Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: a cross-sectional study

Well-being of undergraduate dental students: Questionnaire design, findings and future directions

INTRODUCTION

The recent pandemic has highlighted the importance of addressing well-being in the overall health of students. There is a need for support systems within dental schools to help students demonstrate resilience, adapt to learning environments and thrive in their professional careers.

OBJECTIVES

The main aim of the study was to evaluate Bachelor of Dental Surgery (BDS) students' understanding and experience of well-being. The objectives were to create a suitable survey to assess students' well-being, investigate the factors affecting dental students' well-being and develop a student well-being action plan based on the analysis of the survey.

METHODS

A literature review was conducted to identify and critically assess existing measures of well-being in dental students. Four domains of well-being (emotional, physical, social, intellectual) relevant to dental students were identified. Through a comprehensive iterative process, a two-part survey was developed and tested, which measured individual experiences of well-being across the four domains and collected feedback on proposed initiatives to support student well-being. The survey was disseminated to all 452 dental students from Years 1 through 6, of which 71% (321) responded.

RESULTS

The survey revealed low levels of overall well-being among the dental student population, which worsened with increasing years of clinical study. Fear of failing exams presented the biggest challenge with regard to emotional well-being, while sleep deprivation and occupational health hazards most affected the physical well-being domain. Intellectual well-being was compromised by insufficient free time to pursue extracurricular interests and concerns about achieving the required skills. Despite a majority experiencing positive relationships with their peers and tutors, less than a fifth agreed that the Faculty of Dentistry 'supported my well-being as a dental student'.

CONCLUSION

As the first investigation of the well-being of dental students in Hong Kong, the key stressors identified were examinations, long schedules and the physical burden of dental work, which are consistent with international literature. The findings reveal students' needs and preferences for well-being initiatives which will be optimized in the implementation of student-centred curricular activities.

Perceived stress among dental students and the role of parental influence in career decision-making

OBJECTIVES

The current study aimed to assess perceived stress levels among dental students at Riyadh, Saudi Arabia, and to explore the influence of parental roles in their decision to pursue dentistry as a potential source of social stress.

METHODS

This cross-sectional study employed the validated Dental Environmental Stress (DES) Scale to evaluate perceived stress, and incorporated additional questions to fulfill the research aim. We approached all undergraduate dental students at King Saud University, both male and female, across all academic years, using online channels (such as emails, WhatsApp, Twitter, etc.) and hard copy distribution. Data collected were analyzed using SPSS version 20, utilizing descriptive and correlation statistics.

RESULTS

A total of 326 students participated in the study, with an even distribution of male and female students. Female students reported higher levels of stress compared to their male counterparts across most DES domains. A notable correlation emerged between mean DES scores in certain domains and influence of parents in the decision to pursue dentistry.

CONCLUSION

Our findings indicate that female dental students experience higher stress levels than males in all examined areas, barring social stressors. Furthermore, the study underscores the significant impact of parental involvement in choosing dentistry as a career on students' stress level.

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.

Associations of academic environment, lifestyle, sense of coherence and social support with self-reported mental health status among dental students at a university in Brazil: a cross-sectional study

OBJECTIVES

The study evaluated the association of academic environment, lifestyle, sense of coherence (SOC) and social support with self-reported mental health status among dental students.

DESIGN

Secondary analysis of data from a cross-sectional, questionnaire-based survey conducted from August to October 2018.

SETTING

Dental school of a public-funded university in the south-eastern region of Brazil.

PARTICIPANTS

233 undergraduate dental students recruited across all years of the course.

OUTCOME MEASURES

Socioeconomic and demographic characteristics, city of origin and student's academic semester were obtained through self-completed questionnaires. Perception of the academic environment (Dundee Ready Education Environment Measure (DREEM)), individual lifestyle (Individual Lifestyle Profile Questionnaire (ILPQ)), SOC (SOC Scale (SOC-13)), social support (Medical Outcomes Study Scale (MOS)), and depression, anxiety and stress (Depression, Anxiety and Stress Scale-21 (DASS-21)) were assessed using validated instruments. The relationships between variables were investigated through multivariable negative binomial regression to obtain the rate ratios (RRs) and 95% CIs.

RESULTS

Female sex was associated with greater scores of anxiety (RR 1.74, 95% CI 1.10 to 1.97) and stress (RR 1.52, 95% CI 1.12 to 2.06). Students who perceived a better academic environment and those reporting a greater SOC had a lower probability of depression, anxiety and stress. Furthermore, a favourable lifestyle was associated with lower depression scores (RR 0.99, 95% CI 0.97 to 0.99). Social support did not remain associated with depression, anxiety and stress after adjustment.

CONCLUSIONS

The present findings suggest that self-reported mental health status is associated with students' sex, academic environment, SOC and lifestyle. Enhancing the educational environment and SOC, and promoting a healthy lifestyle may improve the psychological health of dental students.

Prevalence, Symptoms, and Triggering Factors of Panic Attacks among Dental Students in Riyadh Saudi Arabia-A Cross Sectional Survey

Panic disorder by definition is an anxiety disorder of unexpected and repeated episodes of intense fear. Panic attacks are usually diagnosed by four or more of a set of symptoms that include palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, and hot flushes. They usually interfere with daily life situations and also interfere with education. Hence, the aim of this study was to assess the prevalence of panic attacks, their symptoms, and triggering factors among dental students in Riyadh, Saudi Arabia. Data were collected from 394 students using a structured and validated questionnaire. The prevalence of panic attacks among dental students in Riyadh, Saudi Arabia, was 42.9%. Most of the participants who experienced higher episodes of panic attacks were females (53.4%) when compared to males (24.5%). Third year students displayed greater (58.3%) episodes of panic attacks compared to their respective counterparts. The most reported symptom of panic attacks was rapid or pounding heartbeat followed by breathlessness, chest pain, and shaking or trembling. It was also noted that most of the participants (63.31%) encountered a panic attack for the first time after joining dental school. The situations where dental students frequently experienced panic attacks were during exams, clinic procedures, giving presentations, and especially while under a lot of stress. The high occurrence of panic attacks among dental students highlights the importance of providing support programs and implementing preventive measures to help students, particularly those who are most susceptible to higher levels of these psychological conditions. Dental students experiencing panic attacks should be provided with necessary counseling sessions or psychiatric consultation in order to overcome such scenarios. Dental schools should consider these findings when planning the dental curriculum. Hence, the role of the faculty members is essential in these situations to provide support for the affected students.

Patient-specific virtual simulation in the clinical training for prosthetic dentistry

INTRODUCTION

Dental education always involves live patient treatment, and clinical training for each patient is different for students. Using an intraoral scanner and Simodont Dental Trainer, we can provide students with an opportunity to train on actual patient cases in a virtual environment before real preparation. This study aimed to develop, implement and test patient-specific virtual simulation training in prosthetic dentistry curriculum.

MATERIALS AND METHODS

Before the actual preparation, the students' patients were scanned using 3Shape intraoral scanner. Thereafter, the .stl file was uploaded to Simodont Dental Trainer (Nissin dental products) where all the scanned teeth were prepared virtually. The 'prepared' .stl file was downloaded and submitted to the teacher. Instruction manuals for virtual simulation patient-specific tasks were provided. The students were asked to voluntarily complete the survey, at the end of the course.

