Psychiatric symptoms, risk, and protective factors among university students in quarantine during the COVID-19 pandemic in China

• Published in: Globalization and health Vol. 17; no. 1; p. 15
• Main Authors: Sun, Shufang, Goldberg, Simon B, Lin, Danhua, Qiao, Shan, Operario, Don
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 25.01.2021; BioMed Central; BMC
• Subjects: Adolescent; Adult; Anxiety; Anxiety - epidemiology; China; China - epidemiology; College students; Control; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; Cross-Sectional Studies; Demographic aspects; Demographic variables; Depression - epidemiology; Diagnosis; Disadvantaged groups; Epidemics; Female; Health aspects; Health promotion; Humans; Infectious diseases; Male; Mental depression; Mental Disorders - epidemiology; Mental health; Mental illness; Middle Aged; Pandemics; Protective Factors; Psychiatric symptoms; Psychological aspects; Public health; Quarantine; Quarantine - psychology; Risk Factors; Signs and symptoms; Social interactions; Social support; Socioeconomic factors; Stigma; Stress; Stress Disorders, Traumatic - epidemiology; Students; Students - psychology; Students - statistics & numerical data; Universities; University students; Viral diseases; Young Adult; China; COVID-19; Stigma; Psychiatric symptoms; China; Young adult
• ISSN: 1744-8603; 1744-8603
• DOI: 10.1186/s12992-021-00663-x

The COVID-19 pandemic has made unprecedented impact on the psychological health of university students, a population vulnerable to distress and mental health disorders. This study investigated psychiatric symptoms (anxiety, depression, and traumatic stress) during state-enforced quarantine among university students in China (N = 1912) through a cross-sectional survey during March and April 2020. Psychiatric symptoms were alarmingly prevalent: 67.05% reported traumatic stress, 46.55% had depressive symptoms, and 34.73% reported anxiety symptoms. Further, 19.56% endorsed suicidal ideation. We explored risk and protective factors of psychological health, including demographic variables, two known protective factors for mental health (mindfulness, perceived social support), four COVID-specific factors (COVID-19 related efficacy, perceived COVID-19 threat, perceived COVID-19 societal stigma, COVID-19 prosocial behavior) and screen media usage. Across symptom domains, mindfulness was associated with lower symptom severity, while COVID-19 related financial stress, perceived COVID-19 societal stigma, and perceived COVID-19 threat were associated with higher symptom severity. COVID-19 threat and COVID-19 stigma showed main and interactive effects in predicting all mental health outcomes, with their combination associated with highest symptom severity. Screen media device usage was positively associated with depression. Female gender and COVID-19 prosocial behavior were associated with higher anxiety, while COVID-19 self-efficacy associated with lower anxiety symptoms. Findings suggest high need for psychological health promotion among university students during the COVID-19 pandemic and inform an ecological perspective on the detrimental role of stigma during an emerging infectious disease outbreak. Interventions targeting multi-level factors, such as promoting mindfulness and social support at individual and interpersonal levels while reducing public stigma about COVID-19, may be particularly promising. Attending to the needs of disadvantaged groups including those financially impacted by COVID-19 is needed.