Keywords
COVID-19
anxiety
depression
family-functioning
coping
anxiety
depression
family-functioning
coping
Abstract
Introduction: The curtailment of social gatherings as well as lack of online academic engagement, during the COVID-19 lockdown, could have potentially damaging effects on the psychological state of university students in Nigerian public universities. This study examined the prevalence of anxiety and depression, including associated factors and coping methods among undergraduate students.
Methods: The study design was cross-sectional and involved 386 undergraduate students. The study was approved with an approval number UI/EC/20/0242. An online questionnaire was circulated among the students consisting mainly of Hospital Anxiety and Depression Scale and the McMaster Family Assessment Device. The analysis was done using descriptive statistics, chi-square, Analysis of Variance (ANOVA) and linear logistics regression, at α 0.05.
Results: Mean age was 21±2.9 years, with a female population of 60.1%. Prevalence of anxiety and depression were 41.5% and 31.9% respectively. Students in health-related faculties were significantly less anxious than others. Inability to afford three square meals, negative family-functioning, having a chronic illness and living in a State/Region with a high incidence of COVID-19, was significantly associated with depression. These factors jointly accounted for 14% of depression. Coping methods included the use of social media, watching movies and participating in online skill development programmes.
Conclusion: There was a higher prevalence of anxiety and depression among university students with poor family functioning, inability to afford three meals/day, living in a state with a high incidence of COVID-19 and having a chronic illness. Proactive measures ought to be taken to support undergraduate students to prevent the negative consequences of poor mental health.
References
[1]. Prem K, Liu Y, Russell TW, Kucharski AJ, Eggo RM, Davies N. Articles The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China : a modelling study. 2020;261–70. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30073-6/fulltext. DOI:https://doi.org/10.1016/S2468-2667(20)30073-6
[2]. Organisation WH. WHO COVID PREVALENCE 27 JUNE [Internet]. [cited 2020 Jun 27]. Available from: https://covid19.who.int/
[3]. WHO concerned as COVID-19 cases accelerate in Africa | WHO | Regional Office for Africa [Internet]. [cited 2020 Jun 24]. Available from: https://www.afro.who.int/news/who-concerned-covid-19-cases-accelerate-africa
[4]. Lone SA, Ahmad A. COVID-19 pandemic – An African perspective. Emerg Microbes Infect. 2020;1–28. https://www.tandfonline.com/doi/pdf/10.1080/22221751.2020.1775132
[5]. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. [cited 2020 Apr 20]. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
[6]. WHO. COVID-19 Public Health Emergency of International Concern (PHEIC) Global research and innovation forum [Internet]. World Health Organization. 2020. p. 7. Available from: https://www.who.int/publications/m/item/covid-19-public-health-emergency-of-international-concern-(pheic)-global-research-and-innovation-forum%0Ahttps://www.who.int/who-documents-detail/covid-19-public-health-emergency-of-international-concern-(pheic)-glo
[7]. Nigeria Centre for Disease Control (NCDC). NCDC Director First case of coronavirus disease confirmed in Nigeria [Internet]. 2020 [cited 2020 Apr 22]. Available from: https://ncdc.gov.ng/news/227/first-case-of-corona-virus-disease-confirmed-in-nigeri
[8]. Nigeria Centre for Disease Control (NCDC). Guideline on Social Distancing [Internet]. p. 1–4. Available from: https://covid19.ncdc.gov.ng/media/files/Social_Distancing_Guide_2.pdf
[9]. Nigeria Centre for Disease Control (NCDC). NCDC Coronavirus COVID-19 Microsite_27 June 2020 [Internet]. [cited 2020 Jun 27]. Available from: https://covid19.ncdc.gov.ng/
