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Article

College Students’ Mental Health During the COVID-19 Pandemic

by
Raihan K. Khan
1,
Md Towfiqul Alam
1,*,
Sojib Bin Zaman
1 and
Tony Jehi
2
1
Department of Health Sciences, James Madison University, Harrisonburg, VA 22807, USA
2
School of Public Health and Health Sciences, California State University, Dominguez Hills, Carson, CA 90747, USA
*
Author to whom correspondence should be addressed.
Psychiatry Int. 2025, 6(3), 112; https://doi.org/10.3390/psychiatryint6030112
Submission received: 25 June 2025 / Revised: 10 August 2025 / Accepted: 4 September 2025 / Published: 10 September 2025
Versions Notes

Abstract

The COVID-19 pandemic significantly impacted multiple aspects of human life, including the psychological and physical health of college students. This study explores how students in Virginia’s Shenandoah Valley, a region within the larger Appalachian area, experienced anxiety, depression, and fear of COVID-19. An online survey was conducted at a large public university in the US, yielding responses from 680 undergraduate and graduate students. Linear regression was applied to continuous outcomes, specifically the Fear of COVID-19 Scale (FCV-19S) and depression scores. For dichotomous outcomes such as anxiety and depression (when categorized), separate logistic regression models were employed. The majority of respondents were female (78.0%), White (81.9%), and undergraduates (80.4%), with approximately 41.4% majoring in health-related disciplines. Results indicated that female students reported higher levels of anxiety, depression, and fear of infection compared to their male counterparts. Additionally, undergraduate students exhibited greater depressive symptoms than graduate students. Students who perceived less institutional support from their university during the pandemic also reported significantly higher psychological distress. These findings underscore the pressing need for universities and policymakers to collaborate in enhancing mental health resources and communication strategies for students during times of crisis.

1. Introduction

The global outbreak of COVID-19 in January 2020 has resulted in more than 7 million deaths worldwide [1,2]. Over the past few years, academic institutions, including universities, have had to suspend in-person instruction and shift to virtual learning formats for extended periods. This transition introduced a range of challenges for students, including disruptions to academic routines, lifestyle changes, financial hardship, and diminished social interaction due to remote learning [3,4,5,6]. As a result, mental health concerns, such as increased anxiety, depression, became more common among college students [7]. Grubic et al. reported that in one study 83% college students reported that the pandemic worsened their pre-existing mental health conditions [8]. Multiple contributing factors have been linked to heightened anxiety, including being female, fear of contracting the virus, poor sleep quality, job loss, uncertainty about the future, and prolonged social isolation during quarantine [9]. Prior studies have also shown that these psychological symptoms are connected to long-term health issues such as chronic illnesses, obesity, behavioral problems, substance abuse, and suicidal ideation [10,11,12]. Research shows that students often confuse stress and anxiety. While both terms are commonly used, students often describe themselves as “anxious” even when their experiences align more closely with stress. It is important to identify relationships between students’ perceived stress and their anxiety and depression [13,14]. Research shows that rural students face multifaceted obstacles that compromise their higher education [15]. Examining the drivers of mental health outcomes during the pandemic is especially important in regions like the Shenandoah Valley, where such associations have been understudied. Part of the broader Appalachian region, the Shenandoah Valley is largely rural and has historically experienced systemic neglect, including disparities in health care access, digital infrastructure, and public health investment [16,17]. There is also potential stigma about mental health in this region, which might intensify college students’ vulnerability during a public health crisis like the pandemic [18]. Also, this area may have fewer local mental health resource. The student population comprises individuals from both Appalachian and non-Appalachian backgrounds, providing a unique demographic for study. We hypothesize that students’ anxiety, depression, and fear of COVID-19 are significantly influenced by their demographic variables such as gender, academic level, perceived stress, stress management capacity as well as perceived support from the university. This research aimed to assess whether students in the Shenandoah Valley experienced elevated levels of anxiety, depression, and fear related to COVID-19 and to suggest practical recommendations that university administrators could implement to improve student mental health and support.