RESULTS

Forty-two 4th year students from the Faculty of Dentistry performed a patient-specific virtual simulation training task and completed a survey. The created training materials served as guidelines for students to perform all the steps on their own without teacher assistance, except in the final step, where the teacher evaluated the digital preparation. Students appreciated the amount of information provided regarding the technologies used and patient-specific tasks. Students admitted that the patient-specific task was more interesting than standard tasks. However, they were not satisfied with the technical performance of Simodont Dental Trainer or the reflection of reality.

CONCLUSION

Patient-specific virtual simulation can be accepted by students for training before actual teeth preparation in the clinic. However, technical improvements are required in this regard.

The relationship of psychological health and primary emotional traits in medical students

INTRODUCTION

Several studies have called for attention to medical students' well-being. Building on the neuroevolutionary affective neuroscience perspective that views primary emotional systems as central to well-being and the foundation of personality, this study investigated the facets of medical students' psychological well-being that are challenged and the relationships between emotional traits, psychological well-being, and depression.

METHODS

In a single-center cross-sectional study, medical students' primary emotional traits (SEEKING, FEAR, ANGER, SADNESS, CARE, PLAY and Spirituality), psychological well-being dimensions (autonomy, environmental mastery, positive relations, self-acceptance, purpose in life, and personal growth), and depressive symptoms were assessed using the Affective Neuroscience Personality Scale; the Psychological Well-being Scale, which provides normative data; and the Beck Depression Inventory.

RESULTS

Compared with the normative data, the medical students perceived lower psychological autonomy, positive relations, and self-acceptance but higher purpose in life. The medical students' emotional traits were related to specific psychological well-being facets and depression. SEEKING and, inversely, FEAR were related to well-being across dimensions and depressive symptoms.

CONCLUSION

Our findings are the first to show a link between emotional traits and specific facets of psychological health in medical students. Thus, this study encourages medical teachers to set learning environments that target multiple facets of well-being that harness primary emotional traits.

Stress Factors, Stress Levels, and Coping Mechanisms among University Students

Aims

To explore university students' levels of stress, stressors, and their coping style.

Methods

A cross-sectional correlational design with a convenience sample (n = 676) of university students who completed the Student-Life Stress Inventory (SSI) and Coping Strategies Indicator (CSI) was used. Findings. Overall, two-thirds of the participant reported moderate levels of stress. Students with chronic illness, living alone, low CGPA, and having exams today experienced a statistically higher mean level of stress. Students who are living alone used the "avoidance" method more significantly and the "social support" method significantly less compared with students who are living with their families and friends.

Conclusion

This study concurs with others that university students are prone to distress. To our knowledge, this is the first study in the region to explore the students' coping skills. Some of the employed coping and associated factors could be used to lay the groundwork for evidence-based prevention and mitigation.

The prevalence of depressive and anxiety symptoms among first-year and fifth-year medical students during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Medical students have higher risk of psychological disorders due to the relatively stressful environment. Educators are becoming increasingly aware of the impact of stresses on the students general well-being. The objective of the current study was to examine the prevalence of and risk factors for depressive and anxiety symptoms among first-year and fifth-year medical students. Additionally, we aimed to determine whether the COVID-19 pandemic has affected students' mental well-being.

METHODS

A cross-sectional study was performed at the College of Medicine at King Saud University between September 2020 and January 2021. The target population was first-year and fifth-year medical students. Depressive symptoms were screened using the 9-item Patient Health Questionnaire (PHQ-9), while anxiety symptoms were screened using the 7-item Generalized Anxiety Disorder assessment (GAD-7). Students were also directly asked about the effect of the COVID-19 pandemic on their mental well-being. Outcomes were compared between groups using the chi-squared test and Student's t test. Multivariate logistic regression analysis was performed to identify factors associated with depressive and anxiety symptoms.

RESULTS

A total of 182 medical students were included. Depressive symptoms (52.9% versus 35.8%, p = 0.020) and anxiety symptoms (35.6% versus 26.3%, p = 0.176) were higher in the first-year students than in the fifth-year students. Approximately 19.2% of the students were worried about acquiring COVID-19, 49.4% were worried about academic performance, and 30.8% were feeling sad, depressed or anxious during the COVID-19 pandemic. Independent risk factors for depressive symptoms included having concomitant anxiety, being worried about acquiring COVID-19, being worried about academic performance, and feeling sad, depressed or anxious. Independent risk factors for anxiety included having a lower grade point average and having concomitant depressive symptoms.

CONCLUSION

Medical students have an alarmingly high prevalence of depressive and anxiety symptoms, which might have been negatively impacted by the COVID-19 pandemic. There is a need for a special mental health program targeting new and current medical students.

Comparison of depression, anxiety, and stress between public and private university medical students

Context

Depression, anxiety, and stress are common among medical students because of hectic and heavy studies.

Aim

This study was carried out to determine the magnitude of the Depression, Anxiety, and Stress Scale (DASS) among undergraduate medical students and its relationship with its causative factors in public and private universities.

Setting and Design

The study tool was DASS (Depression, Anxiety, Stress Scale-21) which was distributed through the Department of Physiology, College of Medicine, King Saud University, adopting a multistage cluster sampling method for an observational study design.

Subjects and Data

Data from undergraduate medical students (N = 337) was collected from public and private medical colleges in Saudi Arabia.

Statistical Analysis

Independent t-tests and analysis of covariance were applied to analyze the data.

Results

There was a significant difference in depression with a higher mean score in private versus public medical students (8.38±5.93 vs 6.34±5.46, p=0.001), anxiety (9.49±5.12 vs 7.91±5.00, p=0.005), and stress (9.11±5.11 vs 7.93±5.02, p=0.035). There was a significant difference in the level of anxiety between second- and third-years students (p =0.01).

Conclusion

Private medical university students have significantly higher depression, anxiety, and stress levels compared to public universities. More studies are needed to explore the causes of this psychological impact.

Comparative assessment of attitudes among medical and dental professionals in Saudi Arabia toward e-professionalism using the SMEPROF-S scale

Background

Social media (SM) usage is on the rise among health professionals at all levels to align with the emerging digital and SM era. e-Professionalism is described as attitudes and actions that resemble traditional professionalism paradigms but are expressed through digital media. Although there are a number of studies conducted in the past several years measuring e-professionalism of medical and dental professionals, there is no validated scale to assess the level of e-professionalism among medical and dental professionals in Saudi Arabia. Therefore, this study aimed to assess attitudes toward e-professionalism among medical and dental professionals in Saudi Arabia using the SMePROF-S scale.

Methods

This cross-sectional study recruited 338 medical and dental students and practitioners from 20 cities in Saudi Arabia to complete an online SMePROF-S self-reported questionnaire measuring attitudes about e-professionalism.

Results

Among participants, 31.66% believed that it is acceptable to communicate with patients through SM, but only 16.86% agreed with communicating via personal SM account messaging. Many participants (35.80%-50%) fear that SM use can cause problems with getting hired, people making inaccurate assumptions and perceptions, and job losses. There were 31.36% who believed that sharing patient information without consent is acceptable. The majority (63.02%-63.31%) do not believe that medical/dental professionals should be barred from using SM, and 40.53% believe that schools/organizations have no right to interfere with their online activities. Only 22.19% believed that SM use removed professional protections from the public. A few statements were statistically different by specialty and gender.

