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Geographic Distribution of Mental Health Problems Among Chinese College Students During COVID-19 Pandemic: Cross-Sectional, Online Survey Study.

BACKGROUND
Since the outbreak of novel coronavirus disease 2019 (COVID-19), college students' mental health problems had drawn attention.


OBJECTIVE
We aim to estimate the prevalence of anxiety and depressive symptoms among college students in different geographical areas in China during the COVID-19 pandemic.


METHODS
A nationwide cross-sectional survey was conducted in 16 provinces or municipalities among Chinese college students from Feb 4 to Feb 12, 2020. An online survey was adopted to collect information, including demographics, perceived risk of infection, attitudes toward epidemic and control, and mental health status. Anxiety symptom was assessed by the Generalized Anxiety Disorder Scale (GAD-7); depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9). A total of 11 787 participants were involved in the current study. The Chi-square test was used to compare the percentage of the perceived risk of infection and attitude toward the COVID-19 between different geographic locations. The binary logistic models were used to identify associations between associations of geographic location and mental health problems after controlling for covariates.


RESULTS
A total of 11 787 participants were analyzed in the current study (response rate: 79.7%). The prevalence of anxiety, depressive symptoms were 17.8% (95%CI: 17.1%-18.5%) and 25.9% (95%CI: 25.1%-26.7%) for college students. After controlling for covariates, geographically speaking, current living in Wuhan was positively associated with anxiety symptoms (current living OR=1.69, 95%CI: 1.23-2.31, and depressive symptoms (current living OR=1.45, 95%CI: 1.21-1.89) compared with other areas. However, there is no difference in college location. Living or travel history in Wuhan last month was also positively associated with anxiety symptoms (OR=1.79, 95%CI: 1.51-2.31) and depressive symptoms (OR=1.62, 95%CI: 1.41-1.85). Both anxiety and depression were more prevalent among college students who reported with high perceived the infection risk of him/herself (χ2= 220.46 for anxiety, χ2=131.79 for depression; both P < .001) and family members (χ2=197.52 for anxiety, χ2=136.06 for depression; both P < .001). The prevalence of anxiety and depression were highest in college students who reported with very worry about the infection of her/himself (χ2=285.77 for anxiety, χ2=186.10 for depression; both P < .001), and community members(χ2=178.46 for anxiety, χ2=119.60 for depression; both P < .001). The prevalence of anxiety and depression were highest in college students who had a pessimistic attitude toward the COVID-19 epidemic (χ2=444.61 for anxiety, χ2=355.95 for depression; both P<.001) and control (χ2=154.02 for anxiety, χ2=124.84 for depression; both P< .001).


CONCLUSIONS
During the COVID-19 pandemic, mental health problems among Chinese college students were widespread and geographically diverse. Our results provide further insight into developing targeted intervention strategies.