State Depression, Anxiety, Stress, and Sleep Among Students Attending a Canadian University During the COVID-19 Pandemic

Psychological distress and sleep difficulties are common among postsecondary students. Recent evidence suggests that student psychological distress worsened during the early stages of the COVID-19 pandemic; however, the prevalence of intrapandemic psychological distress in university students during 2020 and 2021 is unclear. The present repeated cross-sectional study documented negative emotional states among two cohorts of full-time undergraduate university students attending a Canadian university in the fall of 2020 and 2021 and examined its association with sleep quality in the 2021 cohort. State depression, anxiety, stress (Depression Anxiety Stress Scales 42-item version), and sleep quality (modified version of the Pittsburgh Sleep Quality Index) were assessed. A total of 766 (mean age = 20.72 +/- 3.81 years) and 589 participants (mean age = 20.88 +/- 4.36 years) completed the questionnaire in 2020 and 2021, respectively. Over half of the participants in both cohorts displayed moderate-to-extremely severe state anxiety (56% and 62%), depression (56% and 58%), and stress (49% and 57%). State anxiety and stress were higher (p <= .001) in the 2021 versus 2020 cohort. Also, 79% of participants in the 2021 cohort displayed insomnia. Linear regression demonstrated a positive association (p <= .001) between modified version of the Pittsburgh Sleep Quality Index global sleep quality scores and state depression (R-2 = .22), anxiety (R-2 = .26), and stress (R-2 = .21) scores. This suggests that the negative emotional state of university students has remained consistently poor or worsened throughout the COVID-19 pandemic and that poor sleep quality predicts a worse emotional state. Interventions that target psychological distress and sleep among students may be beneficial.