Conclusion

There is a variability of attitudes about e-professionalism among medical and dental professionals in Saudi Arabia, with some alarming issues requiring national guidelines to ensure patient rights, privacy, and confidentiality.

A systematic review and meta-analysis of studies exploring prevalence of non-specific anxiety in undergraduate university students

BACKGROUND

Anxiety is a common mental health problem in the general population, and is associated with functional impairment and negative impacts upon quality of life. There has been increased concern about university students' mental health in recent years, with a wide range of non-specific anxiety rates reported worldwide in undergraduate university students. We aimed to explore prevalence of non-specific anxiety in undergraduate university student populations.

METHODS

Four databases were searched to identify studies published between 1980 and 2020 which investigated prevalence of non-specific anxiety in undergraduate university students. Each study's quality was appraised using a checklist. Sub-analyses were undertaken reflecting outcome measure utilized, course of study, location of study, and whether study was before or during the COVID-19 pandemic.

RESULTS

A total of 89 studies - representing approx. 130,090 students-met inclusion criteria. Eighty-three were included in meta-analysis, calculating a weighted mean prevalence of 39.65% (95% CI: 35.72%-43.58%) for non-specific anxiety. Prevalence from diagnostic interview studies ranged from 0.3%-20.8% 12-month prevalence. Prevalence varied by outcome measure used to assess non-specific anxiety, the type of course studied by sample, and by study location. In half the studies, being female was associated with being more likely to have higher non-specific anxiety scores and/or screening above thresholds. Few of the included studies met all quality appraisal criteria.

CONCLUSION

The results suggest that approximately a third of undergraduate students are experiencing elevated levels of non-specific anxiety. Results from sub-analyses have identified some methodological issues that need consideration in appraising prevalence in this population.

Impact of COVID-19 on Portuguese Dental Students: A Cohort Study

Introduction: The goal of this study was to assess the impact of COVID-19 on Portuguese dental students on their depression, anxiety, temporomandibular dysfunction, academic degree, and oral behaviors. Methods: The target of this population study was to enroll third-, fourth-, and fifth-year students of the Integrated Master’s degree in Dental Medicine at the Universidade Católica Portuguesa—Faculty of Dental Medicine (Viseu, Portugal) in the academic year 2021–2022. Temporomandibular disorders (TMD) symptoms, oral behaviors, anxiety, and depression were assessed using validated questionnaires. The variables under study were (a) age, gender, marital status, academic level, academic degree, medication, and any existing pathologies; (b) questions related to taste changes or thoughts that would indicate (or not) worsening psychological conditions (anxiety and depression). After data collection (Google Forms®), data were transferred to an Excel file and entered into SPSS® software. A chi-square test allowed the independence between ordinal or nominal variables. The Spearman correlation test was used to analyze the relationship between variables in the study (significant if p ≤ 0.05). Results: 98.2% of the students answered the questionnaire. TMD had a prevalence of 35%, and anxiety and depression a prevalence of 29% and 24%, respectively. The results showed that the female gender was the most affected by psychological and temporomandibular disorders. Statistically significant correlations were identified between variables, such as gender and anxiety, TDM, and depression (respectively, p = 0.0001, p = 0.014, and p = 0.026); between TDM and anxiety and depression (respectively, p = 0.001 and p < 0.001); and between performing oral behaviors and TMD, anxiety, and depression (respectively, p = 0.0001, p = 0.0001, and p = 0.006). The variables, such as age and academic degree, did not establish a statistically significant relationship with TMD, oral behaviors, and the two psychological conditions. Conclusions: It was possible to conclude that there was a moderate prevalence of TMD, anxiety, and depression in the period studied. Moreover, a statistically significant relationship was found between TMD, anxiety, and depression with gender and frequency of OBs; however, no significant association was found for TMD, anxiety, and depression with the age of students and with the academic degree.

Impact of resilience and environmental stress on burnout of students in public and private dental schools in Western Saudi Arabia

Background

Dental students' burnout has been repeatedly reported in the literature; however, there is little information about the contributing factors in different contexts and settings.

Aims

This study aimed to investigate the correlation between burnout among undergraduate dental students and sociodemographic (specifically gender), psychological (resilience), and structural factors (dental environment stress).

Subjects and Methods

An online cross-sectional survey questionnaire was distributed among a convenience sample of 500 undergraduate Saudi dental students. The survey included questions about sociodemographic factors (gender, level of education, academic achievement, type of school [public or private], and living arrangements). The study also included items that allowed assessment of students' burnout using the Maslach Burnout Inventory (MBI) and assessment of student environmental stress and resilience using the Dental Environment Stress Scale (DESS) and the Brief Resilience Scale (BRS). Descriptive statistics, univariate, and linear regression analyses were performed.

Results

The response rate was 67% (male = 119, female = 216). Univariable analysis showed that gender, level of education, and DESS and BRS scores correlated significantly (P <.05) with MBI scores. Adjusted multiple linear regression lends further support to that the MBI scores negatively correlated with the BRS score but positively correlated with the DESS score (β = -0.29, P <.001; β = 0.44, P <.001, respectively).

Conclusions

Within the limitations of this study, the findings demonstrated that increases in resilience correlated significantly with decreases in burnout and increases in environmental stress correlated significantly with increases in burnout among dental students. However, gender had no influence on burnout.

Prevalence of depressive symptoms among dental students is influenced by sex, academic performance, smoking exposure, and sexual orientation

Aim: To estimate the prevalence and associated factors of self-reported depressive symptoms in undergraduate and graduate dental students. Methods: The Depression, Anxiety and Stress Scale (DASS-21) was applied, and only the depression domain was verified. A structured questionnaire was used to collect sociodemographic, behavioral, and COVID-19 pandemic-related fear variables. Academic performance was assessed based on academic records, ranging from 0 (worst possible grade) to 10 (best possible grade). Respondents included 408 regularly enrolled dental students. Bi- and multivariate analyses were performed using Poisson regression with robust variance to verify the association between at least moderate depressive symptoms and independent variables. Results: The prevalence of at least moderate depression was 40.5% among undergraduate students and 26% among graduate students. The prevalence of fear and anxiety due to the COVID-19 pandemic was 96.1% among undergraduate students and 93.5% among graduate students. In the final multivariate analysis, being female (prevalence ratio [PR]:2.01; 95% confidence interval [95%CI]:1.36–2.96) was associated with a higher PR for depression. Conversely, no exposure to smoking (PR:0.54; 95%CI:0.36–0.82) and a final academic performance average ≥7.0 (PR:0.56; 95%CI:0.41–0.76) was associated with a lower PR for depression. Finally, among graduate students, a non-heterosexual orientation was associated with a higher PR for depression (PR:6.70; 95%CI:2.21–20.29). Conclusion: Higher rates of depression symptoms were observed in female undergraduates, students with lower academic performance and smoking exposure, and graduate dental students with a non-heterosexual orientation.

