Abstract
Our research group recently reported that symptom levels of depression, anxiety, and stress among Swedish university students were relatively stable during the first three months of COVID-19 and decreased slightly during the following three summer months. Since then, Sweden has faced a second and third wave of COVID-19.Aims:This study aims to describe the mean trajectories of depression, anxiety and stress symptoms among Swedish university students before and during the second and third waves of the COVID-19 pandemic.Methods:We recruited 1835 participants in September 2020, of whom 81% provided follow-ups in December 2020–January 2021 and 77% provided follow-ups in March–April 2021. The short-form Depression, Anxiety and Stress Scale was used to measure mental health symptoms. Generalized estimating equations were used to estimate the mean differences in symptom levels over the three time periods.Results:Compared with September, mean depression was 0.91 points of 21 higher (95% confidence interval (CI) 0.70–1.13) in December 2020–January 2021 and 0.66 points higher (95% CI 0.43–.88) in March–April 2021. Anxiety levels were 0.20 points higher (95% CI 0.05–0.34) in December 2020–January 2021 and 0.17 points higher (95% CI 0.02–0.33) in March–April 2021. Stress levels were 0.21 points higher (95% CI 0.00–0.41) in December 2020–January 2021 and 0.16 points lower (95% CI −0.38 to 0.05) in March–April 2021.Conclusions: Our results indicate relatively stable levels of mental health among Swedish university students during the second and third waves of COVID-19 compared with before the second wave. Mean depression symptom scores increased slightly, but the importance of this small increase is uncertain.
Highlights
Online education became the main form of education in Swedish universities on 17 March 2020, with no or minimal campus-based education since that date
We included 1835 students in September 2020, before the second wave of COVID-19 started in Sweden, with follow-ups in December 2020–January 2021 and in March–April 2021
Our results suggest that mean symptom levels of depression were slightly higher during the second and third waves of the COVID-19 pandemic compared with before the second wave
Summary
Online education became the main form of education in Swedish universities on 17 March 2020, with no or minimal campus-based education since that date. Our research group recently published results from a cohort study describing the trajectories of mental health symptoms among Swedish university students before and during the first six months of the COVID-19 pandemic [1]. We observed stable symptom levels of depression, anxiety and stress during the first wave of the pandemic and a slight decrease in the following summer months. In Sweden, the number of COVID-19 cases and deaths began to rise markedly in October 2020 and continued rising through November and most of December, with decreasing numbers in late December 2020 and early January 2021 [2]. In March 2021, the spread was once again accelerating [2] into what has been referred to as the third wave.
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