[10]. Times P. Nigeria shuts land borders [Internet]. [cited 2020 May 22]. Available from: https://www.premiumtimesng.com/news/headlines/383448-just-in-coronavirus-nigeria-shuts-land-borders.html
[11]. National Universities Commission. Management of the Corona Virus (COVID-19) Pandemic | [Internet]. [cited 2020 Jun 24]. Available from: https://www.nuc.edu.ng/management-of-the-corona-virus-covid-19-pandemic/
[12]. Times P. Lockdown Extension_ Buhari issues regulation backing action [Internet]. [cited 2020 Apr 23]. Available from: https://www.premiumtimesng.com/news/387759-lockdown-extension-buhari-issues-regulation-backing-action.html
[13]. Saharareporters ny. Breaking_ ASUU Begins Indefinite Strike Action _ Sahara Reporters [Internet]. [cited 2020 Jun 18]. Available from: http://saharareporters.com/2020/03/23/breaking-asuu-begins-indefinite-strike-action
[14]. American Psychological Association. Adolescence: A unique period of challenge and opportunity for positive development [Internet]. 2014 [cited 2020 Jun 8]. Available from: https://www.apa.org/pi/families/resources/newsletter/2014/12/adolescence-development
[15]. John A, Marchant AL, McGregor JI, Tan JOA, Hutchings HA, Kovess V, Choppin, S, Macleod, J, Dennis, MS, Lloyd, K. Recent trends in the incidence of anxiety and prescription of anxiolytics and hypnotics in children and young people: An e-cohort study. J Affect Disord. 2015;183:134–41. https://pubmed.ncbi.nlm.nih.gov/26005207/
[16]. Melling P. Adolescent mental health. [Internet]. Vol. 34, Australian family physician. 2005. Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
[17]. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, Zheng, J The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287 (March):112934. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102633/
[18]. Mazza C, Ricci E, Biondi S, Colasanti M, Ferracuti S, Napoli C and Roma, P. A nationwide survey of psychological distress among italian people during the covid-19 pandemic: Immediate psychological responses and associated factors. Int J Environ Res Public Health. 2020;17(9):1–14. https://www.mdpi.com/1660-4601/17/9/3165
[19]. Wang H, Xia Q, Xiong Z, Li Z, Xiang W, Yuan Y, Liu, Y. and Li, Z.,. The psychological distress and coping styles in the early stages of the 2019 coronavirus disease (COVID-19) epidemic in the general mainland Chinese population: A web-based survey. PLoS One. 2020;15(5):1–10. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0233410
[20]. Huckins JF, Alex W, Wang W, Hedlund E, Rogers C, Wu J, Obuchi, M, Murphy, EI, Meyer, ML, Wagner, DD., Holtzheimer, PE and Campbell, AT. Mental Health and Behavior of College Students During the Early Phases of the COVID-19 Pandemic : Longitudinal Smartphone and Ecological Momentary Assessment Study Corresponding Author : 22. https://www.jmir.org/2020/6/e20185/
[21]. Vice Chancellor. History | UNIVERSITY OF IBADAN [Internet]. University of Ibadan. 2018 [cited 2020 Apr 24]. p. 1–15. Available from: https://ui.edu.ng/History
[22]. American Writing Association. Sample Size Calculator - Confidence Level, Confidence Interval, Sample Size, Population Size, Relevant Population - Creative Research Systems [Internet]. [cited 2020 May 28]. Available from: https://www.surveysystem.com/sscalc.htm
[23]. Bjelland I, Dahl AA, Haug TT ND. Hospital Anxiety and Depression Scale_ An updated literature review - ScienceDirect. J Psychosom Res. 2002; Feb 1;52(2):69–77. https://pubmed.ncbi.nlm.nih.gov/11832252/
[24]. Abiodun OA. A Validity Study of the Hospital Anxiety and Depression Scale in General Hospital Units and a Community Sample in Nigeria 0. 1994;165:669–72. https://pubmed.ncbi.nlm.nih.gov/7866683/
[25]. P. Ööpik, A. Aluoja, R. Kalda, and H. I. Maaroos, “Screening for depression in primary care,” Fam. Pract., vol. 23, no. 6, pp. 693–698, 2006. Available from: https://patient.info/doctor/screening-for-depression-in-primary-care. [Internet]. [cited 2020 May 23].