2. Materials and Methods

Design
We conducted a cross-sectional survey during the 2021 academic year. Approval was granted by the Institutional Review Board (IRB) of the first author’s academic institution (protocol number 21-2386).
Participants
Through the use of email distributions and classroom presentations, 680 university students were recruited for the study. Students aged 18 and older, studying full-time or part-time, were eligible. Data analysis was conducted with 607 completed responses after removing incomplete (n = 73) responses. Participants were aged 22.14 years on average (SD 5.48 years). They consisted of 78.9% females and 21.1% non-Hispanic Whites. The majority of the respondents (78.0%) were undergraduate students living off-campus (77.9%).
Data collection
The QuestionPro online survey system was used to create an online survey [19]. The authors’ university was entirely online during the first half of the academic year and later opened for in-person classes in the later half. Therefore, the recruitment strategy included both online and physical location. Using the bulk email service, a survey invitation was sent to all current undergraduate and graduate students enrolled at the university. The survey invited students to participate by providing a uniform resource locator (URL). A scannable QR-coded flyer was placed on campus notice boards, and the survey invitation was shared with other faculties via email so they could encourage their students to participate to increase the participant pool.
Demographics
Information about participants’ demographics was gathered, including age, biological sex, race/ethnicity, enrollment in educational programs, college affiliation, COVID-19 diagnosis, and housing status. Sex was classified as male or female. To enhance model accuracy and interpretability, some variables with low frequency were regrouped. The racial/ethnic categories (African American, Asian, Hispanic, Native American, White, and Other) were simplified into two groups: White and non-White. Enrollment status in degree programs was condensed from undergraduate, graduate, and doctoral into just undergraduate and graduate. Similarly, college enrollment was grouped into two main categories: the College of Health and Behavioral Studies (CHBS) and non-CHBS, which combined all other colleges, including arts and letters, education, business, visual and performing arts, and integrated science and mathematics. Finally, the COVID-19 diagnosis was recorded as either “yes” or “no”.
Anxiety
This study assessed anxiety using the GAD-7 (Generalized Anxiety Disorder) [16], a highly validated tool [20,21,22,23]. The scale has also shown to be successful in assessing anxiety levels across a variety of adult populations, making it valuable for its reliability. As part of the questionnaire, there were questions that attempted to screen for anxiety on a scale ranging from ‘0′ (not sure at all) to ‘3′ (nearly every day). There is a wide range of possible results for the summed scores, ranging from 0 to 21. Referral to a psychologist/psychiatrist is considered when the cut-off value exceeds 10 [20,21,22,23]. Participants with a score of 0 to 9 were categorized as having no to mild anxiety, and participants with a score of 10 to 21 were categorized as having moderate to severe anxiety.
Depression
To measure depression, the Patient Health Questionnaire (PHQ-9) was used, a highly validated and widely used tool [24,25,26,27]. There is a wide range of scores in PHQ-9, varying from 0 (not at all) to 3 (almost every day), with the summed-up score ranging from 0 to 27. There was a reclassification of PHQ-9 scores in relation to the severity of depression in this study, which was divided into two categories: none/minimal to mild depression (0–9) and moderate to severe depression (10–27).
Fear of COVID-19 (FCV-19S) questionnaire
The FCV-19S (Fear of COVID-19 Scale) was developed during COVID-19 [28]. It was found as highly reliable and valid [28,29,30,31]. A Likert-type question is included on the FCV-19S with five response options, which are “strongly disagree”, “disagree”, “neutral”, “agree”, and “strongly agree”, and each of the response options has a score between 1 and 5. There is a range of 7 to 35 points on the test, and the total score is calculated by summing up all the item scores. The first author received permission from the FCV-19S development team to use it for research [32].
In GAD-7, PHQ-9, and FCV-19S, Cronbach’s alpha values were 0.92, 0.89, and 0.87, respectively, indicating good reliability [33,34].
Although no formal stress measuring scale was used, information on perceived stress was collected through self-reported changes in stress levels during the pandemic and students’ ability to manage stress.
Data analysis
A frequency tabulation method was used in order to summarize the basic information. For categorical variables, percentages were calculated. For continuous variables, mean and standard deviation were calculated.
Bivariate analyses were used to examine the relationships between the dependent variables and potential predictors. Only those predictor variables that showed significant associations with the outcomes were included in the regression models. Linear regression was applied to continuous outcomes, specifically the Fear of COVID-19 Scale (FCV-19S) and depression scores [35]. For dichotomous outcomes such as anxiety and depression (when categorized), separate logistic regression models were employed [36].
In the model predicting anxiety, the independent variables included gender, COVID-19 diagnosis status, perceived changes in stress during the pandemic, perceived ability to manage stress, views on the university’s effectiveness in controlling the spread of COVID-19, and perceptions of institutional support during the pandemic. For depression, predictors included age, gender, perceived stress change, coping strategies during the pandemic, and perceptions of both the university’s COVID-19 containment efforts and the support provided to students. When each of these independent variable’s association was interpreted with the outcome variable, other covariates were adjusted appropriately.
All statistical analyses were conducted using IBM SPSS Statistics for Windows, Version 28.0 [37], with an alpha level of 0.05 set to determine statistical significance.

