Prevalence and Characteristics of Depression, Anxiety and Stress Among Older Persons in Malaysia during the COVID-19 Pandemic.

BackgroundAs a result of the coronavirus disease 2019 (COVID-19) outbreak, many countries have imposed movement restrictions and implemented lockdowns. However, evidence from a variety of nations showed that the COVID-19 outbreak and its associated quarantine measures triggered a wide range of psychological problems, such as anxiety, depression, and stress in the general population. As a result, the purpose of this study was to determine the prevalence and predictors of depression, anxiety, and stress symptoms among Tepi town residents during the pandemic lockdown.MethodologyA community-based cross-sectional survey was conducted among residents of Tepi town from September 15 through September 25, 2020, and residents who have lived in Tepi town for at least 6 months were included. We have employed the depression, anxiety, and stress scale 21 (DASS-21) to evaluate depression, anxiety, and stress. The Chi-squared test of association and logistic regression were used to identify factors associated with depression, anxiety, and stress among residents of Tepi town. For all statistical analysis, we used (IBM) SPSS version 25.ResultsAccording to the current study, the prevalence of depression, anxiety, and stress symptoms were 37.7%, 39.0%, and 44.2%, respectively, among residents of Tepi town. Estimated odds of having depression, anxiety, and stress were as follows: for being female 6.315, 4.591, and 3.155; smoking 1.787, 1.883, and 1.787; sleep problem 2.613, 2.254, and 1.721; chewing Khat 2.156, 2.053, and 2.110; quarantine for 14 days 2.251, 1.902, and 1.960; and frequent use of social media 3.126, 1.849, and 3.126 times more likely as compared to their corresponding reference group respectively. The odds of developing depression and anxiety respectively were as follows: for alcohol consumption 2.438 and 1.797 times higher than their corresponding reference group respectively. Those exposed to COVID-19 were 3.870 times more likely to develop depression symptoms. Estimated odds of having anxiety and stress symptoms for fear of COVID-19 were 1.776 and 1.835; social interactions altered were 3.197 and 2.069, moderate levels of hope were 2.687 and 2.849 respectively. The odds ratio for those taking traditional preventive medicine, and having family members infected with COVID-19 were 2.475 and 1.837 times more likely to experience anxiety symptoms respectively.ConclusionIn this study, the prevalence of depression, anxiety, and stress symptoms was found to be high among residences in Tepi town. Being female, chewing Khat, smoking, being quarantined for 14 days, frequently using social media, and having sleeping problems were all found to be significantly associated with an increased risk of developing depression, anxiety, and stress symptoms, whereas alcohol consumption and family members infected by COVID-19 were considerably linked to depression and anxiety symptoms. Fear of COVID-19, influence on social interaction and having a moderate level of hope were substantially related to stress and anxiety symptoms, while taking preventive medicine was found to be a significant factor in anxiety symptoms among Tepi town residences. Interventions should be made to improve the mental health of Tepi residents.

Globally, COVID-19 pandemic has a significant impact on mental health. In Nepal, COVID-19 positive cases have to self-isolate at home in multi-generational and multi-family households. This could be strongly associated with depression, anxiety, and stress-related health outcomes. Additionally, COVID-19 related stigma and fear of transmission may intensify depression, anxiety, and stress symptoms. This study determined the prevalence of depression, anxiety, and stress symptoms and their association with presence of COVID-19 symptoms and comorbid conditions among home isolated COVID-19 positives in the Karnali province, Nepal. We conducted a cross-sectional study to assess depression, anxiety, and stress symptoms among 402 home isolated COVID-19 patients of Karnali province from January to May 2021 using "Depression, Anxiety and Stress Scale-21 (DASS-21)". We interviewed patients to collect socio-demographic, DASS-21, COVID-19 symptoms, comorbid conditions, and self-treatment. We conducted a telephonic interview using a standardized questionnaire using Kobotoolbox. We calculated the prevalence of depression, anxiety, and stress symptoms. We utilized univariate and multivariate logistic regression to determine their association with the presence of COVID-19 symptoms and comorbid conditions. In multivariate logistic regression, we adjusted sociodemographic factors (age, gender, ethnicity, marital status, monthly family income, education level), smoking status and history of self-treatment. We reported adjusted odds ratios (aOR) with 95% confidence intervals. All analyses were conducted in R (version: 4.0.3). The prevalence of depression, anxiety and stress symptoms among home isolated COVID-19 patients were 8.0% (95% CI: 5.5 to 11.1), 11.2% (95% CI: 8.3 to 14.7), and 4.0% (95% CI: 2.3 to 6.4) respectively. Higher odds of depression symptoms (aOR: 2.86; 95% CI: 1.10-7.44,p= 0.03), anxiety symptoms (aOR: 3.81; 95% CI: 1.62 to 8.93;p= <0.01) and stress symptoms (aOR: 7.78; 95% CI: 1.43 to 42.28;p= 0.02) were associated significantly with presence of COVID-19 symptoms in past week. Higher odds of anxiety symptoms were associated with the presence of comorbid conditions (aOR = 2.92; 95% CI: 1.09 to 7.80;p= 0.03). Depression, anxiety, and stress symptoms were present in a significant proportion of home isolated COVID-19 patients in western Nepal and positively associated with the presence of COVID-19 symptoms. In this global COVID-19 pandemic, it is important to provide timely counseling to high-risk groups like those with comorbidities and COVID-19 symptoms to maintain a high level of mental health among home isolated COVID-19 patients.

