Prevalence of anxiety and depression during COVID-19 pandemic among healthcare students in Jordan and its effect on their learning process: A national survey

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Loneliness during the post-confinement period: The significance of social living conditions for stress biomarkers and memory

In the aftermath of the COVID-19 lockdown, concerns about the impact of loneliness and reduced social interactions on mental health have arisen. This study explored the repercussions of post-lockdown social restrictions across psychological (loneliness, perceived stress, and depressive symptoms), biological (hair cortisol and cardiovascular activity), and cognitive dimensions (subjective memory complaints and working, declarative, and prospective memory), with a specific emphasis on perceived loneliness and the living situation. The study included 45 students: 23 (mean age = 25.69 years) in the Alone Group (AG), who experienced significant family changes and international relocation, and 22 (mean age = 25.50 years) in the Not Alone Group (NAG), who maintained their nuclear family and did not move from their home country. We assessed heart rate variability (HRV) before, during, and after immediate memory evaluations using time-domain (the square root of the mean, RMSSD) measures. The analysis revealed no significant group differences in telematic contact with family and friends, perceived stress, or depression. However, the AG participants reported fewer face-to-face interactions and greater perceived loneliness compared to the NAG. Additionally, the AG group exhibited slightly higher hair cortisol levels and worse working memory (WM) and prospective memory (PM) performance. Importantly, no significant associations were observed between memory outcomes and stress biomarkers. However, a significant interaction effect of loneliness in the relationship between hair cortisol levels and PM was found. That is, hair cortisol concentrations were negatively related to PM when participants perceived high and moderate loneliness. This interaction was absent in the working and declarative memory domains. In summary, these findings underscore the intricate interplay between loneliness, cortisol, and memory, emphasizing the need for comprehensive research on the complex mechanisms governing these multifaceted relationships.

Sociodemographic determinants of depression, anxiety, and stress immediately after the COVID-19 pandemic: a cross-sectional study among university students in Saudi Arabia

Background

The public health measures taken in educational institutions during the COVID-19 pandemic had complex influences on students' mental health. This study aimed to evaluate the prevalence and sociodemographic determinants of Depression, Anxiety, and Stress immediately after the COVID-19 pandemic among students at Qassim University, Saudi Arabia.

Methods

We conducted a cross-sectional study among Qassim University students in Saudi Arabia. All students registered for the academic year 2022 were invited to participate in a survey through social media. A total of 453 participants completed an online survey that included the DASS-21 for assessing the emotional states of Depression, Anxiety, and Stress..

Results

The mean scores for Depression, Anxiety, and Stress, were 10.70, 11.18, and 10.40, respectively. At least 18% of the students reported experiencing moderate-to-severe levels of Depression, Anxiety, and Stress. The study showed that the feminine gender was associated with higher Depression, Anxiety, and Stress scores.

Conclusion

Students in the current study described experiencing higher levels of Depression, Anxiety, and Stress during the COVID-19 pandemic. The findings of the present study can help universities take targeted measures to address the impact of a pandemic like COVID-19 on students' mental health.

Depression and Anxiety among Undergraduate Health Science Students: A Scoping Review of the Literature

Background: Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population. In light of this, this scoping review aims to identify, document, and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research. Methods: This scoping review was planned and executed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL, and PubMed. Results: From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity, and family history, personal health conditions, and academic and socioeconomic issues. Conclusions: With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students.

Mediating effect of self-esteem on the relationship between academic self-efficacy and depression symptoms among nursing students participating in blended learning

Background

Blended learning, which comprises a combination of online and classroom-based activities, in nursing education can cause significant academic stress and depression symptoms among students. However, self-esteem may mediate the relationship between academic self-efficacy and depression symptoms. Studies of the relationship between academic self-efficacy, self-esteem, and depression symptoms among nursing students participating in blended learning are limited.

Objectives

To examine the determinants of depression symptoms and the mediating effect of self-esteem on the relationship between academic self-efficacy and depression symptoms among nursing students who participate in blended learning.

Design

Cross-sectional study using convenience sampling.

Settings

Ten universities across five provinces and two major Indonesian islands.

Participants

A total of 534 undergraduate nursing students with a mean age of 20.30 years (standard deviation, ±1.36 years).

Methods

An online survey was conducted between April and August 2022 to collect data from 10 universities applying blended learning. The study instruments included the General Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and a 9-item Patient Health Questionnaire. Data were analysed by hierarchical linear regression using PROCESS macro version 4.1.

Results

Of the 534 participants, 213 (39.14 %) experienced moderate-to-severe depression symptoms. Two variables, online learning difficulties (β = 0.10; p = .012) and self-esteem (β = -0.40; p < .001), were significant determinants of depression symptoms. Self-esteem mediated the relationship between academic self-efficacy and depression symptoms.

Conclusions

It is necessary to understand the online learning difficulties experienced by blended learning students and improve their self-esteem by maximising academic self-efficacy to prevent depression symptoms.