3. Results

3.1. Demographics

There were 680 students who responded to the survey (77.9%). COVID-19 has been diagnosed by about 21% of respondents. Anxiety levels were moderate to severe in 37.5% of students, and depression levels were moderate to severe in 38.8% of students. There was a mean score of 15.78 (SD 6.00) for the FCV-19S (Table 1).

3.2. Generalized Anxiety

A multiple linear regression analysis was conducted to determine the key factors associated with generalized anxiety (GAD-7) scores among students. The model was statistically significant, explaining 30% of the variance in anxiety levels [R2 = 0.30, F(6, 575) = 41.82, p < 0.01]. The significant predictors identified were gender, a history of COVID-19 diagnosis, perceived changes in stress during the pandemic, perceived ability to manage stress, and perceived support from the university. Higher anxiety scores were observed among female students (β = 0.10, p < 0.01), those who had not been diagnosed with COVID-19 (β = 0.08, p = 0.02), and those who reported increased stress during the pandemic (β = 0.25, p < 0.01). Students who felt unable to manage their stress effectively (β = 0.37, p < 0.01) and those who believed that the university failed to provide adequate support (β = 0.10, p = 0.01) also showed significantly higher levels of anxiety (Table 2). Results from the logistic regression model further supported these findings. Students who experienced elevated stress during the pandemic had over five times the odds of moderate to severe anxiety (OR = 5.55, 95% CI: 2.82–10.93). Similarly, students who struggled to manage their stress (OR = 4.25, 95% CI: 2.87–6.28) or perceived institutional support as lacking (OR = 1.61, 95% CI: 1.03–2.52) were significantly more likely to report moderate to severe anxiety symptoms (Table 3).

3.3. Depression

To explore the predictors of depressive symptoms among students, a multiple linear regression was conducted using PHQ-9 scores as a continuous outcome variable. The model yielded significant findings, accounting for 11% of the variance in depression scores [R2 = 0.11, F(7, 562), p < 0.01]. The analysis identified several factors that significantly predicted depressive symptoms: academic level, perceived stress changes during the pandemic, and students’ perceptions of their university’s response in terms of infection control and support. Students enrolled in undergraduate programs (β = 0.13, p = 0.01), those who experienced increased stress during the pandemic (β = 0.20, p < 0.01), those who believed the university was ineffective at containing the virus (β = 0.11, p = 0.02), and those who felt the university failed to provide adequate support (β = 0.13, p < 0.01) were more likely to report higher depression scores (Table 4). The logistic regression analysis supported these findings. Undergraduate students had nearly double the odds of experiencing moderate to severe depression compared to their graduate counterparts (OR = 1.96, 95% CI: 1.15–3.34). Students who reported heightened stress during the pandemic (OR = 2.92, 95% CI: 1.73–4.94), those who felt the university was ineffective in containing COVID-19 (OR = 1.53, 95% CI: 1.03–2.27), and those who perceived inadequate institutional support (OR = 1.69, 95% CI: 1.11–2.58) were also more likely to report moderate to severe depressive symptoms (Table 5).

