{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:14:43Z","timestamp":1789143283033,"version":"build-2803163510"},"reference-count":91,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>University students are regarded as the backbone of society, and their mental health during a pandemic may have a substantial impact on their performance and life outcomes. The purpose of this study was to assess university students\u2019 mental health, specifically depression, anxiety, and stress, during Lebanon\u2019s extended COVID-19 pandemic, as well as the sociodemographic factors and lifestyle practices associated with it.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>An online anonymous survey assessed the rates of mental health problems during COVID-19, controlling for socio-demographics and other lifestyle practices, in 329 undergraduate and graduate university students. Instruments utilized were the Patient Health Questionnaire (PHQ-9) for depression, the Beck Anxiety Inventory (21-BAI) for anxiety, and the Perceived Stress Scale (PSS-10) for stress. The study employed descriptive statistics and multiple logistic regression models to analyze the association between depression, anxiety, and stress with sociodemographic and lifestyle factors. Results were evaluated using adjusted odds ratios and confidence intervals, with a significance level of 0.05.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Moderate to severe rates of depression, anxiety and stress among students were reported by 75.9%, 72.2%, and 89.3%, respectively. The odds of anxiety and stress were higher among women compared to men. Students who used private counseling services had higher odds of anxiety and stress than those who did not. Overall rated health was a major predictor of depression and anxiety, with the \"poor\" and \"fair\" overall-reported health groups having higher odds than the \"Excellent\" group. When compared to those who did not smoke, students who increased their smoking intake had higher odds of depression, anxiety and stress. Students who reduced their alcohol consumption had lower odds of anxiety compared to those who did not consume alcohol. Students who reduced their physical activity had higher odds than those who increased it. Finally, students who slept fewer than seven hours daily had higher odds of depression than those who slept seven to nine hours.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our findings indicate a national student mental health crisis, with exceptionally high rates of moderate to severe depression, anxiety, and stress. Factors such as gender, university program, overall rated health, importance of religion in daily decisions, private counseling, smoking cigarettes, alcohol consumption, physical activity, and sleeping, were all found to have an impact on mental health outcomes. Our study highlights the need for university administrators and mental health professionals to consider targeted mental health programming for students, particularly for women and those with poor or fair overall perceived health.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302265","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T18:11:25Z","timestamp":1713291085000},"page":"e0302265","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["A cross-sectional study of university students\u2019 mental health and lifestyle practices amidst the COVID-19 pandemic"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8139-9321","authenticated-orcid":true,"given":"Reem","family":"Hoteit","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imad","family":"Bou-Hamad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5318-0223","authenticated-orcid":true,"given":"Sahar","family":"Hijazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinah","family":"Ayna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Romani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6287-3438","authenticated-orcid":true,"given":"Christo","family":"El Morr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"pone.0302265.ref001","author":"WHO","year":"2020","journal-title":"Coronavirus disease 2019 (COVID-19) Situation Report\u2013 62."},{"key":"pone.0302265.ref002","volume-title":"WHO Coronavirus (COVID-19) Dashboard:","author":"WHO","year":"2022"},{"key":"pone.0302265.ref003","article-title":"Omicron (B. 1.1. 