Changes in mental health among Chinese university students before and during campus lockdowns due to the COVID-19 pandemic: a three-wave longitudinal study

The campus lockdown due to the COVID-19 pandemic has adversely affected mental health among university students. However, the heterogeneity in responses to campus lockdown is still poorly known. We collected three-wave prospective data on university students' mental health in Shanghai, China, in 2022: (i) in February before the pandemic; (ii) in April at the initial COVID-19 campus lockdown; and (iii) in May amidst the citywide lockdown. Overall, 205 university students completed sociodemographic questionnaires, the General Health Questionnaire-12 items (GHQ-12), and the Depression, Anxiety and Stress Scale-21 items (DASS-21). Generalized estimating equations were used to examine the longitudinal changes in mental health and symptoms of depression, anxiety, and stress. Latent class mixed models (LCMM) were constructed to identify distinct trajectories. Multinomial regression models were used to identify factors associated with status variation patterns. Mean GHQ-12 scores were 8.49, 9.66, and 11.26 at pre-pandemic and lockdown T1 and T2, respectively (p < 0.001). Mean scores for depression, anxiety, and stress were (5.96, 10.36, and 8.06, p < 0.001), (7.13, 6.67, and 7.16, p = 0.243), and (9.83, 7.28, and 11.43, p < 0.001), respectively. Changing trends of numbers of participants with clinical symptoms were consistent with those of mean scores. LCMM fitted three distinct trajectory classes, respectively, for GHQ-12, depression and anxiety symptoms, and four classes for stress symptoms. Participants with fair or poor peer relationships were more likely to belong to vulnerable trajectories concerning depression, anxiety, and stress symptoms. This study proves heterogeneity in mental health of university students in response to pandemic campus lockdown and highlights the necessity for identifying vulnerable groups to provide targeted support in future pandemics.