3.4. Fear of COVID-19

A significant relationship was found between fear of COVID-19 and the overall linear regression model [R2 = 0.34, F(7, 456) = 33.81, p < 0.01]. The key factors predicting COVID-19 fear among undergraduates included gender, COVID-19 diagnosis status, intention to get vaccinated in the future, perceived changes in stress levels during the pandemic, and perceived ability to cope with stress. Specifically, female students (β = 0.19, p < 0.01), those who had not been diagnosed with COVID-19 (β = 0.15, p < 0.01), those planning to receive the vaccine (β = 0.18, p < 0.01), those who reported increased stress during the pandemic (β = 0.28, p < 0.01), those who felt unable to manage stress (β = 0.21, p < 0.01), and those who believed the university was not effective in controlling COVID-19 spread (β = 0.12, p < 0.01) exhibited significantly higher levels of fear about contracting the virus (see Table 6).

4. Discussion

There was a significant increase in anxiety levels among female students during the pandemic compared to male students. Females who experienced increased stress during the pandemic and were unable to manage it reported significant moderate to severe anxiety. This finding supports earlier research that found females during the pandemic were more anxious and stressed than males [38,39,40,41,42,43,44,45,46]. There are a variety of biological and psychosocial factors that could contribute to these gender differences in anxiety levels [40,43,47,48,49]. Compared to males, females perceive threats more strongly, are more sensitive to loss of control, and are more likely to experience anxiety during times of crisis [50]. Hellemans et al. and Prowse et al. reported that COVID-19-related articles may have been read and posted more by female students than by male students [43,47]. In contrast, males may have used other methods to reduce their stress, such as video games [49].
Our study found that undergraduates experienced higher rates of depression compared to graduate students. Those undergraduates who reported increased stress during the pandemic were also much more likely to experience moderate to severe depression. Similar findings were reported by Rudenstine and Wang et al., who noted that undergraduates have significantly greater levels of depression than graduate students [51,52]. Because undergraduate students are generally younger and often have less life experience coping with anxiety, stress, and depression, they may be more vulnerable to depressive disorders during the pandemic.
The difference in depression between female and male students was marginally significant. This aligns with findings from several other studies conducted during the pandemic [44,51,53,54]. Nomura’s study in Japan revealed that female students experience higher depression levels than their male counterparts [53]. In a study of US college students, Grineski et al. found that the odds of female students having depressive disorders were 1.16 times higher than those of males [54]. Research by Rudenstine showed significantly higher depression levels in females compared to males [51]. Additionally, a meta-analysis conducted before the COVID-19 pandemic by Salk reported that females were considerably more likely to suffer from depressive disorders [55]. Although pinpointing the exact reasons why female students are more prone to depression is challenging, researchers suggest it may be related to social influences, biological factors such as hormonal differences, and exposure to stressful life events [56].
Other studies have also found a significant rise in fear of COVID-19 among female students compared to males [57,58,59]. COVID-19-related complications might have been more frequent in women than men. Additionally, females could score higher on the FCV-19S scale due to differing coping strategies compared to males. Students who had not been diagnosed with COVID-19 during the study exhibited higher stress levels and greater fear of the virus. Those who had yet to receive the COVID-19 vaccine but planned to do so in the future also reported increased fear of infection. This may be because individuals who have not contracted the virus lack firsthand experience of living with the disease during the pandemic’s early and middle stages. Consequently, these students experienced more stress and fear than those who had already contracted COVID-19. Furthermore, the absence of vaccination left them feeling less protected and thus more fearful of infection. Another factor that can potentially play a role on students’ psychology on the pandemic and vaccination is misinformation. During the pandemic, misinformation was widespread, especially online media. There was misinformation on the origin of the pandemic, vaccine side effects, and other speculations that could negatively influence college students, especially considering that at college level, not all students are equally health literate [60]. Misinformation might have disproportionately impacted those who perceived inadequate support by the university and also those who might have relied mostly on peers for pandemic-related information [61].
The findings offer valuable insights into students’ perceptions of their university’s pandemic response and the support available to them. Anxiety, depression, and fear of COVID-19 were more common among students who believed their university provided insufficient support. A higher likelihood of moderate to severe depression and greater COVID-19 fear were also linked to students who felt the university failed to control the infection spread. Similar findings were also reported by Soria et al., who noted that students who felt better supported by their university also had lower anxiety during the pandemic [46]. One possible explanation of this phenomenon is that perceived support of the university can make students feel safer and reduce uncertainty. Previous studies showed that during pandemic crisis, students who believed their institutions were supportive were less likely to experience helplessness and isolation [7,62]. Li et al. reported that regular updates and transparent communication from the university leadership could improve college students’ psychological health [63]. Using the ideas of the transactional model of stress and coping, we can also explain that the university’s actions can shape students’ emotional response towards perceived control, social support, and coping efficacy, where the prompts interventions and communications by the universities will change the thought process of the students and turn more stressful feelings into less stressful ones [64]. Exploring this topic through qualitative research in future could provide a deeper understanding.
