The uncovering of a positive association between inflammatory cytokine levels - Interkleukin-6 (IL-6) in particular - and the experiencing of depressive and anxiety symptoms is one of the most promising and enthusiastically-discussed finding in recent years. Despite considerable ambiguity in the directionality and underpinnings of this association, anti-inflammatory drugs are already being tested on mental health patients who present no physical symptoms of inflammation, risking potential adverse side effects. Researchers have thus urgently called for more rigorous empirical elucidations of this association. Based on a large, longitudinal, nationally representative sample of middle-aged adults in the United States (N = 1255), IL-6 was observed to be significantly associated with one's present experiencing of depressive and anxiety symptoms. However, IL-6 was predictive of only prospective depressive (not anxiety) symptoms measured six years later, and only when baseline number of symptoms was not accounted for. Further, evidence for IL-6's postulated role as being either a biological cause itself (augmenting HPA stress reactivity) or a biological consequence of a psychological cause (psychological stress) for depression and anxiety was not found. These findings underscore the imperativeness of more rigorous studies to be conducted in this area, and caution practitioners against the premature consideration of IL-6 levels in clinical practice.

INTRODUCTION:The aim of the study is to assess the prevalence of anxiety and depressive symptoms in Portuguese medical students compared to students of other faculties, and the possible impact those symptoms have on academic performance. MATERIAL AND METHODS:A cross-sectional study was conducted in a sample of 750 students: 512 medical students and 238 nonmedical students. All students anonymously completed a socio-demographic survey and the Hospital Anxiety and Depression Scale (HADS). Statistical analysis was performed using the chi-square test, Mann-Whitney test, Spearman correlation coefficient or Kruskal-Wallis test. RESULTS:We found a prevalence of 21.5% (n = 161) for anxiety symptoms and 3.7% (n = 28) for depressive symptoms. Being a medical student was more significantly associated with symptoms of anxiety (p = 0.034) compared with other students. Depressive symptoms were slightly associated with poor academic performance (p < 0.01). A percentage of 59.6% (n = 96) of students with anxiety symptoms and 46.4% (n = 13) of students with depressive symptoms did not seek medical or psychological care at that time. DISCUSSION:Medical students in this sample seem to have more symptoms of anxiety, possibly explained by a higher number of female students in that sample. Depressive symptoms could be associated with poor academic performance in both groups, but an evident correlation was not established. CONCLUSION:Considering the high levels of anxiety symptoms, the possible impact of depressive symptoms in academic performance and the lack of psychiatric or psychological follow-up reported in this study, it is urgent to develop adequate means of support to improve students' well-being and mental health.

OBJECTIVE:To explore the association between sleep quality and anxiety symptoms, and the mediation effect of psychological resilience on this association by a repeated measures study. METHODS:In this study, 127 college students were randomly recruited and their sleep quality and psychological status were repeatedly collected using the Pittsburgh Sleep Quality Index (PSQI) scale, Connor-Davidson resilience scale (CD-RISC), and 7-items generalized anxiety disorder scale (GAD-7). Linear mixed-effects models were used to explore the association between sleep quality and anxiety symptoms, and a mediated effects analysis was used to explore the role played by psychological resilience in this association. RESULTS:This study found a positive association between sleep quality and anxiety symptoms (β = 0.40, 95% confidence interval: 0.27, 0.52). Psychological resilience scores and its various dimensions play a significant mediating role in this association. CONCLUSIONS:Although the role of sleep quality in anxiety disorders is not fully understood, this study highlights the importance of improving sleep quality while enhancing psychological resilience to prevent the onset of anxiety symptoms in college students.

