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Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study
Open accessAbstract
Background: The COVID-19 pandemic is found to affect the mental health of the population. Undergraduate medical students are especially prone to mental health disorders and hence could be more vulnerable to the impact of the pandemic. Methods: A prospective longitudinal study was conducted on 217 undergraduate medical students in a medical college at Chennai, India. Depression, anxiety, and stress levels were recorded using Depression Anxiety Stress Scale 21 Items (DASS21) before and during the COVID-19 outbreak in India in December 2019 and June 2020, respectively. In the follow-up survey, in addition to DASS21, the Pittsburgh Sleep Quality Index to assess sleep quality and a self-administered questionnaire to assess the impact of COVID-19 related stressors were used. The self-administered questionnaire assessed the status of COVID-19 testing, interactions with COVID-19 patients, self-perceived levels of concerns and worries related to academics (COVID-19-AA (academic apprehensions)) and those pertaining to the self and family/friends (COVID-19-GA (general apprehensions)). Cross-sectional and longitudinal comparison of overall scores of depression, anxiety, and stress and scores stratified by gender, year of study, place of residence and monthly family income were performed. Predictors for depression, anxiety, and stress during COVID-19 were investigated using adjusted binary logistic regression analysis and results were expressed as adjusted odds ratio with 95% confidence interval (CI). A P value < 0.05 was considered statistically significant. Results: The average scores of depression, anxiety, and stress during the baseline survey were 7.55 ± 7.86, 4.6 ± 6.19 and 7.31 ± 7.34 with the prevalence (95% Cl) of 33.2% [27–39.9%], 21.2% [16–27.2%] and 20.7% [15.5–26.7%]; in follow-up survey, the mean scores were 8.16 ± 8.9, 6.11 ± 7.13 and 9.31 ± 8.18 with the prevalence being 35.5% [29.1–42.2%], 33.2% [27–39.9%] and 24.9% [19.3–31.2%] for depression, anxiety, and stress respectively. There was a significant increase in both the prevalence and levels of anxiety and stress ( P < 0.001), with depression remaining unchanged during COVID-19, irrespective of gender, year of study, place of residence and family’s monthly income. Poor sleep quality, higher levels of baseline depression, anxiety, and stress, higher COVID-19-GA, COVID-19 patients in family/friends and direct interactions with COVID-19 patients were found to be significant predictors of negative mental health in undergraduate medical students. COVID-19-AA was not significantly associated with depression, anxiety, and stress. Conclusion: The COVID-19 pandemic appears to negatively affect the mental health of the undergraduate medical students with the prevalence and levels of anxiety and stress being increased, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population is crucial.
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“Moreover, Covid-19 has had a drastic impact on the population’s mental health [40–43], including medical students [44–48].”
From Effectiveness of online mindfulness interventions on medical students’ mental health: a systematic review (2021) · cites this paper as [48]
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- Sartorao Filho, 2020, Impact Of covid-19 pandemic on mental health of medical students: a cross-sectional study using GAD-7 and PHQ-9 questionnaires, MedRxiv, 10.1101/2020.06.24.20138925 · DOI
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Metadata
- Authors
- Saraswathi, I., Saikarthik, J., Senthil Kumar, K., Madhan Srinivasan, K., Ardhanaari, M., & Gunapriya, R.
- Affiliations
- Department of Physiology, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India
- Department of Basic Medical Sciences, Majmaah University, Ar-Riyadh, Saudi Arabia
- Department of General Medicine, Madha Medical College and Research Institute, Chennai, Tamil Nadu, India
- Department of Psychiatry, Meenakshi Medical College Hospital and Research Institute, Enathur, Tamil Nadu, India
- Department of Anatomy, Saveetha Medical College Hospital, Thandalam, Tamil Nadu, India
- Venue
- PeerJ
- Publisher
- PeerJ
- Published
- 2020-10-16
- Volume
- 8
- Pages
- e10164
- ISSN
- 2167-8359 (ISSN-L)
- PMC
- PMC7571415
- OpenAlex
- W3093298644
- Cited by
- 608
- References
- 71
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 244 · 2023: 67 · 2022: 167 · 2021: 97 · 2020: 2
- FWCI
- 33.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PeerJ (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Greater South Information System
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Keywords
- COVID-19 pandemic, mental health, undergraduate medical students, depression, anxiety, stress, sleep quality, gender differences, predictors of depression, DASS-21, Pittsburgh Sleep Quality Index, medical education during pandemic
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