Given the long duration of the COVID-19 pandemic, monitoring mental health remains important. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 20 months after the first COVID-19 restrictions and (2) which factors were associated with these outcomes. The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 7025 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analysed using multivariable logistic regression models. The mean age of the participants was 23.9 years (SD = 4.9), 67 % were female and 31 % male. The prevalence for depressive symptoms was 29 % (PHQ-2) and 12 % (CES-D 8) and 32 % for anxiety. A complicated relationship status, the lack of a trusted person, and financial difficulties were associated with anxiety and depressive symptoms. University students who were worried about (re-) infection with COVID-19 had a 1.37-times higher chance for reporting anxiety (GAD-2: OR, 95 % CI: 1.09–1.71). Those with pre-existing cardiovascular health conditions had an up to 3.21-times higher chance for reporting depressive symptoms (OR, CESD-D 8, 95 % CI: 1.44–7.14). The study design is cross-sectional and uses self-reported outcomes. Concepts for prevention and counselling to tackle mental health problems in students are needed and programmes should take specific stressors related to the pandemic into account.

Objectives: Higher education students in Germany are vulnerable to depressive symptoms. Despite ample evidence, no comprehensive review has recently been conducted. Thus, our systematic review and meta-analysis aims at describing the extent to which students are affected by depressive symptoms.Methods: We searched three databases for articles reporting the prevalence rates of depressiveness among students in Germany published between 2002 and 2023. Pooled prevalence rates were calculated using random effects models, both for the overall sample and for subgroups categorized by gender, study setting, assessment instrument, and whether the study was conducted before or during the COVID-19 pandemic.Results: The search yielded 992 records. After screening, 60 articles remained for data extraction. About one out of five students (21.1%) exhibits depressive symptoms. Pooled prevalence rates differ between subgroups, with higher rates during the COVID-19 pandemic than before (30.6% versus 18.0%) and with females being more affected than their male counterparts (29.0% versus 23.1%).Conclusion: This review underlines the urgency with which the mental health of students should be addressed at the (higher educational) policy level.Clinical Trial Registration: PROPSPERO, Identifier CRD42022384066.

Introduction: Data on the mental health of university students in Germany during the later stages of the pandemic is still limited. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 1.5 years after the first COVID-19 restrictions and (2) which factors were associated with these outcomes.Methods: The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 6,996 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analyzed using multivariable logistic regression models.Results: The mean age of the participants was 23.9 years (SD = 4.8), 67% were female and 31% male. The prevalence for depressive symptoms was 29 and 32% for anxiety. The lack of a trusted person and financial difficulties were associated with anxiety and depressive symptoms. Being worried that someone in one’s personal network had become severely ill with COVID-19 and concern about (re)infection with COVID-19 were associated with anxiety symptoms. Those with pre-existing health conditions had an up to 1.98-times higher chance for reporting depressive symptoms (OR, 95% CI: 1.01–3.88) and an up to 2.27-times higher chance for anxiety symptoms, respectively (OR, 95% CI: 1.15–4.46).Conclusion: Concepts for prevention and counseling to tackle mental health problems in students are needed and programs should take specific stressors in times of crises into account.

University students are generally vulnerable to mental health problems. This was exacerbated during the COVID-19 pandemic, when students experienced decisive changes and restrictions in their academic lives. Our study aimed at (a) analysing associations between study conditions and symptoms of depression and anxiety and (b) determining the extent of use and motivation to use student counselling services. The C19 GSWS is a cross-sectional study conducted at five universities in Germany (N = 7203). Descriptive analyses and linear regression models were performed to estimate the associations between study conditions and mental health outcomes. A total of 42.4% of the students felt down, depressed, or hopeless on several days over the past 14 days. Between a third and 44.1% of the students felt burdened by their study conditions. Worse perceived study conditions were associated with higher levels of depressive symptoms and anxiety. Only 7.1% indicated that they had utilised student counselling services, and female gender, enrolment in a bachelor’s programme, and having more than 1 reason for utilisation were factors associated with use. The results of our research underline the need for universities to review their study conditions and to provide targeted intervention strategies and counselling services to promote students’ mental well-being.

Zusammenfassung: Hintergrund: Unter Studierenden sind depressive Symptome weit verbreitet, wobei weibliche Studierende häufiger davon betroffen sind als männliche. Vorherige Forschung zeigt einen Anstieg der Prävalenz depressiver Symptome in den ersten Semestern. Die COVID-19-Pandemie („coronavirus disease 2019“) könnte diesen Trend verschärft haben. Die vorliegende Studie untersucht deshalb, ob genderspezifische Unterschiede in der depressiven Symptomatik von Studienanfänger*innen während der COVID-19-Pandemie fortbestehen und ob ein Unterschied in der depressiven Symptomatik von Studienanfänger*innen und fortgeschrittenen Studierenden vorliegt. Methode: Die depressive Symptomatik von Studienanfänger*innen und fortgeschrittenen Studierenden wurde mithilfe des PHQ-2 (Patient Health Questionnaire‑2) ermittelt sowie untersucht, ob ein genderspezifischer Unterschied vorliegt. Ergebnisse: Depressive Symptome wiesen 30 % der Studienanfänger*innen auf. Die Prävalenz war mit 32 % bei weiblichen Studienanfängerinnen höher als bei ihren männlichen Kommilitonen (25 %). Es zeigen sich weder genderspezifische Unterschiede bei Studienanfänger*innen noch (genderspezifische) Unterschiede zwischen Studienanfänger*innen und fortgeschrittenen Studierenden. Schlussfolgerung: Studierende berichteten häufig depressive Symptome, ein genderspezifischer Unterschied zeigte sich aber nicht. Sowohl bei männlichen als auch bei weiblichen Studierenden unterschied sich die Prävalenz nicht zwischen Anfangs- und fortgeschrittener Studienzeit. Frühzeitige Interventionen in der Studieneingangsphase und die Anpassung von Studienbedingungen sind in Anbetracht der hohen Prävalenz für die psychische Gesundheit Studierender wichtig.