The COVID-19 pandemic led to a high prevalence of anxiety and depression among healthcare personnel. To assess the prevalence and independent risk factors associated with anxiety and depression symptoms among healthcare staff working in Intensive Care Units (ICUs) during the COVID-19 pandemic in Bucaramanga and its metropolitan area. This was an analytical cross-sectional study. Anxiety and depression were measured using the Hopkins Symptom Checklist-25 (HSCL-25). Bivariate and multivariate analyses were conducted using linear regressions to investigate associated factors. A total of 288 people were included in the study. The prevalence of anxiety and depression symptoms was 8.34% (95% CI: 5.41-12.14%). In the bivariate analysis, six factors were associated with depression and anxiety symptoms; however, only three remained in the multivariate analysis: female sex (β=0.085, 95% CI: 0.019 - 0.151), experiencing COVID-19 symptoms in the past 14 days (β= 0.115, 95% CI: 0.024 - 0.205), and having worked in general ICUs and COVID-19 ICUs (β =0.009, 95% CI: 0.025 - 0.173). The prevalence of anxiety and depression symptoms was considerably lower than reported in the scientific literature. In the studied population, although the prevalence of depression and anxiety symptoms was low, three independent factors were found to be statistically associated with the presence of these mental symptoms.

The construction industry in Nepal, which employs a significant proportion of the population, ranks as one of the largest industries in the country. Construction work is physically demanding and can be risky due to the use of heavy machinery and the presence of intense physical labor. However, the physical and mental health of construction workers in Nepal is often neglected. This study aimed to assess psychological distress (depression, anxiety, and stress symptoms) and its association with socio-demographic, lifestyle, and occupational factors among construction workers in Kavre district, Nepal. We conducted a cross-sectional study from 1st October 2019 to 15th January 2020 among 402 construction workers in Banepa, and Panauti municipalities of Kavre district, Nepal. We collected data with face-to-face interviews using a structured questionnaire consisting of a) socio-demographic characteristics; b) lifestyle and occupational characteristics; and c) depression, anxiety and stress symptoms. We collected data using electronic forms in KoboToolbox and imported them into R version 3.6.2 for statistical analysis. We present parametric numerical variables as mean and standard deviation, and categorical variables as percentage and frequency. The confidence interval around proportion was estimated with the Clopper-Pearson method. We applied univariate and multivariable logistic regression to determine factors associated with depression symptoms, anxiety, and stress. The result of logistic regression was presented as crude odds ratio, adjusted odds ratio (AOR), and their 95% confidence interval (CI). The prevalence of depression, anxiety and stress symptoms were 17.1% (95%CI: 13.6-21.2), 19.2% (95%CI: 15.5-23.4) and 16.4% (95%CI: 12.9-20.4), respectively. In multivariable logistic regression analysis, depression symptom was positively associated with poor sleep quality (AOR = 3.51; 95%CI: 1.5-8.19; p-value: 0.004); stress symptom was positively associated with Brahmin ethnicity (AOR = 3.76; 95%CI:1.34-10.58; p-value: 0.012) and current smoking (AOR = 2.0; 95%CI: 1.11-3.82 p-value: 0.022). But anxiety symptoms were not associated with any of the variables. The prevalence of depression, anxiety, and stress symptoms were high among construction workers. Developing evidence-based and appropriate community-based mental health prevention programs among laborers and construction workers is recommended.

