Depression, Anxiety, and Stress among Female Undergraduate Students: Physical Health Concerns as Influencing Determinants

Glenn Calaguas

doi:10.56508/mhgcj.v8i1.316

Authors

Glenn Calaguas Pampanga State Agricultural University, Magalang, Pampanga, Philippines https://orcid.org/0000-0002-2018-1932

DOI:

https://doi.org/10.56508/mhgcj.v8i1.316

Keywords:

complex correlational, females, state university, undergraduate students, mental health, physical health

Abstract

Introduction: Mental health concerns are on the rise in the Philippines, especially during and after the COVID-19 pandemic. Several factors, including sex and physical health concerns, contribute to this rise. However, there has been limited available research on the influence of physical health concerns on mental health concerns, particularly among Filipino female undergraduate students.

Purpose: The study investigated the influencing role of physical health concerns, particularly sleep disturbances, headaches, gastrointestinal problems, and respiratory infections, in the experience of depression, anxiety, and stress among Filipino female undergraduate students enrolled in a state university. The participants were freshman and sophomore undergraduate students enrolled during the first-ever semester of residential classes after the COVID-19 pandemic. Results of the investigation can be used in the crafting of a contextualized mental health program.

Methodology: The study employed a quantitative method of research. A total of 976 female undergraduate students (mean age of 18.87, representing 23 programs) from a state university in the Philippines were asked to respond to the Depression, Anxiety, and Stress Scale and to the Physical Health Questionnaire. Both descriptive statistics and multiple linear regression were used to analyze responses from the research instruments.

Results: Using the responses of the female undergraduate students, descriptive statistics revealed that, as a group, they experienced severe depression, extremely severe anxiety, and moderate stress. Also, it was further revealed through multiple regression analysis that sleep disturbances, headaches, gastrointestinal problems, and respiratory infections significantly influenced stress, while sleep disturbances, gastrointestinal problems, and respiratory infections significantly influenced depression and anxiety.

Conclusion: The study highlights the importance of physical wellness in understanding mental health concerns. Therefore, understanding mental health concerns, particularly depression, anxiety, and stress among female undergraduate students, also requires understanding physical health concerns, which is necessary in contextualizing mental health programs.

References

Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96(2), 358–372. https://doi.org/10.1037/0033-295X.96.2.358 DOI: https://doi.org/10.1037//0033-295X.96.2.358

Acampado, E., & Valenzuela, M. (2018). Physical activity and dietary habits of Filipino college students. Kinesiology, 50(1), 57–67. https://doi.org/10.26582/k.50.1.11 DOI: https://doi.org/10.26582/k.50.1.11

Ahmed, I., Hazell, C. M., Edwards, B., Glazebrook, C., & Davies, E. B. (2023). A systematic review and meta-analysis of studies exploring prevalence of non-specific anxiety in undergraduate university students. BMC Psychiatry, 23(1), 240. https://doi.org/10.1186/s12888-023-04645-8 DOI: https://doi.org/10.1186/s12888-023-04645-8

Alalalmeh, S. O., Hegazi, O. E., Shahwan, M., Hassan, N., Humaid Alnuaimi, G. R., Alaila, R. F., Jairoun, A., Tariq Hamdi, Y., Abdullah, M. T., Abdullah, R. M., & Zyoud, S. H. (2024). Assessing mental health among students in the UAE: A cross-sectional study utilizing the DASS-21 scale. Saudi Pharmaceutical Journal, 32(4), 101987. https://doi.org/10.1016/j.jsps.2024.101987 DOI: https://doi.org/10.1016/j.jsps.2024.101987

Alejandria, M. C. P., Casimiro, K. M. D., Gibe, J. A. L., Fernandez, N. S. F., Tumaneng, D. C., Sandoval, E. C. A., Hernandez, P. J. S., Quan-Nalus, M. A., Alipao, F. A., & Alejandria, M. A. C. P. (2023). Attaining well-being beyond the home: A socio-cultural framing of mental health among university students in the Philippines. Health Education Journal, 82(2), 143–155. https://doi.org/10.1177/00178969221141547 DOI: https://doi.org/10.1177/00178969221141547

Alwis, I., Baminiwatta, A., & Chandradasa, M. (2024). Prevalence and associated factors of depression in Sri Lanka: a systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 59(2), 353–373. https://doi.org/10.1007/s00127-023-02495-z DOI: https://doi.org/10.1007/s00127-023-02495-z

