International and domestic university students' mental health over the course of the COVID-19 pandemic in Germany: Comparison between 2020, 2021, and 2022

Aneliana da Silva Prado; Sabrina Baldofski; Elisabeth Kohls; Christine Rummel-Kluge

doi:10.1371/journal.pone.0299812

International and domestic university students' mental health over the course of the COVID-19 pandemic in Germany: Comparison between 2020, 2021, and 2022

PLoS One. 2024 Feb 29;19(2):e0299812. doi: 10.1371/journal.pone.0299812. eCollection 2024.

Authors

Aneliana da Silva Prado^{1

2

3}, Sabrina Baldofski¹, Elisabeth Kohls^{1

4}, Christine Rummel-Kluge^{1

4}

Affiliations

¹ Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Sachsen, Germany.
² Department of Psychology, Federal University of Parana, Curitiba, Parana, Brazil.
³ Campus Curitiba, Federal Institute of Education, Science, and Technology of Parana, Curitiba, Parana, Brazil.
⁴ Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Sachsen, Germany.

Abstract

Background: The COVID-19 pandemic affected university students' mental health worldwide. International students were presenting high levels of stress, anxiety, and depressive symptoms before the pandemic. This study aimed to investigate (i) differences between various timepoints of the COVID-19 pandemic (2020, 2021, and 2022) in mental health outcomes and social and emotional aspects in domestic and international students, separately, (ii) differences between international and domestic students between the three timepoints on mental health outcomes and social and emotional aspects, and (iii) possible moderation effects of timepoints on mental health outcomes and social and emotional aspects of domestic and international students.

Material and methods: Data from three cross-sectional anonymous online surveys conducted in German universities were analyzed and compared. Data were collected in 2020, 2021, and 2022, respectively, with a total N = 14,498. Depressive symptoms, hazardous alcohol use, social support, self-efficacy, resilience, perceived stress, and loneliness were assessed through standardized self-report instruments. Differences between domestic and international students in mental health outcomes, and social and emotional aspects across three timepoints were assessed with one-way and two-way ANCOVAs.

Results: Regardless of the timepoint, international students presented more depressive symptoms and perceived stress, lower perceived social support and resilience, but higher levels of self-efficacy and less alcohol consumption compared to domestic students. A significant interaction effect between timepoint and student status emerged only for loneliness.

Conclusions: International students generally presented poorer mental health outcomes than domestic students. Mental health care and prevention such as low-threshold, online counseling should address university students, especially international students.

Copyright: © 2024 Prado et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

COVID-19* / epidemiology
Cross-Sectional Studies
Germany / epidemiology
Humans
Mental Health*
Pandemics
Students
Universities

Grants and funding

ASP acknowledges the financial support of the German Academic Exchange Service (DAAD) under the program “Bi-nationally Supervised Doctoral Degrees/Cotutelle, 2021/22” (grant no.: 57552338). The authors acknowledge support by the Open Access Publishing Fund of Leipzig University supported by the German Research Foundation within the program Open Access Publication Funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. There was no additional external funding received for this study.