Depression and anxiety before and during the COVID-19 lockdown: a longitudinal cohort study with university students

  1. Virgínia da Conceição
  2. Inês Rothes
  3. Ricardo Gusmão
  4. Henrique Barros

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Abstract

Background

For young people, just as in the general population, COVID-19 caused many changes in their lives, including an increased risk for mental illness symptoms. We aimed to study the impact of the COVID-19 pandemic in anxiety and depression symptoms in a cohort of university students.

Methods

This study is part of broader longitudinal research on university students’ mental health with data of the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information.

Results

341 university students (257 females and 84 males) were included, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived wellbeing loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. The proportion of students with scores equal to or above 15 in the PHQ-9 ranged between 22.6% and 25.5% in 2019 and 37.0% in June 2020. The proportion of GAD-7 scores above cut-off ten ranged between 46.0% and 47.8% in 2019 and 64.5% in 2020. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher.

Discussion

COVID-19 impacted negatively depressive and anxiety symptoms, confirming previous studies and young people’s vulnerability in such uncertain times.

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  1. ScreenIT

    SciScore for 10.1101/2021.02.23.21252284: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The Institute of Public Health of the University of Porto ethics committee approved the research with the I.D. reference CE18096.
    Consent: All participants signed an informed consent digital form according to the Helsinki and Oviedo Conventions.
    RandomizationEthical and registration considerations: This study is part of comprehensive longitudinal research on first-year university students’ mental health, including an experimental single-blind randomised control trial.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableFrom those who accepted to participate, 77 were excluded from the sample because their age exceeded the 25-year-old limit marking the end of developmental adolescence characteristics (Sawyer et al., 2018; Twenge and Park, 2019), resulting in a sample of 626 females and 343 males.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    One limitation of this study is the high number of dropouts, increasing the risk of selection bias. The higher dropout rate occurred between the penultimate and the last evaluation moment, corresponding to the final evaluation pre-pandemic and the evaluation post-pandemic, which may be due to increased online activity in general and online research, in particular, developed in these pandemic times. However, there are no differences in the main study variables between participants and dropouts, minimising the risk of bias. Future research will be essential to explore further the impact on academic performance, social interaction and integration, mental health care service utilisation after the beginning of the pandemic and the type and duration of previous help.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    ISRCTN970936NANA
    ISRCTN63459073NANA

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.02.23.21252284v1 on medRxiv