Amadu, P. M., Enyonam Hoedoafia, R., Dassah, G., Cletus, L. K., Adwoa Kpebu, S. E., Aarah-Bapuah, M., & Kapio Abem, V. (2024). The prevalence of depression, anxiety, and stress among undergraduate nursing students in the University for Development Studies, Tamale. Fortune Journal of Health Sciences, 07(02). https://doi.org/10.26502/fjhs.176 DOI: https://doi.org/10.26502/fjhs.176

Amir Hamzah, N. S., Nik Farid, N. D., Yahya, A., Chin, C., Su, T. T., Rampal, S. R. L., & Dahlui, M. (2019). The prevalence and associated factors of depression, anxiety and stress of first year undergraduate students in a public higher learning institution in Malaysia. Journal of Child and Family Studies, 28(12), 3545–3557. https://doi.org/10.1007/s10826-019-01537-y DOI: https://doi.org/10.1007/s10826-019-01537-y

Anbesaw, T., Zenebe, Y., Necho, M., Gebresellassie, M., Segon, T., Kebede, F., & Bete, T. (2023). Prevalence of depression among students at Ethiopian universities and associated factors: A systematic review and meta-analysis. PLOS ONE, 18(10), e0288597. https://doi.org/10.1371/journal.pone.0288597 DOI: https://doi.org/10.1371/journal.pone.0288597

Armstrong, N., Fu, Z., & Woolf, K. (2024). The relationship between lifestyle behaviors and mental illness in women in college. Nutrients, 16(14), 2211. https://doi.org/10.3390/nu16142211 DOI: https://doi.org/10.3390/nu16142211

Barendse, M. E. A., Flannery, J., Cavanagh, C., Aristizabal, M., Becker, S. P., Berger, E., Breaux, R., Campione?Barr, N., Church, J. A., Crone, E. A., Dahl, R. E., Dennis?Tiwary, T. A., Dvorsky, M. R., Dziura, S. L., van de Groep, S., Ho, T. C., Killoren, S. E., Langberg, J. M., Larguinho, T. L., … Pfeifer, J. H. (2023). Longitudinal change in adolescent depression and anxiety symptoms from before to during the COVID?19 pandemic. Journal of Research on Adolescence, 33(1), 74–91. https://doi.org/10.1111/jora.12781 DOI: https://doi.org/10.1111/jora.12781

Batra, K., Sharma, M., Batra, R., Singh, T. P., & Schvaneveldt, N. (2021). Assessing the psychological impact of COVID-19 among college students: An evidence of 15 countries. Healthcare, 9(2), 222. https://doi.org/10.3390/healthcare9020222 DOI: https://doi.org/10.3390/healthcare9020222

Bazargan, M., Dehghani, A., Ramezani, M. A., & Ramezani, A. (2023). Prevalence of depression among Iranian children and adolescents: An updated systematic review and meta?analysis. Health Science Reports, 6(10). https://doi.org/10.1002/hsr2.1584 DOI: https://doi.org/10.1002/hsr2.1584

Beck, A. T., & Clark, D. A. (1997). An information processing model of anxiety: Automatic and strategic processes. Behaviour Research and Therapy, 35(1), 49–58. https://doi.org/10.1016/S0005-7967(96)00069-1 DOI: https://doi.org/10.1016/S0005-7967(96)00069-1

Berry, W. D. (2005). Probit/Logit and Other Binary Models. In Encyclopedia of Social Measurement (pp. 161–169). Elsevier. https://doi.org/10.1016/B0-12-369398-5/00176-6 DOI: https://doi.org/10.1016/B0-12-369398-5/00176-6

Blackwelder, A., Hoskins, M., & Huber, L. (2021). Effect of inadequate sleep on frequent mental distress. Preventing Chronic Disease, 18, 200573. https://doi.org/10.5888/pcd18.200573 DOI: https://doi.org/10.5888/pcd18.200573

Blanco, V., Salmerón, M., Otero, P., & Vázquez, F. L. (2021). Symptoms of depression, anxiety, and stress and prevalence of major depression and its predictors in female university students. International Journal of Environmental Research and Public Health, 18(11), 5845. https://doi.org/10.3390/ijerph18115845 DOI: https://doi.org/10.3390/ijerph18115845

