Psychology, Interamerican
Longitudinal study on mental health of university students and the COVID-19 pandemic: comparisons and perspectives
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Keywords

college students; mental health; COVID-19

How to Cite

Silva Alvarenga, M. A., Souza Guilhermino, C. ., de Azevedo, T. G., Mansur-Alves, M., Alvares-Teodoro, J., Correa Ribeiro, P. C., Martins Teodoro, M. L., & Ribeiro Bandeira, P. F. (2023). Longitudinal study on mental health of university students and the COVID-19 pandemic: comparisons and perspectives. Revista Interamericana De Psicología/Interamerican Journal of Psychology, 57(1), e1838. https://doi.org/10.30849/ripijp.v57i1.1838

Abstract

The pandemic of COVID-19 affected several social groups, including university students. Thus, this study aimed to evaluate the mental health of higher education students in two different moments of the pandemic. This is a longitudinal study, with a non-probabilistic and convenience sample formed by 95 participants (Mage = 27.29 years; SD = 7.713) from a federal university in Minas Gerais state. One-way Bayesian ANOVA for repeated measures was used to compare the mental health of the volunteers in two moments of the pandemic and network analysis was used to verify how the variables were related in these two moments of the evaluation, as well as which of them had the greatest expected influence in the emerging models. We used measures of life satisfaction, suicidal ideation, depression, anxiety, and stress. The results indicated that there were no differences in the expression of mental health of the participants in the periods, presenting the levels of depression, anxiety, stress, and suicidal ideation with the greatest expected influence on the two models generated. These results revealed the relationships between the variables of each period and their outcomes, besides allowing the raising of considerations about future care in relation to college students' mental health.
https://doi.org/10.30849/ripijp.v57i1.1838
PDF (Português (Brasil))

References

Adedoyin, O. B., & Soykan, E. (2020). Covid-19 pandemic and online learning: The challenges and opportunities. Interactive Learning Environments, 1–13. https://doi.org/10.1080/10494820.2020.1813180

Ahelegbey, D. F., Cerchiello, P., & Scaramozzino, R. (2022). Network based evidence of the financial impact of Covid-19 pandemic. International Review of Financial Analysis, 81, 102101. https://doi.org/10.1016/j.irfa.2022.102101

Aquino, E. M. L., Silveira, I. H., Pescarini, J. M., Aquino, R., Souza-Filho, J. A. de, Rocha, A. dos S., Ferreira, A., Victor, A., Teixeira, C., Machado, D. B., Paixão, E., Alves, F. J. O., Pilecco, F., Menezes, G., Gabrielli, L., Leite, L., Almeida, M. da C. C. de, Ortelan, N., Fernandes, Q. H. R. F., … Lima, R. T. dos R. S. (2020). Medidas de distanciamento social no controle da pandemia de COVID-19: Potenciais impactos e desafios no Brasil. Ciência & Saúde Coletiva, 25(suppl 1), 2423–2446. https://doi.org/10.1590/1413-81232020256.1.10502020

Artemova, E., Bodina, E., Antonova, M., Lukina, E., & Jiang, S. (2022). The development of education in the era of the pandemic and in the perspective. Revista Conrado, 18(S1), 635-639.

Athey, S., Eckles, D., & Imbens, G. W. (2018). Exact p -Values for Network Interference. Journal of the American Statistical Association, 113(521), 230–240. https://doi.org/10.1080/01621459.2016.1241178

Auerbach, R. P., Alonso, J., Axinn, W. G., Cuijpers, P., Ebert, D. D., Green, J. G., Hwang, I., Kessler, R. C., Liu, H., Mortier, P., Nock, M. K., Pinder-Amaker, S., Sampson, N. A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Andrade, L. H., Benjet, C., Caldas-de-Almeida, J. M., Demyttenaere, K., … Bruffaerts, R. (2016). Mental disorders among college students in the World Health Organization World Mental Health Surveys. Psychological Medicine, 46(14), 2955–2970. https://doi.org/10.1017/S0033291716001665

Bairagi, V., & Munot, M. V. (Orgs.). (2019). Research methodology: A practical and scientific approach. CRC Press, Taylor & Francis Group.

