High prevalence of depression, anxiety, and stress among students in Croatia after the COVID-19 pandemic: A possible association with sleep quality and physical activity.

BACKGROUND

Mental disorders pose a significant and pervasive public health challenge. During the pandemic, an additional increase in negative affective disorders among students was observed. This study aimed to assess the prevalence of depression, anxiety, and stress symptoms among students after the COVID-19 pandemic and to establish a possible association with sleep quality and physical activity in the student population.

SUBJECTS AND

METHODS

This cross-sectional study was conducted among first and second-year students at the University of Osijek, Croatia. Mental health was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and physical activity with the International Physical Activity Questionnaire-Short Form (IPAQ-sf).

RESULTS

A total of 673 students participated in the study. The overall prevalence of depression, anxiety, and stress symptoms among students was found to be 45.0%, 58.8%, and 39.4%, respectively. Female students exhibited higher scores of depression (t(671)=3.391, p<0.001), anxiety (t(656)=7.482, p<0.001), and stress (t(671)=9.115, p<0.001) compared to their male counterparts. Furthermore, it was established that poorer sleep quality contributed to increased depression (β=0.485, SE=0.102, t=4.754, p<0.001), anxiety (β=0.544, SE=0.094, t=5.754, p<0.001), and stress scores (β=0.573, SE=0.117, t=4.901, p<0.001), while intense physical activity reduced depression (β=-0.364, SE=0.096, t=-3.804, p<0.001), anxiety (β=-0.386, SE=0.089, t=-4.353, p<0.001), and stress scores (β=-0.465, SE=0.110, t=-4.236, p<0.001) among study participants.

CONCLUSIONS

A high prevalence of depression, anxiety, and stress was identified among students following the conclusion of the COVID-19 pandemic. Additionally, sleep quality and physical activity could be one of the target points for measures and interventions intended to optimize students' mental health.