Background: The COVID-19 pandemic has led to increased rates of depression, anxiety, and stress symptoms. University students have been particularly affected by these psychological consequences due to the pandemic and its accompanying precautions. Purpose: This study aimed to assess the prevalence and predictors of depression, anxiety, and stress symptoms among Jordanian university students amid COVID-19 pandemic. Methods: This is a cross-sectional study. Data was collected through an anonymous online survey from Jordanian university students during the period from February 2022 to May 2022. The survey included a self-reported questionnaire that is composed of sociodemographic variables and the Arabic version of the Depression, Anxiety, and Stress Scale (DASS-21). Results: The mean total scores for depression, anxiety, and stress symptoms were 18.91, 18.04, and 20.71, respectively, indicating the presence of these psychological issues among university students during the pandemic. Psychological problems, parents being diagnosed with mental illness, living arrangements, and academic year explained 25.6% of the variation in depression symptoms. Academic year, living arrangements, specialization, GPA, and gender accounted for 25.9% of the variation in anxiety symptoms. Parents being diagnosed with mental illness, specialization, marital status, and GPA explained 22.3% of the variation in stress symptoms. Conclusion: The findings of this study have significant implications for healthcare practice, policy development, and community engagement. Implications for Nursing: Healthcare providers, including nurses, can utilize this information to develop targeted interventions tailored to address the specific mental-health needs of university students in Jordan. Policymakers can advocate for the implementation of mental-health support services within university settings, while community organizations can collaborate with educational institutions to promote mentalhealth awareness and provide accessible resources for students. By addressing the mentalhealth challenges identified in this study, stakeholders can contribute to fostering a supportive and resilient campus environment conducive to student success and well-being. Keywords: Depression, Anxiety, Stress, COVID-19, University students, Jordan

BackgroundSignificant concerns about mental health were raised during the COVID-19 pandemic. We investigated the prevalence of depression and anxiety symptoms among the participants of the United Arab Emirates Healthy Future Study (UAEHFS); a national cohort study. We further explored the change in the prevalence of depression symptoms among those with comparable pre-pandemic data.MethodsA sample of UAEHFS participants were invited to complete a COVID-19 online questionnaire during the first wave of the pandemic. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire Depression Scale (PHQ-8) and the Generalized Anxiety Disorder-7 Scale (GAD-7) respectively. Unpaired analyses were done to examine the effect of COVID-19 on depression and anxiety symptoms during the pandemic. Paired analysis was conducted to examine the change in depression symptoms.ResultsDuring the pandemic, we reported a prevalence of 32.8% (95% CI: 27.0, 39.1) for depression and 26.4% (95% CI: 21.0, 32.6) for anxiety symptoms. Younger people reported higher levels of depression (40.4%) and anxiety (34.5%) symptoms. Females reported higher levels of depression (36.5%) and anxiety (32.7%) symptoms. In paired analysis, the prevalence of depression symptoms during the pandemic was 34% (95% CI: 26.5, 42.4) compared to 29.9% (95% CI: 22.7, 38.1) before the pandemic. No statistically significant difference was observed, p-value = 0.440. Adjusted multivariate logistic regression models for PHQ-8 and GAD-7 during the pandemic showed that participants, who were experiencing flu-like symptoms, had higher odds of reporting depression symptoms compared to those without symptoms. Additionally, age was significantly negatively associated with anxiety symptoms.ConclusionsOverall, we found that depression and anxiety symptoms were more prevalent among young people and females. However, we did not find a significant change in the prevalence of depression symptoms among those with comparable pre-pandemic data. Identifying vulnerable groups and understanding trajectories through longitudinal studies would help with planning for effective mental health interventions for the current and future pandemics.

ObjectivesDepression and depressive symptoms are common mental disorders that have a considerable effect on patients’ health-related quality of life and satisfaction with medical care, but the prevalence of these conditions...