Boden, M., Zimmerman, L., Azevedo, K. J., Ruzek, J. I., Gala, S., Abdel Magid, H. S., Cohen, N., Walser, R., Mahtani, N. D., Hoggatt, K. J., & McLean, C. P. (2021). Addressing the mental health impact of COVID-19 through population health. Clinical Psychology Review, 85, 102006. https://doi.org/10.1016/j.cpr.2021.102006

Brasil. (2020). Ministério da Educação. Portaria nº 544, de 16 de junho de 2020. Dispõe sobre a substituição das aulas presenciais por aulas em meios digitais. Diário Oficial da União, Brasília.

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395(10227), 912–920. https://doi.org/10.1016/S0140-6736(20)30460-8

Bruffaerts, R., Mortier, P., Auerbach, R. P., Alonso, J., Hermosillo De la Torre, A. E., Cuijpers, P., Demyttenaere, K., Ebert, D. D., Green, J. G., Hasking, P., Stein, D. J., Ennis, E., Nock, M. K., Pinder‐Amaker, S., Sampson, N. A., Vilagut, G., Zaslavsky, A. M., Kessler, R. C., & WHO WMH‐ICS Collaborators. (2019). Lifetime and 12‐month treatment for mental disorders and suicidal thoughts and behaviors among first year college students. International Journal of Methods in Psychiatric Research, 28(2), e1764. https://doi.org/10.1002/mpr.1764

Caldarelli, G. (2020). A perspective on complexity and networks science. Journal of Physics: Complexity, 1(2), 021001. https://doi.org/10.1088/2632-072X/ab9a24

Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 287, 112934. https://doi.org/10.1016/j.psychres.2020.112934

Cerda, A. A., & García, L. Y. (2022). Factors explaining the fear of being infected with COVID‐19. Health Expectations, 25(2), 506–512. https://doi.org/10.1111/hex.13274

Chang, E. C., & Chang, O. D. (2016). Development of the Frequency of Suicidal Ideation Inventory: Evidence for the Validity and Reliability of a Brief Measure of Suicidal Ideation Frequency in a College Student Population. Cognitive Therapy and Research, 40(4), 549–556. https://doi.org/10.1007/s10608-016-9758-0

Chivese, T., Matizanadzo, J. T., Musa, O. A. H., Hindy, G., Furuya-Kanamori, L., Islam, N., Al-Shebly, R., Shalaby, R., Habibullah, M., Al-Marwani, T. A., Hourani, R. F., Nawaz, A. D., Haider, M. Z., Emara, M. M., Cyprian, F., & Doi, S. A. R. (2022). The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis. Pathogens and Global Health, 116(5), 269–281. https://doi.org/10.1080/20477724.2022.2029301

Choompunuch, B., Suksatan, W., Sonsroem, J., Kutawan, S., & In-udom, A. (2021). Stress, adversity quotient, and health behaviors of undergraduate students in a Thai university during COVID-19 outbreak. Belitung Nursing Journal, 7(1), 1–7. https://doi.org/10.33546/bnj.1276

Çoban, S. (2021). Gender and telework: Work and family experiences of teleworking professional, middle‐class, married women with children during the Covid‐19 pandemic in Turkey. Gender, Work & Organization, 29(1), 241–255. https://doi.org/10.1111/gwao.12684

Copeland, W. E., McGinnis, E., Bai, Y., Adams, Z., Nardone, H., Devadanam, V., Rettew, J., & Hudziak, J. J. (2021). Impact of COVID-19 Pandemic on College Student Mental Health and Wellness. Journal of the American Academy of Child & Adolescent Psychiatry, 60(1), 134-141.e2. https://doi.org/10.1016/j.jaac.2020.08.466

Crocq, M.-A. (2015). A history of anxiety: From Hippocrates to DSM. Dialogues in Clinical Neuroscience, 17(3), 319–325. https://doi.org/10.31887/DCNS.2015.17.3/macrocq

de los Reyes, E. J., Blannin, J., Cohrssen, C., & Mahat, M. (2022). Resilience of higher education academics in the time of 21 st century pandemics: A narrative review. Journal of Higher Education Policy and Management, 44(1), 39–56. https://doi.org/10.1080/1360080X.2021.1989736

Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction With Life Scale. Journal of Personality Assessment, 49(1), 71-75.