Bordey, H. (2024). CHED: More college students cited mental health as reason for dropping out. GMA News Online. https://www.gmanetwork.com/news/topstories/nation/922218/ched-more-college-students-cited-mental-health-as-reason-for-dropping-out/story/

Cagas, J. Y., Mallari, M. F. T., Torre, B. A., Kang, M.-G. D. P., Palad, Y. Y., Guisihan, R. M., Aurellado, M. I., Sanchez-Pituk, C., Realin, J. G. P., Sabado, M. L. C., Ulanday, M. E. D., Baltasar, J. F., Maghanoy, M. L. A., Ramos, R. A. A., Santos, R. A. B., & Capio, C. M. (2022). Results from the Philippines’ 2022 report card on physical activity for children and adolescents. Journal of Exercise Science & Fitness, 20(4), 382–390. https://doi.org/10.1016/j.jesf.2022.10.001 DOI: https://doi.org/10.1016/j.jesf.2022.10.001

Casinillo, L. F. (2022). Modeling determinants of challenge in learning Statistics in time of the COVID-19 pandemic. Philippine Social Science Journal, 5(3), 131–139. https://doi.org/10.52006/main.v5i3.536 DOI: https://doi.org/10.52006/main.v5i3.536

Cheung, D. K., Tam, D. K. Y., Tsang, M. H., Zhang, D. L. W., & Lit, D. S. W. (2020). Depression, anxiety and stress in different subgroups of first-year university students from 4-year cohort data. Journal of Affective Disorders, 274, 305–314. https://doi.org/10.1016/j.jad.2020.05.041 DOI: https://doi.org/10.1016/j.jad.2020.05.041

Choychoda, S. . H. I. W. W. . S. J. . & T. K. (2023). A cross-sectional study on the prevalence of Thai adolescent depression. Kasetsart Journal of Social Sciences, 44(2). https://doi.org/10.34044/j.kjss.2023.44.2.21 DOI: https://doi.org/10.34044/j.kjss.2023.44.2.21

Cleofas, J. V. (2023). Family, friends, school and nation: Socio?ecological determinants of mental health among Filipino college students post?lockdown. International Social Science Journal. https://doi.org/10.1111/issj.12459 DOI: https://doi.org/10.1111/issj.12459

Cody, K., Scott, J. M., & Simmer-Beck, M. (2024). Examining the mental health of university students: A quantitative and qualitative approach to identifying prevalence, associations, stressors, and interventions. Journal of American College Health, 72(3), 776–786. https://doi.org/10.1080/07448481.2022.2057192 DOI: https://doi.org/10.1080/07448481.2022.2057192

de Oliveira Viana, M. Á., Porto, É., dos Santos Dantas, L., Soares Forte, F. D., D’Ávila Lins Bezerra Cavalcanti, S., & de Lima Targino Massoni, A. C. (2024). Depression, anxiety, and stress in dental students and associations with sociodemographic variables and the academic environment. Trends in Psychology. https://doi.org/10.1007/s43076-024-00359-2 DOI: https://doi.org/10.1007/s43076-024-00359-2

Deng, J., Zhou, F., Hou, W., Heybati, K., Lohit, S., Abbas, U., Silver, Z., Wong, C. Y., Chang, O., Huang, E., Zuo, Q. K., Moskalyk, M., Ramaraju, H. B., & Heybati, S. (2023). Prevalence of mental health symptoms in children and adolescents during the COVID?19 pandemic: A meta?analysis. Annals of the New York Academy of Sciences, 1520(1), 53–73. https://doi.org/10.1111/nyas.14947 DOI: https://doi.org/10.1111/nyas.14947

Dessauvagie, A. S., Dang, H.-M., Nguyen, T. A. T., & Groen, G. (2022). Mental health of university students in Southeastern Asia: A systematic review. Asia Pacific Journal of Public Health, 34(2–3), 172–181. https://doi.org/10.1177/10105395211055545 DOI: https://doi.org/10.1177/10105395211055545

Doan, T., Ha, V., Strazdins, L., & Chateau, D. (2023). Healthy minds live in healthy bodies – effect of physical health on mental health: Evidence from Australian longitudinal data. Current Psychology, 42(22), 18702–18713. https://doi.org/10.1007/s12144-022-03053-7 DOI: https://doi.org/10.1007/s12144-022-03053-7

