Eileen Heumann

Substance use (SU) and physical activity (PA) among university students changed with the beginning of the COVID-19 pandemic. In this study, we examined factors associated with SU and PA and profiles of these health behaviours in university students in Germany 20 months into the pandemic. A cross-sectional study on student well-being during the COVID 19-pandemic was conducted in October/November 2021 at five German universities. 7203 students completed the web-based survey. Smoking, binge drinking, cannabis use, and moderate and vigorous PA served as outcomes. Twenty months into the pandemic, 17% of students reported smoking, 19% binge drinking and 6% cannabis use at least once during the last week. 13% reported low moderate and 35% low vigorous PA in the last week. Students perceiving studies to be more important than other activities showed lower odds for SU. Depressive symptoms were associated with a higher chance of smoking (OR 1.07; 95%-CI 1.06–1.09 per one unit on the CESD-8-scale) and cannabis use (1.07; 95%-CI 1.04–1.09), low moderate (1.09; 95%-CI 1.07–1.11) and low vigorous (1.06; 95%-CI 1.05–1.07) PA. The ‘health protective behaviour’-profile with high overall PA and low SU was the most common one found. Among other factors, perceiving studying to be less important than other activities and reporting depressive symptoms appear to play a role in reporting risky health behaviours. Prevention programmes should therefore be integrated in the university setting and address mental health issues and health behaviours simultaneously.

Introduction: Evidence shows that German higher education students are vulnerable to depressive symptoms. However, there is no recent review compiling these findings. Thus, our study aims at describing the extent to which higher education students in Germany are affected by depressive symptoms. Methods: We searched three databases for suitable publications using three core concepts (‘depressive symptoms’, ‘students’, and ‘Germany’). The inclusion criteria were: (a) the population studied consisted of students from higher education institutions, (b) data was assessed at higher education institutions in Germany, (c) information on depressive symptoms were pro-vided as outcome of instruments assessing depressive symptoms, (d) articles were published in peer-reviewed journals, in (e) English or German and (f) between 2002 and 2023. Random effects models were used to calculate both general and subgroup-specific pooled prevalence rates. Subgroups were formed based on the included literature (e.g. gender, before or during the COVID-19 pandemic, study phase and programme). Results: The literature search resulted in 992 articles. After the removal of duplicates and the two-stage screening process, prevalence data was extracted from 60 articles. The overall pooled prevalence rate was 21.1% (95% CI: 17.6% - 24.6%). Medical students (13.2%; 95% CI: 9.9% - 16.4%) and first-year students (11.0%; 95% CI: 7.7% - 14.3%) were less likely to be affected than students in general. Women (29.0%; 95% CI: 21.4% - 36.5%) were more prone to depressive symptoms than men (23.1%; 95% CI: 16.5% - 29.6%). In samples collected during the COVID-19 pandemic, the pooled prevalence rates were higher than in pre-pandemic times (30.6%; 95% CI: 22.1% - 39.1% vs. 18.0%; 95% CI: 14.7% - 21.2%). Conclusions: This analysis emphasizes the pressing need to address the mental health of higher education students both at the policy level and within universities. Key messages: • German higher education students show alarming levels of depressive symptoms, demanding immediate action. • During the pandemic mental health was even poorer than before, highlighting the need for tailored interventions and support in challenging times.

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Introduction: Data on the mental health of university students in Germany during the later stages of the pandemic is still limited. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 1.5 years after the first COVID-19 restrictions and (2) which factors were associated with these outcomes.Methods: The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 6,996 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analyzed using multivariable logistic regression models.Results: The mean age of the participants was 23.9 years (SD = 4.8), 67% were female and 31% male. The prevalence for depressive symptoms was 29 and 32% for anxiety. The lack of a trusted person and financial difficulties were associated with anxiety and depressive symptoms. Being worried that someone in one’s personal network had become severely ill with COVID-19 and concern about (re)infection with COVID-19 were associated with anxiety symptoms. Those with pre-existing health conditions had an up to 1.98-times higher chance for reporting depressive symptoms (OR, 95% CI: 1.01–3.88) and an up to 2.27-times higher chance for anxiety symptoms, respectively (OR, 95% CI: 1.15–4.46).Conclusion: Concepts for prevention and counseling to tackle mental health problems in students are needed and programs should take specific stressors in times of crises into account.

Objectives: Higher education students in Germany are vulnerable to depressive symptoms. Despite ample evidence, no comprehensive review has recently been conducted. Thus, our systematic review and meta-analysis aims at describing the extent to which students are affected by depressive symptoms.Methods: We searched three databases for articles reporting the prevalence rates of depressiveness among students in Germany published between 2002 and 2023. Pooled prevalence rates were calculated using random effects models, both for the overall sample and for subgroups categorized by gender, study setting, assessment instrument, and whether the study was conducted before or during the COVID-19 pandemic.Results: The search yielded 992 records. After screening, 60 articles remained for data extraction. About one out of five students (21.1%) exhibits depressive symptoms. Pooled prevalence rates differ between subgroups, with higher rates during the COVID-19 pandemic than before (30.6% versus 18.0%) and with females being more affected than their male counterparts (29.0% versus 23.1%).Conclusion: This review underlines the urgency with which the mental health of students should be addressed at the (higher educational) policy level.Clinical Trial Registration: PROPSPERO, Identifier CRD42022384066.