Eisenberg, D., Hunt, J., Speer, N., & Zivin, K. (2011). Mental Health Service Utilization Among College Students in the United States. Journal of Nervous & Mental Disease, 199(5), 301–308. https://doi.org/10.1097/NMD.0b013e3182175123

Engelbrecht, F. A., & Scholes, R. J. (2021). Test for Covid-19 seasonality and the risk of second waves. One Health, 12, 100202. https://doi.org/10.1016/j.onehlt.2020.100202

Ettman, C. K., Abdalla, S. M., Cohen, G. H., Sampson, L., Vivier, P. M., & Galea, S. (2020). Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic. JAMA Network Open, 3(9), e2019686. https://doi.org/10.1001/jamanetworkopen.2020.19686

European Centre for Disease Prevention and Control (ECDC) (2020). Considerations relating to social distancing measures in response to COVID-19 – second update. Stockholm.

Field, A. (2017). Discovering Statistics Using IBM SPSS Statistics (5th Edition). Sage.

Flor, L. S., Friedman, J., Spencer, C. N., Cagney, J., Arrieta, A., Herbert, M. E., Stein, C., Mullany, E. C., Hon, J., Patwardhan, V., Barber, R. M., Collins, J. K., Hay, S. I., Lim, S. S., Lozano, R., Mokdad, A. H., Murray, C. J. L., Reiner, R. C., Sorensen, R. J. D., … Gakidou, E. (2022). Quantifying the effects of the COVID-19 pandemic on gender equality on health, social, and economic indicators: A comprehensive review of data from March, 2020, to September, 2021. The Lancet, 399(10344), 2381–2397. https://doi.org/10.1016/S0140-6736(22)00008-3

Foygel, R., & Drton, M. (2010). Extended Bayesian Information Criteria for Gaussian Graphical Models. Advances Neural Information Processing Systems, 23, 2020-2028.

Fruchterman, T. M. J., & Reingold, E. M. (1991). Graph drawing by force-directed placement. Software: Practice and Experience, 21(11), 1129–1164. https://doi.org/10.1002/spe.4380211102

Fruehwirth, J. C., Biswas, S., & Perreira, K. M. (2021). The Covid-19 pandemic and mental health of first-year college students: Examining the effect of Covid-19 stressors using longitudinal data. PLOS ONE, 16(3), e0247999. https://doi.org/10.1371/journal.pone.0247999

Gavin, B., Hayden, J., Adamis, D., & McNicholas, F. (2020). Caring for the psychological well-being of healthcare workers in the COVID-19 pandemic crisis. Irish Medical Journal, 113(4), 51.

Gibbons, M. M., Rhinehart, A., & Hardin, E. (2019). How First-Generation College Students Adjust to College. Journal of College Student Retention: Research, Theory & Practice, 20(4), 488–510. https://doi.org/10.1177/1521025116682035

Golino, H., Shi, D., Christensen, A. P., Garrido, L. E., Nieto, M. D., Sadana, R., ... & Martinez-Molina, A. (2020). Investigating the performance of exploratory graph analysis and traditional techniques to identify the number of latent factors: A simulation and tutorial. Psychological Methods, 25(3), 292. https://doi.org/10.1037/met0000255

Gouveia, V. V., Milfont, T. L., da Fonseca, P. N., & Coelho, J. A. P. de M. (2009). Life Satisfaction in Brazil: Testing the Psychometric Properties of the Satisfaction With Life Scale (SWLS) in Five Brazilian Samples. Social Indicators Research, 90(2), 267–277. https://doi.org/10.1007/s11205-008-9257-0

Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N., Khan, M., O’Connor, R. C., Pirkis, J. (2020). Suicide risk and prevention during the COVID-19 pandemic. The Lancet Psychiatry, 7(6), 468–471.

Gurgel, A. do M., Santos, C. C. S. dos, Alves, K. P. de S., Araujo, J. M. de, & Leal, V. S. (2020). Estratégias governamentais para a garantia do direito humano à alimentação adequada e saudável no enfrentamento à pandemia de Covid-19 no Brasil. Ciência & Saúde Coletiva, 25(12), 4945–4956. https://doi.org/10.1590/1413-812320202512.33912020

Guo, K., Zhang, X., Bai, S., Minhat, H. S., Nazan, A. I. N. M., Feng, J., Li, X., Luo, G., Zhang, X., Feng, J., Li, Y., Si, M., Qiao, Y., Ouyang, J., & Saliluddin, S. (2021). Assessing social support impact on depression, anxiety, and stress among undergraduate students in Shaanxi province during the COVID-19 pandemic of China. PLOS ONE, 16(7), e0253891. https://doi.org/10.1371/journal.pone.0253891

Hall, H. (2020). The effect of the COVID-19 pandemic on healthcare workers' mental health. Jaapa, 33(7), 45-48.