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting reproductive aged women. The prevalence of comorbidities associated with PCOS vary with phenotype and race. An increased risk of moderate and severe depressive and anxiety symptoms has been reported in this group. Racial differences in prevalence of mood disorders described in the general population are influenced by factors such as obesity and socioeconomic status (SES). We aimed to determine the prevalence of depression, anxiety and decreased quality of life between black and white women with PCOS and controls. We screened women (18-50 years) at an academic center from November 2015-18 using the Hospital Anxiety and Depression Scale (HADS) and PCOS quality of life survey (PCOSQ). Multivariable regression models were used to evaluate racial differences in the prevalence of depression and anxiety (HADS≥8) and mean scores for depression, anxiety and PCOSQ. Correlations between FG score, testosterone, BMI, HOMA-IR and depression, anxiety and PCOSQ scores were analyzed. Overall women with PCOS (n=272) had a higher prevalence of depressive (26% vs 17%, p<0.01) and anxiety symptoms (72% vs 52%, p<0.01) compared to controls (n=295) after adjusting for age, BMI, SES and race. Compared to black women with PCOS (n=70), white women with PCOS (n=202) had a higher prevalence of anxiety symptoms (76% vs 61%, p=0.01) and scores (10.3 +4.1 vs 8.7 +4.6, p=0.01) after adjusting for age, BMI and SES. BMI correlated with anxiety scores in white but not black women with PCOS (p<0.01). There were no racial differences in the prevalence of depressive symptoms (p=0.8) or mean scores (p=0.4). In the control group, white women (n=186) had a higher prevalence for anxiety symptoms (60% vs 47%, p=0.04) not depressive symptoms (13 % vs 18%, p=0.7) compared to black women (n=109). There were no significant differences in mean anxiety or depression scores in the controls. There were no racial differences in global PCOSQ score (110.7 +30 for white women vs 98.6 +36.1 for black women, p=0.6). On examining the individual domains of the PCOSQ, black women scored lower than white women on the emotion and infertility domain (p<0.01). There were no racial differences in the correlation between FG score, testosterone, HOMA-IR and anxiety, depression and total PCOSQ scores. This study is the first to examine racial differences in anxiety and depressive symptoms in PCOS. White women with PCOS had significantly higher anxiety symptoms compared to black women and BMI positively correlated with these symptoms. Black women however have lower scores in several PCOSQ domains indicating lower quality of life. Despite racial differences in anxiety symptoms, our study confirms the need to screen both races for anxiety and depressive symptoms given their high prevalence. Targeted interventions such as weight management may help mitigate some of these symptoms.

ObjectivesTo evaluate the prevalence and determinants of anxiety and depression and to assess their impact on glycaemic control in participants with type 2 diabetes mellitus.DesignA cross-sectional study.SettingCommunity-based investigation in Xuzhou,...

Background: Mental health issues, particularly anxiety and depression, among women of reproductive age, remain a significant public health concern, yet comprehensive studies addressing these issues are limited in Nepal. Objective: This study aimed to assess the prevalence, associated factors and wealth-related inequality of anxiety and depression symptoms among women aged 15-49 years in Nepal. Methods: Data from the Nepal Demographic and Health Survey (NDHS) 2022 included 7410 women. Logistic regression analysis was conducted to identify factors associated with anxiety, depression and combined symptoms. We also employed the concentration curve to assess wealth-related disparities with mental health outcomes. Findings: The prevalence of depression and anxiety symptoms was 5.4% (95% CI: 4.8% to 6.2%) and 7.5% (95% CI: 6.7% to 8.4%), respectively. Furthermore, 9.1% (95% CI: 8.2% to 10.1%) of the women experienced either condition, while 3.8% (95% CI: 3.3% to 4.4%) experienced both. Women with lower educational attainment, a higher number of children, unemployed partners, residents in rural areas and those living in Karnali province exhibited a higher prevalence of anxiety and depression symptoms. Women with limited mass media exposure were associated with a higher risk of anxiety and depression symptoms. Additionally, women with tobacco habits demonstrated a significantly higher risk of depression. Finally, wealth-related inequality was evident; women with lower socioeconomic status were more vulnerable to anxiety and depression symptoms. Conclusions: The study highlights the need for targeted interventions addressing socio-economic determinants and lifestyle factors, including tobacco use, to mitigate the burden of anxiety and depression symptoms among women in Nepal.

Systemic sclerosis (SSc) is a chronic multisystem connective tissue disorder with detrimental impact on quality of life. Patients with SSc face emotional distress and frequently meet criteria for a psychiatric disorder. However, the pattern of psychiatric manifestations may vary according to socioethnic background. We investigated the prevalence of depressive and anxiety symptoms and examined their association with sociodemographic and clinical factors in Iranian SSc patients. Depressive and anxiety symptoms were evaluated by Beck Depression Inventory and Cattell questionnaire in 114 SSc patients. The associations between sociodemographic and clinical factors and depressive/anxiety symptoms were examined via multivariate analysis. The prevalence of depressive symptoms was 68.4%. There was a significant association between depressive symptoms and pulmonary and gastrointestinal manifestations. Also, diffuse SSc patients were more prone to depressive symptoms. Mean Rodnan scores were significantly higher in patients with depressive symptoms in comparison with subjects with no depressive symptoms. The prevalence of anxiety symptoms was 23.6%. Anxiety symptoms were not associated with demographic characteristics, SSc subtype, disease duration, Rodnan score, other clinical features, and previous history of depression in the patients or their family. The coincidence of anxiety and depression was 82.8%. Depressive and anxiety symptoms are prevalent among Iranian SSc population. The depressive symptoms showed correlation with pulmonary and gastrointestinal involvement, as well as diffuse SSc subtype.