Depression, Anxiety, and Stress Among Medical Students During COVID-19 at Sultan Qaboos University in Oman

Introduction With the spread of COVID-19 around the world, several interventions have been reported to be useful to control disease transmission. However, the impact of the pandemic on the mental health of medical students is underreported in the Arab world. This study aimed to explore the rates of depression, anxiety, and stress among medical students at Sultan Qaboos University (SQU) and to identify the factors associated with a higher risk of these mental disruptions. Method This was a cross-sectional study where medical students were approached to answer an online questionnaire via emails from the administrative affairs in the College of Medicine in SQU from 16/01/2021 to 18/05/2021. A 21-item depression, anxiety, and stress (DASS-21) scale was used as a self-reporting tool to measure the negative feelings of depression, anxiety, and stress. Results Out of 700 students, 184 (26.3%) students responded fully to the study questionnaire. More than half of the participants were females (58.7%, n=108), and the mean (SD) age was 20.31 (1.642). Most students were Omani (93.5%, n=172), and 34.2% (n=63) lived in Muscat. More than half of the students (51.6%) were in phase 2 of the academic years, in which the majority were considered within the cohort ≥2017 (81%, n=149), with a mean (SD) GPA of 2.9 (1.5). Scores from the DASS-21 scale showed that 29.4% vs 27.2% vs 14.7% had extremely severe depression vs anxiety and vs stress. The proportion of students who reported lower GPAs was significantly associated with higher scores of severe-to-extremely-severe depression (P=0.001), anxiety (P=<0.001), and stress (P=0.001). Living in Muscat vs other regions was associated with severe anxiety and stress (P=0.038 and P=0.007, respectively). Conclusion Similar to a few studies in Oman, this study confirms the high rates of depression, anxiety, and stress among medical students during the COVID-19 pandemic. Results may be utilized to alert decision-makers, student academic council, and academic authority to the need to adopt a preventive mental health policy and design guidelines with resilience measures for college students, including prolonged cognitive-behavioral interventions and recovery programs.

Physical Activity Reduces Depression among Healthcare Workers during the COVID-19 Pandemic in Jordan

Aims

This study aimed to assess mental health status by measuring depression and investigating the effect of physical activity in lessening the mental health burden among HCWs during the COVID-19 pandemic in Jordan.

Background

The COVID-19 pandemic has caused distress and depression among healthcare workers and drastic disruptions in social, economic, and health systems worldwide.

Methods

A cross-sectional online study through google forms involved HCWs across Jordan for two months. The 10-item short form of the Center for Epidemiological Studies Depression Scale Revised (CESD-R10) was used to assess depressive symptoms.

Results

The total sample was 295, females were 50.5% with mean age of 33.1 (>80% less than 40 years old), married 51.9%, 63% were physicians, 88.1% had contact with patients, and 64.7% were smokers. Depression symptoms were perceived by 59.3% of the total samples (53.1).

Conclusion

During the COVID-19-induced nationwide lockdown in Jordan, HCWs who engaged in enough physical exercise reported fewer depressive symptoms. Promoting physical exercise among HCWs may lead to better results for their mental health. Various clinical implications support promoting designated time and space for physical activity at work.

Anxiety and associated factors among Vietnamese students during COVID-19 pandemic: A cross-sectional study

Mental health care for students in general, particularly anxiety, is a significant problem that needs more attention, especially during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to describe the prevalence of anxiety and examine the associated factors among students during the COVID-19 pandemic in Vietnam. A cross-sectional study was conducted from August to September 2021 among 5730 students. An online survey was used to collect sociodemographic information, and the generalized anxiety disorder questionnaire (GAD-7) was used to assess anxiety symptoms among Vietnamese students. Results showed that the prevalence of anxiety among study participants was 16.2% (95% confidence interval [CI]: 15.3%-17.2%). Factors related to anxiety among students were gender, type of housemate, COVID-19 exposure/infection status, vaccination status, health status, academic performance, and social relationships during the COVID-19 pandemic. A significant number of students experienced anxiety during COVID-19, and this rate was related to several factors. Psychological interventions are required to support students during and after the COVID-19 pandemic and other health crises. Further studies are required to confirm our findings.

Internet Addiction and Online Gaming Disorder in Children and Adolescents During COVID-19 Pandemic: A Systematic Review

The Indonesian government has enforced several social restrictions to prevent the spread of the coronavirus disease-2019 (COVID-19) virus, such as closures of in-person schools, public areas, and playgrounds as well as reduced outdoor activities. These restrictions will affect mental health of school-age children and adolescents. The internet is chosen as one of the media to keep academic activities running, but excessive internet use will increase internet addiction and online gaming disorder. This study aimed to understand the prevalence and psychological impacts of internet addiction and online gaming disorder on children and adolescents globally during the pandemic. Systematic searches were carried out on the PubMed, ProQuest, and Google Scholar search engines. All studies were assessed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 criteria and the Newcastle Ottawa Scale. Five studies met the criteria for assessing internet addiction and online gaming disorder cases in children and adolescents. Four studies discussed internet addiction, and one study addressed the negative impacts of online gaming on children and adolescents during the COVID-19 pandemic. There has been an increase in internet use and online gaming disruption in children and adolescents in almost all parts of Asian and Australian countries during the COVID-19 pandemic period.

Social Media, Anxiety and COVID-19 Lockdown Measurement Compliance

The aim of the present research was to analyze the effect of anxiety levels during the COVID-19 pandemic in the use of social media and compliance with lockdown measures during the confinement. A total of 1723 participants (32.1% males and 77.9% females; 32.6 ± 9.2 years) were interviewed by a Spanish version of the Spielberger State-Trait Anxiety Inventory. From the results obtained, the sample was divided into two 50th percentile groups, a high anxiety group (HAG) and a low anxiety group (LAG). We found how the LAG had lower use of social networks such as Facebook and Twitter during confinement. Also, this group presented a higher rate of leaving home during the confinement and higher values in people with whom they had lived with during confinement than high anxiety group. Regardless of the lack of results in the remaining variables, the present study nuances the high levels of anxiety experienced during COVID-19 confinement. The multifactorial analysis of factors related to the perception of anxiety during COVID-19 confinement may be a useful tool to measure multiple social behaviors when examining mental health factors. Thus, explaining and preventing the psychological consequences of the COVID-19 pandemic. The present knowledge could be used to determine key intervention factors for reducing the perception of fear and anxiety.