Our identification that higher anxiety and fear of COVID-19 among female students, and higher levels of depressive symptoms among the undergraduate students indicates that tailored responses are needed. For example, incoming freshmen or first-year students can receive information on coping mechanisms and access to telehealth programs offered by the university during their onboarding or weeks of welcome [65]. Another approach can be to offer gender specific outreach programs and a peer support system to help students deal with their mental health issues [66]. This strategy can improve acceptability and adoptability by the students. It is important to consider both students’ and the university administration’s viewpoints on these issues. The university may not have effectively communicated all pandemic containment strategies to students. For example, Son et al. found that although colleges offered support services, many students did not utilize them [7]. The transition to online classes and activities likely hindered in-person services, such as mental health support, making it difficult to deliver them virtually. Additionally, some students may have avoided university support systems during the pandemic, especially if they were already struggling with stress or depression. In this study, only 2% of students received university-provided support, while 98% relied on friends or family members. The shift to online learning and limited face-to-face interaction may have reduced student interest in university services [67,68]. Factors such as lack of awareness, personal beliefs, and social stigma surrounding mental health could have further discouraged students from recognizing or seeking psychological help [69]. Moreover, university administrations may have been unable to meet the high demand for psychological support during the pandemic, which contributed to the underutilization of resources. Prior studies have shown that psychological support systems in US higher education were inadequate even before COVID-19 [70]. Insufficient personnel and challenges in transitioning services online further limited students’ access to university support [71]. In response to similar challenges, some universities, especially in the Appalachian region, have started to enhance student support. For instance, a large public university in Appalachia began releasing a monthly online newsletter about mental health resources in January 2023 [72]. It is crucial for other universities to adopt similar initiatives. University authorities should prioritize students’ mental health care to better prepare for future large-scale crises. However, budget constraints at many public institutions may impede such efforts [72,73]. Therefore, collaboration between university officials and government representatives is recommended.
The geographical context of the Shenandoah Valley might have played roles in students’ psychological stress, especially due to the limited availability of psychological health care. Several counties of the Shenandoah Valley lack an adequate number of mental health care providers, as well as financial support from the government [74,75,76]. Lack of high-speed internet is also another challenge, since students might have had difficulty in receiving virtual care [77].
While this study was among the first to examine stress, depression, and COVID-19 fear among college students in the Shenandoah Valley, it has some limitations. First, as a cross-sectional study, it could not track changes in stress, anxiety, or fear over time. Future research should investigate whether these mental health concerns decrease as the pandemic evolves. Second, without surveying university administration, the study could not fully capture all pandemic-related interventions. Third, the survey responses were self-reported, leading to possible social desirability or recall bias. Also, the sample overrepresented females than the males. In the future, stratified or quota sampling can be used to reduce such overrepresentation. However, we also need to consider that the authors’ university had 59% female students, vs. 41% male students when this study was conducted [78]. Being purely quantitative, the research did not reveal specific student concerns about university services, highlighting the need for qualitative studies. Fourth, the study did not differentiate between students from the Shenandoah Valley and those from other regions, so comparisons regarding anxiety, depression, or COVID-19 fear between these groups were not possible. Additionally, only one public university was included, preventing comparisons with other local institutions. The authors suggest conducting comparative analyses between regional and national universities to inform administrative planning. Our study also did not account for several factors such as history of chronic illness, financial situation, or academic performance. Including those could have shown some significant relationships with the study outcome. Since the study already had many survey questions, the authors wanted to avoid distractions and reduce the number of incomplete survey responses, which is a common concern in college student surveys due to non-response bias [79]. Our study also had relatively small R2 in the regression models. However, this is not uncommon in behavioral and psychological studies where many variables that are not included in the study can have influence on the outcomes [80]. Future studies can incorporate additional variables to increase the effect size. We also included very few coping strategies. Future studies can include standardized methods to measure coping [81,82]. We dichotomized anxiety and depression scores for logistic regression. Although this can lead to some loss of information compared to using the full continuous or ordinal scales [83], dichotomization allowed us to align with established clinical cut-off values for the GAD-7 and PHQ-9 [21,24]. This helped us interpret the results in terms of clinically meaningful categories. We also used linear regression for the continuous outcome variables. Future studies can use ordinal or multinomial models, or conduct sensitivity analyses.

