{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:50:26Z","timestamp":1790704226016,"version":"4.1.0"},"reference-count":39,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>University students were confronted with abrupt changes to their daily lives by the COVID-19 lock-down. We investigated Generalized Anxiety Disorder Scale-7 (GAD-7) and anxiety levels, and the association between perceived impact on well-being, studies, and daily lives and anxiety levels, adjusted for gender, age, social class and affiliation. Early in the lock-down all students of the Zurich University of Applied Sciences (N = 12,429) were invited to a voluntary longitudinal health survey. Participation rate was 20% (n = 2437): 70% females, median age 25 yrs. (IQR 23\u201328). A total of 10% reported a deterioration of well-being compared to pre-Corona. LCA yielded three classes varying in perceived COVID-19 impact: 1 (low, n = 675), 2 (moderate, n = 1098), and 3 (strong, n = 656). Adjusted proportion of moderate to severe anxiety by class were 45% (95% CI: 28.0\u201362.0), 15.5% (95% CI: 13.1\u201317.9), and 5.1% (95% CI: 4.7\u20135.6), respectively. Multivariate regression analyses yielded an OR for moderate to severe anxiety of 3.88 (95% CI: 2.5\u20136.0, class 2) and 22.43 (95% CI: 14.5\u201334.6, class 3) compared to class-1. The investigated association implies that containment measures have a selective effect on anxiety in students. The diversity of students\u2019 perception and associated anxiety should be monitored and considered in future response to pandemics.<\/jats:p>","DOI":"10.3390\/ijerph17207433","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T22:02:02Z","timestamp":1602626522000},"page":"7433","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Swiss University Students\u2019 Risk Perception and General Anxiety during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9003-2027","authenticated-orcid":false,"given":"Julia","family":"Dratva","sequence":"first","affiliation":[{"name":"Department of Health, Institute of Health Sciences, Zurich University of Applied Sciences Winterthur, 8400 Winterthur, Switzerland"},{"name":"Medical Faculty, University of Basel, 4001 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9871-5324","authenticated-orcid":false,"given":"Annina","family":"Zysset","sequence":"additional","affiliation":[{"name":"Department of Health, Institute of Health Sciences, Zurich University of Applied Sciences Winterthur, 8400 Winterthur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Schlatter","sequence":"additional","affiliation":[{"name":"Department of Health, Institute of Health Sciences, Zurich University of Applied Sciences Winterthur, 8400 Winterthur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"von Wyl","sequence":"additional","affiliation":[{"name":"Department of Psychology, Zurich University of Applied Sciences Winterthur, 8400 Winterthur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-1289","authenticated-orcid":false,"given":"Marion","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Health, Institute of Health Sciences, Zurich University of Applied Sciences Winterthur, 8400 Winterthur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1490-011X","authenticated-orcid":false,"given":"Thomas","family":"Volken","sequence":"additional","affiliation":[{"name":"Department of Health, Institute of Health Sciences, Zurich University of Applied Sciences Winterthur, 8400 Winterthur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Salvatore, R., Nikki, K., Jes\u00fas, F.B.-M., and David, K. (2020). As COVID-19 cases, deaths and fatality rates surge in Italy, underlying causes require investigation. J. Infect. Dev. Ctries., 14.","DOI":"10.3855\/jidc.12734"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"438","DOI":"10.3349\/ymj.2020.61.5.438","article-title":"The Psychological Impact of COVID-19 on Chinese Individuals","volume":"61","author":"Wang","year":"2020","journal-title":"Yonsei Med. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: Rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"ref_4","unstructured":"UNESCO (2020). COVID-19 Educational Disruption and Response, UNESCO."