Depression, anxiety and the COVID-19 pandemic: Severity of symptoms and associated factors among university students after the end of movement lockdown

COVID-19 has struck the world by surprise since it began to spread as a novel viral infection in China in December 2020. In Malaysia, it only began to spread among the local population since March 2020 and resulting in movement lockdown imposed by the government from mid-March 2020 to June 2020. Although the movement lockdown was lifted in June 2020, academic activities in Malaysian universities are still restricted. Consequently, prevalence of psychological complications surge among the university students. Nevertheless, there is paucity of data on mental health status of university students in response to COVID-19 after the movement lockdown was lifted. This cross-sectional study aimed to fill the research gap by: (1) investigating the severity of depressive, anxiety, and psychological stress symptoms in response to the COVID-19 pandemic after the movement lockdown was lifted among a cohort of Malaysian university students and (2) determining the association between various COVID-19 stressors and religious coping, personal and clinical factors, social support, and the levels of depressive and anxiety symptoms. There was a total of 314 university students enrolled in this study. We found that the participants reported mild, moderate, and severe depression in the survey study i.e. at 14.3%, 11.8% and 8.9%, respectively. 6.1% of participants had mild anxiety, 16.2% had moderate anxiety, and 13.4% had severe to extremely severe anxiety. 24.8% of participants had mild stress, 9.6% had moderate stress, and 6.7% had severe to extremely severe stress. After adjusting for age and marital status, frustration due to loss of daily routine and study disruption, and history of pre-existing medical, depressive and anxiety disorders were associated with elevated depressive and anxiety symptoms, while those who enrolled in medicine-based courses and greater social support were associated with decreased depressive and anxiety symptoms. Based on our findings, we suggested a few points to improve the mental health of university students during an infection pandemic.