Hancková, M., & Betáková, T. (2021). Pandemics of the 21st Century: The Risk Factor for Obese People. Viruses, 14(1), 25. https://doi.org/10.3390/v14010025

Horta, B. L., Silveira, M. F., Barros, A. J. D., Hartwig, F. P., Dias, M. S., Menezes, A. M. B., & Hallal, P. C. (2022). COVID-19 and outpatient care: A nationwide household survey. Cadernos de Saúde Pública, 38(4), e00194121. https://doi.org/10.1590/0102-311x00194121

Ibrahim, A. K., Kelly, S. J., Adams, C. E., & Glazebrook, C. (2013). A systematic review of studies of depression prevalence in university students. Journal of Psychiatric Research, 47(3), 391–400. https://doi.org/10.1016/j.jpsychires.2012.11.015

Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (Inep) (2019). Censo da Educação Superior 2018: notas estatísticas. Brasília

Khan, K. S., Mamun, M. A., Griffiths, M. D., & Ullah, I. (2022). The Mental Health Impact of the COVID-19 Pandemic Across Different Cohorts. International Journal of Mental Health and Addiction, 20(1), 380–386. https://doi.org/10.1007/s11469-020-00367-0

Khudaykulov, A., Changjun, Z., Obrenovic, B., Godinic, D., Alsharif, H. Z. H., & Jakhongirov, I. (2022). The fear of COVID-19 and job insecurity impact on depression and anxiety: An empirical study in China in the COVID-19 pandemic aftermath. Current Psychology. https://doi.org/10.1007/s12144-022-02883-9

Kim, H.-G., Cheon, E.-J., Bai, D.-S., Lee, Y. H., & Koo, B.-H. (2018). Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature. Psychiatry Investigation, 15(3), 235–245. https://doi.org/10.30773/pi.2017.08.17

Li, Y., Wang, A., Wu, Y., Han, N., & Huang, H. (2021). Impact of the COVID-19 Pandemic on the Mental Health of College Students: A Systematic Review and Meta-Analysis. Frontiers in Psychology, 12, 669119. https://doi.org/10.3389/fpsyg.2021.669119

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U

McGinty, E. E., Presskreischer, R., Han, H., & Barry, C. L. (2020). Psychological Distress and Loneliness Reported by US Adults in 2018 and April 2020. JAMA, 324(1), 93. https://doi.org/10.1001/jama.2020.9740

Morey, R. D., & Rouder, J. N. (2015). Bayes Factor 0.9.12-4.2. Comprehensive R Archive Network. https://CRAN.R-project.org/package=BayesFactor

Morris, M. R., Feldpausch, N. I., Inga Eshelman, M. G., & Bohle-Frankel, B. U. (2019). Recovering in Place: Creating Campus Models of Care for the High-Risk College Student. Current Psychiatry Reports, 21(11), 111. https://doi.org/10.1007/s11920-019-1101-5

Nathoo, F. S., & Masson, M. E. J. (2016). Bayesian alternatives to null-hypothesis significance testing for repeated-measures designs. Journal of Mathematical Psychology, 72, 144–157. https://doi.org/10.1016/j.jmp.2015.03.003

Neubauer, A. B., Smyth, J. M., & Sliwinski, M. J. (2019). Age differences in proactive coping with minor hassles in daily life. The Journals of Gerontology: Series B, 74(1), 7-16.

Neuman, W. L. (2014). Social research methods: Qualitative and quantitative approaches (7th ed.). Pearson education.

