Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis.

BACKGROUND: To evaluate the global prevalence of depression and anxiety symptoms among college students and potential associated factors. METHODS: PubMed and Web of Science were searched from their inception to March 28, 2021. Random-effects models were used to calculate the pooled prevalence of depression and anxiety. Subgroup analyses were conducted to explore potential heterogeneity. Egger's and Begg's test were used to assess publication bias. RESULTS: A total of 64 studies with 100,187 individuals were included in the present meta-analysis. The pooled prevalence of depression and anxiety symptoms among college students was 33.6% (95% confidence interval [CI] 29.3%-37.8%) and 39.0% (95% CI, 34.6%-43.4%), respectively. The highest prevalence of depression symptoms was found in Africa region (40.1%, 95% CI 12.3-67.9%), lower middle-income countries (42.5%, 95% CI 28.6-56.3%), and medical college students (39.4%, 95% CI 29.3-49.6%). For the prevalence of anxiety symptoms, the highest was observed in North America (48.3%, 95% CI 37.4-59.2%), lower middle-income countries (54.2%, 95% CI 35.0-73.4%), medical college students (47.1%, 95% CI 35.1-59.1%) and identified by Beck Anxiety Inventory (BAI) (49.1%, 95% CI 31.0-43.0%). Besides, the prevalence of depression symptoms (35.9%, 95% CI 20.2-51.7%) and anxiety symptoms (40.7%, 95% CI 39.5-42.0%) was higher in studies conducted after the coronavirus disease 2019 (COVID-19) outbreak. CONCLUSIONS: Our study suggests that a lot of college students experience depression and anxiety symptoms and clarifies factors that are related to these mental disorders. Effective prevention and intervention strategies for mental disorders should be developed among college students.

Anxiety, Depression, and Satisfaction With Life Among College Students in China: Nine Months After Initiation of the Outbreak of COVID-19.

BACKGROUND/OBJECTIVE: Mental health problems are common among college students. This study sought to assess the prevalence and risk factors of depressive and anxiety symptoms and well-being among Chinese college students 9 months after initiation of the outbreak of COVID-19. METHOD: A cross-sectional study (N = 3,951, mean age = 19.58) was conducted from October to December 2020. An online survey was used to collect socio-demographic data, and the symptoms of depression and anxiety and satisfaction with life using Disorder 7-Item Scale (GAD-7), the Patient Health Questionnaire 9-Item Scale (PHQ-9), and the 5-items Satisfaction with Life Scale (SWLS). RESULTS: The prevalence of depressive and anxiety symptoms was 59.35 and 54.34%, respectively, and the score of satisfaction with life was 20.51 ± 6.42 among Chinese college students during the pandemic. After controlling for covariates, students in urban areas (AOR = 0.73, 95% CI = 0.61-0.87), with good family economic levels (AOR = 0.77, 95% CI = 0.66-0.91), and having psychological counseling (AOR = 0.55, 95% CI = 0.42-0.73) were positively associated with depression symptoms; meanwhile, higher anxiety symptoms were observed among medical students (AOR = 0.81, 95% CI = 0.69-0.95). Besides, healthy lifestyle such as regular physical activity and diet was associated with depression and anxiety symptoms. Multiple linear models revealed that medical students (ß = 0.479, P = 0.031), those with good family economic level by self-evaluation (ß = 1.283, P < 0.001 for good; ß = 3.013, P < 0.001 for general), good academic performance by self-evaluation (ß = 1.786, P < 0.001 for good; ß = 3.386, P < 0.001 for general), learning burden (ß = 1.607, P < 0.001 for general; ß = 2.117, P < 0.001 for light), regular physical activity (ß = 0.859, P < 0.001), daily routine (ß = 1.289, P < 0.001), diet (ß = 1.714, P < 0.001), and sufficient sleep (ß = 1.408, P < 0.001) had more score of SWLS (all ß > 0, P < 0.05), while senior students (ß = -1.053, P=0.009), students having psychological counseling (ß = -1.753, P < 0.001), and drinking (ß = -0.743, P = 0.012) had lower satisfaction with life. CONCLUSIONS: These findings suggest that more attention should be paid to psychological health among college students, especially during and after the COVID-19 outbreak. Policy makers and educators should help college students develop a healthy lifestyle with regular diet and exercise to promote the psychological health of college students.