T. MS, Barakat M, Abdelaziz DH, Mansour NO, Thabit AK, Ramatillah DL, Al-Jumaili AA, Syed NK, Adam MF, Hossain MS, Baraka MA, Jose J, Elkalmi R, Chandran S, Singh Dehele I, Elrggal M, Fathelrahman AI. Assessment of mental wellbeing of undergraduate pharmacy students from 14 countries: The role of gender, lifestyle, health-related, and academic-related factors

Background

Pharmacy students will assume future roles as frontline healthcare providers. Therefore, evaluating their current state of mental wellbeing and its associated factors is essential for better planning students' support initiatives. This study aimed to assess mental wellbeing and its associated factors among undergraduate pharmacy students from 14 countries during the pandemic.

Methods

A cross-sectional study was conducted among undergraduate pharmacy students in 14 countries in Asia and the Middle East. The validated Warwick-Edinburgh Mental Wellbeing Scale (the 14-item WEMWBS) was adopted to assess mental wellbeing. Data collection was performed online between February and April 2022. Descriptive and inferential statistics were used as appropriate.

Results

A total of 2,665 responses were received, mainly from females (68.7%) with a higher presence of private universities (59.1%). About 34.9% had low mental wellbeing levels, while 57 and 8.1% had medium, and high levels, respectively. Binary logistic regression showed that males (AOR: 1.34; CI 95%: 1.11-1.61; p < 0.01) and students with no chronic illnesses (AOR: 2.01; CI 95%: 1.45-2.80; p < 0.001) were more likely to have higher mental wellbeing. Also, participants who did not engage in any exercise (AOR: 0.71; CI 95%: 0.52-0.98; p = 0.04) and those in public universities (AOR: 0.82; CI 95%: 0.69-0.97; p = 0.02) were less likely to have higher mental wellbeing. Additionally, students who had interest/passion for pharmacy (AOR: 1.69; CI 95%: 1.07-2.68; p = 0.02), and those who known pharmacists inspired (AOR: 1.81; CI 95%: 1.06-3.12; p = 0.03), were more likely to have higher mental wellbeing compared with those who had no specific reason for their choice to study pharmacy. The participants with excellent (AOR: 1.87; CI 95%: 1.29-2.70; p = 0.001) or very good self-reported academic performance (AOR: 1.57; CI 95%: 1.12-2.22; p = 0.01) were more likely to have higher mental wellbeing compared to those with fair academic performance.

Conclusion

More than a third of the participants had low mental wellbeing. Various demographic, lifestyle, medical and academic factors appeared to affect students' mental wellbeing. Careful consideration of these factors and their integration into the pharmacy schools' plans for student support services and academic advising would be essential to improve students' mental wellbeing.

Dental students' attitude towards propranolol non-medical use: A multi-institutional cross-sectional study in Riyadh, Saudi Arabia

INTRODUCTION

The lives of college students are full of various stressors. Students seek a number of stress-relieving modalities as self-prescribed beta-blockers to improve their academic performance. The aim of this study was to assess the extent of beta-blockers (propranolol) usage amongst Saudi dental students and their attitude towards its use to enhance academic performance.

METHODS

A cross-sectional study involving a convenient sample was conducted on a group of undergraduate dental students enrolled in Riyadh dental schools during the academic year of 2019/2020. A paper format closed-ended questionnaire was used.

RESULTS

A sample of 680 students participated in the survey (43% response rate). Approximately 12% of dental students used propranolol for non-medical reasons. The prevalence did not differ significantly with the gender or year of study. A significantly higher percentage of students from private dental schools reported using propranolol for non-medical reasons (odds ratio (OR), 3.1; 95% confidence interval (CI), 1.7-5.4; p < .001). Propranolol users were significantly more likely to connect with other students using the medication. Both students, those who used and those who did not use propranolol, similarly, highly endorsed the need for being informed about the risk of using propranolol. Compared with non-users, there was more disagreement amongst propranolol users on the necessity for placing school regulations controlling medication use.

CONCLUSION

The use of propranolol to enhance academic performance amongst dental students in Saudi Arabia should not be disregarded. The study findings emphasise the importance of regulating students' usage of beta-blockers to promote a fair academic environment.

Endodontic Clinical Diagnostic Skills amongst Undergraduate Dental Students: Cross-Sectional Study

The purpose of the study was to evaluate the clinical endodontic diagnostic skills amongst undergraduate dental students at pre-clinical and clinical levels at Cardiff University School of Dentistry. An online questionnaire containing eight questions about endodontic diagnosis and hypothetical clinical scenarios was sent to all year 3rd, 4th, and 5th-year undergraduate dental students who were divided into G1, G2, and G3 groups. The data were analysed descriptively and reported in percentages. Around 121 students out of 226 responded to the questionnaire with a response rate of 53.5%. The overall correct response from G1 (3rd year) was 31.6% to 65.8%, G2 (4th year) was 73% to 93%, and G3 (5th year) was 73.2% to 92.7%. The study concludes that the 4th and 5th-year undergraduate dental students’ responses to the hypothetical clinical scenarios were higher than the 3rd-year students. However, regarding questions about the endodontic diagnosis, the percentages of correct answers were similar among all the 3rd, 4th, and 5th-year students. Therefore, further studies assessing endodontic diagnostic skills amongst the same cohort of students during their progression in the undergraduate course are recommended.

Mental distress among university students in the Eastern Cape Province, South Africa

Introduction

Mental distress is a global health concern. Studies show that the prevalence of mental distress is higher in students’ population than in the general population. Therefore, there is need to understand the extent and factors associated with mental distress among students to help policymakers and practitioners in South Africa.

Aim of the study

The study was designed to investigate into the prevalence and factors associated with mental distress among students at universities in the Eastern Cape Province, South Africa.

Methods

A cross-sectional study was conducted among students from four universities in the Eastern Cape Province. The data were collected from 844 students using an online self-reporting questionnaire-20 to assess mental distress of students. Multivariable logistic regression modelling determined the association between socio-demographic and psychosocial factors with students’ mental distress.

Findings

The prevalence of mental distress among students was 53.3% (95% CI 47.0%, 58.1%). Female students were more prone to mental distress than male students ([AOR]: 4.67; 95% CI 2.82, 7.72, P = 0.001). Field of study ([AOR]: 3.9; 95% CI 1.74, 5.50, P = 0.010), year of study ([AOR]: 4.29; 95% CI 0.86, 21.46, P = 0.002), academic workload ([AOR]: 4.66; 95% CI 2.81, 7.71, P = 0.003), poor sleep quality ([AOR]: 2.24; 95% CI 1.13, 3.67, P = 0.010) and using cannabis ([AOR]: 3.10; 95% CI 1.755, 5.51, P = 0.020) were other factors significantly correlated with students’ mental distress.

Conclusions and recommendations

The study found the level of mental distress to be higher among students than what is reported in most of the previous studies on the student population in South Africa. Being a female student, a user of cannabis, and field of study, academic workload and having poor sleep quality were predictors of mental distress. Findings point to the need to devise evidence-driven interventions and strategies to prevent and reduce the problem of mental distress among students.

