Abstract

Background: The COVID-19 crisis has become the largest crisis in modern times and has particularly impacted students due to school closures, prolonged social isolation, and anxieties related to their future and health. All these factors may have caused significant stress and led to anxiety and depression in students. The purpose of this study was to study the prevalence and severity of COVID-19 associated mental health morbidity in students in the United States (US). Methods: A online cross-sectional survey was conducted using two instruments – the Perceived Stress Scale-4 (PSS-4) and the Patient Health Questionnaire for Depression and Anxiety-4 (PHQ-4). The survey was administered in the months of March to June during the COVID-19 pandemic to both high school and undergraduate college students. Results: In total, 369 students agreed to participate: 51.8% were male, 44.1% were college students. An elevated perceived stress level (PSS- 4 > 8) and a positive mood disorder (PHQ-4 > 4) was present in 49.6% and 56.6% of respondents, respectively. The mean (SD) PSS scores in males and females were 6.7 (2.7) and 8.2 (2.9) respectively among all the respondents, while the mean (SD) PHQ scores in males and females were 3.7 (3.2) and 5.3 (3.2) respectively. Prevalence of anxiety and depression in the respondents was 35.0% and 36.3% respectively. Females students reported higher PSS and PHQ scores compared to male students. There is a significant correlation between PSS and PHQ (r=0.66) Conclusion: The COVID-19 pandemic has resulted in an extremely high level of stress and mental health morbidity in both high school and college students, and this is more pronounced in females. Specific screening measures and interventions to improve the mental health of students is urgently warranted with a focus on females.

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