Miyake Yoshie, Takagaki Koki, Yoshino Atsuo, Okamoto Yuri
Health Service Center, Hiroshima University, Higashi-Hiroshima, Japan.
Front Psychiatry. 2025 Jun 16;16:1480992. doi: 10.3389/fpsyt.2025.1480992. eCollection 2025.
The COVID-19 pandemic had exposed university students to unusual environmental stresses. High stress levels have been reported among adolescents with depressive symptoms. Subthreshold depression is highly prevalent among university students who are at high risk of developing clinical depression and other psychiatric disorders such as eating disorders. Therefore, this study aimed to investigate the effects of the pandemic on depressive symptoms and eating behaviors among Japanese university students with subthreshold depression from a cohort study.
A total of 555 fourth-year university students, 261 students before the pandemic and 294 students during the pandemic, were participated. The inclusion criteria were age 18-19 years and subthreshold depression upon entering the university and completed questionnaires at both university entrance and during their fourth year. We examined differences in depressive symptoms (Beck Depression Inventory II), eating behaviors (Eating Attitudes Test-26 and Bulimic Inventory Test, Edinburgh [BITE]), stress coping (Coping Inventory for Stressful Situations [CISS]), and the frequencies of the three depression groups (clinical, subthreshold, and healthy) before and during the pandemic. We also investigated the relationship between changes in depression and stress coping during the pandemic.
There was no significant differences in depression frequency in the fourth year before and during the pandemic. However, the two-way ANOVA on the grade and time revealed significant interaction effects on the BITE scores for females ( < 0.05), and the BITE scores were significantly higher for fourth-year female students during the pandemic than those when they entered the university. Although a decrease in the CISS-emotion-oriented score was associated with a reduction in depressive symptoms both before and during the pandemic, a decrease in the CISS-task-oriented score was associated with an increased risk of depressive symptoms during the pandemic only in males.
Our results suggest that not only depressive but also bulimic symptoms should have been monitored among university students with subthreshold depression during the pandemic. Attention to stress-coping behaviors may be important for interventions to prevent the deterioration from subthreshold depression to clinical depression during a pandemic. However, the results could have been affected by many other factors, and further research is required.
新冠疫情使大学生面临异常的环境压力。据报道，有抑郁症状的青少年压力水平较高。亚阈值抑郁在大学生中非常普遍，他们患临床抑郁症和其他精神疾病（如饮食失调）的风险很高。因此，本研究旨在通过一项队列研究，调查疫情对日本有亚阈值抑郁的大学生抑郁症状和饮食行为的影响。
共有555名四年级大学生参与，其中261名在疫情前入学，294名在疫情期间入学。纳入标准为年龄在18至19岁之间，入学时患有亚阈值抑郁，并在大学入学时和四年级时完成问卷。我们检查了疫情前和疫情期间抑郁症状（贝克抑郁量表第二版）、饮食行为（饮食态度测试-26和爱丁堡贪食量表[BITE]）、压力应对（应激情境应对量表[CISS]）以及三个抑郁组（临床、亚阈值和健康）频率的差异。我们还调查了疫情期间抑郁变化与压力应对之间的关系。
疫情前和疫情期间四年级学生的抑郁频率没有显著差异。然而，年级和时间的双向方差分析显示，女性的BITE得分存在显著的交互作用（<0.05），疫情期间四年级女生的BITE得分显著高于入学时。虽然在疫情前和疫情期间，CISS情绪导向得分的降低都与抑郁症状的减轻有关，但只有男性在疫情期间，CISS任务导向得分的降低与抑郁症状风险的增加有关。
我们的结果表明，在疫情期间，不仅应该监测有亚阈值抑郁的大学生的抑郁症状，还应该监测其贪食症状。关注压力应对行为对于在疫情期间预防亚阈值抑郁恶化为临床抑郁的干预措施可能很重要。然而，结果可能受到许多其他因素的影响，需要进一步研究。