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S2215-0366(20)30168-1","article-title":"Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science","volume":"7","author":"Holmes","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Liu, J.J., Bao, Y., Huang, X., Shi, J., and Lu, L. (2020). Mental health considerations for children quarantined because of COVID-19. Lancet Child Adolesc. Health.","DOI":"10.1016\/S2352-4642(20)30096-1"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s13033-020-00371-w","article-title":"Mental health and psychosocial well-being during the COVID-19 pandemic: The invisible elephant in the room","volume":"14","author":"Otu","year":"2020","journal-title":"Int. J. Ment. Health Syst."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Vieta, E., P\u00e9rez, V., and Arango, C. (2020). Psychiatry in the aftermath of COVID-19. Rev. Psiquiatr. Salud Ment.","DOI":"10.1016\/j.rpsm.2020.04.004"},{"key":"ref_9","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":"Zhai","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2955","DOI":"10.1017\/S0033291716001665","article-title":"Mental disorders among college students in the World Health Organization World Mental Health Surveys","volume":"46","author":"Auerbach","year":"2016","journal-title":"Psychol. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"112977","DOI":"10.1016\/j.psychres.2020.112977","article-title":"Impact of Sars-Cov-2 And Its Reverberation In Global Higher Education And Mental Health","volume":"288","author":"Cidade","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"327","DOI":"10.31887\/DCNS.2015.17.3\/bbandelow","article-title":"Epidemiology of anxiety disorders in the 21st century","volume":"17","author":"Bandelow","year":"2015","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S0193-953X(05)70204-5","article-title":"The Epidemiology of Generalized Anxiety Disorder","volume":"24","author":"Kessler","year":"2001","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_14","first-page":"357","article-title":"Size and burden of mental disorders in Europe\u2014A critical review and appraisal of 27 studies","volume":"15","author":"Wittchen","year":"2005","journal-title":"Size Burd. Ment. Disord. Eur."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1017\/S003329171200147X","article-title":"Global prevalence of anxiety disorders: A systematic review and meta-regression","volume":"43","author":"Baxter","year":"2013","journal-title":"Psychol. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1037\/a0023632","article-title":"Relations of SARS-related stressors and coping to Chinese college students\u2019 psychological adjustment during the 2003 Beijing SARS epidemic","volume":"58","author":"Main","year":"2011","journal-title":"J. Couns Psychol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"NP1867","DOI":"10.1177\/1010539512443699","article-title":"Preventive Behaviors and Mental Distress in Response to H1N1 Among University Students in Guangzhou, China","volume":"27","author":"Gu","year":"2015","journal-title":"Asia Pac. J. Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/s12529-010-9083-z","article-title":"Initial psychological responses to swine flu","volume":"18","author":"Goodwin","year":"2011","journal-title":"Int. J. Behav. Med."},{"key":"ref_19","unstructured":"Usher, K., Jackson, D., Durkin, J., Gyamfi, N., and Bhullar, N. (2020). A rapid review of pandemic-related behaviours and psychological outcomes. Int. J. Ment. Health Nurs."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"112934","DOI":"10.1016\/j.psychres.2020.112934","article-title":"The psychological impact of the COVID-19 epidemic on college students in China","volume":"287","author":"Cao","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s00787-020-01541-4","article-title":"Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19","volume":"29","author":"Zhou","year":"2020","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.jiph.2020.01.005","article-title":"Middle East Respiratory Syndrome-Corona Virus (MERS-CoV) associated stress among medical students at a university teaching hospital in Saudi Arabia","volume":"13","author":"Temsah","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Shanahan, L., Steinhoff, A., Bechtiger, L., Murray, A.L., Nivette, A., Hepp, U., Ribeaud, D., and Eisner, M. (2020). Emotional Distress in Young Adults During the COVID-19 Pandemic: Evidence of Risk and Resilience From a Longitudinal Cohort Study. Psychol. Med., 1\u201332.","DOI":"10.1017\/S003329172000241X"},{"key":"ref_24","unstructured":"Sotomo (2020, October 12). Corona-Krise: Monitoring der Bev\u00f6lkerung 24\/03\/20, 2020. Available online: https:\/\/sotomo.ch\/site\/corona-krise-monitoring-der-bevoelkerung\/."