Related Experiment Video
Updated: Jul 17, 2025
Social Isolation Model: A Noninvasive Rodent Model of Stress and Anxiety
Published on: November 11, 2022
Impact of COVID-19 mitigations on anxiety and depression amongst university students: A systematic review and
Bohee Lee1,2,3, Prerna Krishan1, Lara Goodwin1
1Usher Network for COVID-19 Evidence Reviews (UNCOVER) group, Usher Institute, University of Edinburgh, Edinburgh, UK.
Background:
While much research has addressed mental health concerns related to the coronavirus disease 2019 (COVID-19) pandemic, there remains a scarcity of studies specifically exploring the changes in anxiety and depression among university students before and after the implementation of COVID-19 mitigation measures.
Methods:
In this systematic review and meta-analysis, we searched databases including MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), ERIC (EBSCO), the WHO COVID-19 database, Scopus, and Science Citation Index (Web of Science) as of 15 February 2023. We included studies that used a validated tool to measure changes in anxiety or depression at two distinct time points - before (T1) and during (T2); during (T2) and after (T3); or before (T1) and after (T3) COVID-19 mitigation. The quality of studies was assessed using an adapted Joanna Briggs Institute Checklist for longitudinal studies. Utilising random-effects models, we synthesised changes in continuous outcomes as standardised mean difference (SMD) with 95% confidence interval (CI) and binary outcomes as risk difference (RD) with 95% CI.
Results:
In total, 15 studies were included in this review, with eight of moderate and seven of high quality. In most of the included studies (n = 13), the majority of participants were women. Eleven studies analysed mental health outcomes between T1 and T2 of COVID-19 mitigations. Continuous symptom changes were a minimal or small improvement for anxiety (SMD = -0.03, 95% CI = -0.24 to 0.19, I2 = 90%); but worsened for depression (SMD = 0.26, 95% CI = -0.01 to 0.62). However, the proportions of students reporting moderate-to-severe symptoms, defined by specific cut-offs, increased during COVID-19 mitigation measures for both anxiety (RD = 0.17, 95% CI = -0.04 to 0.38, I2 = 95%) and depression (RD = 0.12, 95% CI = 0.03 to 0.22, I2 = 72%). Sensitivity analyses, which distinguished between baseline periods based on awareness of COVID-19, demonstrated an exacerbation of both symptoms when comparing the period before the global awareness of the COVID-19 outbreak (before December 2019) with the period during the implementation of mitigation measures.
Conclusions:
Mental health outcomes, especially depressive symptoms, were observed to worsen in university students during COVID-19 mitigations. Despite considerable heterogeneity requiring careful interpretation of results, the impact of COVID-19 mitigations on mental health in university students is evident.
Registration:
PROSPERO (CRD42021266889).
Related Concept Videos
01:30Stress and Mental Health
Individuals with depression often experience challenges in both their personal and professional...
01:20Psychological Responses to Stress
01:18Anxiety: Overview
Individuals with anxiety often experience a range of physical and emotional symptoms, including sweating, trembling, tachycardia, and disturbances in sleep patterns. These symptoms vary in intensity and frequency but are generally disruptive and distressing.
01:28Stress Prevention and Stress Management Techniques V
01:25Stress Prevention and Stress Management Techniques III
The Role of Exercise in Stress Management
Regular physical activity is essential for reducing stress and promoting cardiovascular health. Exercise strengthens the heart, enhances blood flow, keeps blood vessels flexible, and helps lower blood pressure, all of which reduce the body's stress response. Research shows that adults who exercise regularly have nearly half the...
01:27Introduction to Stress and Lifestyle