The health-related quality of life (HRQOL) of college students is not promising and needs to be improved through effective interventions. This study aimed to investigate the associations of nutrition literacy (NL) with HRQOL and anxiety among college students, and to identify the role of anxiety in the relationship between NL and HRQOL. The cross-sectional survey was conducted via the "Wenjuanxing" platform from September to November 2023. The Food and Nutrition Literacy Questionnaire (FNLQ), the Generalized Anxiety Disorder (GAD-7) diagnostic tool and the SF-12 scale were used to assess NL, anxiety, and HRQOL, respectively. Logistic regression models, mediation analysis, additive and multiplicative interaction analyses were used. 2066 college students participated in the analysis. After adjusting for potential confounders, we found that college students with higher NL had higher HRQOL (OR = 2.52, 95% CI: 2.09-3.03, p < 0.001) and a lower risk of anxiety (OR = 0.53, 95% CI: 0.39-0.73, p < 0.001). Additionally, anxious college students had lower HRQOL (OR = 0.16, 95% CI: 0.11-0.24, p < 0.001). Furthermore, mediation analysis confirmed that anxiety was a partial mediator of the relationship between NL and HRQOL (β = 0.600, 95% CI: 0.406-0.779/0.430-0.818). Significant additive interactions were found between NL and Anxiety (RERI = 6.96, 95% CI: 2.74-11.17; AP = 0.51, 95% CI: 0.37-0.64; SI = 2.21, 95% CI: 1.58-3.07). Higher levels of NL are associated with better HRQOL and lower anxiety among college students. Additionally, anxiety partially mediated the relationship between NL and HRQOL. Furthermore, there is a synergy between NL and anxiety.

AIM:The aim of this study was to assess the prevalence of depression, anxiety, and stress among dental students and its association with factors such as gender, year of study, phase of the course, and ethnicity. MATERIALS AND METHODS:A questionnaire-based cross-sectional study was conducted among medical students in a medical institute in Malaysia. Prevalence of depression, anxiety, and stress was assessed by Depression, Anxiety, and Stress Scale-21 (DASS-21). RESULTS:A total of 351 students took part in the study with a mean age of 22.38 (+1.69) years. The overall prevalence of depression, anxiety, and stress with varying severity among the study population was 60.4, 75.2, and 50.4%, respectively. The prevalence of symptoms of depression among the study population appears to be independent of gender, ethnicity, and academic year of study. Our results show that stress and anxiety may be influenced by gender with more prevalence in females. CONCLUSION:Early detection of symptoms of depression, anxiety and stress is of great importance to take timely remedial action to keep the mental well-being of individuals. Maintaining the mental health of young medical professionals is a need of society in the present world. Further studies are suggested to recognize other factors associated with depression, anxiety, and stress among dental students. CLINICAL SIGNIFICANCE:Considering the students who experience depression, anxiety, or stress during undergraduate schooling, appropriate measures shall be taken to ensure effective learning. Students who have shown higher scores shall be advised for further follow-up and treatment strategies or appropriate counseling programs.

The commentary cites a study by Li and colleagues (2022) that conducted a comprehensive study of depression and anxiety symptoms among college students worldwide. We highlight the valuable contribution of this work to ongoing research, policy, and practice related to the early diagnosis and prevention of depression and anxiety symptoms in college students. The comprehensive report compensates for the lack of similar comprehensive studies in relevant areas and draws attention to the limitations of this and similar studies that require new solutions if well-designed, theoretically robust and implementable interventions are to be advanced. The author's work is timely and persuasive, providing important insights and theoretical support for specific work in the field of mental health of college students.

BACKGROUND:As the stages of the COVID-19 pandemic evolved, the symptoms of depression, anxiety, and insomnia have increasingly manifested among Chinese college students. The aim of this study is to investigate the relationships between these symptoms through network analysis among Chinese college students during COVID-19. METHOD:A three-wave cross-sectional survey was conducted at 22 colleges in Guangdong Province, involving 381,152 students during three specific time intervals: T1 (baseline, February 3 to 10, 2020), T2 (19 months after baseline, June 10 to 18, 2021), and T3 (37 months after baseline, March 15 to April 22, 2023). Depression (PHQ-9), anxiety (GAD-7), and insomnia (YSIS) were used separately. We analyzed two key network indices: "Expected influence" and "Bridge expected influence". Network stability was assessed through a case-dropping bootstrap program. RESULT:The effective sample sizes for the three periods were as follows: T1 - 164,101 (103,645 females, 63.2 %), T2 - 86,767 (52,146 females, 60.1 %), and T3 - 130,284 (76,720 females, 58.9 %). Across these three periods, the key central symptoms were "Fatigue" (PHQ4), "Restlessness" (GAD5), "Uncontrollable worrying" (GAD2), "Worry too much" (GAD3) and "Sleep insufficiency" (YSIS6). Notably, "Fatigue" (PHQ4), "Restlessness" (GAD5) and "Irritability" (GAD6) consistently served as bridge symptoms. In the T1 and T2 period, "Motor" (PHQ8) acted as a bridge symptom but weakened in T3. CONCLUSION:Throughout the three periods, the mental health issues among Chinese college students displayed characteristics of somatization within the depression-anxiety-insomnia comorbidity network. Over time, anxiety symptoms appeared to become more prominent. Consequently, this study highlights the importance of accurately identifying and promptly intervening in these core symptoms of mental health among college students, as these symptoms may evolve across different stages of a pandemic.

