Mental health in Swiss university students during the COVID-19 pandemic

Background University students were confronted with abrupt changes by the COVID-19 lock-down in their personal and academic lives. The “Health in Students during the Corona pandemic” study investigated the impact on mental health and health behaviors of Swiss university students. Methods April 2020 all students of the Zurich University of Applied Sciences (N = 12,431) were invited to a repeated cross-sectional open cohort survey, participation ranged from T0 20% - T5 13%. Generalized anxiety (GAD-7), stress (PSS) and depression (PHQ-9) were investigated with descriptive and multivariate analyses. Latent class analyses (LCA) was applied to identify groups who differed in perception of impact on daily and student life. PHQ-9 results were compared with pre-pandemic data matched for age, sex and education. Results At T0 mean age was 26.5 (sd 5.6), 69% were female. Participants were similar across all surveys. LCA yielded three classes of perceived impact: 1 (low, n = 675), 2 (moderate, n = 1098), and 3 (strong, n = 656). At T0 adjusted proportion of moderate to severe anxiety was significantly higher in class 3 (45% (95% CI: 28.0-62.0), compared to 2 (15.5%, 95% CI: 13.1-17.9) and 1 (5.1%, 95% CI: 4.7-5.6). Class 3 showed significantly higher odds of high stress levels (class 3: OR = 28.4;95% CI: 15.5 - 52.0;p = 0.000;class 2: OR = 2.8;95% CI: 1.5 - 5.3;p = 0.002) compared to other students. Anxiety and stress levels declined with time. The adjusted prevalence of depressive symptoms in females (30.8% (95% CI: 28.6-33.0)) and males (24.8% (95% CI: 21.7-28.1) was substantially higher than in a matching pre-pandemic national sample of young women (10.9% (95% CI: 8.9-13.2)) and men (8.5% (6.6-11.0)). Depressive symptoms between T0 and T3 did not decline. Conclusions Students reported high anxiety, stress and depressive symptoms during the pandemic. Depressive symptoms did not decline with time, indicating a continuing impact on mental health throughout the pandemic.