5. Conclusions

Students’ mental health is vulnerable during emergencies, and the way academic institutions respond plays a crucial role in influencing their well-being. The findings of this study can assist universities in better preparing for future crises, including pandemics. Additionally, these results offer valuable information for college health behavior researchers, psychologists, and counselors. For instance, health behavior researchers can apply theories like ecological models [84] to guide college administrators in improving or developing new programs aimed at promoting students’ physical and mental health during pandemics or other emergencies.

Author Contributions

Conceptualization, R.K.K.; methodology, R.K.K.; software, R.K.K.; validation, R.K.K.; formal analysis, R.K.K. and T.J.; investigation, R.K.K.; resources, R.K.K. and M.T.A.; data curation, R.K.K.; writing—original draft preparation, R.K.K.; writing—review and editing, R.K.K., M.T.A. and S.B.Z.; supervision, R.K.K.; project administration, R.K.K.; funding acquisition, R.K.K. All authors have read and agreed to the published version of the manuscript.

Funding

This PI (RKK) of this research was funded by new faculty startup funding from the DEPARTMENT OF HEALTH SCIENCES, JMU.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of JAMES MADISON UNIVERSITY in 2021 (protocol code 21-2386).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are available on request from the PI due to privacy or ethical restrictions.

Conflicts of Interest

The authors declare no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
COVID-19Coronavirus disease of 2019
IRBInstitutional Review Board
URLUniform resource locator
CHBSCollege of Health and Behavioral Studies
GAD-7Generalized Anxiety Disorder 7-item scale
PHQ-9Patient Health Questionnaire 9-item depression scale
FCV-19SFear of COVID-19 Scale
SPSSStatistical Package for the Social Sciences
IBM International Business Machines
SDStandard deviation
OROdds ratio
CIConfidence interval

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Table 1. Descriptive statistics of study variables.
Table 1. Descriptive statistics of study variables.
VariableMean (SD)Participants
Number (%)
Age22.14 (5.48)
Gender
Male 117 (19.3)
Female 479 (78.9)
Ethnicity
Non-Whites 109 (18.1)
Non-Hispanic Whites 494 (81.9)
Degree program enrolled
Undergraduate 472 (78.0)
Graduate 133 (22.0)
College enrolled 1
CHBS 249 (41.4)
Non-CHBS 353 (58.6)
COVID-19 diagnosis status 2
Yes 129 (21.4)
No 475 (78.6)
Generalized anxiety (GAD7)8.47 (5.84)
Minimal or mild anxiety 375 (62.5)
Moderate to severe anxiety 225 (37.5)
Depressive disorder (PHQ9)
None/minimal to mild depression 366 (61.2)
Moderate, moderately severe to severe depression 323 (38.8)
Fear of COVID-19 (FCV-19S)15.78 (6.00)
Perception of change in stress during the pandemic
Increased 484 (79.9)
Decreased or remained same 122 (20.1)