Association between Leptin (G2548A) and Leptin Receptor (Q223R) Polymorphisms with Plasma Leptin, BMI, Stress, Sleep and Eating Patterns among the Multiethnic Young Malaysian Adult Population from a Healthcare University

Relative leptin resistance in childhood to absolute leptin resistance in maturity suggests sleep, eating behaviour, and the psychological state as probable causes. The current body of research provides inconclusive evidence linking G2548A and Q223R to obesity. Furthermore, we could find very little data that have observed the association between the environment and gene polymorphism, especially in the multiethnic population that exists in Malaysia. This study searched for a possible link between sleeping habits, eating behaviour, and stress indicators with plasma leptin and its genetic variation in young adult Malaysian healthcare students. The study involved 185 first- and second-year medical and dental students from a healthcare university. Polymerase Chain Reaction−Restriction Fragment Length Polymorphism(PCR-RFLP) determined the genotype, Enzyme Linked Immunoabsorbant Assay (ELISA) tested the serum leptin, and a self-administered questionnaire evaluated sleep, eating behaviour, and psychological condition. Gender and ethnicity are linked to fasting plasma leptin levels (p < 0.001). Plasma leptin also affects stress, anxiety, and sadness. Leptin (LEP) and Leptin Receptor (LEPR) polymorphisms were not associated with BMI, plasma leptin, sleep, eating behaviour, or psychological state. Young adult Malaysian Indians were obese and overweight, while Chinese were underweight. These findings imply overweight and obese participants were in stage I of leptin resistance and lifestyle change or leptin therapy could prevent them from becoming cripplingly obese as they age.

Temporomandibular joints disorders (TMDs) prevalence and their relation to anxiety in dental students

Background: Temporomandibular joint disorders (TMDs) are very common disorders affecting the population and causing pain. Researchers have reported a high prevalence of TMDs among university students due to increased distress. The aims of this study were to determine the frequency of TMDs in Umm al-Qura University (UQU) dental students using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and to examine the relationship between anxiety, bruxism, and TMDs among those students. Methods: The DC/TMD pain screener questionnaire was completed by dental students. Students who reported TMD pain or had at least one positive TMD symptom were invited to the dental clinic for a full TMJ evaluation. History of bruxism was documented and an ultra-brief tool for detecting anxiety and depression (Patient Health Questionnaire-4 PHQ) was completed by all students. Results: A total of 240 students responded to the TMD pain screener in which 119 reported at least one TMJ symptom. Only 93 dental students presented to clinical examination in which 64.5% (n=60) of them had temporomandibular joint disorders. Disc displacement with reduction and local myalgia (38.7% & 32.25%, respectively) were the most frequent diagnosis. A total of 29% (n=27) of students had more than one diagnosis. Overall, 41 participants (44.09%) reported a positive response to the anxiety scale and (n=38) 40% of participants reported parafunctional habits. Both the history of bruxism and anxiety were significantly related to TMDs (P=0.0002) and also significantly higher in women of higher academic years (P≤0.01). Conclusions: This study found a high prevalence of TMDs among UQU dental students. Disc displacement with reduction was the most prevalent disorder. Bruxism and anxiety were associated with painful TMDs.

Test Anxiety and Related Factors among Health Professions Students: A Saudi Arabian Perspective

The study aimed to evaluate test anxiety and its relationship with demographic factors among undergraduate medical, dental, and pharmacy students in Dammam, Saudi Arabia. The health professions students from Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia participated in this cross-sectional study. Test Anxiety Inventory (TAI) by Spielberger was used to evaluate test anxiety and the score on the scale ranges from 20 to 80. Of the total 1098 participants, 878 returned completed questionnaires and the response rate of the study was 79.9%. In response to the items of TAI, 33% of participants reported that they almost always “wished examinations did not bother so much”. The mean TAI score of the sample was 43.17 (SD = 10.58). There were statistically significant differences in the mean scores of TAI among dental (44.15 ± 0.48), medical (41.64 ± 1.31), and pharmacy (43.44 ± 9.29) students (p = 0.003). The students with high grade point average (GPA) (mean TAI = 41.91 ± 10.43) demonstrated significantly lower test anxiety than those with low GPA (mean TAI = 44.05 ± 10.67) (p = 0.006). Academic grade in the previous year (GPA) remained a statistically significant factor associated with test anxiety (B = −2.83, p = 0.003) in multivariate analysis. This study showed that test anxiety was common among health professions students, and dental students and students with low GPA demonstrated high test anxiety. Students with high test anxiety should be the target of preventive strategies.

Understanding the well-being of dentistry students

INTRODUCTION

The transactional model of stress is a framework describing the process for coping with stressful events as a relationship between the individual person and environment. This study aimed to investigate the associations between personality, learning environment and experiences of mental health for a cohort of Australian dentistry students.

MATERIALS AND METHODS

Students were invited in 2017 to complete an online questionnaire including the Depression, Anxiety and Stress Scale (DASS-21), The Dundee Ready Education Environment Measure (DREEM) and Cloninger's Temperament and Character Inventory (TCIR-140). Students were followed-up one year later, and generalised estimating equations were used.

RESULTS

A total of 219 (response 73.5%) students participated in the study. Two personality profiles of dentistry students were identified. Group 1 were significantly higher in the traits persistence, self-directedness, cooperativeness and reward dependence, whereas Group 2 were significantly higher in harm avoidance. Students with Group 2 personality had a 3.12 (CI:1.72-5.65) increased odds of depression compared to Group 1 students. Compared to students with positive perceptions of the learning environment, students with negative perceptions had increased odds of stress (3.48, CI: 1.85-6.53), depression (2.71, CI: 1.57- 4.65) and anxiety (2.59, CI: 1.56-4.28).

CONCLUSION

Students with personalities high in levels of self-directedness, cooperativeness and persistence and low in harm avoidance, as found in Group 1, demonstrate high levels of general well-being. Positive perceptions of the dentistry learning environment were found to be an important influence on students stress. This study highlighted a number of factors important to student well-being and provides direction for further investigation of interventions aimed at enhancing student well-being.

Body dysmorphic disorder and depression among male undergraduate students in a Malaysian University

INTRODUCTION

Body dysmorphic disorder (BDD) and depression have been reported to be both prevalent among young people worldwide, resulting in serious implications in their quality of life and social functioning. This is worrying especially in men where mental disorders are often overlooked and under-researched. This study aims to determine the proportion of male university students with symptoms suggestive of body dysmorphic disorder and depression, as well as their perception on their body image.

METHODS

In this cross-sectional study, 1,308 male students between the aged of 17-26 years in a private university in Malaysia via self-administered online questionnaire comprising the Patient Health Questionnaire (PHQ)-9, the Body Dysmorphic Disorder Questionnaire (BQQD) and the Body Self-Image Questionnaire (BSIQ), in addition to their sociodemographic parameters. Data analyses were performed with Mann Whitney test, chi square test and Fisher's exact test.

RESULTS

3.3 and 54.2% of the students had symptoms suggestive of BDD and depression respectively, with up to 9.02% of the students reporting having moderate to severe depression. There was a significant association between BDD symptoms and students staying alone, whilst depression was significantly associated with studying in the rural campus. Furthermore, a significant association was demonstrated between presence of BDD and depression symptoms. Most of the students were dissatisfied with their whole body, especially their height.

