In a recent study posted to the Research Square* preprint server, researchers investigated alcohol usage, psychological health status, and alcohol-associated concerns among university students during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Hong Kong.

Study: Alcohol use, mental health status, and alcohol-related problems in university students amid COVID-19 pandemic. Image Credit: DC Studio/Shutterstock.com

*Important notice: Research Square publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Background

Switching from offline to online schooling modes with stringent social distancing measures during the COVID-19 pandemic significantly impacted university students’ drinking habits, leading to an increased risk of alcohol-related harm and decreased academic performance.

University attendees are more susceptible to these risks due to social gatherings, peer pressures, and increased academic stress levels associated with examinations.

COVID-19 also led to increased home isolation and the termination of social activities critical to their mental health, resulting in higher risks of alcohol consumption. Students with poor academic performance have lower motivation to learn and decreased class attendance. However, the impact of the pandemic on alcohol-drinking behaviors and harms has not been extensively investigated.

About the study

In the present study, researchers assessed the alcohol-consumption behaviors and psychological health, the harms related to alcohol drinking, and the moderating impact of psychological health on the associations among Chinese university students during COVID-19.

The present study is a secondary evaluation of findings from a randomized clinical trial, for which the team enrolled students showing Alcohol Usage Disorder Identification Test (AUDIT) scores ≥8.0 from 10 universities between October 2020 and May 2022. Alcohol-associated issues were assessed using the Academic Role Expectations and Alcohol Scale (AREAS).

Depression and anxiety symptoms were assessed using the two-item Patient Health Questionnaire (PHQ-2) and the General Anxiety Disorder-2 (GAD-2) scales. In addition, sociodemographic data (including age, gender, and perceived family affluence) and alcohol consumption behaviors were analyzed.

Multiple logistic regression modeling was performed to determine the adjusted odds ratio (AOR) values, and unstandardized coefficients (b values) for AREAS scores were calculated.

All participants were aged above 18 years and could communicate and read Chinese; had resided in Hong Kong for one year; and had instant messaging applications on their smartphones. The team excluded individuals with histories of psychiatric disorders and those who participated in other alcohol therapy programs.

Results

Among 772 individuals, the mean values for participant age, AREAS score, AUDIT score, and weekly alcohol intake (alcohol unit) were 21 years, 2.4, 13, and 8.7, respectively.

Among the participants, 48% were male, 75% perceived their family affluence as at least average, 69.0% practiced binge drinking, 68% were below the legal age for drinking, 29% drank heavily in the previous month, and 38% reported an increase in alcohol intake during COVID-19.

Anxiety and depression symptoms were reported by 28% and 29% of participants, respectively. AREAS scores were higher for individuals who drank frequently, and binge drank.

In addition, AREAS scores were higher for anxious and depressed individuals. Students with depression or anxiety showed stronger relationships with increased frequency of alcohol intake highighted by the AREAS scores (anxiety: 1.7 versus 1.0; depression: 2.5 versus 0.8), binge drinking (b values for anxiety: 2.8 versus 1.7; depression: 2.9 versus 1.6), and heavy alcohol consumption (anxiety: 2.4 versus 1.2; depression: 2.6 versus 1.3).

Drinking alcohol ≥2.0 times weekly (adjusted b, 1.1), binge drinking once (adjusted b, 1.1) or ≥2.0 times monthly (adjusted b, 1.9), heavy drinking monthly or more (adjusted b, 1.4), and having anxiety (adjusted b, 0.8) or depression (adjusted b, 1.1) showed significant associations with higher AREAS scorings.

Binge drinking ≥2.0 times monthly was significantly associated with not reaching class on time, being absent in class, being inattentive, and delayed submission of assignments, with AOR values of 3.0, 3.9, 2.0, and 1.8, respectively.

Heavy drinking monthly or more was significantly associated with being late for class, class absenteeism, and class inattention, with AOR values ranging between 1.9 and 2.3. Increased drinking amid the pandemic showed significant associations with class inattention (AOR, 1.7).

Students with anxiety or depressive symptoms were significantly associated with class inattention (AOR values for anxiety and depression of 1.7 and 2.1, respectively) and late assignment submission (AORs values for anxiety and depression of 1.7 and 2.5, respectively).

Conclusion

Overall, the study findings highlighted the proportions of binge alcohol drinkers, heavy drinkers, and psychological health issues among university students during COVID-19.

Alcohol consumption in pandemic times was related to several alcohol-associated issues, especially among university attendees with psychological disorders. The findings underscored the need for interventions to decrease alcohol intake and associated harm among the youth in the coming years.