[26]. Duckett S. Family assessment device. Arch Phys Med Rehabil. 1997;78(2):234. https://doi.org/10.1016/S0003-9993(97)90272-0
[27]. Otekunrin O, Okon E, Otekunrin O. Analysis of Candidates’ Performance in Unified Tertiary Matriculation Examinations (UTME) and Post-UTME in the University of Ibadan, Nigeria. J Sci Res Reports. 2017;14(5):1–8. https://doi.org/10.9734/JSRR/2017/34322
[28]. American Psychological Association. Women outnumber men in psychology, but not in the field’s top echelons. Monitor on Psychology. 2017. p. 18. https://www.apa.org/monitor/2017/07-08/women-psychology
[29]. Cope C, Michalski DS, Fowler GA. Graduate study in Psychology 2017 summary report: Student Demographics. 2016;(December 2016):1–10. https://www.apa.org/education/grad/survey-data/2017-student-demographics.pdf
[30]. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, Ho RC. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084952/
[31]. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatry. 2020;33(2):1–4. https://pubmed.ncbi.nlm.nih.gov/32215365/
[32]. Liu X, Liu J, Zhong X. Psychological State of College Students During COVID-19 Epidemic. SSRN Electron J. 2020; https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3552814. doi.org/10.2139/ssrn.3552814
[33]. Al-Tammemi AB, Akour A, Alfalah L. Is it Just About Physical Health? An Internet-Based Cross-Sectional Study Exploring the Psychological Impacts of COVID-19 Pandemic on University Students in Jordan Using Kessler Psychological Distress Scale. medRxiv. 2020;2020.05.14.20102343. https://europepmc.org/article/ppr/ppr164177 DOI: 10.21203/rs.3.rs-29439/v1
[34]. Chang J., Yuan J. Wang D. Mental Health Status and Its Influencing Factors Among College Students During the Epidemic of COVID-19 - PubMed [Internet]. [cited 2020 Jun 9]. Available from: https://pubmed.ncbi.nlm.nih.gov/32376528/ doi: 10.12122/j.issn.1673-4254.2020.02.06
[35]. United Nations Department of Economics and social. Rural population - Nigeria _ Data [Internet]. United Nations Population Division’s World Urbanization Prospects: 2018 Revision. 2018 [cited 2020 Jun 18]. Available from: https://data.worldbank.org/indicator/SP.RUR.TOTL?locations=NG
[36]. Ayandele O, Popoola O, Obosi A, Busari A. Depression, Anxiety and Smartphone Addiction among Young People in South-West Nigeria. 2019;4(2):1–14. DOI: 10.1108/JHR-10-2019-0225
[37]. Odriozola-gonzález P, Planchuelo-gómez Á, Jesús M, de Luis-García R. Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Res. 2020;290(May):113108. https://pubmed.ncbi.nlm.nih.gov/32450409/ DOI: 10.1016/j.psychres.2020.113108
[38]. Fatiregun AA, Kumapayi TE. Prevalence and correlates of depressive symptoms among in-school adolescents in a rural district in southwest Nigeria. J Adolesc. 2014;37(2):197–203. https://pubmed.ncbi.nlm.nih.gov/24439625/ DOI: 10.1016/j.adolescence.2013.12.003
[39]. Peltzer K, Pengpid S, Olowu S, Olasupo M. Depression and associated factors Among University students in Western Nigeria. J Psychol Africa. 2013;23(3):459–65. https://www.tandfonline.com/doi/abs/10.1080/14330237.2013.10820652
[40]. Li Y, Wang Y, Jiang J, Valdimarsdóttir UA, Fall K, Fang F, Song H, Lu D, Zhang W. Psychological distress among health professional students during the COVID-19 outbreak. Psychol Med. 2020;0–2. https://pubmed.ncbi.nlm.nih.gov/32389148/
[41]. Jianjun D, Tsingan L, Jiali W, Limei T. The Effect of COVID-19 Stress on Sexual Compulsivity Symptom: The Mediating Role of Perceived Social Support. Research Square. 2020. p. 1–23.
[42]. Huang L, Xu FM, Liu HR. Emotional responses and coping strategies of nurses and nursing college students during COVID-19 outbreak. medRxiv. 2020;2020.03.05.20031898.
