Discussion:
The goal of this study was to evaluate the psychological conditions of
university students during the COVID-19 pandemic and explore factors
influencing their psychological problems. This study indicated that
41.1% of university students at Umm AlQura University in Saudi Arabia
were afflicted with symptoms of depression, 26.9% with anxiety, and
22.4% with stress.
Previous
studies have suggested that the
COVID-19 pandemic had profound negative psychological impacts on the
general population as well as
students(16). A study from Jordan
assessed the prevalence of depression using the Patient Health
Questionnaire and anxiety using Generalized Anxiety Disorder-7 among
1165 university students and showed that more than 60% of the surveyed
students had moderate to severe depression and more than 45% had
moderate to severe anxiety (6). Yet, it is
difficult to compare their results with those of the current study
because the authors used a convenience sampling approach that favors the
inclusion of students with psychological problems in addition to using a
different tool to assess depression and anxiety. In Spain, a total of
2530 members of the University of Valladolid were surveyed online for
their psychological conditions using the DASS-21. The results showed
that the prevalence of any degree of depression, anxiety, and stress was
as follows: 48.1%, 35.2%, and 40.3% while the prevalence of the
moderate to severe forms was as follows: 34.2%, 21.3%, and 28.1%,
respectively(13).
The higher rates of all psychological conditions compared with ours,
despite using the same study design and evaluation methods, could be
explained by the fact that Spain was among the most affected countries
worldwide in terms of the COVID-19 cases, deaths, and economic losses
(2, 17).
It could be predicted that the quarantine measures and the state of
anticipation about the academic progress during
the COVID-19 pandemic may have
harmed the students’ mental and psychological health. A longitudinal
study on 555 university students in China revealed increases in symptoms
of anxiety and depression after two weeks of
quarantine(10). Besides, the new learning
environment that is based completely on online education may be
addressed differently among students with various psychological
reflections(7). Moreover, the students’
psychological affection may have been related to stressors associated
with social and physical distancing measures, infection fear, and
boredom (18). It is not surprising that
anxiety disorders are more likely to occur and worsen in the absence of
interpersonal communication(19). A study
conducted in Saudi Arabia on medical students claimed that being
detached from friends was a major cause of anxiety
(8). Our findings and similar studies can
recommend the importance of providing urgent psychological services to
university students to mitigate the psychological impacts of the
COVID-19 pandemic.
We also highlighted the role played by other stressors in the students’
psychological instability during the current COVID-19 pandemic. For
example, the current study illustrated that having a relative or a
friend infected with or died from the COVID-19 was associated with an
increased level of depression and anxiety and this was consistent with
previous literature(11,
20). Watching COVID-19 news for long
times per day was associated with depression, anxiety, and stress. As a
consequence of the current pandemic, many people turn to social media
outlets to connect with others and to express their feelings about the
pandemic (21). Although media is
considered a good source of information about safety precautions and
prevention strategies, excessive description of COVID-19 news can create
a sense of panic among vulnerable individuals. Social media and
uncurious netizens may also be a source of fake scary information
(20,
22). This finding should raise the
attention of mental health professionals to advise the public for a wise
watching of the news and to cautiously use social media and
telecommunication websites.
Moreover, the current study showed that students who reported lack of
sleep had more stress and anxiety. Sleep disturbances are a stand-alone
risk factor for psychological consequences. Appropriate treatment of
sleep disturbances is always vital and reduces symptoms of psychiatric
disorders (23). Recognizing and treating
such disorders are particularly important during stressful times
(24).
Furthermore, students who did not receive emotional support from their
families, societies, and universitywere more likely to experience
psychological problems. The current COVID-19 pandemic is considered an
inexperienced crisis that affected the mental health of the exposed
people and requires psychological support. A study on medical students
from China showed that social support correlated negatively with their
level of anxiety(11). One study discussed
the need for providing mental healthcare services to students to
alleviate their psychological disturbances
(25).
We should, therefore, there is a need to pay greater attention to the
mental health of university students and actively provide them with
psychological support and counseling.
This study carried many strengths such as investigating, for the first
time, the psychological conditions among a large cohort of university
students in Saudi Arabia and using a validated tool to measure their
psychological problems. However, the study has some limitations that
should be addressed. First, the cross-sectional design of this study
cannot imply causality, and the baseline psychological conditions before
the COVID-19 pandemic could not be assessed. Therefore, we cannot
conclude that the COVID-19 pandemic was the only reason to provoke such
psychological disturbances. Second, investigating one university in
Saudi Arabia maybe not representative of the rest of the universities in
the country. Third, the online approach of data collection could carry a
potential possibility of non-response bias
(26). To minimize the risk of this bias,
we sent the questionnaire through all the possible means of
communication with students of Umm AlQura University. We made the online
questionnaire available for participation for a week and extended its
availability for another week while sending reminders to students and
encouraging them to share the questionnaire by sending it to their
colleagues.
In conclusion, this study showed that students at Umm AlQura University
suffered psychological problems during the COVID-19 pandemic. These
problems were associated with related infection or death of a family
member or relative, excessive following of news, lack of emotional
support from the family, society, and the university. Our findings can
be used to articulate psychological interventions to improve mental
health and psychological resilience during the COVID-19 pandemic. It is
warranted for universities to have a role in helping students respond to
the pandemic in a healthier psychological performance.
Conflict of interest : the authors declare no competing
interests.
Author Contributions: ZM and AA drafted the manuscript and
substantially revised it, under supervision of AE. All authors have read
and agreed to the published version of the manuscript.
Acknowledgment: The authors acknowledge the participated
students
Funding: no funding source