Abstract
BACKGROUND: This study examines the trajectories of the mental health conditions of 13,494 new undergraduate students who enrolled in 2019 in China from the beginning of the pandemic to the local recurrence of the pandemic, and found factors which may be associated with diverse trajectories. METHODS: The trajectories of depression-anxiety outcomes were modeled using the growth mixture model. The multinomial logistic regression model was used to identify variables associated with different trajectory groups. RESULTS: Both depression and anxiety in the new college students slightly increased during the 16-month period. The slopes of depression and anxiety were lower after the local outbreak. From the trajectories of depression and anxiety, five heterogeneous groups were identified: low-stable (64.3%), moderate-increased (18.2%), high-stable (11.1%), recovery (4.5%), and rapid-increased (1.8%). Environmental, somatic, and social factors were used to differentiate the low-stable group from the other groups. We found that college students with female gender, more conflict with parents, and feelings of loneliness during the pandemic were more likely to enter a high stability trajectory compared to a recovery trajectory. CONCLUSION: Most participants showed a stable mental health status, while others experienced deteriorating or chronic mental health problems, especially those who had sleep disturbances, less social support before the pandemic, or conflicts with parents during the pandemic. These students may need additional support and monitoring from college mental health providers to improve their wellbeing.