[43]. Tang W, Hu T, Hu B, Jin C, Wang G, Xie C, Chen S, Xu J. Prevalence and correlates of PTSD and depressive symptoms one month after the outbreak of the COVID-19 epidemic in a sample of home-quarantined Chinese university students. J Affect Disord. 2020;274(March):1–7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217769/ https://doi.org/10.1016/j.jad.2020.05.009
[44]. Ogundele OA, Ogundele T, Taha SM. Factors Influencing Adolescents Stigmatising Attitudes and Perception of Community Reaction towards Mental Illness in Nigeria. Sudan J Med Sci. 2017;12(4):240. https://www.ajol.info/index.php/sjms/article/view/168553/158024
[45]. Effiong Jombo H, Udo Idung A, Author C. Stigmatising Attitudes towards Persons with Mental Illness among University Students in Uyo, South-South Nigeria. Int J Heal Sci Res. 2018;8(April):24. https://www.researchgate.net/publication/335893008_Stigmatising_Attitudes_towards_Persons_with_Mental_Illness_among_University_Students_in_Uyo_South-South_Nigeria
[46]. Anosike C, Ukwe CV OA. Attitudes of pharmacy and non‐pharmacy students towards mental illness in Nigeria: a comparative survey. Int J Pharm Pract 2020 Feb 4. 2020; Feb. https://onlinelibrary.wiley.com/doi/abs/10.1111/ijpp.12601
[2]. Organisation WH. WHO COVID PREVALENCE 27 JUNE [Internet]. [cited 2020 Jun 27]. Available from: https://covid19.who.int/
[3]. WHO concerned as COVID-19 cases accelerate in Africa | WHO | Regional Office for Africa [Internet]. [cited 2020 Jun 24]. Available from: https://www.afro.who.int/news/who-concerned-covid-19-cases-accelerate-africa
[4]. Lone SA, Ahmad A. COVID-19 pandemic – An African perspective. Emerg Microbes Infect. 2020;1–28. https://www.tandfonline.com/doi/pdf/10.1080/22221751.2020.1775132
[5]. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. [cited 2020 Apr 20]. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
[6]. WHO. COVID-19 Public Health Emergency of International Concern (PHEIC) Global research and innovation forum [Internet]. World Health Organization. 2020. p. 7. Available from: https://www.who.int/publications/m/item/covid-19-public-health-emergency-of-international-concern-(pheic)-global-research-and-innovation-forum%0Ahttps://www.who.int/who-documents-detail/covid-19-public-health-emergency-of-international-concern-(pheic)-glo
[7]. Nigeria Centre for Disease Control (NCDC). NCDC Director First case of coronavirus disease confirmed in Nigeria [Internet]. 2020 [cited 2020 Apr 22]. Available from: https://ncdc.gov.ng/news/227/first-case-of-corona-virus-disease-confirmed-in-nigeri
[8]. Nigeria Centre for Disease Control (NCDC). Guideline on Social Distancing [Internet]. p. 1–4. Available from: https://covid19.ncdc.gov.ng/media/files/Social_Distancing_Guide_2.pdf
[9]. Nigeria Centre for Disease Control (NCDC). NCDC Coronavirus COVID-19 Microsite_27 June 2020 [Internet]. [cited 2020 Jun 27]. Available from: https://covid19.ncdc.gov.ng/
[10]. Times P. Nigeria shuts land borders [Internet]. [cited 2020 May 22]. Available from: https://www.premiumtimesng.com/news/headlines/383448-just-in-coronavirus-nigeria-shuts-land-borders.html
[11]. National Universities Commission. Management of the Corona Virus (COVID-19) Pandemic | [Internet]. [cited 2020 Jun 24]. Available from: https://www.nuc.edu.ng/management-of-the-corona-virus-covid-19-pandemic/
[12]. Times P. Lockdown Extension_ Buhari issues regulation backing action [Internet]. [cited 2020 Apr 23]. Available from: https://www.premiumtimesng.com/news/387759-lockdown-extension-buhari-issues-regulation-backing-action.html
[13]. Saharareporters ny. Breaking_ ASUU Begins Indefinite Strike Action _ Sahara Reporters [Internet]. [cited 2020 Jun 18]. Available from: http://saharareporters.com/2020/03/23/breaking-asuu-begins-indefinite-strike-action
[14]. American Psychological Association. Adolescence: A unique period of challenge and opportunity for positive development [Internet]. 2014 [cited 2020 Jun 8]. Available from: https://www.apa.org/pi/families/resources/newsletter/2014/12/adolescence-development