CONCLUSION

The proportion of BDD and depression symptoms among male students in our university is quite high. Universities and the public health sector should develop better support service targeting male university students.

Psychological Distress among Bangladeshi Dental Students during the COVID-19 Pandemic

Background: Psychological sufferings are observed among dental students during their academic years, which had been intensified during the COVID-19 pandemic. Objectives: This study assessed the levels and identified factors associated with psychological distress, fear and coping experienced by dental undergraduate students in Bangladesh. Methods: A cross sectional online survey was conducted during October-November, 2021. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used in order to assess psychological distress, fear and coping strategies, respectively. Results: A total of 327 students participated; the majority (72%) were 19-23 years old and females (75%). One in five participants were infected with COVID-19 and 15% reported contact with COVID-19 cases. Negative financial impact (AOR 3.72, 95% CIs 1.28-10.8), recent or past COVID-19 infection, and contact with COVID-19 cases were associated with higher levels of psychological distress; but being a third year student (0.14, 0.04-0.55) and being satisfied about current social life (0.11, 0.03-0.33) were associated with lower levels of psychological distress. Being a third year (0.17, 0.08-0.39) and a fourth year student (0.29, 0.12-0.71) were associated with lower levels of fear. Health care service use and feeling positive about life were associated with medium to high resilience coping. Conclusions: This study identified dental students in Bangladesh who were at higher risk of psychological distress, fear and coping during the ongoing pandemic. Development of a mental health support system within dental institutions should be considered in addition to the academic and clinical teaching.

Learning Environment Quality for Medical Students at Umm Al-Qura University: A Comprehensive Study on Stressors, Sources, and Solutions After Introduction of a New Bachelor of Medicine and Bachelor of Surgery (MBBS) Curriculum

OBJECTIVE

Due to introduction of a new curriculum and the related stressors that medical students might encounter, we aimed to assess the quality of the students' learning environment across academic years at Umm Al-Qura University (UQU), by evaluating stress levels, their sources, and impacts on students, to help improve the quality of learning environment and protect students from personal and academic burnout.

METHODS

We conducted a descriptive cross-sectional study in August and September of 2020 on 572 students enrolled in the new Bachelor of Medicine and Bachelor of Surgery (MBBS) curriculum at UQU. All statistical analyses were performed using SPSS software and two-tailed tests.

RESULTS

In total, 46.5% of participants encountered severe stress levels during their studies at UQU. In term of stressor sources, the highest prevalence of severe stress was found among students who lacked learning resources (68.8%), followed by those who complained of ambiguity in teaching, learning, and assessment strategies (64.1%). Self-study strategy issues (58.4%) and difficulty in reading textbooks (58.2%) also ranked high. Anxiety was often reported by the students as an impact of stress (62.9%), followed by mood swings (60%). Severe stress levels showed a statistically significant relationship to gender, being highest among females (P = 0.001). For a solution to manage the stress, 79% of the students suggested a supportive learning environment and identification of students' struggles at early stages.

CONCLUSION

Almost half the medical students were severely stressed after the new curriculum was introduced. Therefore, professors and universities should look out for potential stressors and help students overcome them. Universities can also help by offering counseling services to students, improving the student tutoring system, providing appropriate learning environment and resources, and including stress management courses as a part of the overall curriculum.

Academic and non-academic life stressors and their impact on psychological wellbeing of medical students

Objectives

Among medical students, depression, anxiety, and stress (DAS) are key public wellbeing challenges that require epidemiological research. We aimed to evaluate potential sources of these psychological disturbances and assess the contribution of academic and non-academic life stressors in psychological morbidity among medical students.

Methods

This exploratory questionnaire-based survey was conducted in a Saudi Arabian public sector medical college. A total of 231 medical students were enrolled and completed the depression, anxiety, and stress scale-21 (DASS-21) questionnaire.

Results

More than half of the medical students, 129 (55.8%), had depression, 106 (45.9%) students had anxiety, and 87 (37.7%) students had stress. Academic achievement was the largest explanatory factor for depression and stress, whereas bodily appearance constituted the largest explanatory factor of anxiety among the study sample. Academic and non-academic stressors score was significantly associated with depression (adjusted Odds Ratio, aOR = 1.13, 95% CI 1.07–1.19), anxiety (aOR = 1.07, 95% CI 1.03–1.12), and stress (aOR = 1.12, 95% CI 1.08–1.17).

Conclusions

Medical students have a high incidence of negative emotional states. These negative psychological states were explained by academic achievement and bodily appearance. The studied stressors influenced medical students' psychological wellbeing.

Emotional well-being of dentists and the effect of lockdown during the COVID-19 pandemic: A nationwide study

BACKGROUND

Lockdown in India might have adverse effects on the emotional health of the dental professionals; hence, the aim of the present study was to determine the impact of various factors on emotional well-being of dental professionals due to the effect of lockdown during COVID-19.

MATERIALS AND METHODS

It was a cross-sectional, descriptive, questionnaire study conducted on dentists in India during April 2020. Sampling technique was convenient sampling, and sampling frame was all the dental professionals in India. The questionnaire was prepared online using Google Forms, and the link was generated which was shared among as many dentists accessible as possible, with the help of message, mails, and WhatsApp. The questionnaire consists of questions on Demographic details, practice, and emotional well-being. A total of 1844 dental professionals in 14 states in India responded. The statistical analysis was done using SPSS version no. 20. IBM SPSS version 20.0 (IBM; Armonk, New York USA) Descriptive statistics and multinomial regression test was applied.

RESULTS

Majority of study participants (1096 [59.4%]) belonged to age group of 26-35 years. Emotional well-being score of 1206 (65.4%) dental professionals in the times of COVID-19 outbreak was poor with score between 26 and 78. It was assessed that males have significantly (P = 0.00**) (P < 0.001**) (**highly significant) poorer emotional well-being 0.085 (0.829-1.429) compared to females. Married dental professionals - 0.023 (0.011-1.221) had significantly better (P = 0.05*) emotional well-being than others.

CONCLUSION

Emotional well-being score of majority of dental professionals in the times of COVID-19 outbreak was poor. Gender, marital status, socioeconomic status, years of experience, practicing in clinic, and average number of patients seen per month before lockdown have significant impact on emotional wellbeing of dental professionals.

Psychological impacts of COVID-19 pandemic on the university students in Egypt

University students are at elevated risk for mental health problems. The COVID-19 pandemic and subsequent public health measures taken to combat it burdened the students' life with additional dramatic psychological impacts. The aim of this study was to investigate the psychological impacts that affected the university students in Egypt during the COVID-19 pandemic. An online survey was sent to the Egyptian university students via all means of online communication during the first week of May 2020 by using a non-probability snowball sampling. A survey included a short version Depression Anxiety Stress Scale-21 (DASS-21) and socio-demographic data. Overall, 70.5, 53.6 and 47.8% of Egyptian students had depression, anxiety and stress, respectively. Being a female, having a relative or acquaintance infected with COVID-19, having a preexisting chronic disease and lacking of psychological support from families, community and universities increase the risk of depression, anxiety and stress among Egyptian students. Being a medical student is associated with depression while, spending more time to follow news of COVID-19 pandemic is associated with increased anxiety. Egyptian students experience varying levels of psychological disturbance during COVID-19 pandemic. This study suggests that mental health of the university students should be carefully, monitored during the crisis and the universities should provide psychological-oriented services, adapted to these circumstances to mitigate its emotional impact on the students.

