Factors influencing depression and mental distress related to COVID-19 among university students in China: Online cross-sectional mediation study

Yanqiu Yu, Rui She, Sitong Luo, Meiqi Xin, Lijuan Li, Suhua Wang, Le Ma, Fangbiao Tao, Jianxin Zhang, Junfeng Zhao, Liping Li, Dongsheng Hu, Guohua Zhang, Jing Gu, Danhua Lin, Hongmei Wang, Yong Cai, Zhaofen Wang, Hua You, Guoqing HuJoseph Tak-Fai Lau

Research output: Journal article publicationJournal articleAcademic researchpeer-review

34 Citations (Scopus)

Abstract

Background: The COVID-19 epidemic may elevate mental distress and depressive symptoms in various populations in China. Objective: This study investigates the levels of depression and mental distress due to COVID-19, and the associations between cognitive, behavioral, and psychosocial factors, and depression and mental distress due to COVID-19 among university students in China. Methods: A large-scale online cross-sectional study (16 cities in 13 provinces) was conducted among university students from February 1 to 10, 2020, in China; 23,863 valid questionnaires were returned. The Patient Health Questionnaire-9 was used to assess depression. Structural equation modeling was performed to test mediation and suppression effects. Results: Of the 23,863 participants, 47.1% (n=11,235) reported high or very high levels of one or more types of mental distress due to COVID-19; 39.1% (n=9326) showed mild to severe depression. Mental distress due to COVID-19 was positively associated with depression. All but one factor (perceived infection risks, perceived chance of controlling the epidemic, staying at home, contacted people from Wuhan, and perceived discrimination) were significantly associated with mental distress due to COVID-19 and depression. Mental distress due to COVID-19 partially mediated and suppressed the associations between some of the studied factors and depression (effect size of 6.0%-79.5%). Conclusions: Both mental distress due to COVID-19 and depression were prevalent among university students in China; the former may have increased the prevalence of the latter. The studied cognitive, behavioral, and psychosocial factors related to COVID-19 may directly or indirectly (via mental distress due to COVID-19) affect depression. Interventions to modify such factors may reduce mental distress and depressive symptoms during the COVID-19 epidemic.

Original languageEnglish
Article numbere22705
JournalJMIR Mental Health
Volume8
Issue number2
DOIs
Publication statusPublished - Feb 2021
Externally publishedYes

Keywords

  • China
  • COVID-19
  • Depression
  • Mediation
  • Mental distress
  • Online survey
  • Psychological responses

ASJC Scopus subject areas

  • Psychiatry and Mental health

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