[15]. John A, Marchant AL, McGregor JI, Tan JOA, Hutchings HA, Kovess V, Choppin, S, Macleod, J, Dennis, MS, Lloyd, K. Recent trends in the incidence of anxiety and prescription of anxiolytics and hypnotics in children and young people: An e-cohort study. J Affect Disord. 2015;183:134–41. https://pubmed.ncbi.nlm.nih.gov/26005207/
[16]. Melling P. Adolescent mental health. [Internet]. Vol. 34, Australian family physician. 2005. Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
[17]. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, Zheng, J The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287 (March):112934. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102633/
[18]. Mazza C, Ricci E, Biondi S, Colasanti M, Ferracuti S, Napoli C and Roma, P. A nationwide survey of psychological distress among italian people during the covid-19 pandemic: Immediate psychological responses and associated factors. Int J Environ Res Public Health. 2020;17(9):1–14. https://www.mdpi.com/1660-4601/17/9/3165
[19]. Wang H, Xia Q, Xiong Z, Li Z, Xiang W, Yuan Y, Liu, Y. and Li, Z.,. The psychological distress and coping styles in the early stages of the 2019 coronavirus disease (COVID-19) epidemic in the general mainland Chinese population: A web-based survey. PLoS One. 2020;15(5):1–10. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0233410
[20]. Huckins JF, Alex W, Wang W, Hedlund E, Rogers C, Wu J, Obuchi, M, Murphy, EI, Meyer, ML, Wagner, DD., Holtzheimer, PE and Campbell, AT. Mental Health and Behavior of College Students During the Early Phases of the COVID-19 Pandemic : Longitudinal Smartphone and Ecological Momentary Assessment Study Corresponding Author : 22. https://www.jmir.org/2020/6/e20185/
[21]. Vice Chancellor. History | UNIVERSITY OF IBADAN [Internet]. University of Ibadan. 2018 [cited 2020 Apr 24]. p. 1–15. Available from: https://ui.edu.ng/History
[22]. American Writing Association. Sample Size Calculator - Confidence Level, Confidence Interval, Sample Size, Population Size, Relevant Population - Creative Research Systems [Internet]. [cited 2020 May 28]. Available from: https://www.surveysystem.com/sscalc.htm
[23]. Bjelland I, Dahl AA, Haug TT ND. Hospital Anxiety and Depression Scale_ An updated literature review - ScienceDirect. J Psychosom Res. 2002; Feb 1;52(2):69–77. https://pubmed.ncbi.nlm.nih.gov/11832252/
[24]. Abiodun OA. A Validity Study of the Hospital Anxiety and Depression Scale in General Hospital Units and a Community Sample in Nigeria 0. 1994;165:669–72. https://pubmed.ncbi.nlm.nih.gov/7866683/
[25]. P. Ööpik, A. Aluoja, R. Kalda, and H. I. Maaroos, “Screening for depression in primary care,” Fam. Pract., vol. 23, no. 6, pp. 693–698, 2006. Available from: https://patient.info/doctor/screening-for-depression-in-primary-care. [Internet]. [cited 2020 May 23].
[26]. Duckett S. Family assessment device. Arch Phys Med Rehabil. 1997;78(2):234. https://doi.org/10.1016/S0003-9993(97)90272-0
[27]. Otekunrin O, Okon E, Otekunrin O. Analysis of Candidates’ Performance in Unified Tertiary Matriculation Examinations (UTME) and Post-UTME in the University of Ibadan, Nigeria. J Sci Res Reports. 2017;14(5):1–8. https://doi.org/10.9734/JSRR/2017/34322
[28]. American Psychological Association. Women outnumber men in psychology, but not in the field’s top echelons. Monitor on Psychology. 2017. p. 18. https://www.apa.org/monitor/2017/07-08/women-psychology
[29]. Cope C, Michalski DS, Fowler GA. Graduate study in Psychology 2017 summary report: Student Demographics. 2016;(December 2016):1–10. https://www.apa.org/education/grad/survey-data/2017-student-demographics.pdf
[30]. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, Ho RC. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084952/
