*1.2. The Study: Aims and Scope*

Such evidence suggests the need to prioritize students' mental health [27] and that the psychological health of university students impacted by the pandemic should be taken seriously. Sapienza University of Rome has offered online psychological support to its students in the wake of this emergency. Online therapy represents the best way to help students facing psychological and emotional problems due to the pandemic and the consequence of routine disruption [28]. In addition to a counselling service, students could also join the NoiBene program. NoiBene is a web-based intervention to promote psychological well-being and prevent psychological distress by developing a series of competencies (i.e., life skills) and reducing dysfunctional coping strategies. Before the pandemic, NoiBene had already been used, and analyses showed its effectiveness in promoting psychological well-being and reducing dysfunctional coping strategies among university students [29]. To deal with COVID-19-related stress, modules about loneliness, relaxation techniques, breathing exercises, and mindfulness were added. Moreover, the intervention included individual weekly meetings with a tutor, a psychologist that supervised the program. The tutor aimed to monitor the online program's progress, provide answers to any questions that the students might have about the exercises, and give support for any issues concerning the quarantine.

The present study aims to provide an explorative and descriptive overview of the symptomatology and help-seeking behaviour of students included in NoiBene between March 2019 and March 2021. The Ethical Committee of the Department of Psychology, Sapienza University of Rome, approved the NoiBene protocol. We hypothesized that the following restrictions had impacted the individuals' psychological health as well as the first quarantine. We divided students into three phases: (a) March 2020–May 2020 (Quarantine Phase); (b) October 2020–December 2020 (Second Phase); (c) January 2021–March 2021 (Third Phase). The quarantine phase was characterized by the most stringent lockdown and by a gradual reopening. During the second phase, after an increase in transmission, the government imposed new restrictive measures such as the mandatory use of masks (including outdoors), the prohibition of gatherings of more than a certain number of

people, and a nationwide night curfew. Moreover, the government classified regions into three areas corresponding to three risk scenarios. Lastly, during the third phase, besides previous rules that were maintained, a specific national quarantine was imposed during the national holidays (Table 1). Therefore, we compared clinical symptomatology between students Before COVID with students gathered in the three phases (Quarantine Phase, Second Phase, Third Phase). We formulated a series of research hypotheses based on the specific restriction measures in the different phases, the evolution of the pandemic, and the increasing knowledge about COVID-19 (including the origin of the virus, its transmission, and the mechanisms to stop its spread).

Considering that the COVID-19 quarantine significantly limited social interaction, thereby increasing feelings of loneliness [30,31], we expected that students' depressive symptomatology and relational problems during the first quarantine were higher than those of students in the other groups. Moreover, considering the high level of uncertainty regarding health and economic issues during the quarantine and the uncertainty about the evolution of the pandemic, we expected that anxiety symptomatology during the first quarantine was higher than anxiety symptomatology during the other phases [32]. Lastly, we expected that students' distress was higher than the Second Phase but lower than the Quarantine Phase during the Third Phase. Indeed, in the Third Phase, people brought with them a year of restriction and suffering. Moreover, the beginning of the vaccination campaign promoted hope and a more positive perspective of change but, on the other hand, was associated with fear and uncertainty regarding its efficacy [33,34].