Dopelt, K., & Houminer-Klepar, N. (2024). War-related stress among Israeli college students following 7 October 2023 terror attack in Israel. European Journal of Investigation in Health, Psychology and Education, 14(8), 2175–2186. https://doi.org/10.3390/ejihpe14080145 DOI: https://doi.org/10.3390/ejihpe14080145

Du, C., Zan, M. C. H., Cho, M. J., Fenton, J. I., Hsiao, P. Y., Hsiao, R., Keaver, L., Lai, C.-C., Lee, H., Ludy, M.-J., Shen, W., Swee, W. C. S., Thrivikraman, J., Tseng, K.-W., Tseng, W.-C., Almotwa, J., Feldpausch, C. E., Folk, S. Y. L., Gadd, S., … Tucker, R. M. (2021). Health behaviors of higher education students from 7 countries: Poorer sleep quality during the COVID-19 pandemic predicts higher dietary risk. Clocks & Sleep, 3(1), 12–30. https://doi.org/10.3390/clockssleep3010002 DOI: https://doi.org/10.3390/clockssleep3010002

Emmerton, R. W., Camilleri, C., & Sammut, S. (2024). Continued deterioration in university student mental health: Inevitable decline or skirting around the deeper problems? Journal of Affective Disorders Reports, 15, 100691. https://doi.org/10.1016/j.jadr.2023.100691 DOI: https://doi.org/10.1016/j.jadr.2023.100691

Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136. https://doi.org/10.1126/science.847460 DOI: https://doi.org/10.1126/science.847460

Fudolig, M. I., Bloomfield, L. S. P., Price, M., Bird, Y. M., Hidalgo, J. E., Kim, J. N., Llorin, J., Lovato, J., McGinnis, E. W., McGinnis, R. S., Ricketts, T., Stanton, K., Dodds, P. S., & Danforth, C. M. (2024). The two fundamental shapes of sleep heart rate dynamics and their connection to mental health in college students. Digital Biomarkers, 8(1), 120–131. https://doi.org/10.1159/000539487 DOI: https://doi.org/10.1159/000539487

Santiago, G. R., & Ibarra, C. V. (2023). Health, physical fitness, and skills of first year college students: evidence from a Philippine college. Malaysian Mental Health Journal, 2(1), 07–12. https://doi.org/10.26480/mmhj.01.2023.07.12 DOI: https://doi.org/10.26480/mmhj.01.2023.07.12

Han, W., Altalbe, A., Rehman, N., Rehman, S., & Sharma, S. (2024). Exploring the longitudinal impacts of academic stress and lifestyle factors among Chinese students. Journal of Pharmaceutical Policy and Practice, 17(1). https://doi.org/10.1080/20523211.2024.2398706 DOI: https://doi.org/10.1080/20523211.2024.2398706

Hathaway, E. D., Peyer, K. L., & Doyle, K. A. (2023). A first look at perceived stress in southeastern university students during the COVID-19 pandemic. Journal of American College Health, 71(2), 329–332. https://doi.org/10.1080/07448481.2021.1895809 DOI: https://doi.org/10.1080/07448481.2021.1895809

Heumann, E., Helmer, S. M., Busse, H., Negash, S., Horn, J., Pischke, C. R., Niephaus, Y., & Stock, C. (2023). Retracted: Anxiety and depressive symptoms of German university students 20 months after the COVID-19 outbreak – A cross-sectional study. Journal of Affective Disorders, 320, 568–575. https://doi.org/10.1016/j.jad.2022.09.158 DOI: https://doi.org/10.1016/j.jad.2022.09.158

Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11(2), 213–218. https://doi.org/10.1016/0022-3999(67)90010-4 DOI: https://doi.org/10.1016/0022-3999(67)90010-4

Huang, X., Wang, Y., & Zhang, H. (2023). Effects of physical exercise intervention on depressive and anxious moods of college students: A meta-analysis of randomized controlled trials. Asian Journal of Sport and Exercise Psychology, 3(3), 206–221. https://doi.org/10.1016/j.ajsep.2023.01.001 DOI: https://doi.org/10.1016/j.ajsep.2023.01.001