BackgroundThis study examines how the prevalence of depression and anxiety symptoms differ by socioeconomic status and explores their associations with diabetes in rural southwest China.MethodsData were collected from a cross-sectional health interview and examination survey of 5,005 adults aged ≥ 35 years in rural southwest China. Height, weight, waist circumference, and fasting blood glucose measurement were taken. Depression and anxiety symptoms were assessed using Zung’s Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS), respectively. An individual socioeconomic position (SEP) index was constructed using principal component analysis.ResultsThe overall prevalence of depression, anxiety, comorbid depression and anxiety symptoms, and diabetes was 5.4%, 12.8%, 4.0%, and 9.6%, respectively. Females had higher prevalence of depression (7.3% vs. 3.4%, P < 0.01), anxiety (17.4% vs. 8.1%, P < 0.01), and comorbid depression and anxiety symptoms (5.8% vs. 2.3%, P < 0.01) than males. Han ethnicity participants had a higher prevalence of depression, anxiety, and comorbid depression and anxiety symptoms than ethnic minority participants (P < 0.01). Individuals with a lower education level and lower SEP were more likely to experience depression, anxiety, and comorbid depression and anxiety symptoms (P < 0.01), while individuals with good access to medical services were more likely to exhibit depression symptoms and comorbid depression and anxiety symptoms (P < 0.05). Multivariable logistic regression analysis found that individuals with depression symptoms (OR = 1.78, 95% CI: 1.25 to 2.53), anxiety symptoms (OR = 1.66, 95% CI: 1.30 to 2.16), and comorbid depression and anxiety symptoms (OR = 1.61, 95% CI: 1.07 to 2.44) all had a greater probability of having diabetes (P < 0.01); depression symptoms had the strongest association with diabetes prevalence (P < 0.01).ConclusionsThere are significant socioeconomic differences in the prevalence of depression and anxiety in rural southwest China, and both depression and anxiety symptoms have strong associations with diabetes. Future diabetes prevention and management strategies should focus on individuals with depression, anxiety, and comorbid depression and anxiety symptoms.

With the dramatic growth of the Chinese economy, the number of children/adolescents with being overweight/having obesity is increasing, which has a certain impact on their psychology, such as depression and anxiety symptoms. Our purpose was to conduct a meta-analysis to assess the prevalence and odds ratios of depression and anxiety symptoms among overweight/obese children/adolescents and non-overweight/obese children/adolescents in China. As of July 2018, the three most comprehensive computerized academic databases in China have been systematically screened, namely China national knowledge infrastructure (CNKI) databases, Wanfang databases and Vip databases. The same operations are performed in PubMed and Web of Science (SCIE) databases without language restrictions. Case-control studies on prevalence of depression and anxiety symptoms in overweight/obese children/adolescents in China were analyzed. Study selection and evaluation were performed independently by three authors. Unweighted prevalence, pooled random-effects estimates of odds ratio (OR), and 95% confidence intervals (CI) were all calculated. A total of 11 eligible studies involving 17,894 subjects were included. The prevalence of depression and anxiety symptoms in overweight/obese children/adolescents was significantly higher than that in non-overweight/non-obese children/adolescents (depression: 21.73% vs. 17.96%, OR = 1.46, 95% CI: 1.14, 1.87, p = 0.003; anxiety: 39.80% vs. 13.99%, OR = 1.47, 95% CI: 1.21, 1.79, p < 0.001). Subgroup analyses conducted according to scale types showed that scale types have certain significance to evaluate the relationship between depression symptoms and overweight/obesity. The OR of depression symptoms between overweight/obese children/adolescents and non-overweight/non-obese children/adolescents was greatest on the Middle School Student Mental Health Scale (MSSMHS) was 2.06 (95% CI: 1.41, 3.02, I2 = 0.00%), Center for Epidemiologic Studies Depression Scale (CES-D) was 1.03 (95% CI: 0.84, 1.25, I2 = 0.00%), and Children’s Depression Inventory (CDI) was 1.21 (95% CI: 1.02, 1.42, I2 = 0.00%). We concluded that the prevalence of depression and anxiety symptoms in overweight/obese children/adolescents in China is higher than that in the non-overweight/obese children/adolescents. The results of the study indicate that the prevalence of depression and anxiety symptoms among overweight/obese children/adolescents in Chinese medical institutions should receive more attention. Physical exercise and psychological interventions should be strengthened to prevent psychological problems. However, because of some clear limitations (no clinical interview and few studies), these results should be interpreted with caution.

