Factors Associated with University Students’ Deterioration from Subthreshold Depression to Depression before and during the COVID-19 Pandemic

COVID-19 has exposed university students to high-stress situations, and the percentage of individuals with depressive symptoms was high during the COVID-19 pandemic. Furthermore, subthreshold depression carries a risk for the subsequent development of major depressive disorder (MDD). During the COVID-19 pandemic, we examined whether differences exist between university students who deteriorated from subthreshold depression to MDD and those who remained stable or improved. Four hundred seventeen participants completed all the measures twice over a one-year interval. One hundred twenty-three participants met the criteria for subthreshold depression at Time 1. One year later, 42 participants no longer met the criteria for subthreshold depression, 68 participants maintained the criteria for subthreshold depression, and 13 participants met the criteria for MDD. We conducted two-way repeated measures ANOVA to examine the differences between those who deteriorated from subthreshold depression to MDD and those who did not. The study results suggest that avoidance behavior is associated with the development of MDD from subthreshold depression. Additionally, the study showed that experiencing isolation relates to MDD onset. Therefore, we should monitor avoidance behavior and isolation in pandemic conditions. Consequently, attention to avoidance behavior and isolation may be important; however, further research is required.