Trajectories of Depressive Symptom Among College Students in China During the COVID‐19 Pandemic: Association With Suicidal Ideation and Insomnia Symptoms

Despite the burgeoning literature on mental health problems during the COVID-19 pandemic, little is understood about the heterogeneous developmental trajectories of depressive symptoms and their subsequent mental health outcomes. This three-year, five-wave longitudinal study aimed to identify distinct trajectories of depressive symptoms among Chinese college students during the COVID-19 pandemic. We further examined the impact of these different trajectories on suicidal ideation and insomnia symptoms. Participants included 1387 Chinese college students (27% male, average age = 19.24, SD = 0.99) from a five-wave longitudinal online survey. Data were analyzed using Growth Mixture Modeling (GMM), a person-centered approach, to identify distinct symptom trajectories. Five distinct trajectories of depression were identified: resilient (24.01%), moderate-remission (46.27%), low-increasing (19.68%), high-recover (5.55%), and moderate-increasing (4.35%). The analysis demonstrated that these trajectories of depression symptoms effectively predicted changes in suicidal ideation and insomnia symptoms over time. These findings highlight the significant heterogeneity of depression trajectories among Chinese college students and their strong association with critical mental health outcomes. The results suggest that individuals following increasing-symptom trajectories are at particular risk for negative outcomes like suicidality and sleep disturbances. Therefore, mental health service workers should not only focus on individuals' temporary state of depression but also monitor shifts in their depressive symptoms over time. Early identification of adverse trajectories can inform targeted interventions to mitigate the risk of severe outcomes like suicidal ideation and insomnia.