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      Disentangling depression in Belgian higher education students amidst the first COVID-19 lockdown (April-May 2020)

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          The surge of COVID-19 infections has prompted many countries to take unprecedented policy measures. In Belgium, the authorities implemented a nation-wide stay-at-home order for several months. Evidence of the mental health effect of such measures is scarce. A recent review by Brooks et al. has compiled a defined list of stressors affecting people’s mental health under quarantine during previous epidemic settings. This study aims to test the association between these stressors and the mental health of students attending higher education during the stay-at-home order in Belgium.


          In this cross-sectional study, 18,301 students from 13 higher education institutions (HEI) participated in an online survey between 26 April and 11 May 2020. We assessed the association between potential stressors and depressive symptoms severity scores and structural equation modeling was used to assess how stressors may mediate the association between duration of exposure and depressive symptoms severity.


          The stressors proposed by Brooks et al. were found to be associated with depressive symptoms severity. The stressors ‘perceived academic stress’, ‘institutional dissatisfaction’ and ‘fear of being infected’ were associated with substantially higher depressive symptoms severity scores. The association between duration of exposure and depressive symptoms severity was mediated by ‘academic stress’. Being in a steady relationship and living together with others were both associated with a lower depressive symptoms severity.


          Findings underline the need for a student-centered approach and mental health prevention. Authorities and HEIs should consider whether and if so, how a stay-at-home order should be implemented.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13690-020-00522-y.

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          Most cited references 21

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          The psychological impact of quarantine and how to reduce it: rapid review of the evidence

          Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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            Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives

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              The CES-D Scale: A Self-Report Depression Scale for Research in the General Population

               L Radloff (1977)

                Author and article information

                Arch Public Health
                Arch Public Health
                Archives of Public Health
                BioMed Central (London )
                7 January 2021
                7 January 2021
                : 79
                [1 ]GRID grid.5284.b, ISNI 0000 0001 0790 3681, Department of Family Medicine and Population Health, , University of Antwerp, ; Doornstraat 331, 2610 Wilrijk, Belgium
                [2 ]GRID grid.5284.b, ISNI 0000 0001 0790 3681, Department of Sociology, , University of Antwerp, ; Antwerp, Belgium
                [3 ]GRID grid.5342.0, ISNI 0000 0001 2069 7798, Department of Sociology, , Ghent University, ; Antwerp, Belgium
                [4 ]GRID grid.5284.b, ISNI 0000 0001 0790 3681, Social Epidemiology and Health Policy, , University of Antwerp, ; Antwerp, Belgium
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                Funded by: FundRef http://dx.doi.org/10.13039/501100007660, Universiteit Antwerpen;
                Award ID: 37025
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                © The Author(s) 2021


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