reported 17 205 confirmed cases in Mainland China, and the WHO had reported 146 confirmed cases in 23 countries outside China. The virus has not been contained within Wuhan, and other major cities in China are likely to experience localized outbreaks. Foreign cities with close transport links to China could also become outbreak epicenters without careful public health interventions. In Japan, economic impacts and social disruptions have been reported. Several Japanese individuals who were on Japanese-government-chartered airplanes from Wuhan to Japan were reported as coronavirus-positive. Also, human-to-human transmission was confirmed in Nara Prefecture on 28 January 2020. Since then, the public has shown anxiety-related behaviors and there has been a significant shortage of masks and antiseptics in drug stores. The economic impact has been substantial. Stock prices have dropped in China and Japan, and other parts of the world are also showing some synchronous decline. As of 3 February 2020, no one had died directly from coronavirus infection in Japan. Tragically, however, a 37-year-old government worker who had been in charge of isolated returnees died from apparent suicide. This is not the first time that the Japanese people have experienced imperceptible-agent emergencies – often dubbed as ‘CBRNE’ (i.e., chemical, biological, radiological, nuclear, and high-yield explosives). Japan has endured two atomic bombings in 1945, the sarin gas attacks in 1995, the H1N1 influenza pandemic in 2009, and the Fukushima nuclear accident in 2011: all of which carried fear and risk associated with unseen agents. All of these events provoked social disruption. Overwhelming and sensational news headlines and images added anxiety and fear to these situations and fostered rumors and hyped information as individuals filled in the absence of information with rumors. The affected people were subject to societal rejection, discrimination, and stigmatization. Fukushima survivors tend to attribute physical changes to the event (regardless of actual exposure) and have decreased perceived health, which is associated with decreased life expectancy. Fear of the unknown raises anxiety levels in healthy individuals as well as those with preexisting mental health conditions. For example, studies of the 2001 anthrax letter attacks in the USA showed long-term mental health adversities as well as lowered health perception of the infected employees and responders. Public fear manifests as discrimination, stigmatization, and scapegoating of specific populations, authorities, and scientists. As we write this letter, the coronavirus emergency is rapidly evolving. Nonetheless, we can more or less predict expected mental/physical health consequences and the most vulnerable populations. First, peoples’ emotional responses will likely include extreme fear and uncertainty. Moreover, negative societal behaviors will be often driven by fear and distorted perceptions of risk. These experiences might evolve to include a broad range of public mental health concerns, including distress reactions (insomnia, anger, extreme fear of illness even in those not exposed), health risk behaviors (increased use of alcohol and tobacco, social isolation), mental health disorders (post-traumatic stress disorder, anxiety disorders, depression, somatization), and lowered perceived health. It is essential for mental health professionals to provide necessary support to those exposed and to those who deliver care. Second, particular effort must be directed to vulnerable populations, which include: (i) the infected and ill patients, their families, and colleagues; (ii) Chinese individuals and communities; (iii) individuals with pre-existing mental/physical conditions; and, last but not least, (iv) health-care and aid workers, especially nurses and physicians working directly with ill or quarantined persons. If nothing else, the death of the government quarantine worker must remind us to recognize the extent of psychological stress associated with imperceptible agent emergencies and to give paramount weight to the integrity and rights of vulnerable populations.
1,191 citations
"The psychological impact of the COV..." refers background in this paper
...The urban economy is relatively prosperous and provides citizens with better material security (Shigemura et al., 2020) ....
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