Perception of ability to manage stress during the pandemic
Can manage 401 (66.2)
Can’t manage or don’t know 205 (33.8)
Perception of university’s ability to contain COVID-19 infection
Was able to contain 301 (49.9)
Couldn’t contain or don’t know 302 (50.1)
Perception of university’s support during the pandemic
Provided support 214 (35.5)
Didn’t provide support or don’t know 388 (64.5)
Coping mechanism used during the pandemic
University provided 12 (2.0)
Family and friends or online 579 (98.0)
Plan for receiving COVID-19 vaccine in future
Plan to receive vaccine 362 (74.9)
No plan to receive vaccine or don’t know 121 (25.1)
1 Percentage of students who were enrolled in College of Health and Behavioral Studies (CHBS) and those who were enrolled in other colleges. 2 Percentage of students who reported if they had a diagnosed COVID-19 infection or not.
Table 2. Linear regression model for generalized anxiety disorder (GAD7).
Table 2. Linear regression model for generalized anxiety disorder (GAD7).
Covariatesβt* p-Value 95% CI
Gender (female)0.102.77<0.01 *(0.42, 2.47)
COVID-19 diagnosis status (no)0.082.780.02 *(0.16, 2.11)
Stress perception during the pandemic (increased)0.256.80<0.01 **(2.56, 4.63)
Pandemic stress perceptions (can’t manage or don’t know)0.3710.25<0.01 **(3.71, 5.47)
University’s capability to contain COVID-19 (couldn’t contain or don’t know)0.030.770.44(−0.55, 1.27)
Pandemic support perceived by university students (didn’t provide support or don’t know)0.102.490.01 *(0.25, 2.11)
* p < 0.05; ** p < 0.01; β = standardized beta; CI = Confidence Interval.
Table 4. Linear regression model for depressive disorder (PHQ9).
Table 4. Linear regression model for depressive disorder (PHQ9).
Covariatesβtp-Value 95% CI
Age0.010.310.76(−0.09, 0.13)
Gender (female)0.071.680.09(−0.18, 2.34)
Degree program enrolled (undergraduate)0.132.680.01 *(0.51, 3.32)
Perception of change in stress during the pandemic (decreased or remained same)0.204.82<0.01 **(1.82, 4.33)
Coping mechanism used during the pandemic (university provided)<0.010.040.97(−3.63, 3.79)
Perception of university’s ability to contain COVID-19 infection (couldn’t contain or don’t know)0.112.400.02 *(0.24, 2.43)
Perception of university supporting students during the pandemic (Didn’t provide support or don’t know) 0.132.82<0.01 **(0.50, 2.78)
* p < 0.05; ** p < 0.01; β = standardized beta; CI = Confidence Interval.
Table 6. Linear regression model for fear of COVID-19 (FCV-19S).
Table 6. Linear regression model for fear of COVID-19 (FCV-19S).
Covariatesβtp-Value 95% CI
Gender (female)0.194.86<0.01 **(1.63, 3.84)
COVID-19 diagnosis status (no)0.154.02<0.01 **(1.14, 3.31)
Plan for receiving COVID-19 vaccine in future (Plan to receive vaccine)0.184.56<0.01 **(1.47, 3.62)
Perception of change in stress during the pandemic (increased)0.286.99<0.01 **(3.08, 5.48)
Perception of ability to manage stress during the pandemic (can’t manage or no answer)0.215.33<0.01 **(1.73, 3.76)