Hutchesson, M., Whatnall, M., Fenton, S., Ashton, L., Patterson, A., Smith, J., Duncan, M. J., Kay-Lambkin, F., & Burrows, T. (2023). Are health behaviors associated with mental health among tertiary education students? A systematic review of cohort studies. Journal of American College Health, 1–13. https://doi.org/10.1080/07448481.2023.2201865 DOI: https://doi.org/10.1080/07448481.2023.2201865

Hwang, J., Ding, Y., Chen, E., Wang, C., & Wu, Y. (2023). Asian American university Students’ adjustment, coping, and stress during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 20(5), 4162. https://doi.org/10.3390/ijerph20054162 DOI: https://doi.org/10.3390/ijerph20054162

Jamali, Y. A., Khan, J. A., Jamali, I. A., Shah, H., Jeetendar, ., & Kumari, R. (2024). Depression, anxiety and stress among undergraduate students of Shah Abdul Latif University, Khairpur. Pakistan Journal of Health Sciences, 99–104. https://doi.org/10.54393/pjhs.v5i04.1384 DOI: https://doi.org/10.54393/pjhs.v5i04.1384

Kamruzzaman, M., Hossain, A., Islam, M. A., Ahmed, M. S., Kabir, E., & Khan, M. N. (2024). Exploring the prevalence of depression, anxiety, and stress among university students in Bangladesh and their determinants. Clinical Epidemiology and Global Health, 28, 101677. https://doi.org/10.1016/j.cegh.2024.101677 DOI: https://doi.org/10.1016/j.cegh.2024.101677

Kaur, P., Stoltzfus, J., & Yellapu, V. (2018). Descriptive statistics. International Journal of Academic Medicine, 4(1), 60. https://doi.org/10.4103/IJAM.IJAM_7_18 DOI: https://doi.org/10.4103/IJAM.IJAM_7_18

Kavvadas, D., Kavvada, A., Karachrysafi, S., Papaliagkas, V., Chatzidimitriou, M., & Papamitsou, T. (2023). Stress, anxiety, and depression levels among university students: Three years from the beginning of the pandemic. Clinics and Practice, 13(3), 596–609. https://doi.org/10.3390/clinpract13030054 DOI: https://doi.org/10.3390/clinpract13030054

Kharroubi, S. A., Al-Akl, N., Chamate, S.-J., Abou Omar, T., & Ballout, R. (2024). Assessing the relationship between physical health, mental health and students’ success among universities in Lebanon: A cross-sectional study. International Journal of Environmental Research and Public Health, 21(5), 597. https://doi.org/10.3390/ijerph21050597 DOI: https://doi.org/10.3390/ijerph21050597

Li, W., Zhao, Z., Chen, D., Peng, Y., & Lu, Z. (2022). Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta?analysis. Journal of Child Psychology and Psychiatry, 63(11), 1222–1230. https://doi.org/10.1111/jcpp.13606 DOI: https://doi.org/10.1111/jcpp.13606

Liu, X.-Q., Guo, Y.-X., & Xu, Y. (2023). Risk factors and digital interventions for anxiety disorders in college students: Stakeholder perspectives. World Journal of Clinical Cases, 11(7), 1442–1457. https://doi.org/10.12998/wjcc.v11.i7.1442 DOI: https://doi.org/10.12998/wjcc.v11.i7.1442

Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety & Stress Scales. (2nd Ed.). DOI: https://doi.org/10.1037/t01004-000

Lyu, J., Jin, S., Ji, C., Yan, R., Feng, C., Rozelle, S., & Wang, H. (2024). The connection between sleep patterns and mental health: Insights from rural Chinese students. Healthcare, 12(15), 1507. https://doi.org/10.3390/healthcare12151507 DOI: https://doi.org/10.3390/healthcare12151507

Mahindru, A., Patil, P., & Agrawal, V. (2023). Role of physical activity on mental health and well-being: A review. Cureus, 15(1), e33475. https://doi.org/10.7759/cureus.33475 DOI: https://doi.org/10.7759/cureus.33475

Malagodi, F., Dommett, E. J., Findon, J. L., & Gardner, B. (2024). Physical activity interventions to improve mental health and wellbeing in university students in the UK: A service mapping study. Mental Health and Physical Activity, 26, 100563. https://doi.org/10.1016/j.mhpa.2023.100563 DOI: https://doi.org/10.1016/j.mhpa.2023.100563

