Prospective examination of mental health in university students during the COVID-19 pandemic

  1. Ru Jia
  2. Holly Knight
  3. Kieran Ayling
  4. Carol Coupland
  5. Jessica Corner
  6. Chris Denning
  7. Jonathan Ball
  8. Kirsty Bolton
  9. Joanne R Morling
  10. Grazziela Figueredo
  11. David Ed Morris
  12. Patrick Tighe
  13. Armando Villalon
  14. Holly Blake
  15. Kavita Vedhara

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Abstract

Background

The impact of changing social restrictions on the mental health of students during the COVID-19 pandemic warrants exploration.

Aims

To prospectively examine changes to university students’ mental health during the pandemic.

Methods

Students completed repeated online surveys at three time points (October 2020 (baseline), February 2021, March 2021) to explore relationships between demographic and psychological factors (loneliness and positive mood) and mental health outcomes (depression, anxiety, and stress).

Results

A total of 893 students participated. Depression and anxiety levels were higher at all timepoints than pre-pandemic normative data ( p <.001). Scores on all mental health measures were highest in February, with depression and anxiety remaining significantly higher in March than baseline. Female students and those with previous mental health disorders were at greatest risk of poor mental health outcomes. Lower positive mood and greater loneliness at baseline were associated with greater depression and anxiety at follow-ups. Baseline positive mood predicted improvement of depression and anxiety at follow-ups.

Conclusion

Depression and anxiety were significantly higher than pre-pandemic norms, with female students and those with previous mental health difficulties being at greatest risk. Given these elevated rates, universities should ensure adequate support is available to meet potentially increased demand for services.

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  1. ScreenIT

    SciScore for 10.1101/2021.07.29.21261196: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: Recruitment: Ethical approval was received from the University of Nottingham Faculty of Health Sciences Research Ethics Committee (FMHS 96-0920).
    Consent: Procedures: Participants provided informed consent online before completing the online survey (JISC Online Surveys).
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were performed using STATA (Version 16) and GraphPad Prism (Version 7).
    STATA
    suggested: (Stata, RRID:SCR_012763)
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    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:
    (Barton & Pretty, 2010; Dubad et al., 2018; Grajfoner et al., 2017; Habak et al., 2020) Limitations: Despite the several strengths of this study such as longitudinal design and relatively large cohort, we acknowledge several limitations. First, the observational nature of the study means we cannot assume causal relationships between mental health outcomes and the impact of the COVID-19 pandemic. Second, nearly half (47%) of the original cohort were lost to follow-up. Although those who were lost to follow-up and completed all three surveys did not differ on most of the sociodemographic and baseline mental health measures, with the exception of anxiety. Although unlikely, it is possible that by excluding right censored data, our results overrepresented those with higher baseline anxiety. Third, our participants were self-selected and from a single institution in England with predominant proportion of undergraduate students and higher proportion of women than reported by Higher Education Policy Institute, (Higher Education Policy Institute) which also limits the generalisability of our findings. Nevertheless, our study showed the profound mental health difficulties university students experienced during the COVID-19 pandemic and point to potential avenues for psychological intervention (i.e., interventions addressing loneliness and positive mood).

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    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.

    Results from scite Reference Check: We found no unreliable references.

    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 10.1101/2021.07.29.21261196 on medRxiv