In December 2019, a new wave of pneumonia cases emerged which later received the name Coronavirus disease 2019 (COVID-19) from the World Health Organization (WHO) on February 11, 2020. The virus causing the disease, SARS-CoV-2, was found to be a novel strain of coronavirus closely related to SARS-CoV virus from the 2003 outbreak, sharing around 79% of its genetic code. Later, on March 11, 2020, the WHO announced that this outbreak had escalated into a global pandemic [1].

As a consequence of the Global Pandemic, lockdowns were imposed and extended in several phases, lasting nearly 1.5 to 2 years. During this time, except for the frontline workers, people were confined to their homes, experiencing overwhelming anxiety and uncertainty.

Lockdown is a safety protocol that limits or stops people from moving between different areas, usually during a crisis or public emergency. It is implemented as a precautionary measure or as an immediate response to protect those who are at risk or to safeguard vulnerable populations during critical situations [2].

The rapidly changing circumstances significantly impacted people’s lives and affected many aspects of community life, individual well-being, and global economies [3]. The fear and uncertainty generated by the virus outbreak, together with the impact of widespread lockdowns and economic challenges, were projected to cause a rise in suicide rates and related mental health disorders [1]. The COVID-19 crisis posed a serious and unprecedented threat to global mental health. Children and adolescents, in particular, may have been more vulnerable to the psychological effects due to their developmental stage, fears of infection, prolonged confinement at home, disrupted schooling, and broader-scale issues such as global economic downturns and their consequences [3].

Reflecting on the consequences of epidemics, a comprehensive and thorough investigation is essential to uncover the psychological toll of infectious diseases and subsequent outbreaks. This study was conducted to bridge the existing gap in research by exploring the psychological impact of the COVID-19 pandemic on students and systematically reviewing the prevalence of mental health challenges faced by them during extended periods of confinement [4]. The survey findings are practically important for guiding government communication, improving public awareness, and supporting psychological care. Studying the psychological state of the public during the COVID-19 pandemic will help in understanding responses to large-scale health crises and in improving preparedness for future public health emergencies, while highlighting the role of social, family, and mental health support [5].

Study Design:

This research was conducted as a retrospective cross-sectional questionnaire-based study.

Aim: To describe the changes in appetite, mood, behavioral, and sleep patterns among college students during the lockdown of COVID-19.

Study population:

The study population comprised of individuals from across the country who were enrolled in various academic institutions and pursuing diverse fields of study, including undergraduate and post-graduate courses in Medicine, Engineering, and other academic disciplines. The sample size was 100.

Study measures:

Institutional Ethical clearance was taken. Data were collected through a survey, and the questionnaire comprised closed-ended questions distributed online (in English) via Google Forms or as a hard-copy. This was conducted from September 2025 to January 2026, with responses filled out retrospectively regarding the first lockdown in India.

Timeline of lockdown in India

In this study, by lockdown we mean to refer to the first lockdown in India was implemented from March 24 to May 31, 2020. The period before March 24 was considered before lockdown, while the period from March 24 to May 31 was considered during the first lockdown. The relaxation of lockdown occurred in six phases from June to November 2020. This period was considered after lockdown.

Sampling method

The questionnaires were distributed to students at various institutes which included medical, engineering and other academic discipline colleges from across India, and they, in turn, forwarded it further; thus, a non-probability snowball sampling was performed.

Variables

Based on the variables for which information was sought, the questionnaire was divided into two sections:

Appendix A: Sociodemographic (name, age, sex) and basic knowledge and understanding about the lockdown.

Appendix B: Status of mental health of college students based on the questions from the Quick Inventory of Depressive Symptomatology (QIDS) scale.

Sociodemographic profiles

A total of 100 responses were collected.

Out of which, 40 were Male and 60 were Female.

Age-wise distribution of participants (n = 100).

The respondents were aged between 18-30 years, with peak representation at 22 years (14%) and 23 years (13%).