Manasan, P. L., Quitor, C. G., Ronquillo, V. P., Dabu, D. C., Dela Cruz, J. T., Sode, M. A. V., & Cruz, S. J. L. (2023). Motives and barriers to exercise among underweight Filipino college students. International Journal of Multidisciplinary: Applied Business and Education Research, 4(9), 3244–3263. https://doi.org/10.11594/ijmaber.04.09.16 DOI: https://doi.org/10.11594/ijmaber.04.09.16

Masuda, M., & Holmes, T. H. (1967). Magnitude estimations of social readjustments. Journal of Psychosomatic Research, 11(2), 219–225. https://doi.org/10.1016/0022-3999(67)90011-6 DOI: https://doi.org/10.1016/0022-3999(67)90011-6

Moussa-Chamari, I., Farooq, A., Romdhani, M., Washif, J. A., Bakare, U., Helmy, M., Al-Horani, R. A., Salamh, P., Robin, N., & Hue, O. (2024). The relationship between quality of life, sleep quality, mental health, and physical activity in an international sample of college students: a structural equation modeling approach. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1397924 DOI: https://doi.org/10.3389/fpubh.2024.1397924

Nahar, Z., Sohan, M., Supti, K. F., Hossain, M. J., Shahriar, M., Bhuiyan, M. A., & Islam, M. R. (2022). Prevalence and associated risk factors for mental health problems among female university students during COVID-19 pandemic: A cross-sectional study findings from Dhaka, Bangladesh. Heliyon, 8(10), e10890. https://doi.org/10.1016/j.heliyon.2022.e10890 DOI: https://doi.org/10.1016/j.heliyon.2022.e10890

Nour, M. O., Alharbi, K. K., Hafiz, T. A., Alshehri, A. M., Alyamani, L. S., Alharbi, T. H., Alzahrani, R. S., Almalki, E. F., Althagafi, A. A., Kattan, E. T., & Tamim, H. M. (2023). Prevalence of depression and associated factors among adults in Saudi Arabia: Systematic review and Meta-Analysis (2000-2022). Depression and Anxiety, 2023, 1–18. https://doi.org/10.1155/2023/8854120 DOI: https://doi.org/10.1155/2023/8854120

Olson, R., Fryz, R., Essemiah, J., Crawford, M., King, A., & Fateye, B. (2023). Mental health impacts of COVID-19 lockdown on US college students: Results of a photoelicitation project. Journal of American College Health, 71(2), 411–421. https://doi.org/10.1080/07448481.2021.1891921 DOI: https://doi.org/10.1080/07448481.2021.1891921

Paudel, U., Parajuli, A., Shrestha, R., Kumari, S., Adhikari Yadav, S., & Marahatta, K. (2023). Perceived stress, sources of stress and coping strategies among undergraduate medical students of Nepal: a cross-sectional study. F1000Research, 11, 167. https://doi.org/10.12688/f1000research.75879.2 DOI: https://doi.org/10.12688/f1000research.75879.2

Pei, J., Amanvermez, Y., Vigo, D., Puyat, J., Kessler, R. C., Mortier, P., Bruffaerts, R., Rankin, O., Chua, S. N., Martínez, V., Rapsey, C., Fodor, L. A., David, O. A., Garcia, C., & Cuijpers, P. (2024). Sociodemographic correlates of mental health treatment seeking among college students: A systematic review and meta-analysis. Psychiatric Services, 75(6), 556–569. https://doi.org/10.1176/appi.ps.20230414 DOI: https://doi.org/10.1176/appi.ps.20230414

Puyat, J. H., Gastardo-Conaco, M. C., Natividad, J., & Banal, M. A. (2021). Depressive symptoms among young adults in the Philippines: Results from a nationwide cross-sectional survey. Journal of Affective Disorders Reports, 3, 100073. https://doi.org/10.1016/j.jadr.2020.100073 DOI: https://doi.org/10.1016/j.jadr.2020.100073

Rahlin, N. A., Suriawaty, A., Bahkiar Bahkiar, S. A., Turan, S., & Fauzi, S. N. A. (2024). Global Crucial Risk Factors Associated Stress Among University Students During Post Covid-19 Pandemic: Empirical Evidence from Asian Country (pp. 315–327). https://doi.org/10.1007/978-3-031-35828-9_27 DOI: https://doi.org/10.1007/978-3-031-35828-9_27