Ng, K., Poon, B. H., Kiat Puar, T. H., Shan Quah, J. L., Loh, W. J., Wong, Y. J., Tan, T. Y., & Raghuram, J. (2020). COVID-19 and the Risk to Health Care Workers: A Case Report. Annals of Internal Medicine, 172(11), 766–767. https://doi.org/10.7326/L20-0175

Organização Mundial da Saúde (OMS) (2017). Depression and other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization

Organização Mundial da Saúde (OMS) (2020). WHO Director-General's opening remarks at the media briefing on COVID-19. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Organização Mundial da Saúde (OMS) (2021). Adapting to life with COVID-19 and staying safe. https://www.who.int/westernpacific/news-room/commentaries/detail-hq/adapting-to-life-with-covid-19-and-staying-safe

Organização Mundial da Saúde (OMS) (2022). Advice for the public: Coronavirus disease (COVID-19). https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Organização das Nações Unidas para a Educação, a Ciência e a Cultura (UNESCO) (2020). Coronavirus COVID-19 and Higher Education: Impact and Recommendations. https://www.iesalc.unesco.org/en/2020/03/09/coronavirus-covid-19-and-higher-education-impact-and-recommendations/

Pakpour, A. H., & Griffiths, M. D. (2020). The fear of COVID-19 and its role in preventive behaviours. Journal of Concurrent Disorders, 2(1). https://doi.org/10.54127/WCIC8036

Paula, W. de, Breguez, G. S., Machado, E. L., & Meireles, A. L. (2020). Prevalence of anxiety, depression, and suicidal ideation symptoms among university students: A systematic review. Brazilian Journal of Health Review, 3(4), 8739–8756. https://doi.org/10.34119/bjhrv3n4-119

Pijls, B. G., Jolani, S., Atherley, A., Derckx, R. T., Dijkstra, J. I. R., Franssen, G. H. L., Hendriks, S., Richters, A., Venemans-Jellema, A., Zalpuri, S., & Zeegers, M. P. (2021). Demographic risk factors for COVID-19 infection, severity, ICU admission and death: A meta-analysis of 59 studies. BMJ Open, 11(1), e044640. https://doi.org/10.1136/bmjopen-2020-044640

Pradhan, M., Chettri, A., & Maheshwari, S. (2022). Fear of death in the shadow of COVID-19: The mediating role of perceived stress in the relationship between neuroticism and death anxiety. Death Studies, 46(5), 1106–1110. https://doi.org/10.1080/07481187.2020.1833384

Rana, K. S. (2021). Impact of Novel Coronavirus (COVID-19) on Aspects of Personal and Professional Life. 27(2), 17.

Rodríguez-Planas, N. (2022). Hitting where it hurts most: COVID-19 and low-income urban college students. Economics of Education Review, 87, 102233. https://doi.org/10.1016/j.econedurev.2022.102233

Roozenbeek, J., Schneider, C. R., Dryhurst, S., Kerr, J., Freeman, A. L., Recchia, G., van der Bles, A. M. & Van Der Linden, S. (2020). Susceptibility to misinformation about COVID-19 around the world. Royal Society open science, 7(10), 201199.

Ruiz-Hernández, J. A., Guillén, Á., Pina, D., & Puente-López, E. (2022). Mental Health and Healthy Habits in University Students: A Comparative Associative Study. European Journal of Investigation in Health, Psychology and Education, 12(2), 114–126. https://doi.org/10.3390/ejihpe12020010

Sallam, M., Dababseh, D., Yaseen, A., Al-Haidar, A., Taim, D., Eid, H., Ababneh, N. A., Bakri, F. G., & Mahafzah, A. (2020). COVID-19 misinformation: Mere harmless delusions or much more? A knowledge and attitude cross-sectional study among the general public residing in Jordan. PLOS ONE, 15(12), e0243264. https://doi.org/10.1371/journal.pone.0243264

Shah, G. H., Rochani, H. D., Telfair, J., Ayangunna, E., & Skuraton, G. (2021). College Students’ Experiences of Race-Related Bias or Hatred in Their Lifetimes and COVID-19 Era. Journal of Public Health Management and Practice, 27(3), 258–267. https://doi.org/10.1097/PHH.0000000000001351

Shanahan, L., Steinhoff, A., Bechtiger, L., Murray, A. L., Nivette, A., Hepp, U., Ribeaud, D., & Eisner, M. (2022). Emotional distress in young adults during the COVID-19 pandemic: Evidence of risk and resilience from a longitudinal cohort study. Psychological Medicine, 52(5), 824–833. https://doi.org/10.1017/S003329172000241X

Son, C., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020). Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study. Journal of Medical Internet Research, 22(9), e21279. https://doi.org/10.2196/21279

Stamatis, C. A., Broos, H. C., Hudiburgh, S. E., Dale, S. K., & Timpano, K. R. (2022). A longitudinal investigation of COVID‐19 pandemic experiences and mental health among university students. British Journal of clinical psychology, 61(2), 385-404.