The pie chart represents responses from 100 participants assessing sad mood during the COVID-19 lockdown using a questionnaire.

• 34% of respondents reported that they did not feel sad, indicating that about one-third of the population maintained relatively stable mood despite lockdown conditions.
• The largest proportion (48%) reported feeling sad less than half the time, suggesting that while sadness was present, it was intermittent and not persistent for most individuals.
• 12% of participants experienced sadness more than half the time, reflecting a moderate level of emotional distress during the lockdown period.
• A small minority (approximately 6%) reported feeling intensely sad virtually all the time, indicating a high-risk group potentially vulnerable to depressive symptoms.

The pie chart depicts responses from 100 participants regarding concentration and decision-making abilities during the COVID-19 lockdown, as assessed through a questionnaire.

• 41% of respondents reported no change in their usual capacity to concentrate and make decisions, indicating preserved cognitive functioning in a substantial proportion of participants.
• 34% stated that they occasionally felt indecisive or noticed that their attention often wandered, suggesting mild but noticeable cognitive difficulties.
• 17% reported that they struggled most of the time to focus attention or make decisions, reflecting moderate impairment in cognitive functioning.
• 8% of participants indicated that they could not concentrate well enough to read or make even minor decisions, representing a smaller yet clinically significant group with severe difficulty.

The pie chart illustrates responses from 100 participants regarding their self-outlook during the COVID-19 lockdown, as assessed using a questionnaire.

• 65% of respondents reported that they viewed themselves as equally worthwhile and deserving as others, indicating preserved self-esteem in the majority of participants.
• 28% indicated that they were more self-blaming than usual, suggesting increased negative self-evaluation during the lockdown period.
• A small proportion of participants (approximately 4%) reported that they largely believed they caused problems for others, reflecting more pronounced feelings of guilt and worthlessness.
• An even smaller minority (3%) reported ruminating over major and minor defects in themselves, indicating severe negative self-perception.

The pie chart presents responses from 100 participants regarding their level of involvement and interest in activities and social interactions during the COVID-19 lockdown, as assessed through a questionnaire.

• 46% of respondents reported no change from their usual level of interest in other people and activities, indicating preserved engagement in nearly half of the participants.
• 39% noticed a reduction in former interests and activities, suggesting the presence of mild anhedonia or decreased motivation during the lockdown period.
• 10% of participants reported that only one or two former interests remained, reflecting a moderate reduction in involvement.
• A small minority (5%) indicated that they had virtually no interest in formerly pursued activities, representing a more severe loss of interest.

The pie chart illustrates responses from 100 participants regarding energy levels and fatigability during the COVID-19 lockdown, as assessed using a questionnaire.

• 37% of respondents reported no change in their usual level of energy, indicating preserved energy levels in over one-third of the participants.
• The largest proportion (44%) reported that they tired more easily than usual, suggesting increased fatigability during the lockdown period.
• 13% of participants indicated that they had to make significant personal effort to initiate or maintain usual daily activities, reflecting moderate impairment in energy and motivation.
• A small minority (6%) reported being unable to carry out most usual daily activities due to lack of energy, indicating severe fatigue with functional impact.

The following findings summarize responses from 100 participants assessing psychomotor changes during the COVID-19 lockdown, as measured through a questionnaire.

Psychomotor Slowing

• A large majority of participants (82%) reported normal speed of thinking, gesturing, and speaking, indicating preserved psychomotor function in most individuals.
• 11% noted slowed thinking and reduced voice modulation, suggesting mild psychomotor retardation.
• A small proportion reported taking several seconds to respond to questions or being largely unresponsive without encouragement, reflecting moderate to severe psychomotor slowing.

Psychomotor Agitation

• 75% of respondents reported no increase in speed or disorganization of thinking or gesturing, indicating absence of psychomotor agitation in most participants.
• 13% reported behaviors such as frequent fidgeting, wringing of hands, or frequent changes in posture, suggestive of mild agitation.
• A small minority described motor restlessness or inability to remain seated, reflecting more severe psychomotor agitation.