Ramar, K., Malhotra, R. K., Carden, K. A., Martin, J. L., Abbasi-Feinberg, F., Aurora, R. N., Kapur, V. K., Olson, E. J., Rosen, C. L., Rowley, J. A., Shelgikar, A. V., & Trotti, L. M. (2021). Sleep is essential to health: An American Academy of Sleep Medicine position statement. Journal of Clinical Sleep Medicine, 17(10), 2115–2119. https://doi.org/10.5664/jcsm.9476 DOI: https://doi.org/10.5664/jcsm.9476

Sampaga Fernandez, C. Lou, & Cardinal, A. M. (2024). 62. Prevalence, risk factors, and types of anxiety during the COVID-19 pandemic among adolescents in a public secondary school in the Philippines. Journal of Adolescent Health, 74(3), S34. https://doi.org/10.1016/j.jadohealth.2023.11.260 DOI: https://doi.org/10.1016/j.jadohealth.2023.11.260

Schat, A. C. H., Kelloway, E. K., & Desmarais, S. (2005). The Physical Health Questionnaire (PHQ): Construct validation of a self-report scale of somatic symptoms. Journal of Occupational Health Psychology, 10(4), 363–381. https://doi.org/10.1037/1076-8998.10.4.363 DOI: https://doi.org/10.1037/1076-8998.10.4.363

Scott, A. J., Webb, T. L., Martyn-St James, M., Rowse, G., & Weich, S. (2021). Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Medicine Reviews, 60, 101556. https://doi.org/10.1016/j.smrv.2021.101556 DOI: https://doi.org/10.1016/j.smrv.2021.101556

Serrano, I. M. A., Cuyugan, A. M. N., Cruz, K., Mahusay, J. M. A., & Alibudbud, R. (2023). Sociodemographic characteristics, social support, and family history as factors of depression, anxiety, and stress among young adult senior high school students in metro Manila, Philippines, during the COVID-19 pandemic. Frontiers in Psychiatry, 14, 1225035. https://doi.org/10.3389/fpsyt.2023.1225035 DOI: https://doi.org/10.3389/fpsyt.2023.1225035

Siddik, M. A. B., Ali, A., Miah, S., Hasan, M., Ahmed, M., & Sunna, T. C. (2024). Psychological disorders among college going students: A post Covid-19 insight from Bangladesh. Journal of Affective Disorders Reports, 15, 100686. https://doi.org/10.1016/j.jadr.2023.100686 DOI: https://doi.org/10.1016/j.jadr.2023.100686

Singh, S., Lai, C. H., Iderus, N. H. M., Ghazali, S. M., Ahmad, L. C. R. Q., Cheng, L. M., Nadzri, M. N., Zulkifli, A. A., Suppiah, J., Zaki, R. A., Farid, N. D. N., Supramanian, R. K., Nordin, A. A., Lin, C. Z., Kaur, K., & Ghazali, N. M. (2023). Prevalence and determinants of depressive symptoms among young adolescents in Malaysia: A cross-sectional study. Children, 10(1), 141. https://doi.org/10.3390/children10010141 DOI: https://doi.org/10.3390/children10010141

Sivertsen, B., O’Connor, R. C., Nilsen, S. A., Heradstveit, O., Askeland, K. G., Bøe, T., & Hysing, M. (2024). Mental health problems and suicidal behavior from adolescence to young adulthood in college: linking two population-based studies. European Child & Adolescent Psychiatry, 33(2), 421–429. https://doi.org/10.1007/s00787-023-02167-y DOI: https://doi.org/10.1007/s00787-023-02167-y

Souza, L. C., Galvão, L. P., Paiva, H. S., Périco, C. de A.-M., Ventriglio, A., Torales, J., Castaldelli-Maia, J. M., & Martins-da-Silva, A. S. (2023). Major depressive disorder as a risk factor for suicidal ideation for attendees of educational institutions: a meta-analysis and meta-regression. Revista Paulista de Pediatria, 41. https://doi.org/10.1590/1984-0462/2023/41/2021344 DOI: https://doi.org/10.1590/1984-0462/2023/41/2021344