Health worker education during the COVID-19 pandemic: global disruption, responses and lessons for the future-a systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis identified early evidence quantifying the disruption to the education of health workers by the COVID-19 pandemic, ensuing policy responses and their outcomes.

METHODS

Following a pre-registered protocol and PRISMA/AMSTAR-2 guidelines, we systematically screened MEDLINE, EMBASE, Web of Science, CENTRAL, clinicaltrials.gov and Google Scholar from January 2020 to July 2022. We pooled proportion estimates via random-effects meta-analyses and explored subgroup differences by gender, occupational group, training stage, WHO regions/continents, and study end-year. We assessed risk of bias (Newcastle-Ottawa scale for observational studies, RοB2 for randomized controlled trials [RCT]) and rated evidence certainty using GRADE.

RESULTS

Of the 171 489 publications screened, 2 249 were eligible, incorporating 2 212 observational studies and 37 RCTs, representing feedback from 1 109 818 learners and 22 204 faculty. The sample mostly consisted of undergraduates, medical doctors, and studies from institutions in Asia. Perceived training disruption was estimated at 71.1% (95% confidence interval 67.9-74.2) and learner redeployment at 29.2% (25.3-33.2). About one in three learners screened positive for anxiety (32.3%, 28.5-36.2), depression (32.0%, 27.9-36.2), burnout (38.8%, 33.4-44.3) or insomnia (30.9%, 20.8-41.9). Policy responses included shifting to online learning, innovations in assessment, COVID-19-specific courses, volunteerism, and measures for learner safety. For outcomes of policy responses, most of the literature related to perceptions and preferences. More than two-thirds of learners (75.9%, 74.2-77.7) were satisfied with online learning (postgraduates more than undergraduates), while faculty satisfaction rate was slightly lower (71.8%, 66.7-76.7). Learners preferred an in-person component: blended learning 56.0% (51.2-60.7), face-to-face 48.8% (45.4-52.1), and online-only 32.0% (29.3-34.8). They supported continuation of the virtual format as part of a blended system (68.1%, 64.6-71.5). Subgroup differences provided valuable insights despite not resolving the considerable heterogeneity. All outcomes were assessed as very-low-certainty evidence.

CONCLUSION

The COVID-19 pandemic has severely disrupted health worker education, inflicting a substantial mental health burden on learners. Its impacts on career choices, volunteerism, pedagogical approaches and mental health of learners have implications for educational design, measures to protect and support learners, faculty and health workers, and workforce planning. Online learning may achieve learner satisfaction as part of a short-term solution or integrated into a blended model in the post-pandemic future.

Moderation of the association between COVID-19-related income loss and depression by receipt of financial support: Repeated cross-sectional surveys of young adults in Canada and France (2020-2021)

Background

To mitigate the adverse effects of the COVID-19 pandemic on financial resources, governments and family/friends mobilized financial support interventions (e.g., emergency aid funds) and assistance. However, little is known about how financial assistance alleviated mental health problems. This study aimed to investigate the moderating effect of financial support from the government or from family/friends on the association between income loss and depression among young adults.

Methods

Two online cross-sectional surveys among young adults ages 18-29 living in Canada and France were conducted in 2020 (n = 4,511) and 2021 (n = 3,329). Moderate-to-severe depressive symptoms were measured using the Patient Health Questionnaire-9 (cut-off score: ≥10). Two logistic regression models were performed for each survey with an interaction term between income loss and financial support (government or family/friends modeled separately), controlling for demographics.

Results

Overall, half reported depressive symptoms (2020/2021: 53.5%/45.6%), and over a third lost income (2020/2021: 10.2%/11.6% all income, 37.7%/21.6% some income). In 2020, 40.6% received government financial support (17.7% in 2021) while family/friends support was received by 12% (in both surveys). In both surveys, among those who received governmental financial support, income loss was associated with depression, whether participants lost all their income (e.g., 2020: Adjusted Odds Ratios (AOR) 1.75, 95% Confidence Interval [1.29-2.44]), or some of their income (e.g., 2020: AOR 1.45 [1.17-1.81]). However, among those who received family/friends financial support, income loss was no longer significantly associated with depression in both cycles, whether participants lost all their income (e.g., 2020: AOR 1.37 [0.78-2.40]), or some of their income (e.g., 2020: AOR 1.31 [0.86-1.99]).

Conclusions

Association between income loss and depression was moderated by receipt of family/friends financial support but not by receipt of government financial support. Financial support interventions may help to mitigate the negative effects of income loss on young adults mental health during periods of economic crisis.

Assessing Anxiety and Depression Among Students Post-COVID-19: Exploring Associating Factors

Background

The COVID-19 pandemic has had a large impact on global mental health including anxiety and depression rates, many factors affected the vulnerability to these psychological conditions amongst university students.

Aim

To explore the level of anxiety and depression of university students living in Jordan.

Methods

A cross-sectional study design was conducted in which an electronic survey was created and distributed, university students residing in Jordan participated in the study.

Results

A total of 1241 students were enrolled in the study. The mean anxiety score among males and females was (9.68 (SD = 4.10)) and (10.46 (SD = 4.14)), respectively. 42.1% of males had "abnormal" anxiety score compared to 48.4% females. The mean depression score among males (7.77 (SD = 4.31)) was similar to that for the females (7.64 (SD = 4.14)), and 26.0% of the males had "abnormal" depression score compared to 22.6% of the females. Factors affecting anxiety scores included younger age, being a female, taking medication/s, or drinking two cups of coffee or more a day.

