Associated Risk and Protective Factors with Mental Health and Substance Use Among University Students After COVID-19 Restrictions Were Lifted in Spain

Abstract Background: The impact of the COVID-19 pandemic on mental health and substance use among students in Spain following the lifting of COVID-19 guidelines has not been adequately assessed. The aim of this study was to determine the prevalence of anxiety, depression, and alcohol use, as well as identify significant risk and protective factors among university students after the relaxation of COVID-19 social guidelines. Methods: A total of 490 university students from Andalusia, Spain, participated in the study. Frequencies and prevalence rates were calculated. Regression analyses identified significant risk and protective factors associated with the outcomes of interest. Results: Our findings showed that after the COVID-19 guidelines were lifted, students displayed moderate levels of depression and anxiety, which were higher than those observed prior to the pandemic. Risk factors included a positive association between adverse traumatic experiences and alcohol use [F (2, 405) = 37.1, p < .02, R2 = .012]; between loneliness and anxiety in young females [F (3, 598) = 97.7, p < .03, R2 = .015]. Protective factors included a significant negative association between family closeness and anxiety [F (3, 678) = 23.6, p < .02, R2 = .109]; between spiritual connection and alcohol use in young males [F (2, 316) = 54.2, p < .05, R2 = .059]. Anger and stress were identified as common predictors of depression, anxiety, and alcohol use among both genders. Conclusion: These results emphasize the ongoing importance of prioritizing the mental health of students in Andalusia, Spain, even in the post-pandemic era.