Spence, J. T., Helmreich, R. L., & Pred, R. S. (1987). Impatience versus achievement strivings in the Type A pattern: Differential effects on students’ health and academic achievement. Journal of Applied Psychology, 72(4), 522–528. https://doi.org/10.1037/0021-9010.72.4.522 DOI: https://doi.org/10.1037//0021-9010.72.4.522

Talapko, J., Peri?, I., Vuli?, P., Pustijanac, E., Juki?, M., Beki?, S., Meštrovi?, T., & Škrlec, I. (2021). Mental health and physical activity in health-related university students during the COVID-19 pandemic. Healthcare, 9(7), 801. https://doi.org/10.3390/healthcare9070801 DOI: https://doi.org/10.3390/healthcare9070801

Tan, G. X. D., Soh, X. C., Hartanto, A., Goh, A. Y. H., & Majeed, N. M. (2023). Prevalence of anxiety in college and university students: An umbrella review. Journal of Affective Disorders Reports, 14, 100658. https://doi.org/10.1016/j.jadr.2023.100658 DOI: https://doi.org/10.1016/j.jadr.2023.100658

Torres, L., Caciula, M. C., Tomoiaga, A. S., & Gugu-Gramatopol, C. (2023). Correlations between mental health, physical activity, and body composition in American college students after the COVID-19 pandemic lockdown. International Journal of Environmental Research and Public Health, 20(22), 7045. https://doi.org/10.3390/ijerph20227045 DOI: https://doi.org/10.3390/ijerph20227045

University of the Philippines- Population Institute (2022). Pinoy youth in worse mental shape today, nationwide survey indicates. https://www.uppi.upd.edu.ph/news/2022/pinoy-youth-in-worse-mental-health-shape-today

Woffindin, L. (2023). All about the Connection Between Physical and Mental Health. https://cpdonline.co.uk/knowledge-base/mental-health/all-about-the-connection-between-physical-and-mental-health/

Wynter, K., Redley, B., Holton, S., Manias, E., McDonall, J., McTier, L., Hutchinson, A. M., Kerr, D., Lowe, G., Phillips, N. (Nikki) M., & Rasmussen, B. (2021). Depression, anxiety and stress among Australian nursing and midwifery undergraduate students during the COVID-19 pandemic: a cross-sectional study. International Journal of Nursing Education Scholarship, 18(1). https://doi.org/10.1515/ijnes-2021-0060 DOI: https://doi.org/10.1515/ijnes-2021-0060

Xiong, S. (2023). Gender differences in stress levels among Southeast Asian American college students. Journal of American College Health, 71(3), 651–654. https://doi.org/10.1080/07448481.2021.1908306 DOI: https://doi.org/10.1080/07448481.2021.1908306

Yang, W., Sun, R., Wang, C., Chen, J., Zhang, C., Yu, J., & Liu, H. (2023). Epidemiology of depressive disorders among youth during Gaokao to college in China: results from Hunan Normal University mental health survey. BMC Psychiatry, 23(1), 481. https://doi.org/10.1186/s12888-023-04972-w DOI: https://doi.org/10.1186/s12888-023-04972-w

Yu, Y., Liu, J., Skokauskas, N., Liu, F., Zhang, L., Teng, T., Zou, Y., Lyu, Q., Liu, R., Liu, X., Meng, H., & Zhou, X. (2023). Prevalence of depression and anxiety, and associated factors, among Chinese primary and high school students: A cross?sectional, epidemiological study. Asia-Pacific Psychiatry, 15(1). https://doi.org/10.1111/appy.12523 DOI: https://doi.org/10.1111/appy.12523

Zeng, F. (2024). A Study of the Impact of Health Behavior on The mental health of female college students. American Journal of Health Behavior, 48(2), 126–136. https://doi.org/10.5993/AJHB.48.2.12 DOI: https://doi.org/10.5993/AJHB.48.2.12

Zheng, H., Li, C., Zhang, L., Wang, T., Cai, Z., & Lei, M. (2024). Evaluation of depression and its correlates in terms of demographics, eating habits, and exercises among university students: A multicenter cross-sectional analysis. Neuropsychiatric Disease and Treatment, Volume 20, 1079–1095. https://doi.org/10.2147/NDT.S462836 DOI: https://doi.org/10.2147/NDT.S462836