Perception of university’s ability to contain COVID-19 infection (couldn’t contain or don’t know)0.122.77<0.01 **(0.44, 2.57)
Perception of university supporting students during the pandemic (didn’t provide support or don’t know)0.020.550.58(−0.79, 1.41)
* p < 0.05; ** p < 0.01; β = standardized beta; CI = Confidence Interval.
Table 3. Logistic regression model for generalized anxiety disorder (GAD7).
Table 3. Logistic regression model for generalized anxiety disorder (GAD7).
Covariatesβp-ValueOR95% CI
Gender (female)0.380.161.46(0.86, 2.47)
COVID-19 diagnosis status (no)0.420.081.51(0.94, 2.43)
Stress perception during the pandemic (increased)1.71<0.01 **5.55(2.82, 10.93)
Pandemic stress perceptions (can’t manage or don’t know)1.45<0.01 **4.25(2.87, 6.28)
University’s capability to contain COVID-19 (couldn’t contain or don’t know)0.160.471.17(0.76, 1.79)
Pandemic support perceived by university students (didn’t provide support or don’t know)0.480.04 *1.61(0.03, 2.52)
* p < 0.05; ** p < 0.01; β = standardized beta; OR: Odds ratio; CI = Confidence Interval.
Table 5. Logistic regression model for depressive disorder (PHQ9).
Table 5. Logistic regression model for depressive disorder (PHQ9).
Covariatesβp-ValueOR95% CI
Age0.010.501.01(0.97, 1.06)
Gender (female)0.270.261.31(0.82, 2.10)
Degree program enrolled (undergraduate)0.670.01 *1.96 (1.15, 3.34)
Perception of change in stress during the pandemic (increased)1.07<0.01 ** 2.92(1.73, 4.94)
Coping mechanism used during the pandemic (university provided)0.080.911.08(0.28, 4.25)
Perception of university’s ability to contain COVID-19 infection (couldn’t contain or don’t know)0.430.03 *1.53(1.03, 2.27)
Perception of university supporting students during the pandemic (Didn’t provide support or don’t know)0.530.01 *1.69(1.11, 2.58)
* p < 0.05; ** p < 0.01; β = standardized beta; OR: Odds ratio; CI = Confidence Interval.
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Khan, R.K.; Alam, M.T.; Zaman, S.B.; Jehi, T. College Students’ Mental Health During the COVID-19 Pandemic. Psychiatry Int. 2025, 6, 112. https://doi.org/10.3390/psychiatryint6030112

AMA Style

Khan RK, Alam MT, Zaman SB, Jehi T. College Students’ Mental Health During the COVID-19 Pandemic. Psychiatry International. 2025; 6(3):112. https://doi.org/10.3390/psychiatryint6030112

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Khan, Raihan K., Md Towfiqul Alam, Sojib Bin Zaman, and Tony Jehi. 2025. "College Students’ Mental Health During the COVID-19 Pandemic" Psychiatry International 6, no. 3: 112. https://doi.org/10.3390/psychiatryint6030112

APA Style

Khan, R. K., Alam, M. T., Zaman, S. B., & Jehi, T. (2025). College Students’ Mental Health During the COVID-19 Pandemic. Psychiatry International, 6(3), 112. https://doi.org/10.3390/psychiatryint6030112

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