Zusammenfassung: Hintergrund: Unter Studierenden sind depressive Symptome weit verbreitet, wobei weibliche Studierende häufiger davon betroffen sind als männliche. Vorherige Forschung zeigt einen Anstieg der Prävalenz depressiver Symptome in den ersten Semestern. Die COVID-19-Pandemie („coronavirus disease 2019“) könnte diesen Trend verschärft haben. Die vorliegende Studie untersucht deshalb, ob genderspezifische Unterschiede in der depressiven Symptomatik von Studienanfänger*innen während der COVID-19-Pandemie fortbestehen und ob ein Unterschied in der depressiven Symptomatik von Studienanfänger*innen und fortgeschrittenen Studierenden vorliegt. Methode: Die depressive Symptomatik von Studienanfänger*innen und fortgeschrittenen Studierenden wurde mithilfe des PHQ-2 (Patient Health Questionnaire‑2) ermittelt sowie untersucht, ob ein genderspezifischer Unterschied vorliegt. Ergebnisse: Depressive Symptome wiesen 30 % der Studienanfänger*innen auf. Die Prävalenz war mit 32 % bei weiblichen Studienanfängerinnen höher als bei ihren männlichen Kommilitonen (25 %). Es zeigen sich weder genderspezifische Unterschiede bei Studienanfänger*innen noch (genderspezifische) Unterschiede zwischen Studienanfänger*innen und fortgeschrittenen Studierenden. Schlussfolgerung: Studierende berichteten häufig depressive Symptome, ein genderspezifischer Unterschied zeigte sich aber nicht. Sowohl bei männlichen als auch bei weiblichen Studierenden unterschied sich die Prävalenz nicht zwischen Anfangs- und fortgeschrittener Studienzeit. Frühzeitige Interventionen in der Studieneingangsphase und die Anpassung von Studienbedingungen sind in Anbetracht der hohen Prävalenz für die psychische Gesundheit Studierender wichtig.

Background and Objective: University students are generally vulnerable to mental health problems. This vulnerability was further exacerbated by the COVID-19 pandemic as students experienced restrictions in public and academic life. The aim of this study was (1) to describe students’ perception...

University students are generally vulnerable to mental health problems. This was exacerbated during the COVID-19 pandemic, when students experienced decisive changes and restrictions in their academic lives. Our study aimed at (a) analysing associations between study conditions and symptoms of depression and anxiety and (b) determining the extent of use and motivation to use student counselling services. The C19 GSWS is a cross-sectional study conducted at five universities in Germany (N = 7203). Descriptive analyses and linear regression models were performed to estimate the associations between study conditions and mental health outcomes. A total of 42.4% of the students felt down, depressed, or hopeless on several days over the past 14 days. Between a third and 44.1% of the students felt burdened by their study conditions. Worse perceived study conditions were associated with higher levels of depressive symptoms and anxiety. Only 7.1% indicated that they had utilised student counselling services, and female gender, enrolment in a bachelor’s programme, and having more than 1 reason for utilisation were factors associated with use. The results of our research underline the need for universities to review their study conditions and to provide targeted intervention strategies and counselling services to promote students’ mental well-being.

Background: Anxiety is widespread among university students. The COVID-19 pandemic af-fected students’ mental health negatively. Given the long duration of the pandemic monitoring mental health remains important. This study aims to determine to which extent anxiety is preva-lent among students (1), what factors are associated with it (2) and which student groups are mostly affected (3). Methods: The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) sur-veyed mental health and well-being of students at five universities in Germany from 27.10.-14.11.21. Anxiety was assessed using the GAD-2. Associations between anxiety and sociodem-ographic, socioeconomic/social support factors as well as health- and COVID-19-related factors were determined using multiple binary logistic regression models. Results: The mean age of students was 24.1 years (SD = 4.9), 67% were women and 31% men. The prevalence of anxiety was 32% and diverse gender (OR = 3.98, 95% CI: 1.71-9.23), a com-plicated relationship status (OR = 1.66, 95% CI: 1.06-2.60), the lack of a confidant (OR = 2.50, 95% CI: 1.80-3.46), and financial difficulties (e.g., being able to cover monthly expenses; OR = 1.76, 95% CI: 1.36-2.29) were associated with anxiety. Participants who were worried about (re)infection with COVID-19 had a 1.28-times higher chance (OR, 95% CI: 1.03-1.59) for anxie-ty. Students who were (rather) not worried that a relative would become severely ill with COVID-19 had a lower chance to experience anxiety (OR = 0.72, 95% CI: 0.53-0.98) as well as those who were confident receiving medical care in case of an infection with COVID-19 (OR = 0.80, 95% CI: 0.65-0.98). Conclusions: Concepts for prevention and counselling in terms of mental health problems in students should be developed considering specific stressors due to the pandemic. Key messages: • This study shows that anxiety is widespread among university students and associated with a variety of stressors. • The findings can help to develop specific concepts for prevention and counselling.