Management of anxiety and depression disorders by university students during the covid-19 pandemic: A cross-sectional study

Authors

DOI:

https://doi.org/10.21527/2176-7114.2025.50.15683

Keywords:

Anxiety, Depression, University students, Psychotropic drugs, Psychotherapy

Abstract

Objectives: to  evaluate the use of psychotropic drugs and/or psychotherapy for anxiety and/or depression management among Brazilian university students during the COVID-19 pandemic. Methods: a cross-sectional, quantitative study conducted by an online questionnaire containing sections related to sociodemographic data, academic information, mental health-related information, and evaluation of the  severity of anxiety and depression symptoms. Participants included university students aged 18 and older with a previous anxiety and/or depression disorders diagnosis. Descriptive and inferential analyses were performed. The study received approval from the Ethics Committee for Human Research. Results: 409 students with an anxiety and/or depression disorders diagnosis participated in the study. Most students reported using psychotropic drugs (62.3%; n = 255). There was no significant association between medication use and sociodemographic variables. Psychotherapy use was reported by 36.7% (n = 150) of students. A significant association was observed between psychotherapy use and ethnicity/color (p < 0.01) and engagement in paid activities (p = 0.02). Conclusion: The medication use prevalence is higher compared to psychotherapy use. Ethnicity/race and performance in paid activities may be associated with psychotherapy use among Brazilian university students.

References

1. Santomauro DF, Mantilla Herrera AM, Shadid JP, Zheng P, Ashbaugh C, Pigott D, et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398(10312):1700–12.

2. Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Global Health. 2020;16(1):1–11.

3. El-Nayal M, Alaeddine H. Mental Health Among University Students. BAU J - Soc Cult Hum Behav. 2020;1(2):1–19.

4. Li W, Zhao Z, Chen D, Peng Y, Lu Z. Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis. J Child Psychol Psychiatry. 2022 Nov;63(11):1222-1230.

5. Aristovnik A, Keržič D, Ravšelj D, Tomaževič N, Umek L. Impacts of the COVID-19 Pandemic on Life of Higher Education Students: Sustain. 2020;12(20):1–34.

6. American Psychiatric Association (APA). Manual diagnóstico e estatístico de transtornos mentais: DSM-5. 5. ed. Porto Alegre: Artmed, 2014.

7. Walkup JT, Albano AM, Piacentini J, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med. 2008;359(26):2753-2766.

8. Imel ZE, Malterer MB, McKay KM, Wampold BE. A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia. J Affect Disord. 2008;110(3):197-206.

9. Stahl, S. Psicofarmacologia: Bases Neurocientíficas e Aplicações Práticas. 4. ed. Porto Alegre: Guanabara Koogan, 2017.

10. Zhang A, Borhneimer LA, Weaver A, Franklin C, Hai AH, Guz S, et al. Cognitive behavioral therapy for primary care depression and anxiety: a secondary meta-analytic review using robust variance estimation in meta-regression. Journal of Behavioral Medicine. 2019;42(6):1117–41.

11. Scott KM, Lim C, Al-Hamzawi A, Alonso J, Bruffaerts R, Caldas-De-Almeida JM, et al. Association of mental disorders with subsequent chronic physical conditions: World mental health surveys from 17 countries. JAMA Psychiatry. 2016;73(2).

12. Lun KWC, Chan CK, Ip PKY, Ma SYK, Tsai WW, Wong CS, et al. Depression and anxiety among university students in Hong Kong. Hong Kong Medical Journal. 2018;24(5).

13. Demenech LM, Neiva-Silva L, Brignol SMS, Marcon SR, Lemos SM, Tassitano RM, et al. Suicide risk among undergraduate students in Brazil in the periods before and during the COVID-19 pandemic: results of the SABES-Grad national survey. Psychological Medicine. 2023;53(11):4977–89.

14. Benistand P, Vorilhon P, Laporte C, Bouillon-Minois JB, Brousse G, Bagheri R, et al. Effect of the COVID-19 pandemic on the psychotropic drug consumption. Front Psychiatry. 2022;13(December):1–10.

15. Demenech LM, Neiva-Silva L, Brignol SMS, Marcon SR, Lemos SM, Tassitano RM, et al. Suicide risk among undergraduate students in Brazil in the periods before and during the COVID-19 pandemic: results of the SABES-Grad national survey. Psychol Med. 2023;53(11):4977–89.

16. Sousa MLC, Firmino RT, Gomes RDAD, Nunes WB, Perazzo MF, Paiva SM, et al. Use of anxiolytics/antidepressants among university students in the pre-vaccine period of the COVID-19 pandemic. Rev da ABENO. 2023;23(1):2170.

17. Sharma A, Minh Duc NT, Luu Lam Thang T, Nam NH, Ng SJ, Abbas KS, et al. A Consensus-Based Checklist for Reporting of Survey Studies (CROSS). J Gen Intern Med. 2021 Oct 1;36(10):3179–87.

18. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med. 2006;166(10).

19. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9).

20. Zimmerman M. Using the 9-Item Patient Health Questionnaire to Screen for and Monitor Depression. Depress Anxiety. 2019;29(10):865–73.

21. Moreno AL, Desousa DA, De Souza AMFLP, Manfro GG, Salum GA, Koller SH, et al. Factor structure, reliability, and item parameters of the Brazilian-Portuguese version of the GAD-7 questionnaire. Temas em Psicol. 2016;24(1):367–76.

22. Osório FL, Mendes AV, Crippa JA, Loureiro SR. Study of the discriminative validity of the PHQ-9 and PHQ-2 in a sample of Brazilian women in the context of primary health care. Perspect Psychiatr Care. 2009;45(3):216-227.

23. Santos IS, Tavares BF, Munhoz TN, et al. Sensitivity and specificity of the Patient Health Questionnaire-9 (PHQ-9) among adults from the general population. Cad Saude Publica. 2013;29(8):1533-1543.

24. Silva LS, Leite MF, Feitosa ALB, Faro A. Propriedades psicométricas da GAD-7 no Brasil. Psico. 2023 Oct 23;54(1):e39902–2.

25. Nunes D, Faro A. Factor Structure, Invariance Analysis and Social Distribution of the Patient Health Questionnaire-9 (PHQ-9). Rev Iberoam Diagnostico y Eval Psicol. 2022;1(62):37–49.

26. WHO Collaborating Centre for Drugs Statistics Methodology. ATC/DDD Index 2024 [updated 2024 May 13; cited 2024 May 13]. Available at: http://www.whocc.no/atc_ddd_index/

27. Morris MR, Hoeflich CC, Nutley S, Ellingrod VL, Riba MB, Striley CW. Use of psychiatric medication by college students: A decade of data. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2021 Apr 1; 41(4):

28. Oliva V, Possidente C, De Prisco M, et al. Pharmacological treatments for psychotic depression: a systematic review and network meta-analysis. Lancet Psychiatry. 2024;11(3):210-220

29. Slee A, Nazareth I, Bondaronek P, Liu Y, Cheng Z, Freemantle N. Pharmacological treatments for generalised anxiety disorder: a systematic review and network meta-analysis. Lancet. 2019;393(10173):768-777.

30. Fontes BA, Jacinto PM, Rocha RV. Consumo de ansiolíticos benzodiazepínicos durante a pandemia de COVID-19: um estudo remoto com estudantes universitários. Sapienza Int J Interdiscip Stud. 2022;3(1):34–44.

31. Balayssac D, Pereira B, Darfeuille M, Cuq P, Vernhet L, Collin A, et al. Use of psychotropic medications and illegal drugs, and related consequences among French pharmacy students - SCEP study: A nationwide cross-sectional study. Front Pharmacol. 2018;9(JUL).

32. Campanha AM, Ravagnani B, Milhorança IA, et al. Benzodiazepine use in Sao Paulo, Brazil. Clinics (Sao Paulo). 2020;75:e1610.

33. Dubovsky SL, Marshall D. Benzodiazepines Remain Important Therapeutic Options in Psychiatric Practice. Vol. 91, Psychotherapy and Psychosomatics. S. Karger AG; 2022. p. 307–34.

34. Bauchrowitz C, Paz LEC, Muller EV, Possagno GCH, Minozzo BR. Prevalência de uso de psicofármacos por acadêmicos: efeitos do processo de graduação. Brazilian Journal of Development. 2019;5(11).

35. Ribeiro AG, Cruz LP da, Marchi KC, Tirapelli CR, Miasso AI. Antidepressants: use, adherence and awareness among medical students. Cien Saude Colet. 2014;19(6).

36. Marasine NR, Sankhi S. Factors Associated with Antidepressant Medication Non-adherence. Turk J Pharm Sci. 2021;18(2):242-249.

37. Fasanella NA, Custódio CG, Cabo JSD, Andrade GS, Almeida FA, Pavan MV. Use of prescribed psychotropic drugs among medical students and associated factors: a cross-sectional study. Sao Paulo Med J. 2022;140(5):697-704.

38. Mizael TM, Castro MSLB de, Dittrich A. Uma interpretação analítico-comportamental do colorismo e de suas implicações clínicas. Acta Behavioria: Revista Latina de Análisis de Comportamiento. 2021;29(4).

Published

2025-03-24

How to Cite

Silva, B., Antonucci, B. L., Salomão, S. B., Mazzini, Y., Reis, W., Santos-Junior, G., … Araújo, D. C. (2025). Management of anxiety and depression disorders by university students during the covid-19 pandemic: A cross-sectional study. Revista Contexto & Saúde, 25(50), e15683. https://doi.org/10.21527/2176-7114.2025.50.15683

Issue

Section

ORIGINAL ARTICLE