529 variant of SARS\u2010CoV\u20102); an emerging threat: current global scenario","author":"RK Mohapatra","year":"2021","journal-title":"Journal of medical virology"},{"key":"pone.0302265.ref004","doi-asserted-by":"crossref","first-page":"113003","DOI":"10.1016\/j.psychres.2020.113003","article-title":"Addressing collegiate mental health amid COVID-19 pandemic.","volume":"288","author":"Y Zhai","year":"2020","journal-title":"Psychiatry research."},{"issue":"1","key":"pone.0302265.ref005","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jaac.2020.08.466","article-title":"Impact of COVID-19 Pandemic on College Student Mental Health and Wellness. 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Younes","year":"2021","journal-title":"Encephale."},{"issue":"3","key":"pone.0302265.ref036","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1111\/ppc.12676","article-title":"Knowledge, attitudes, and practices toward the coronavirus disease 2019 (COVID\u201019) among nurses in Lebanon.","volume":"57","author":"D Saadeh","year":"2021","journal-title":"Perspectives in psychiatric care."},{"key":"pone.0302265.ref037","doi-asserted-by":"crossref","first-page":"542","DOI":"10.3389\/fmed.2020.00542","article-title":"Knowledge, attitude, and practice of the Lebanese community toward COVID-19.","volume":"7","author":"S Domiati","year":"2020","journal-title":"Frontiers in Medicine"},{"issue":"9","key":"pone.0302265.ref038","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ\u20109: validity of a brief depression severity measure","volume":"16","author":"K Kroenke","year":"2001","journal-title":"Journal of general internal medicine"},{"issue":"1","key":"pone.0302265.ref039","first-page":"1","article-title":"Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network.","volume":"15","author":"WY Chin","year":"2014","journal-title":"BMC family practice."},{"issue":"3","key":"pone.0302265.ref040","doi-asserted-by":"crossref","first-page":"E191","DOI":"10.1503\/cmaj.110829","article-title":"Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis.","volume":"184","author":"L Manea","year":"2012","journal-title":"Cmaj"},{"issue":"6","key":"pone.0302265.ref041","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1542\/peds.2010-0852","article-title":"Evaluation of the Patient Health Questionnaire-9 Item for detecting major depression among adolescents","volume":"126","author":"LP Richardson","year":"2010","journal-title":"Pediatrics"},{"issue":"4","key":"pone.0302265.ref042","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/appy.12103","article-title":"Validity and reliability of P atient H ealth Q uestionnaire\u20109 and P atient H ealth Q uestionnaire\u20102 to screen for depression among college students in C hina.","volume":"5","author":"YL Zhang","year":"2013","journal-title":"Asia\u2010Pacific Psychiatry"},{"key":"pone.0302265.ref043","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.psychres.2016.03.030","article-title":"Adaptation and initial validation of the Patient Health Questionnaire\u20139 (PHQ-9) and the Generalized Anxiety Disorder\u20137 Questionnaire (GAD-7) in an Arabic speaking Lebanese psychiatric outpatient sample.","volume":"239","author":"H Sawaya","year":"2016","journal-title":"Psychiatry research."},{"issue":"6","key":"pone.0302265.ref044","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1037\/0022-006X.56.6.893","article-title":"An inventory for measuring clinical anxiety: psychometric properties","volume":"56","author":"AT Beck","year":"1988","journal-title":"Journal of consulting and clinical psychology"},{"issue":"3","key":"pone.0302265.ref045","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/0887-6185(91)90002-B","article-title":"Relationship between the Beck anxiety inventory and the Hamilton anxiety rating scale with anxious outpatients","volume":"5","author":"AT Beck","year":"1991","journal-title":"Journal of Anxiety Disorders"},{"key":"pone.0302265.ref046","author":"RA Steer","year":"1997","journal-title":"Beck Anxiety Inventory"},{"key":"pone.0302265.ref047","article-title":"Beck anxiety inventory","author":"AT Beck","year":"1993","journal-title":"Journal of consulting and clinical psychology"},{"issue":"1","key":"pone.0302265.ref048","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/0887-6185(92)90026-4","article-title":"Reliability and validity of the Beck Anxiety Inventory","volume":"6","author":"T Fydrich","year":"1992","journal-title":"Journal of anxiety disorders"},{"issue":"02","key":"pone.0302265.ref049","article-title":"Psychometric properties of the Arabic Version of the Beck Anxiety Inventory in the State of