The Impact of the COVID-19 Pandemic on Students' Mental Health and Sleep in Saudi Arabia

Background: Mental health problems are prevalent among university students in Saudi Arabia. This study aimed to investigate the impact of the COVID-19 pandemic on university students’ mental health and sleep in Saudi Arabia. Method: A total of 582 undergraduate students from Saudi Arabia aged between 18 and 45 years old (M = 20.91, SD = 3.17) completed a cross-sectional online questionnaire measuring depression, anxiety, stress, resilience, and insomnia during the COVID-19 pandemic (2020). Analysis included an independent samples t-test, one-way ANOVA, and Hierarchical regression analysis. Results: Undergraduate students reported high levels of depression, anxiety, and perceived stress and low levels of resilience (p < 0.001) during the pandemic. In addition, students reported experiencing insomnia. A hierarchical regression analysis indicated that lower resilience, high levels of insomnia, having a pre-existing mental health condition, and learning difficulties (such as dyslexia, dyspraxia, or dyscalculia) were significantly associated with high levels of depression and stress. In addition, lower resilience, a high level of insomnia, and pre-existing mental health conditions were significantly associated with high levels of anxiety. Finally, a lower level of psychological resilience and a high level of insomnia were significantly associated with increased levels of depression, anxiety and stress within university students. Conclusion: This study has provided evidence that a lower level of psychological resilience and insomnia were associated with mental health problems among undergraduate students in Saudi Arabia, thus enhancing psychological resilience and interventions to support sleep and mental health are vital to support student well-being outcomes throughout the pandemic.

Depression and suicidal ideation among dental students of Southern Saudi Arabia: A cross sectional study

PURPOSE

To assess depression and suicidal ideation among dental students at King Khalid University College of Dentistry, Abha, Saudi Arabia.

METHODS

A cross-sectional questionnaire-based study was carried out among dental students between January and March 2020. The Arabic version of the Patient Health Questionnaire (PHQ-9) was used to assess depression, while suicidal ideation was assessed using three questions related to suicidal behaviors drawn from the literature.

RESULTS

A total of 218 participants completed the questionnaires. More than 40% of the participants experienced depression while the prevalence of suicidal ideation was 48.2%; around a third of the sample had suicidal ideation, and half of which made a suicidal attempt in the preceding year (p < 0.05). There was a lack of association between depression severity and suicidal ideation.

CONCLUSION

A large proportion of dental students experienced depression and suicidal ideation. These findings invite in depth analysis of the causative and contributing factors for such high rates as well as ways for addressing them.

What Lies Beneath: The Role of Self-Efficacy, Causal Attribution Habits, and Gender in Accounting for the Success of College Students

Existing research has identified gender as a driving variable of student success in higher education: women attend college at a higher rate and are also more successful than their male peers. We build on the extant literature by asking whether specific cognitive variables (i.e., self-efficacy and causal attribution habits) distinguish male and female students with differing academic performance levels. Using a case study, we collected data from students enrolled in a general education course (sample size N = 400) at a large public university in the United States. Our findings indicate that while students’ course grades and cumulative college grades did not vary by gender, female and male students reported different self-efficacy and causal attribution habits for good grades and poor grades. To illustrate, self-efficacy for female students is broad and stretches across all their courses; in contrast, for male students, it is more limited to specific courses. These gender differences in cognition, particularly in accounting for undesirable events, may assist faculty members and advisors in understanding how students respond to difficulties and challenges.

Depression among the Non-Native International Undergraduate Students Studying Dentistry in Bangladesh

BACKGROUND

Bangladesh has been attracting international students with interests in various subjects recently. Every year students from different parts of the world come to study undergraduate and postgraduate courses, mostly at private universities in Bangladesh. This study evaluates the depression status among international students who are studying dentistry in Bangladesh.

METHODS

This cross-sectional survey was conducted among International undergraduate dental students who enrolled in the Bachelor of Dental Surgery program in nine public and private dental colleges in Bangladesh. Participants were selected using a convenience sampling method. A total of 206 students completed the survey where 78.5% of them were female students and 21.5% students were male, and a CES-D 10-item Likert scale questionnaire was used for data collection. The Cronbach alpha for the 10-item CES-D scale for this population is 0.812.

RESULTS

The majority of the students (79.5%) are below 24 years of age with a mean age of 23.22 years and standard deviation of 2.3, and are students who cannot communicate well in Bengali (Bangla), about 60% of them have experienced depression. About 77.3% (p < 0.00) of the international students having financial difficulties exhibited depression. The international students who went through financial problems were two times more likely to suffer from depression (OR = 2.38; p-value < 0.01).

CONCLUSION

This study tried to highlight the struggles faced by international students in Bangladesh studying dentistry. It is evident from the findings that several factors influence students' mental well-being during demanding dental education years.

Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study

Objectives:

To quantify the extent and variation of depression, anxiety and stress among medical and non-medical Saudi Arabian students.

Methods:

In this cross-sectional study, students from Umm Al-Qura University, Makkah, Saudi Arabia, were recruited. The Faculty of Education was randomly selected to represent the non-medical colleges. The depression, anxiety and stress scale-21 items (DASS-21) was used to estimate the study outcomes.

Results:

Of the 465 undergraduates recruited in this study, 49.68% (n=231) were medical students and 50.32% (n=234) were non-medical students. Approximately 54%, 53%, and 38% of the participants were found to be suffering from depression, anxiety, and stress, respectively. The analyses showed that the two groups did not differ significantly with respect to stress and depression (p=0.934 and 0.423, respectively). However, the non-medical students exhibited a significantly higher anxiety score compared to the medical students (p=0.002). Family conflicts was a common risk factor for the studied psychological disturbances. Female gender and travel time from home to university were significant predictors of depression and anxiety, whereas a positive history of a psychological condition increased the likelihood of depression and stress.

Conclusion:

There was a high prevalence of anxiety, stress, and depression among the students, with a significantly higher anxiety levels among the non-medical students.

The impact of resilience on anxiety and depression among grass-roots civil servants in China

Background

The grass-roots civil servants are the final implementers and executors of a series of government policies and the fundamental force for social stability and harmonious development. However, the mental health problems of grass-roots civil servants have not got full attention. This study aimed to assess the impact of resilience on anxiety and depression among grass-roots civil servants in China.

Method

From Oct to Dec 2019, 302 civil servants completed a series of questionnaires. The Civil Servants Stress Scale (CSSS) was used to assess the stress of civil servants. The Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS) were used to evaluate the depression and anxiety of participants, respectively. The resilience of civil servants evaluates by the Connor-Davidson Resilience Scale (CD-RSCI). We conducted the moderating and mediating analysis on the impact of resilience on depression and anxiety in grass-roots civil servants.

Results

There were significant differences in gender, education, position, relationship with coworkers, physical exercise, and monthly income for stress in grass-roots civil servants (P < 0.05). Resilience can negatively regulate the stress of grass-roots civil servants, and an effective mediator and moderator in the relationship between stress and anxiety and depression and the mediating effect ratios of 7.77 and 22.79%.