Conclusion

With 46% and 24% of students suffering from abnormal anxiety and depression respectively, it is important for education policy makers to take immediate measures to allocate students in need of psychological assessment and help to deliver suitable interventions.

Social Health and Psychological Safety of Students Involved in Online Education during the COVID-19 Pandemic

Our paper focuses on the issues of social health and psychological safety of university students involved in digital sustainable education during the COVID-19 pandemic. Currently, modern education is becoming inclusive due to the advancements in information and communication technologies (ICT), and it is important not only to stress the relevance of sustainable development and the use of digital technologies, but also their impact on students at schools and universities worldwide. Digital literacy is a newly emerging feature that results from the attitude of team members in the field of digital technologies. This paper explores the impacts of the COVID-19 pandemic on students' learning and well-being and outlines the potential considerations for educational systems as they support students through the recovery period and beyond. Our study is based on the results of our own survey that was administered using a snowball and convenient sample of 1524 respondents (aged 19-26 years; 56.2% females and 43.8% males) from the Czech Republic (N = 804) and Russia (N = 720). We employed the ANOVA and Dirichlet Process mixtures of Generalized Linear Models (DP-GLM) in order to explain the causes of stress and anxiety after grouping variables represented by gender and the study specializations. Our results demonstrate that more than 87% of the students in the sample expressed a medium to high vulnerability to stress, while 58% of the respondents were affected by severe anxiety during their online education engagement. The most important factors that emerged as significant were the fear of getting infected and social distancing, while the best strategy to cope with the stress was self-control. These results allow us to provide practical recommendations for effectively coping with and controlling stress and anxiety among students in the post-pandemic era. In addition, our findings might contribute considerably to the study of the overall long-term effect of the COVID-19 pandemic on the university students, in general, and the use of digital technologies in higher education, as well as on the public health.

Prevalence of mental health problems among stranded international students during the COVID-19 pandemic

BACKGROUND

The novel coronavirus disease (COVID-19) spread fast throughout China and the rest of the world, prompting the World Health Organization to declare a worldwide pandemic on March 11, 2020. Many countries have implemented travel bans, lockdowns, and stay-at-home policies to combat the spread of the COVID-19 pandemic. This study aimed to investigate the risk factors of mental health problems among international students stranded outside of China during the pandemic.

METHODS

A qualitative study was conducted among non-Chinese international students enrolled at Chinese universities who were stranded in their home countries. The participants were recruited using a purposive sampling technique. Following informed consent, in-depth interviews were conducted with the help of a semi-structured guide. Two independent investigators transcribed and coded the interview data. The investigators established themes after going through a detailed discussion.

RESULTS

Participants reported several mental health risk factors, such as a rise in hopelessness and level of uncertainty, worry, lost interest and focus, lack of support, unemployment and financial hardships, social pressure, behavioral and mood changes, sleep disorder, and increased smoking. These mental health problems will affect the concentration and deep learning, thereby increasing academic stress. In addition, we found that the outbreak of the delta-variant led to a further increase in these mental health risk factors.

CONCLUSIONS

The pandemic scenario, along with international travel restrictions, increased the likelihood of mental health problems among stranded international students. Thus, preventing further rises in mental health disorders and reducing the effects of pandemic-related measures on stranded international students, such as researchers and policymakers can mitigate the pandemic's effects and achieve national or international health and educational goals. Adequate intervention for this group is strongly recommended.

Pharmacy Students' Mental Health and Resilience in COVID-19: An Assessment after One Year of Online Education

COVID-19 has impacted mental health and affected education due to the shift to remote learning. The purpose of the current study was to assess the mental health of pharmacy students one year following the onset of the pandemic. A descriptive cross-sectional questionnaire was distributed to pharmacy students. The severity of depression, anxiety, and stress was assessed by the Depression Anxiety Stress Scale (DASS-21), and resilience was assessed by the Brief Resilience Scale (BRS). COVID-19-related economic, educational, and health stressors, and students’ vaccine attitudes were surveyed. Descriptive, bivariate, and multivariable analysis were used, and a p-value of <0.05 was considered significant. A total of 561 students participated; 37% had mild-to-moderate depression, 37% had severe-to-extremely-severe anxiety, and 52% demonstrated normal stress levels. Severe depression, anxiety, and stress were associated with smoking and feeling isolated due to COVID-19. Around 40% of students had low resilience, associated with smoking, being in the third or fourth year of pharmacy study, and the consumption of caffeinated beverages. The mean score of satisfaction with online learning was 60.3 ± 21.3%. Only 5% of participants were vaccinated, of which 87% trusted the benefits of vaccines and their role in controlling the pandemic. One year after the onset of COVID-19, depression, anxiety, stress, and low resilience were observed among pharmacy students; the investigation of the long-term mental effects of the pandemic on university students is warranted.

Mental Health and Physical Activity of Female Higher Education Students during the COVID-19 Pandemic: A Comparative Cross-Sectional Study from Lithuania

During emerging adulthood (EA), higher education medical students undergo a higher risk of anxiety and depression compared to the general population. The aim of this comparative cross-sectional study was to compare the proportions of three mental disorders, namely anxiety, depression and somatisation in terms of their symptoms and self-reported physical activity (PA) levels across the cohorts of biomedical and non-biomedical female students as well as to assess the association between the mental health outcomes and PA use. Between September 2021 and January 2022, a total of 1231 female higher education students aged between 18 and 29 years old were recruited for the study. Severe symptoms of anxiety and depression, as well as unexplained somatic complaints, were suffered by 51.9%, 11% and 23% of female students, respectively. Non-biomedical female students, compared to medicine and health sciences students, were more vulnerable due to the increased prevalence of negative mental health outcomes. The relationship between increased sports activity as a potential trigger for mental well-being and decreased severity of depressive symptoms was identified in the cohorts of both biomedical (adjusted odd ratio (OR_adj) 0.4; 95% confidence interval (CI): 0.1-1.0) and non-biomedical (OR_adj 0.4; 95% CI: 0.2-0.9) female students. The current research highlights the importance of increasing sports activity by involving students in regular physical exercise of specific types for decreasing the severity of depressive symptoms in student-aged female populations.