Kuwait","volume":"16","author":"TS Al-Shatti","year":"2015","journal-title":"Journal of Educational & Psychological Sciences"},{"key":"pone.0302265.ref050","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","author":"S Cohen","year":"1983","journal-title":"Journal of health and social behavior"},{"key":"pone.0302265.ref051","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1590\/S1518-8787.2016050005617","article-title":"The impact of migration on women\u2019s mental health in the postpartum period.","volume":"50","author":"LM Almeida","year":"2016","journal-title":"Revista de Sa\u00fade P\u00fablica"},{"key":"pone.0302265.ref052","first-page":"1","article-title":"Assessing psychological stress in South African university students: Measurement validity of the perceived stress scale (PSS-10) in diverse populations","author":"M. Makhubela","year":"2020","journal-title":"Current Psychology."},{"issue":"8","key":"pone.0302265.ref053","doi-asserted-by":"crossref","first-page":"3287","DOI":"10.3390\/ijerph8083287","article-title":"Perceived stress scale: reliability and validity study in Greece.","volume":"8","author":"E Andreou","year":"2011","journal-title":"International journal of environmental research and public health"},{"issue":"3","key":"pone.0302265.ref054","first-page":"43","article-title":"Factor structure and reliability of the Malay version of the perceived stress scale among Malaysian medical students.","volume":"19","author":"SAR Al-Dubai","year":"2012","journal-title":"The Malaysian journal of medical sciences: MJMS."},{"issue":"4","key":"pone.0302265.ref055","first-page":"35348","article-title":"Mental Health Effects of COVID-19 Within the Socioeconomic Crisis and After the Beirut Blast Among Health Care Workers and Medical Students in Lebanon.","volume":"23","author":"AEA El Rassoul","year":"2021","journal-title":"The Primary Care Companion for CNS Disorders."},{"issue":"12","key":"pone.0302265.ref056","doi-asserted-by":"crossref","first-page":"e0189543","DOI":"10.1371\/journal.pone.0189543","article-title":"Chinese version of the Perceived Stress Scale-10: A psychometric study in Chinese university students.","volume":"12","author":"W Lu","year":"2017","journal-title":"PloS one"},{"issue":"1","key":"pone.0302265.ref057","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-244X-10-111","article-title":"Validation of the Arabic version of the Cohen Perceived Stress Scale (PSS-10) among pregnant and postpartum women.","volume":"10","author":"M Chaaya","year":"2010","journal-title":"BMC psychiatry."},{"issue":"3","key":"pone.0302265.ref058","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1093\/eurpub\/ckt208","article-title":"The evolution of mental health in Spain during the economic crisis","volume":"24","author":"X Bartoll","year":"2014","journal-title":"Eur J Public Health"},{"issue":"1","key":"pone.0302265.ref059","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12939-017-0518-x","article-title":"Socio-economic factors linked with mental health during the recession: a multilevel analysis.","volume":"16","author":"I Ruiz-P\u00e9rez","year":"2017","journal-title":"International journal for equity in health"},{"key":"pone.0302265.ref060","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.jad.2022.01.086","article-title":"Anxiety, depression and PTSD in children and adolescents following the Beirut port explosion","volume":"302","author":"FT Maalouf","year":"2022","journal-title":"Journal of Affective Disorders"},{"issue":"8","key":"pone.0302265.ref061","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1136\/jim-2020-001553","article-title":"Mental health impairment triggered by the COVID-19 pandemic in a sample population of German students","volume":"68","author":"J Schlichtiger","year":"2020","journal-title":"Journal of Investigative Medicine"},{"key":"pone.0302265.ref062","doi-asserted-by":"crossref","first-page":"797","DOI":"10.2147\/PRBM.S266511","article-title":"Examining anxiety, life satisfaction, general health, stress and coping styles during COVID-19 pandemic in Polish sample of university students.","volume":"13","author":"AM Rogowska","year":"2020","journal-title":"Psychology Research and Behavior Management"},{"issue":"1","key":"pone.0302265.ref063","doi-asserted-by":"crossref","first-page":"e0245327","DOI":"10.1371\/journal.pone.0245327","article-title":"Psychological impacts from COVID-19 among university students: Risk factors across seven states in the United States.","volume":"16","author":"MH Browning","year":"2021","journal-title":"PloS 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analysis of the impact of COVID-19 on levels and patterns of exercise among adults in Belgium.","volume":"17","author":"B Constandt","year":"2020","journal-title":"International journal of environmental research and public health"},{"key":"pone.0302265.ref070","volume-title":"Physical activity promoting policies in the era of COVID-19: is Europe on the right track? 