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It is unclear about the mutual impact of COVID-19 related psychological stress and infection on mental health of adolescent and youth students. This study aimed to explore the mutual impact of COVID-19 related psychological stress and infection on mental health problems among students. This study was conducted from December 14, 2022 to February 28, 2023 in Sichuan, China. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, PTSD Checklist for DSM-5, Insomnia Severity Index, and Internet Addiction Test were used. Participants were grouped by COVID-19 infection and psychological stress level. The differences among groups were compared, and logistic regression analysis was used to investigate risk factors for depression, anxiety, PTSD and insomnia among groups. Of 90,118 participants, 82,873 (92.0 %) finished the questionnaires and were included in the study. Of 82,873 participants, 33,314 (40.2 %) reported to be infected with COVID-19. Participants had depression symptoms (38.1 %), anxiety symptoms (31.8 %), PTSD (33.9 %), insomnia (34.0 %), and internet addiction (60.3 %). Compared with participants uninfected with low psychological stress level, the risk for symptoms of depression, anxiety, PTSD and insomnia increased by 9.6 %, 12.3 %, 6.6 %, and 12.0 % in participants infected with low psychological stress level (p < 0.001), 106.8 %, 125.9 %, 125.2 %, and 95.7 % in participants uninfected with high psychological stress level (p < 0.001), and 147.3 %, 161.1 %, 158.7 %, and 141.0 % in participants infected with high psychological stress level (p < 0.001). This study is a cross-sectional design, and no causal associations should be inferred. Infection status was based on self-report of participants with infectious symptoms. COVID-19 related psychological stress and infection per se have mutually overlapping impacts on mental health problems among students. Further health policies and psychosocial interventions should be developed to reduce mutually overlapping impact and improve the long-term mental health among students. • It is unclear about the mutual impact of COVID-19 infection and psychological stress on individuals' mental health • This study supports the mutual overlapping theory (MOT) of COVID-19 infection and psychological stress • The overlap of COVID-19 infection and psychological stress may cause more severe mental health problems • Health policies and interventions should be developed for reducing the impact of infection and psychological stress [ABSTRACT FROM AUTHOR]

Gender differences in mental health emerge in adolescence. The timing coincides with the development of premenstrual disorders (PMDs). Here, we examine the association between PMDs and adolescent mental health in the context of gender differences. A cross-sectional analysis comprising 21,239[10,563 (49.7 %) girls] individuals aged 10–19 years from the Santai Youth Mental Health Promotion Cohort in China. Possible PMDs, major depression disorder (MDD), general anxiety disorder (GAD), history of self-injury, and high suicide-risk status were surveyed using standard questionnaires. We used logistic regression to contrast the prevalence of outcomes between girls with and without PMDs, and boys. The prevalence rates of possible MDD and GAD were comparable between girls without PMDs and boys [OR1.03 (0.96–1.11) and 0.99 (0.92–1.07)], whereas a higher burden was observed in girls with PMDs [OR4.76(4.31–5.26) and 3.86(3.50–4.27), respectively]. Moreover, MDD/GAD prevalence among premenarchal girls was comparable to their peer boys. Greater gender differences in self-injury and high suicide-risk status were also found for girls with PMDs [OR 4.70 (4.22–5.24) and 7.49 (6.6–8.5)] than that for girls without PMDs [OR1.45(1.33–1.59) and 1.81 (1.62–2.03)]. Girls with PMDs may have overreported depressive and/or anxiety symptoms due to the overlap of symptomology. The greater gender differences in adolescent mental ill-health among girls with PMDs lend support to the hypothesis that PMDs play an important role in the gender disparities in adolescent mental health, particularly in depression and anxiety. • The gender differences in mental health are well-documented in adolescence; yet the determinants are poorly understood. • The development of premenstrual disorders (PMDs) highly coincides the emergence of gender differences in depression/anxiety in adolescence. • PMDs may play an important role in the well-known gender disparities in adolescent mental health. • If confirmed in prospective data, prevention strategies for PMDs should be developed to reduce the gender disparity in mental health. [ABSTRACT FROM AUTHOR]