Storrie, K., Ahern, K., & Tuckett, A. (2010). A systematic review: Students with mental health problems-A growing problem. International Journal of Nursing Practice, 16(1), 1–6. https://doi.org/10.1111/j.1440-172X.2009.01813.x

Sundarasen, S., Chinna, K., Kamaludin, K., Nurunnabi, M., Baloch, G. M., Khoshaim, H. B., Hossain, S. F. A., & Sukayt, A. (2020). Psychological Impact of COVID-19 and Lockdown among University Students in Malaysia: Implications and Policy Recommendations. International Journal of Environmental Research and Public Health, 17(17), 6206. https://doi.org/10.3390/ijerph17176206

Taber, K. S. (2018). The use of Cronbach’s alpha when developing and reporting research instruments in science education. Research in science education, 48(6), 1273-1296.

Taylor, S. (2019). The psychology of pandemics: Preparing for the next global outbreak of infectious disease. Cambridge scholars publishing.

Teodoro, M., de Souza, R. S. B., Martins, C. de C., Sediyama, C. Y. N., Alvares-Teodoro, J., Chang, O. D., & Chang, E. C. (2020). Validity of the Frequency of Suicidal Ideation Inventory in Brazilian adults. Death Studies, 1–5. https://doi.org/10.1080/07481187.2020.1824201

Teodoro, M. L. M., Alvares-Teodoro, J., Peixoto, C. B., Pereira, E. G., Diniz, M. L. N., De Freitas, S. K. P., Ribeiro, P. C. C., Gomes, C. M. A., & Mansur-Alves, M. (2021). Saúde mental em estudantes universitários durante a pandemia de COVID-19. Revista Família, Ciclos de Vida e Saúde no Contexto Social, 9(2), 372. https://doi.org/10.18554/refacs.v9i2.5409

Thorley, C. (2017). Not by degrees: Improving student mental health in the UK's universities. London: Institute for Public Policy Research

Unwin, B. K., Goodie, J., Reamy, B. V., & Quinlan, J. (2013). Care of the college student. American Family Physician, 88(9), 596–604.

Vila-Corcoles, A., Satue-Gracia, E., Vila-Rovira, A., de Diego-Cabanes, C., Forcadell-Peris, M. J., & Ochoa-Gondar, O. (2021). Development of a predictive prognostic rule for early assessment of COVID-19 patients in primary care settings. Atencion Primaria, 53(9), 102118.

Vignola, R. C. B., & Tucci, A. M. (2014). Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. Journal of Affective Disorders, 155, 104–109. https://doi.org/10.1016/j.jad.2013.10.031

Wang, X., Hegde, S., Son, C., Keller, B., Smith, A., & Sasangohar, F. (2020). Investigating Mental Health of US College Students During the COVID-19 Pandemic: Cross-Sectional Survey Study. Journal of Medical Internet Research, 22(9), e22817. https://doi.org/10.2196/22817

Xiao, H., Carney, D. M., Youn, S. J., Janis, R. A., Castonguay, L. G., Hayes, J. A., & Locke, B. D. (2017). Are we in crisis? National mental health and treatment trends in college counseling centers. Psychological Services, 14(4), 407–415. https://doi.org/10.1037/ser0000130

Zhen‐Duan, J., Gade, N., Falgas‐Bagué, I., Sue, K. L., DeJonckheere, M., & Alegría, M. (2022). Using a structural vulnerability framework to understand the impact of COVID‐19 on the lives of Medicaid beneficiaries receiving substance use treatment in New York City. Health Services Research, 1475-6773.13975. https://doi.org/10.1111/1475-6773.13975

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Copyright (c) 2023 Marco Antonio Silva Alvarenga, Carollina Souza Guilhermino, Tiago Geraldo de Azevedo, Marcela Mansur-Alves, Juliana Alvares-Teodoro, Pricila Cristina Correa Ribeiro, Maycoln Leoni Martins Teodoro, Paulo Felipe Ribeiro Bandeira