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International journal of environmental research and public health"},{"issue":"1","key":"pone.0302265.ref078","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1186\/s12888-016-1075-3","article-title":"Insomnia and the risk of depression: a meta-analysis of prospective cohort studies.","volume":"16","author":"L Li","year":"2016","journal-title":"BMC Psychiatry."},{"issue":"1\u20133","key":"pone.0302265.ref079","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jad.2011.01.011","article-title":"Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies","volume":"135","author":"C Baglioni","year":"2011","journal-title":"J Affect Disord"},{"issue":"2","key":"pone.0302265.ref080","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1002\/oby.23066","article-title":"The impact of COVID\u201019 stay\u2010at\u2010home orders on health behaviors in adults.","volume":"29","author":"EW Flanagan","year":"2021","journal-title":"Obesity"},{"issue":"6","key":"pone.0302265.ref081","doi-asserted-by":"crossref","first-page":"953","DOI":"10.17269\/s41997-020-00434-y","article-title":"Changes in health behaviours during early COVID-19 and socio-demographic disparities: a cross-sectional analysis","volume":"111","author":"A Zajacova","year":"2020","journal-title":"Canadian Journal of Public Health"},{"issue":"1","key":"pone.0302265.ref082","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.evalprogplan.2007.05.009","article-title":"Spirituality, sense of coherence, and coping responses in women receiving treatment for alcohol and drug addiction","volume":"31","author":"S Ar\u00e9valo","year":"2008","journal-title":"Eval Program Plann"},{"issue":"5","key":"pone.0302265.ref083","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1007\/s10943-017-0400-6","article-title":"Mechanisms Behind Religiosity and Spirituality\u2019s Effect on Mental Health, Quality of Life and Well-Being.","volume":"57","author":"MFP Peres","year":"2018","journal-title":"J Relig Health."},{"issue":"1","key":"pone.0302265.ref084","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s10943-020-01121-5","article-title":"The Association Between Positive Religious Coping, Perceived Stress, and Depressive Symptoms During the Spread of Coronavirus (COVID-19) Among a Sample of Adults in Palestine: Across Sectional Study","volume":"60","author":"FA Mahamid","year":"2021","journal-title":"J Relig Health"},{"issue":"6","key":"pone.0302265.ref085","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1080\/00263200701568279","article-title":"Religion, demography, and politics in Lebanon.","volume":"43","author":"MA Faour","year":"2007","journal-title":"Middle Eastern Studies"},{"issue":"3","key":"pone.0302265.ref086","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1177\/135910539700200305","article-title":"Racial differences in physical and mental health: Socio-economic status, stress and discrimination","volume":"2","author":"DR Williams","year":"1997","journal-title":"Journal of health psychology"},{"issue":"3","key":"pone.0302265.ref087","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1192\/apt.10.3.216","article-title":"Poverty, social inequality and mental health.","volume":"10","author":"V Murali","year":"2004","journal-title":"Advances in psychiatric treatment."},{"key":"pone.0302265.ref088","first-page":"340","article-title":"Budget crises, health, and social welfare programmes","author":"D Stuckler","year":"2010","journal-title":"Bmj"},{"key":"pone.0302265.ref089","author":"Reuters","year":"2022","journal-title":"Lebanon\u2019s currency plummets again amid financial crisis and political deadlock: Reuters"},{"key":"pone.0302265.ref090","doi-asserted-by":"crossref","first-page":"105425","DOI":"10.1016\/j.childyouth.2020.105425","article-title":"The impact of social media usage and lifestyle habits on academic achievement: Insights from a developing country context","volume":"118","author":"I. 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