During the last months of 2019, worldwide attention has focused on a pandemic of COVID-19, and the pandemic spread rapidly, becoming a public health emergency of international concern. The Chinese government has quickly taken quarantine measures and the drastic measures incurred to curtail it, which could have harmful consequences for everyone's behavior and mental health. This study aimed to investigate the correlation of influencing factors and mental health symptoms among Chinese college students according to two rounds of surveys during the COVID-19 pandemic. This study was divided into two stages of cross-sectional investigation. In February 2020 and May 2020, two cross-sectional surveys were conducted on college students in the above areas by means of cluster sampling. From February 4 to February 12, 2020, 14,789 college students completed the first round of online study from 16 cities and universities in 21 in China, excluding participants who completed the questionnaire, and finally included 11,787 college students. After 3 months, we also conducted a large-scale questionnaire survey based on the first study area to observe the behavioral changes and psychological symptoms of college students within 3 months. Using the convenience sampling method, a survey on the cognitive and psychological status of COVID-19 among college students was conducted in 21 universities in 16 regions in May 2020. The regions among the two surveys are divided into Wuhan (District 1), neighboring Hubei (District 2), first-tier cities, namely, Beijing, Shanghai and Guangzhou (District 3), and other provinces (District 4). (1) In the first survey, the average age of the participants was 20.51 ± 1.88 years. One-third of the college students were male. In total, 25.9 and 17.8% of college students reported depression and anxiety symptoms, respectively. College students, who reported higher ST, lower PA, higher soda beverage and tea beverage intake, have Chinese herbal medicine and vitamin drinking, and decreased frequency of diet had higher depression and anxiety symptoms. Moreover, infection risk, perceived resistance to COVID-19, concerns about physical symptoms, family/friends directly/indirectly contacted with confirmed cases, and seeking psychological counseling had significant associations with anxiety and depression symptoms. (2) In the second round of surveys, 6803 males (41.7%) and 9502 females (58.3%) had a mean age of 20.58 ± 1.81 years. The prevalence of depressive symptoms and anxiety symptoms during COVID-19 was 30.7 and 23.9%, respectively. (3) In both surveys, college students who reported having higher ST, lower PA, higher soda beverage and tea beverage intake, Chinese herbal medicine and vitamin drinking, and decreased frequency of diet also had higher depression and anxiety symptoms. Coping styles with COVID-19 partially mediate the association between some related lifestyle behaviors and anxiety and depression. The results of the conditional process model analysis support our hypothesis that lifestyle behaviors, and coping styles are both predictors of anxiety and depression symptoms, with both direct and indirect effects moderated by gender level. In logistic regression analysis, the correlation of depression and anxiety in the second rounds of the survey was higher than that in the first survey. In two surveys, there was a correlation between lifestyle health behaviors and coping style, gender and mental health. Our findings demonstrated that the prevalence of anxiety and depression in the two rounds of surveys was different, and the prevalence in the second round was higher than that in the first round, as well as that in the two rounds of surveys. All survey identified that unhealthy lifestyle behaviors were positively associated with depression and anxiety symptoms. Compared with the emerged city of risk areas, other pandemic regions have a lower risk of mental health problems. The survey findings complement each other. Lifestyle health behaviors and coping style alleviated mental health symptoms. COVID-19-related social stressors were positively associated with mental health symptoms. The study also suggests that at the beginning of the pandemic, the effective management of college students' mental health problems, corresponding coping measures and maintaining a good lifestyle play a key role in the prevention and control of other cities. Understanding the college students' lifestyle behaviors during COVID-19 lockdown will help public health authorities reshape future policies on their nutritional recommendations, in preparation for future pandemics.

The Global Prevalence of Anxiety and Depressive Symptoms Among Caregivers of Stroke Survivors