Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.
Front Public Health. 2023 Jan 12;10:1031560. doi: 10.3389/fpubh.2022.1031560. eCollection 2022.
BACKGROUND: 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. OBJECTIVE: 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. MATERIALS AND METHODS: 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). RESULTS: (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. CONCLUSIONS: 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.
背景:在 2019 年的最后几个月,全世界的注意力都集中在 COVID-19 的大流行上,疫情迅速蔓延,成为国际关注的公共卫生紧急事件。中国政府迅速采取了隔离措施和遏制疫情的严厉措施,这可能对每个人的行为和心理健康产生有害影响。
目的:本研究旨在根据 COVID-19 大流行期间的两轮调查,探讨中国大学生影响因素与心理健康症状的相关性。
材料和方法:本研究分为两个阶段的横断面调查。2020 年 2 月和 5 月,通过整群抽样方法对上述地区的大学生进行了两轮横断面调查。2020 年 2 月 4 日至 2 月 12 日,来自中国 21 个城市和 16 个地区的 14789 名大学生完成了第一轮在线研究,不包括完成问卷的参与者,最终纳入 11787 名大学生。3 个月后,我们还根据第一项研究领域进行了一项大规模问卷调查,以观察大学生在 3 个月内的行为变化和心理症状。2020 年 5 月,采用方便抽样法对 16 个地区的 21 所大学的 COVID-19 认知和心理状况进行了调查。两轮调查的地区分为武汉(第 1 区)、邻近湖北(第 2 区)、北京、上海和广州(第 3 区)和其他省份(第 4 区)。
结果:(1)在第一轮调查中,参与者的平均年龄为 20.51±1.88 岁。三分之一的大学生是男性。共有 25.9%和 17.8%的大学生报告有抑郁和焦虑症状。报告 ST 较高、PA 较低、苏打饮料和茶饮料摄入较高、服用中草药和维生素、饮食频率降低的大学生,抑郁和焦虑症状较高。此外,感染风险、对 COVID-19 的抵抗力感知、对身体症状的关注、家庭/朋友直接/间接接触确诊病例、寻求心理咨询均与焦虑和抑郁症状显著相关。(2)在第二轮调查中,6803 名男性(41.7%)和 9502 名女性(58.3%)的平均年龄为 20.58±1.81 岁。COVID-19 期间抑郁症状和焦虑症状的患病率分别为 30.7%和 23.9%。(3)在两轮调查中,报告 ST 较高、PA 较低、苏打饮料和茶饮料摄入较高、服用中草药和维生素、饮食频率降低的大学生,抑郁和焦虑症状也较高。应对 COVID-19 的方式在一定程度上调节了一些相关生活方式行为与焦虑和抑郁之间的关系。条件过程模型分析的结果支持我们的假设,即生活方式行为和应对方式是焦虑和抑郁症状的预测因素,具有直接和间接影响,并受性别水平的调节。在逻辑回归分析中,第二轮调查中抑郁和焦虑的相关性高于第一轮调查。在两轮调查中,生活方式健康行为和应对方式、性别与心理健康之间存在相关性。
结论:我们的研究结果表明,两轮调查的焦虑和抑郁患病率不同,第二轮调查的患病率高于第一轮,两轮调查的患病率均高于第一轮。所有调查均表明,不健康的生活方式行为与抑郁和焦虑症状呈正相关。与风险地区新兴城市相比,其他大流行地区的心理健康问题风险较低。调查结果相互补充。生活方式健康行为和应对方式缓解了心理健康症状。与 COVID-19 相关的社会压力源与心理健康症状呈正相关。研究还表明,在大流行初期,有效管理大学生的心理健康问题、采取相应的应对措施和保持良好的生活方式,对于预防和控制其他城市的疫情至关重要。了解大学生在 COVID-19 封锁期间的生活方式行为将有助于公共卫生当局重塑未来的营养建议政策,为未来的大流行做好准备。
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