},{"key":"ref_25","first-page":"749","article-title":"Messung des subjektiven sozialen Status in der Gesundheitsforschung mit einer deutschen Version der MacArthur Scale","volume":"58","author":"Hoebel","year":"2015","journal-title":"Bundesgesundh. Gesundh. Gesundh."},{"key":"ref_26","unstructured":"Vermunt, J.K., and Magidson, J. (2004). Latent class analysis. The Sage Encyclopedia of Social Sciences Research Methods, Sage."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"43","DOI":"10.2333\/bhmk.33.43","article-title":"Avoiding Boundary Estimates in Latent Class Analysis by Bayesian Posterior Mode Estimation","volume":"33","author":"Vermunt","year":"2006","journal-title":"Behaviormetrika"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.jad.2019.04.032","article-title":"Factorial invariance of a computerized version of the GAD-7 across various demographic groups and over time in primary care patients","volume":"252","author":"Moreno","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"325","DOI":"10.2147\/NSS.S222440","article-title":"Psychometric Analysis of The Sleep Hygiene Index And Correlation With Stress And Anxiety Among Saudi University Students","volume":"11","author":"Anwer","year":"2019","journal-title":"Nat. Sci. Sleep"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s11596-015-1512-4","article-title":"Prevalence and related risk factors of anxiety and depression among Chinese college freshmen","volume":"35","author":"Lu","year":"2015","journal-title":"J. Huazhong Univ. Sci. Technolog. Med. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.4088\/JCP.v69n1011","article-title":"Gender differences in generalized anxiety disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)","volume":"69","author":"Schneier","year":"2008","journal-title":"J. Clin. Psychiatry"},{"key":"ref_33","unstructured":"Gr\u00fctzmacher, J., Gusy, B., Lesener, T., Sudheimer, S., and Willige, J. (2020, October 12). Gesundheit Studierender in Deutschland 2017. Available online: https:\/\/www.ewi-psy.fu-berlin.de\/einrichtungen\/arbeitsbereiche\/ppg\/bwb-2017\/_inhaltselemente\/faktenblaetter\/Gesamtbericht-Gesundheit-Studierender-in-Deutschland-2017.pdf."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Quek, T.T.-C., Tam, W.W.-S., Tran, B.X., Zhang, M., Zhang, Z., Ho, C.S.-H., and Ho, R.C.-M. (2019). The Global Prevalence of Anxiety among Medical Students: A Meta-Analysis. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16152735"},{"key":"ref_35","first-page":"171","article-title":"Mental health status and its influencing factors among college students during the epidemic of COVID-19","volume":"40","author":"Chang","year":"2020","journal-title":"Nan Fang Yi Ke Da Xue Xue Bao"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Zhang, H., Ma, X., and Di, Q. (2020). Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17103722"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Li, Y., Wang, Y., Jiang, J., Valdimarsd\u00f3ttir, U.A., Fall, K., Fang, F., Song, H., Lu, D., and Zhang, W. (2020). Psychological distress among health professional students during the COVID-19 outbreak. Psychol. Med., 1\u20133.","DOI":"10.1017\/S0033291720001555"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Mazza, C., Ricci, E., Biondi, S., Colasanti, M., Ferracuti, S., Napoli, C., and Roma, P. (2020). 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, 17.","DOI":"10.3390\/ijerph17093165"},{"key":"ref_39","first-page":"e924609-1","article-title":"Comparison of Prevalence and Associated Factors of Anxiety and Depression Among People Affected by versus People Unaffected by Quarantine During the COVID-19 Epidemic in Southwestern China","volume":"26","author":"Lei","year":"2020","journal-title":"Med. Sci. Monit. Int. Med. J. Exp. Clin. Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/20\/7433\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:20:08Z","timestamp":1760178008000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/20\/7433"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,13]]},"references-count":39,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["ijerph17207433"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17207433","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,13]]}}}