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      Prevalence and predictors of anxiety, depression and stress among university students during the period of the first lockdown in Germany

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          Abstract

          Background

          The COVID-19 pandemic exacerbates the risk for mental health issues of university students. The aims of the study were to investigate the prevalence of anxiety, depression and stress among university students during the period of the first lockdown in Germany, and the associations of possible risk and protective factors with all three outcome variables.

          Methods

          A total of 2.548 university students were included in the study. The study took place during the period of the first lockdown in Germany. Multiple hierarchical regression analyses were conducted to explore the role of demographic variables, personality traits, psychological capital variables, mindfulness, COVID-19 related variables, and coping strategies on anxiety, depression and stress.

          Results

          Results showed on average mild depressive and anxiety symptoms, and moderate perceived stress among the students. Alarmingly, 35.9% of the students showed a moderate-to-severe level of depression, 27.7% reported moderate to severe symptoms of anxiety, and 25.1% perceived high stress. Mindfulness and optimism were the most relevant protective factors against depression, anxiety and stress, whereas COVID-related stressors (e.g., worries about study and financial problems, being stressed by the Corona-pandemic and media reporting, quarantine experience) as well as personal characteristics (e.g., neuroticism, older age, being female) were risk factors for increasing mental health issues and/ or stress.

          Conclusion

          The pandemic has negatively affected the mental health of students. The results emphasize the importance of both professional help for students with mental health problems and effective prevention programs on university campuses that promote coping skills, and mental health during the current pandemic.

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          Most cited references80

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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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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              Is Open Access

              Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

              Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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                Author and article information

                Journal
                J Affect Disord Rep
                J Affect Disord Rep
                Journal of Affective Disorders Reports
                The Author. Published by Elsevier B.V.
                2666-9153
                13 June 2021
                July 2021
                13 June 2021
                : 5
                : 100174
                Affiliations
                [0001]Friedrich-Schiller-Universität Jena, Friedrich-Schiller-Universitat Jena, Jena, Germany
                Article
                S2666-9153(21)00101-3 100174
                10.1016/j.jadr.2021.100174
                8497174
                34642682
                2e6f1821-2de7-401f-a4ee-72539071c970
                © 2021 The Author

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 8 April 2021
                : 28 May 2021
                : 8 June 2021
                Categories
                Research Paper

                covid-19,lockdown,students,mental health,stress,mindfulness
                covid-19, lockdown, students, mental health, stress, mindfulness

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