The pie chart represents responses from 100 participants assessing suicidal thoughts during the COVID-19 lockdown, as measured through a self-reported questionnaire.

• A clear majority of respondents (84%) reported that they did not think of suicide or death, indicating absence of suicidal ideation in most participants.
• 12% of participants reported that they felt life was empty or not worth living, reflecting passive death wishes or subthreshold suicidal ideation.
• A very small proportion reported thinking of suicide or death several times a week, suggesting intermittent but concerning ideation.
• An extremely small minority reported frequent suicidal thoughts, detailed ideation, or having made specific plans, indicating severe suicidal risk.

Sleep changes during the COVID-19 lockdown were assessed across four domains—sleep onset insomnia, mid-nocturnal insomnia, early morning insomnia, and hypersomnia—based on responses from 100 participants.

• With respect to sleep onset insomnia, 37% of participants reported no difficulty falling asleep, while 32% took at least 30 minutes to fall asleep on fewer than half of nights. A smaller proportion reported persistent difficulty, with 23% taking more than 60 minutes to fall asleep on more than half of the nights, indicating significant problems with sleep initiation.
• For mid-nocturnal insomnia, the majority (67%) reported that they did not wake up during the night. However, 15% experienced restless or light sleep with few awakenings, and another 13% reported waking at least once nightly but returning to sleep easily. A small minority reported frequent awakenings with prolonged wakefulness, suggesting disturbed sleep continuity.
• Regarding early morning insomnia, most participants (81%) reported awakening no more than 30 minutes before the required time on less than half of occasions. Only a small proportion reported consistent early morning awakening, indicating that terminal insomnia was relatively uncommon.
• In terms of hypersomnia, 52% of respondents reported normal sleep duration (7–8 hours per night without naps). However, 37% slept up to 10 hours within a 24-hour period, including naps. A minority reported sleeping longer than 12 hours, reflecting excessive sleep duration in a small subset.

• The majority of participants did not report appetite disturbance, with 65% showing no decrease in appetite and 68% showing no increase in appetite, indicating largely preserved appetite during the COVID-19 lockdown.
• Decreased appetite was reported by 26% of participants in the form of mild reduction in food intake, suggesting that nearly one-third experienced some degree of appetite loss.
• Moderate to severe appetite reduction was observed in only a small proportion of respondents, indicating that clinically significant hypophagia was uncommon in the study population.
• Increased appetite was reported by 26% of participants, reflecting stress-related or emotional eating behaviors during the lockdown.
• Moderate to severe increase in appetite, including frequent overeating, was reported by a very small minority, suggesting that marked hyperphagia was rare.

Weight Decrease

• About 68% experienced no weight change or weight gain, indicating preserved nutritional status in most respondents.
• Approximately 18% felt they had lost some weight, suggesting minor weight fluctuations likely secondary to appetite reduction or illness-related factors.
• Only ~7% reported losing ≥1 kg, and ~7% reported ≥2 kg weight loss, indicating limited severe weight loss.

Weight Increase

• Around 62% reported no weight change or weight loss.
• About 16% felt they had gained some weight, possibly reflecting reduced physical activity or increased caloric intake during lockdowns.
• Roughly 22% combined reported gaining ≥1 kg, with 13% gaining ≥2 kg, indicating modest but meaningful weight gain in a minority.

In the previous study done by Barooah R et al, a substantial disruption in mood, sleep, appetite, and daily routines was reported during lockdown periods [2]. A similar study done by Wang Y et al stated that this was largely attributed to stress, uncertainty, and lifestyle changes [5]. In the present study, mood changes were common but predominantly mild, with most participants reporting transient sadness rather than persistent depressive symptoms. This corresponds with findings reported in community-based studies conducted during the pandemic [2]. 