Challenges and Implications of the COVID-19 Pandemic on Mental Health: A Systematic Review

The measures put in place to contain the rapid spread of COVID-19 infection, such as quarantine, self-isolation, and lockdown, were supportive but have significantly affected the mental wellbeing of individuals. The primary goal of this study was to review the impact of COVID-19 on mental health. An intensive literature search was conducted using PsycINFO, PsyciatryOnline, PubMed, and the China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and June 2022 were retrieved and appraised. Reviews and retrospective studies were excluded. One hundred and twenty-two (122) relevant articles that fulfilled the inclusion criteria were finally selected. A high prevalence of anxiety, depression, insomnia, and post-traumatic stress disorders was reported. Alcohol and substance abuse, domestic violence, stigmatization, and suicidal tendencies have all been identified as direct consequences of lockdown. The eminent risk factors for mental health disorders identified during COVID-19 include fear of infection, history of mental illness, poor financial status, female gender, and alcohol drinking. The protective factors for mental health include higher income levels, public awareness, psychological counseling, social and government support. Overall, the COVID-19 pandemic has caused a number of mental disorders in addition to economic hardship. This strongly suggests the need to monitor the long-term impact of the COVID-19 pandemic on mental health.

Learning Through a Pandemic: Youth Experiences With Remote Learning During the COVID-19 Pandemic

The objective of this paper was to examine the school-related experiences of youth during the COVID-19 pandemic. Participants represented both clinical and community youth aged 14 to 28 who were sampled as part of a larger study. Feedback from youth attending school during the pandemic was qualitatively examined and youth who planned to attend school prior to the pandemic and did (n = 246) and youth who planned to attend but did not (n = 28) were compared quantitatively. Youth appreciated the flexibility of online learning and some also reported experiencing a lack of support from their school and the need for instructor training on how to deliver virtual classes effectively. Future studies should examine what factors influence student engagement with virtual learning, what strategies could improve supports for student in their long-term career development, and the longitudinal experiences of youth who may have chosen not to go back to school due to the pandemic. This survey was conducted in Ontario, Canada. A more diverse sample collected outside of Ontario would improve generalizability. Qualitative data were based on survey responses and not interviews. Thus we were unable to discern the reasons youth decided to attend school, or not, during the COVID-19 pandemic.

The Difference in Learning Activities of Postgraduate Students of Different Qualification Types Under the COVID-19 Pandemic: A Multi-Group Latent Class Analysis

Introduction

There are two types of master’s qualifications in China. One is the academic qualification that pays more attention to academic research, aiming to cultivate research-oriented talents; while the other is the application-oriented qualification that focuses more on practical ability, aiming to cultivate applied-oriented talents. The purpose of this study is to explore the impact of the COVID-19 on the learning activities of postgraduate students, as well as the differences in the extent to which the learning activities of postgraduate students of different qualification types are affected and their mental health status.

Methods

A self-constructed scale for the pandemic’s impact on master’s students, the self-rating anxiety scale and the self-rating depression scale were applied in the study. The single- and multi-group latent class analyses were used to investigate the impact of the pandemic on postgraduate students of different qualification types.

Results

A total of 2818 responses were collected. The single-group latent class analysis identified four classes. The multi-group latent class analysis showed that no absolute homogeneity existed between different groups. In general, the number of academic master’s students affected was greater than application-oriented master’s students. Application-oriented master’s students were more affected by course activities, while academic master’s students were more affected by academic and social activities. Results show that individuals more affected had higher levels of anxiety and depression. Compared to course activities, impacts on social activities were more likely to cause anxiety and depression.

Discussion

Universities can provide a more flexible way of assistance to different qualification types of postgraduate students. Furthermore, social activities play an important role in the mental health of postgraduate students. Therefore, under the background of normalization of pandemic prevention and control, schools should pay more attention to students’ interpersonal communication activities to help relieve students’ anxiety, depression, and other negative emotions.

Mental Health Among Medical Students During COVID-19: A Systematic Review and Meta-Analysis

Background

The mental health of medical students is an issue worthy of attention, especially during COVID-19. Many studies have shown that depression and anxiety are the main problems faced by medical students. To assess the pooled prevalence of depression and anxiety among medical students worldwide, we conducted this meta-analysis.

Methods

According to PRISMA, we used a computerized strategy to search studies in EMBASE, PubMed, PsycArticles, Web of Science, and China Biology Medicine disc. The pooled prevalence of depression and anxiety was calculated by a random-effects model. Heterogeneity was explored by subgroup analysis. Sensitivity analysis and publication bias were also carried out in this meta-analysis.

Results

Of 1316 studies, 41 studies were selected based on 36608 medical students. The pooled depression prevalence was 37.9% (95% CI: 30.7-45.4%), and pooled anxiety prevalence was 33.7% (95% CI: 26.8-41.1%). The prevalence of depression and anxiety among medical students varied by gender, country, and continent.