[31]. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatry. 2020;33(2):1–4. https://pubmed.ncbi.nlm.nih.gov/32215365/
[32]. Liu X, Liu J, Zhong X. Psychological State of College Students During COVID-19 Epidemic. SSRN Electron J. 2020; https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3552814. doi.org/10.2139/ssrn.3552814
[33]. Al-Tammemi AB, Akour A, Alfalah L. Is it Just About Physical Health? An Internet-Based Cross-Sectional Study Exploring the Psychological Impacts of COVID-19 Pandemic on University Students in Jordan Using Kessler Psychological Distress Scale. medRxiv. 2020;2020.05.14.20102343. https://europepmc.org/article/ppr/ppr164177 DOI: 10.21203/rs.3.rs-29439/v1
[34]. Chang J., Yuan J. Wang D. Mental Health Status and Its Influencing Factors Among College Students During the Epidemic of COVID-19 - PubMed [Internet]. [cited 2020 Jun 9]. Available from: https://pubmed.ncbi.nlm.nih.gov/32376528/ doi: 10.12122/j.issn.1673-4254.2020.02.06
[35]. United Nations Department of Economics and social. Rural population - Nigeria _ Data [Internet]. United Nations Population Division’s World Urbanization Prospects: 2018 Revision. 2018 [cited 2020 Jun 18]. Available from: https://data.worldbank.org/indicator/SP.RUR.TOTL?locations=NG
[36]. Ayandele O, Popoola O, Obosi A, Busari A. Depression, Anxiety and Smartphone Addiction among Young People in South-West Nigeria. 2019;4(2):1–14. DOI: 10.1108/JHR-10-2019-0225
[37]. Odriozola-gonzález P, Planchuelo-gómez Á, Jesús M, de Luis-García R. Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Res. 2020;290(May):113108. https://pubmed.ncbi.nlm.nih.gov/32450409/ DOI: 10.1016/j.psychres.2020.113108
[38]. Fatiregun AA, Kumapayi TE. Prevalence and correlates of depressive symptoms among in-school adolescents in a rural district in southwest Nigeria. J Adolesc. 2014;37(2):197–203. https://pubmed.ncbi.nlm.nih.gov/24439625/ DOI: 10.1016/j.adolescence.2013.12.003
[39]. Peltzer K, Pengpid S, Olowu S, Olasupo M. Depression and associated factors Among University students in Western Nigeria. J Psychol Africa. 2013;23(3):459–65. https://www.tandfonline.com/doi/abs/10.1080/14330237.2013.10820652
[40]. Li Y, Wang Y, Jiang J, Valdimarsdóttir UA, Fall K, Fang F, Song H, Lu D, Zhang W. Psychological distress among health professional students during the COVID-19 outbreak. Psychol Med. 2020;0–2. https://pubmed.ncbi.nlm.nih.gov/32389148/
[41]. Jianjun D, Tsingan L, Jiali W, Limei T. The Effect of COVID-19 Stress on Sexual Compulsivity Symptom: The Mediating Role of Perceived Social Support. Research Square. 2020. p. 1–23.
[42]. Huang L, Xu FM, Liu HR. Emotional responses and coping strategies of nurses and nursing college students during COVID-19 outbreak. medRxiv. 2020;2020.03.05.20031898.
[43]. Tang W, Hu T, Hu B, Jin C, Wang G, Xie C, Chen S, Xu J. Prevalence and correlates of PTSD and depressive symptoms one month after the outbreak of the COVID-19 epidemic in a sample of home-quarantined Chinese university students. J Affect Disord. 2020;274(March):1–7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217769/ https://doi.org/10.1016/j.jad.2020.05.009
[44]. Ogundele OA, Ogundele T, Taha SM. Factors Influencing Adolescents Stigmatising Attitudes and Perception of Community Reaction towards Mental Illness in Nigeria. Sudan J Med Sci. 2017;12(4):240. https://www.ajol.info/index.php/sjms/article/view/168553/158024
[45]. Effiong Jombo H, Udo Idung A, Author C. Stigmatising Attitudes towards Persons with Mental Illness among University Students in Uyo, South-South Nigeria. Int J Heal Sci Res. 2018;8(April):24. https://www.researchgate.net/publication/335893008_Stigmatising_Attitudes_towards_Persons_with_Mental_Illness_among_University_Students_in_Uyo_South-South_Nigeria
[46]. Anosike C, Ukwe CV OA. Attitudes of pharmacy and non‐pharmacy students towards mental illness in Nigeria: a comparative survey. Int J Pharm Pract 2020 Feb 4. 2020; Feb. https://onlinelibrary.wiley.com/doi/abs/10.1111/ijpp.12601