BACKGROUND:The global pandemic of COVID-19 has brought huge changes to people's lifestyles, college students have also been affected seriously. Evidence about these significant changes indicated that college students were more prone to feel anxious and depressed. To derive a precise assessment of the prevalence of anxiety symptom and depressive symptom among college students worldwide, we conducted this meta-analysis. METHODS:Based on the guidance of PRISMA, literature was searched in Pubmed, Web of Science, Embase, and PsycArticles (last search November 6, 2020). These articles after the screening were analyzed by a random-effects model to estimate the pooled prevalence of anxiety symptom and depressive symptom. Also, subgroup analysis, sensitivity analysis, and publication bias were performed in this meta-analysis. RESULTS:The results showed that the pooled anxiety symptom prevalence was 31% (95% CI: 23-39%), pooled depressive symptom prevalence was 34% (95% CI: 27-41%). Subgroup analysis showed that the prevalence of anxiety symptom and depressive symptom among different countries' college students were different, and the pooled depressive symptom prevalence of females was higher compared with males. LIMITATIONS:The prevalence of anxiety symptom and depressive symptom in worldwide college students could be better assessed by a standard and reliable questionnaire. CONCLUSIONS:The results suggest that the prevalence of anxiety symptom and depressive symptom during the COVID-19 pandemic is relatively high. Except for interventions that should be taken to control the pandemic urgently, mental health services are also needed to decrease the risk of anxiety and depression among college students.

BACKGROUND:To evaluate the global prevalence of depression and anxiety symptoms among college students and potential associated factors. METHODS:PubMed and Web of Science were searched from their inception to March 28, 2021. Random-effects models were used to calculate the pooled prevalence of depression and anxiety. Subgroup analyses were conducted to explore potential heterogeneity. Egger's and Begg's test were used to assess publication bias. RESULTS:A total of 64 studies with 100,187 individuals were included in the present meta-analysis. The pooled prevalence of depression and anxiety symptoms among college students was 33.6% (95% confidence interval [CI] 29.3%-37.8%) and 39.0% (95% CI, 34.6%-43.4%), respectively. The highest prevalence of depression symptoms was found in Africa region (40.1%, 95% CI 12.3-67.9%), lower middle-income countries (42.5%, 95% CI 28.6-56.3%), and medical college students (39.4%, 95% CI 29.3-49.6%). For the prevalence of anxiety symptoms, the highest was observed in North America (48.3%, 95% CI 37.4-59.2%), lower middle-income countries (54.2%, 95% CI 35.0-73.4%), medical college students (47.1%, 95% CI 35.1-59.1%) and identified by Beck Anxiety Inventory (BAI) (49.1%, 95% CI 31.0-43.0%). Besides, the prevalence of depression symptoms (35.9%, 95% CI 20.2-51.7%) and anxiety symptoms (40.7%, 95% CI 39.5-42.0%) was higher in studies conducted after the coronavirus disease 2019 (COVID-19) outbreak. CONCLUSIONS:Our study suggests that a lot of college students experience depression and anxiety symptoms and clarifies factors that are related to these mental disorders. Effective prevention and intervention strategies for mental disorders should be developed among college students.