Conclusion

The data reported that the prevalence of depression and anxiety among medical students during COVID-19 was relatively higher than those of the general population and the healthcare workers. The impact of COVID-19 on medical students and how to protect the mental health of medical students are needed to determine through further research.

Systematic Review Registration

[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021274015], identifier [CRD42021274015].

The Impact of the Coronavirus Pandemic on the Learning Process among Students: A Comparison between Jordan and Turkey

COVID-19 was declared by the WHO as a pandemic affecting several aspects of human lives. Follow-up investigations showed that the pandemic affected tertiary education. This study was designed to assess the online learning process among students living in Turkey and Jordan during the COVID-19 pandemic. This descriptive cross-sectional study was conducted via an online survey. The survey was followed by a focus group. Data were analyzed using the Statistical Package for Social Science (SPSS). A total number of 214 students participated in this study. Most of the participants were female, single, and undergraduates. Regarding the theory courses, the percentage of Turkish and Jordanian students who evaluated the online learning as ‘excellent’ or ‘very good’ or ‘good’ was greater than that for the practical courses. With regards to the practical training, more than half of the Turkish students (57.5%) ranked their experience in practical training as ‘excellent’ or ‘very good’ or ‘good’, while a lower proportion was reported by Jordanian students (47.7%). During the focus group, the cons of online learning were more numerous than the pros. The tertiary education in Turkey and Jordan was affected during the pandemic.

Effects of the COVID-19 Pandemic on Chinese Graduate Students' Learning Activities: A Latent Class Analysis

To investigate the impact of the pandemic on graduate students' learning activities, a series of questionnaires were distributed to graduate students in universities across China, and 2,818 responses were collected. A latent class analysis was performed to classify the effects of the pandemic on graduate students' learning activities. Then, a multinomial logistic regression analysis and an analysis of variance analysis were carried out to explore the impact of demographic variables on the classification and their mental health status. The analysis identified four latent classes: "the overall less affected" (34.83%), "the overall more affected" (31.97%), "course activities were more affected" (19.40%), and "social activities were more affected" (13.79%). The multinomial logistic regression analysis indicated that during the pandemic, the learning activities of graduate students in all grades were affected to varying degrees, and the impacts on second-year and third-year graduate students were greater than those of first-year graduate students. The analysis of variance revealed that the scores for anxiety, depression, and social anxiety of "the overall more affected" were significantly greater than those of the other three groups, and nearly one-third of students belonged to this class, suggesting that more attention and care should be given to these students. As a result of the COVID-19 pandemic, a number of graduate students have suffered mental problems (anxiety and depression). Under the current backdrop of a new normal, schools and teachers should pay attention to graduate students' mental health, providing targeted assistance to different types of students.

Association between depression and HbA1c levels in the elderly population with type 2 diabetes mellitus during COVID-19 pandemic

Diabetes mellitus is a chronic progressive disease affecting the metabolic hormonal system and its prevalence in the elderly population is high. Depression is one of the psychiatric disorders in diabetic patients in particular during the coronavirus disease 2019 (COVID-19) pandemic. People with depression are more susceptible to leading an unhealthy lifestyle; therefore, depression and diabetes have a negative influence on life quality and aggravate complications and symptoms. The aim of this study was to determine the association between depression and hemoglobin A1c (HbA1c) levels in elderly with type 2 diabetes mellitus patients. A cross-sectional study was conducted where a total of 42 diabetic patients from the Puskesmas Belakang Padang, Batam of Indonesia was recruited. The HbA1c level, the main determinant of optimum glycemic control, was measured using ion-exchange high-performance liquid chromatography while the level of depression was assessed using Geriatric Depression Scale-15 (GDS-15). The association between depression and HbA1c levels was analyzed using the chi-squared test. Our study found that that 69% of the elderly with diabetes experienced a depression, classified as mild (40.5%), moderate (21.4%) and severe (7.1%). There were 61.9% of the subjects had poor HbA1c control. Our data suggested that the depression level was associated with HbA1c (p = 0.002). In conclusion, there is a significant association between depression and HbA1c levels in the elderly with type 2 diabetes mellitus.

Depression, anxiety, stress, and suicidal behavior among Bangladeshi undergraduate rehabilitation students: An observational study amidst the COVID-19 pandemic

Background and Aims

Common mental health symptoms (CMHS) like depressive moods, anxiety, and stress are the underlying causes of suicidal behavior. The incidence of suicide is higher among Bangladeshi students. Due to the pandemic, students of health/rehabilitation sciences are at the most significant risk. This study aimed to measure the prevalence rate and predicting factors for depression, anxiety and stress, suicidal ideation, and suicide attempts in Bangladeshi undergraduate rehabilitation students.

Methods

This cross-sectional study included data from 731 participants. Descriptive analyses estimated prevalence, and multivariate logistic regression models identified the factors associated with CMHS and suicidal behavior after adjusting the confounders.

Results

The result shows a high prevalence of moderate to very severe CMHS and a higher risk of suicidal ideation among rehabilitation students. Sociodemographic factors, illness, behavior, institution, and subject-related issues were identified as the predicting factors of CMHS and suicidal behavior. The students suffering from mental health symptoms reported suicidal ideation and attempted at a significantly higher rate.

Conclusion

To deal with CHMS and suicide risk, a holistic, supportive approach from government and academic institutions are essential for minimizing the predicting factors identified by this study. The study is helpful for the government regulatory body and policymakers to take immediate steps for preventing CMHS and suicidal behavior among rehabilitation students in Bangladesh.