In the current study, sleep disturbances emerged as one of the most affected domains. This was consistent with earlier studies that describe sleep disruption as a sensitive indicator of psychological distress during lockdown periods [2]. Similarly, the present study also showed that 26% of participants reported a decreased appetite, while 26% reported an increased appetite, indicating that a major group of respondents experienced appetite dysregulation. Weight changes during lockdown have been reported in earlier studies, with weight gain ranging from 25–40% and weight loss reported in 15–30% of participants. The present study demonstrated comparable findings, with approximately 38% reporting weight gain and around 32% reporting weight loss, reflecting bidirectional weight changes likely mediated by altered appetite, physical activity, and lifestyle patterns. This corresponds with prior evidence found in the study conducted by Xiong J et al, which attributed changes in appetite and decreased physical activity during the lockdown [1].

However, severe psychomotor disturbances and suicidal ideation were uncommon in the current study. About 80% of participants exhibited normal psychomotor activity, and only a small proportion reported mild slowing or agitation. Similarly, suicidal ideation was absent in the majority (84%), with passive death wishes reported by 12% and active or severe ideation being rare. This was in contrast with higher severity reported in some earlier studies that was conducted by Wang Y et al [5]. In contrast to previous studies from other countries that reported significant psychological burden during the pandemic, the present study observed mainly mild to moderate symptoms, indicating potential differences related to population characteristics, context, and adaptive coping mechanisms.

LIMITATIONS

Despite providing valuable insights into the psychological impact of the COVID-19 pandemic, the present study has certain limitations. First, the use of a self-reported questionnaire may have introduced response bias, including underreporting or overreporting of symptoms such as appetite, sleep, and weight changes. Second, the cross-sectional and retrospective design limits causal inference and may be influenced by recall bias, particularly as participants were asked to reflect on experiences during an earlier phase of the pandemic. Third, the sample size was relatively modest. Additionally, the absence of pre-pandemic baseline data restricts direct comparison of symptom severity before and during COVID-19. Finally, objective measures (e.g., clinical interviews, actigraphy for sleep, or measured weight) were not employed, which may have limited the precision of symptom assessment.

The study findings indicate that the COVID-19 pandemic exerted a multidimensional impact on mental health, affecting emotional, cognitive, behavioral, and somatic domains. While most participants reported minimal symptoms, a significant minority experienced mild to moderate psychological distress, reflecting varied mental health responses.

Affective and cognitive symptoms such as low mood, reduced interest, impaired concentration, and negative thoughts were common, whereas severe manifestations were infrequent. Psychomotor changes were largely mild, with preserved activity levels in most respondents. Sleep and appetite disturbances were frequent, though severe appetite or weight changes were uncommon.

Overall, the pandemic was associated predominantly with mild to moderate distress rather than severe psychiatric morbidity, suggesting resilience and adaptive coping in the majority. These findings emphasize the importance of early identification and targeted preventive mental health interventions during public health crises.

1. Xiong J, Lipsitz O, Nasri F, et al. Impact of COVID-19 pandemic on mental health in the general population: A systemic review. Journal of Affective Disorders 277 (2020) 55-64.
2. Barooah R, S S, Tasneem Z, et al. The effect of Lockdown on Physiological Parameters of Sleep, Diet, Bowel Movement, Physical Activity and Menstrual Cycle of Individuals Residing in Northeast India. Cureus 17 (4): e81651. DOI 10.7759/cureus.81651.
3. Ladole C, Takalkar K. The Impact of the COVID-19 Pandemic on Mental Health Among the General Population: A Narrative Review. Journal of Clinical and Diagnostic Research. 2023 Sep, Vol-17(9): VE01-VE06.
4. Ahmed M, Ahmed O, Aibao Z, et al. Epidemic of COVID-19 in China and associated Psychological Problems. Asian Journal of Psychiatry 51 (2020) 102092.
5. Wang Y, Di Y, et al. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychology, Health & Medicine, DOI: 10.1080/13548506.2020.1746817