Prevalence and associated factors of suicidal ideation among college students during the COVID-19 pandemic in China: a 3-wave repeated survey.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic, a major public health crisis, harms individuals' mental health. This 3-wave repeated survey aimed to examine the prevalence and correlates of suicidal ideation at different stages of the COVID-19 pandemic in a large sample of college students in China. METHODS: Using a repeated cross-sectional survey design, we conducted 3 online surveys of college students during the COVID-19 pandemic at 22 universities in Guandong, China. The 3 surveys were conducted during the outbreak period (T1: 3 February to 10 February 2020, N = 164,101), remission period (T2: 24 March to 3 April 2020, N = 148,384), and normalized prevention and control period (T3: 1 June to 15 June 2020, N = 159,187). Suicidal ideation was measured by the ninth item of the Patient Health Questionnaire-9. A range of suicide-related factors was assessed, including sociodemographic characteristics, depression, anxiety, insomnia, pre-existing mental health problems, and COVID-19-related factors. RESULTS: The prevalence of suicidal ideation was 8.5%, 11.0% and 12.6% at T1, T2, and T3, respectively. Male sex (aOR: 1.35-1.44, Ps < 0.001), poor self-perceived mental health (aOR: 2.25-2.81, Ps < 0.001), mental diseases (aOR: 1.52-2.09, P < 0.001), prior psychological counseling (aOR: 1.23-1.37, Ps < 0.01), negative perception of the risk of the COVID-19 epidemic (aOR: 1.14-1.36, Ps < 0.001), depressive symptoms (aOR: 2.51-303, Ps < 0.001) and anxiety symptoms (aOR: 1.62-101.11, Ps < 0.001) were associated with an increased risk of suicidal ideation. CONCLUSION: Suicidal ideation appeared to increase during the COVID-19 pandemic remission period among college students in China. Multiple factors, especially mental health problems, are associated with suicidal ideation. Psychosocial interventions should be implemented during and after the COVID-19 pandemic to reduce suicide risk among college students.

The Psychological Impact of the COVID-19 Epidemic on Guangdong College Students: The Difference Between Seeking and Not Seeking Psychological Help.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has considerably psychologically impacted Chinese college students. Several types of online mental health services were widely implemented for college students during the outbreak. This study investigated the relationship between college students' mental health status and psychological help-seeking behavior to test the phases-decision-making model (PDM). METHODS: A cross-sectional survey was conducted among college students in Guangdong Province using an online platform. In total, 4,164 students were assigned to the "counseling group" or "non-counseling group" according to whether they had sought psychological help because of the COVID-19 outbreak; the groups were matched based on age, sex, and grade. Demographics, perceived mental health, and experience with seeking psychological help were recorded. Fear, depression, and trauma were assessed by the COVID-19 Fear Screening Scale, Patient Health Questionnaire, and Impact of Event Scale-6. RESULTS: The fear, depression, and trauma scores were significantly higher in the counseling group than in the non-counseling group (P s < 0.001). Fear (OR = 1.27, p < 0.001), depression (OR = 1.02, p = 0.032), trauma (OR = 1.08, p < 0.001), poor perceived mental health status (OR = 3.61, p = 0.001), and experience with seeking psychological help (OR = 7.06, p < 0.001) increased the odds of seeking psychological help. CONCLUSION: During the COVID-19 epidemic, the rate of psychological help-seeking was still low, and college students in poor psychological condition sought psychological counseling more. Fear, depression, trauma, experience with seeking psychological help, and perceived mental health can effectively predict psychological help-seeking behavior. These findings emphasized the importance of closely monitoring college students' psychological status, providing psychological intervention, and improving the probability of seeking psychological help.