Examining anxiety and stress regarding virtual learning in colleges of health sciences: A cross-sectional study in the era of the COVID-19 pandemic in Saudi Arabia

Background

Stress and anxiety are relatively common, particularly in females and college students. Stress can impact students' overall performance and their physical and mental health. The COVID-19 pandemic has affected all aspects of life and is associated with high levels of psychological distress. It has considerably affected the education sector, not only locally but worldwide, forcing a shift in the education system from on-site to virtual learning. This cross-sectional study was undertaken to evaluate the prevalence of anxiety and stress regarding virtual learning among health sciences college students in the Kingdom of Saudi Arabia (KSA) after introducing blended virtual classes and exams and in-person laboratory training. The study was carried six months after the COVID-19 outbreak.

Methodology

Participants were recruited by convenient sampling and snowballing strategies. Our study was conducted between November 18 and December 6, 2020. Questionnaires were employed; they included the General Anxiety Disorder-7 (GAD-7) scale and focused on the participants' attitudes toward virtual learning. The present research was validated by a pilot study, followed by implementing some amendments.

Results

A total of 418 health sciences college students, aged 18-27 (M = 20.88, SD = 1.97), participated in the study. Our analysis indicated that more than half the sample (51.44%) reported a risk of moderate to severe GAD. Anxiety was recognized more frequently in women (72.09%) than in men (27.91%). Interestingly, our Χ2 analysis revealed an association between marital status and anxiety, with a higher risk of GAD found in single people (compared with married). In addition, we found that the risk of anxiety increased in junior students (1st-3rd year) compared to senior students (4th-6th year).

Conclusion

Our study highlights the need to establish gender-based tailored mental health support systems that provide preventive measures. The study findings also recommend that institutions develop programs and platforms that safely support students to interact and seek guidance, particularly those at higher risk of stress, such as females and first-year students. Overall, our study underlines the need to pursue an understanding of the complicated nature of anxiety disorders..

The Impact of COVID-19 on Behavior and Physical and Mental Health of Romanian College Students

Background and Objectives: The COVID-19 pandemic caused by SARS-CoV-2 significantly marked people’s lives with respect to their behavior, and their physical and mental health. Materials and Methods: This is a cross-sectional study that was conducted in 2021 for a period of 5 months. The study sample included 218 students from the College of Physical Education and Sports of the University of Suceava who filled in a questionnaire on mental, physical and behavioral symptoms caused by the COVID-19 pandemic, as well as the Anxiety Assessment Questionnaire (STAI). Results: The responses indicated increased anxiety, physical symptoms, altered behavior, and increased perception of social restrictions. Regression analyses indicated that the levels of anxiety during the COVID-19 outbreak were strongly correlated with cognitive, physical and behavioral symptoms of the students. These were influenced by the living arrangements, location (urban vs. rural), age group and study year. Conclusions: The results show that first-year students did not exhibit significant physical and cognitive symptoms despite reporting anxiety, probably due to their enthusiasm as beginners. The 3rd year students were prone to anxiety and reported cognitive symptoms, possibly due to the prospects of an uncertain future.

Predicting Anxiety and Depression Among Patients With COVID-19 in Concentrated Isolation at Medical Camps in Vietnam: A Descriptive Cross-Sectional Study

INTRODUCTION

This study aims to assess the requirement for anxiety and depression treatment for patients with coronavirus disease 2019 (COVID-19) in medical camps in Bac Giang province, Vietnam. This information can help improve the government policy to reduce anxiety and depression in patients with COVID-19.

METHODS

A total of patients with 427 COVID-19 participated in the survey conducted from 5 to 15 June 2021 in Bac Giang province. The survey included 17 questions about the general characteristics of the patients, 15 questions to assess common COVID-19 symptoms, the Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder-7 (GAD-7) scores, and four questions to assess hospital reviews, including facilities, food, medical staff, and living conditions. Logistics regression analyses were conducted to assess the association between COVID-19 symptoms and high anxiety and depression (HAD) status.

RESULTS

A logistic regression analysis evaluated the risk factors in need of intervention. Our study showed that lower hospital review scores (odd ratio = 0.98; 95% confident interval = 0.97-0.99) were found to be a risk needing intervention. It was also identified that older patients (odd ratio = 1.1; 95% confident interval = 1.03-1.18), women (odd ratio = 1.31; 95% confident interval = 1.09-1.31), patients who were primary income earners in the family (odd ratio = 1.15; 95% confident interval = 1.03-1.28), patients who had headaches (odd ratio = 1.16; 95% confident interval = 1.06-1.21), and patients who had joint pain (odd ratio = 1.17; 95% confident interval = 1.06- 1.3) were risk factors for HAD status.

CONCLUSION

Our research shows that every 10-year age increase was associated with a 10% increase in the likelihood of HAD status. Study subjects being primary income earners were also associated with a 15% increased risk of having HAD status. This study showed that a decrease in family income due to COVID-19 caused an increase in high-level anxiety/depression status.

Perceived Safety of Learning Environment and Associated Anxiety Factors during COVID-19 in Ghana: Evidence from Physical Education Practical-Oriented Program

The outbreak of COVID-19 led to the swift migration to alternate instructional delivery models and pedagogical practices in educational institutions. This study examined the perceived safety of the learning environment and associated anxiety factors among physical education students amidst COVID-19. Using a cross-sectional design, a sample of 638 students drawn purposively and conveniently from a public university in Ghana completed a self-developed questionnaire. Frequency counts, percentages, and ordered logistic regression were used to analyze the data. Findings of the study showed that students perceived the practical lesson environment as unsafe, with self-reported moderate to high levels of anxiety during their practical lessons. The ordered logistic regression results revealed that varied factors such as age, COVID-19 information platforms, certainty about personal safety, and adequacy of preparation to manage COVID-19 cases were associated with anxiety. The study concluded that an unsafe practical physical education learning environment increases the anxiety levels of students. Academic departments/units should provide periodic interventions (e.g., positive self-talk, mental rehearsal, cognitive restructuring) and counseling services for students amidst the ongoing pandemic to help moderate situational-specific anxiety. In addition, key to the management of students' anxiety is the provision of a safe and supportive school environment, including the provision of adequate personal protective equipment for practical lessons by school authorities.

Prevalence and factors associated with anxiety and depression amongst hospitalised COVID-19 patients in Laquintinie Hospital Douala, Cameroon

Studies assessing the mental health of patients with COVID-19 infection remain limited. Disasters and major emergencies, not just COVID-19, undoubtedly lead to greater incidence of mental health problems. Previous studies indicate that the novel Coronavirus disease can cause panic and stress in patients. Our literature search didn't reveal any previous published data from Cameroon and the Central African sub-region. In order to bridge this gap, we assessed the prevalence and factors associated with depression and anxiety in COVID-19 patients. We carried out a cross-sectional study in a secondary hospital in the Littoral Region of Cameroon. We recruited hospitalised COVID-19 patients during a 4-month period. We collected data on sociodemographic characteristics. The HADS score was used to assess levels of anxiety and depression. All analysis were done using Stata 14. A P value of <0.05 was used as the cut-off for statistical significance. A total number of 285 patients took part in this study with a mean age of 48.47 years. The prevalence of anxiety in COVID-19 patients was 60.35% while the prevalence of depression was 81.40%. At multivariate logistic regression male gender (OR: 1.89, P = 0.04), hypoxaemia (OR: 2.20, P = 0.01), presence of COVID-19 complications (OR: 1.61, P = 0.02) and current episode of depression (OR: 4.14, P<0.01) were independently associated with anxiety. Similarly, age > 35 years (OR:2.03, P = 0.02), presence of comorbidity (OR: 1.68, P = 0.01), BMI > = 30kg/m2 (OR: 1.78, P = 0.02), presence of COVID-19 complications (OR: 1.28, P = 0.01) and anxiety (OR: 4.60, P<0.001) were independently associated with depression. Hospitalised patients with COVID-19 experienced high levels of anxiety and depression. Treatment of hospitalised patients with COVID-19 should therefore include psychotherapy and psychiatric support.

After the Pandemic: The Future of Italian Medicine. The Psychological Impact of COVID-19 on Medical and Other Healthcare-Related Degrees Students

Objective: The study aimed to explore the psychological symptoms and the readiness to fight the pandemic of the new generation of healthcare professionals: medical and other healthcare degree students. Methods: We enrolled 509 medical and healthcare-related degree students during the second outbreak of COVID-19 in Italy. We have examined their psychological symptoms using the 12-item General Health Questionnaire (GHQ-12) and their readiness to fight the pandemic together with their academic career status, their relationship with the university, and their emotional reactions to the pandemic with Visual Analog Scales. Results: We retrieved a GHQ mean of 21.65 (SD = 40.63) and readiness to fight the pandemic mean of 53.58 (SD = 31.49). Perceived control affects variables: a negative effect on psychological symptoms and a positive effect on the willingness to fight the pandemic. The other variables with an impact were stress, loneliness, and anger that had a significant and positive impact on psychological symptoms. Age and concern for patients had a significant positive impact on readiness to fight for the pandemic, while years of attendance had a significant but negative impact. Conclusion: Universities and Institutions should consider the impact of the pandemic on students, in particular, for its effect on their mental health.

Fifteen-Years Follow-Up in a Cohort of Children with Functional Gastrointestinal Disorders: Prevalence and Risk Factors to Develop Neuropsychiatric Disorders and Other Comorbidities

BACKGROUND

Functional gastrointestinal disorders (FGIDs) are chronic and recurrent disorders, which affect up to 23% of children and adolescents and represent 50% of gastroenterological accesses. The association between FGIDs diagnosed at paediatric age and the onset of migraine or headache and neuropsychiatric diseases in adolescence and adulthood is widely reported in the literature. However, there is still limited knowledge about the long-term prognosis and risk factors for neuropsychiatric pathologies and other comorbidities.

AIM

The aim is to assess the prevalence and persistence of FGIDs as well as the occurrence of migraine or headache and neuropsychiatric disorders in a cohort of patients diagnosed with FGIDs 15 years ago compared with a control group of peers.

MATERIALS AND METHODS

We enrolled a group of patients diagnosed with FGIDs at paediatric age, at least 10 years ago (FGIDs group, n = 79; median age 23), and control subjects (control group, n = 201; median age 23). In both groups, an online questionnaire created explicitly for the study was submitted in order to investigate the presence of chronic intestinal diseases, migraine, headache or neuropsychiatric disorders.

RESULTS

45.6% (36 out of 79) of patients previously diagnosed with FGIDs still suffer from FGIDs versus 12% (24 out of 201) of healthy controls (p < 0.0001). The prevalence of chronic organic gastrointestinal disorders was comparable in the two groups (2.5% in FGIDs group versus 1% in healthy group, p = 0.3). Thirty-three percent (26 out of 79) of FGIDs patients reported headache or migraine versus 13% (26 out of 201) of healthy peers (p < 0.001). No differences were found regarding the prevalence of anxiety and depression.

CONCLUSION

The outcome at 15 years of FGIDs was characterized by a high prevalence of persisting functional symptoms along with a significant incidence of headaches and migraines. Abbreviation: FGIDs: Functional gastrointestinal disorders; IBS: Inflammatory Bowel Syndrome.