Conclusion

Resilience has moderating and mediating effects on the relationship between stress and depression, and anxiety. The negative effects of stress on depression and anxiety of grass-roots civil servants can be buffered by resilience as a dynamic moderator directly and indirectly. These findings contribute to society and government better understand the mental health status of grass-roots civil servants and provide references and guidance for the formulation of corresponding management and prevention measures.

Psychological Distress among Undergraduate Dental Students in Saudi Arabia and Its Coping Strategies-A Systematic Review

The objective of this paper was to evaluate the studies that have reported on psychological issues among dental students in Saudi Arabia and to develop coping strategies to overcome these mental health-related issues. The present systematic review is in accordance with the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search for the articles was carried out in the electronic databases by four independent researchers. The data search was performed in the electronic search engines like PubMed, Google Scholar, Web of Science, Scopus, Medline, Embase, Cochrane and Saudi Digital Library for scientific research articles published from January 2000 until December 2020. STROBE guidelines were adopted for qualitative analysis of six articles which met the eligibility criteria. The analysis of the literature revealed that most of the studies included were conducted in the past 8 years in different regions of Saudi Arabia. Findings of this systematic review clearly state that dental students in Saudi Arabia experience higher levels of depression, stress and anxiety and stress during their education period, with a higher stress for female students compared to male students. There is an urgent need to introduce interventional programs and preventive strategies to overcome the long-term effects.

Increased Levels of Anxiety Among Medical and Non-Medical University Students During the COVID-19 Pandemic in the United Arab Emirates

Introduction

The COVID-19 pandemic is likely to increase anxiety levels within the community and in particular medical students who are already considered psychologically vulnerable groups. Since the COVID-19 outbreak, no study has yet estimated the effect of this pandemic on university students in the UAE or its impact on the psychological well-being of medical students.

Methods and Materials

We surveyed 1485 medical (comprising medical and dental) and non-medical university students across 4 emirates within the UAE. We used an online platform to assess knowledge, sources of information, changes in hygienic behavior, perceptions of fear and worry and anxiety levels using the generalized anxiety disorder 7 (GAD-7) scale. The GAD-7 score was measured at three time points: during hospital visits for medical/dental students, before the introduction of online learning and after online learning for all students.

Results

The majority of students demonstrated high levels of knowledge and utilized reliable sources of information. Non-medical students exercised higher compliance with social restrictions, while medical students practiced better hand hygiene. Almost half of students reported anxiety levels ranging from mild to severe with females reporting higher anxiety scores during hospital visits (OR=2.02, 95% CI, 1.41 to 2.91) and medical students reporting lower anxiety levels in comparison to dental students (OR=0.61, 95% CI, 0.45 to 0.84). Medical students reported higher levels of anxiety during their clinical rotations which decreased with the introduction of online learning, yet, non-medical students’ anxiety levels increased with online learning.

Conclusion

This study provides important information on the initial response and anxiety levels in university students across the UAE during the COVID-19 pandemic. The findings from our study can be used to support the development of effective screening strategies and interventions to build psychological resilience among university students during the COVID-19 pandemic or any other public health emergencies in the future.

Psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on dental students: A nationwide study

OBJECTIVES

Public mental health concerns have been raised during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to assess the psychological impact of the pandemic on dental students in Saudi Arabia.

METHODS

A cross-sectional analytical study was conducted among dental students from different universities in Saudi Arabia selected using 2-stage cluster sampling. The psychological impact was assessed using the validated Arabic version of the Depression, Anxiety and Stress Scale-21 Item questionnaire. The data were analyzed using SPSS software. The Mann-Whitney U and Kruskal-Wallis tests were used as appropriate. A chi-squared test was used to compare the proportions between the sociodemographic data and logistic regression analysis to identify variables associated with the student's responses.

RESULTS

The internal consistency of the scale was excellent (0.954). A total of 697 dental students participated voluntarily in the study; their mean age was 21.76 ± 1.859 years, and 54.7% were female. The majority (96.1%) were single, and 69.4% lived in a household of > 5 persons. Significant differences in mental health outcomes were evident for gender, university, and survey time. Elevated levels of depression, anxiety, and stress were recorded among 60.64%, 37.02%, and 34.92%, respectively, of the students. Females, students who lived alone, and junior students were more likely to experience psychological problems during the COVID-19 pandemic.

CONCLUSIONS

The presence of elevated levels of depression, anxiety and stress among dental students highlights the need for psychological empowerment strategies involving institutional counseling services.

Depressive disorders in the Arabian Gulf Cooperation Council countries: a literature review

OBJECTIVE

To determine the contributions from the six Arabian Gulf Cooperation Council (GCC) countries to the national scientific literature on depressive disorders.

METHODS

This literature review identified all of the published studies on all major depressive disorders as cited on the PubMed® and APA PsycInfo® databases from inception to 31 December 2016 from the six GGC countries. Data were extracted using a standardized form. The study compared the volume of research production between the countries by calculating an index that allowed for the country population size.

RESULTS

A total of 28 studies met the inclusion criteria. Saudi Arabia headed the list of publications (10 articles) followed by the United Arab Emirates (n = 6), Kuwait (n = 5), Qatar (n = 3); and Bahrain and Oman produced two articles each. Only six out of the 28 (21.4%) studies included a random sample or adopted good sampling strategies. The majority of studies (24 of 28; 85.7%) were cross-sectional in design. Only one study clearly stated the use of the DSM-4 criteria for diagnosis.

CONCLUSION

The scientific literature published by the GCC countries on depressive disorders is scant and lacking scientific depth. These findings should be considered as a wake-up call for public health researchers, mental health workers and policymakers.

The effect of life coaching on psychological distress among dental students: interventional study

Background

Depression, stress, and anxiety are common psychological conditions among dental students in many countries around the world. A number of researchers have found life coaching to be effective at reducing psychological distress. The aim of this study was to assess the effect of a life coaching program on dental students’ psychological status.

Methods

A quasi-experiment study with two arms was conducted on 88 female dental students at Umm Al-Qura University (study group = 44; control group = 44). The psychological status was assessed by questionnaire before and after intervention. The questionnaire was composed of the Depression and Anxiety Stress Scale (DASS-21), Resilience Scale (RS-14), the Psychological Well-Being Scale–Short (PWB-S), and goal approach questions. The study group received a coaching program comprising one lecture for 1 h and five phone coaching sessions over 5 weeks, while the control group received no intervention.

Results

The study group showed a significant reduction in depression, anxiety, stress, resilience, and self-acceptance according to the PWB-S scale. Also, goal approach was significantly improved. On the other hand, the control group showed a significant reduction on the RS-14 only. The differences in the tested scales between the study group and the control group from pre-intervention (T1) to post-intervention (T2) showed significant differences in depression, stress, self-acceptance, and goal approach measurements per t-test.

Conclusion

The study’s findings showed that life coaching had the effect of reducing psychological distress, which encouraged the implementation of coaching practice in the daily life of dental students.

Self-reported depressive symptoms in dental students: Systematic review with meta-analysis

OBJECTIVE

This study aimed to systematically review the literature about the prevalence of self-reported depressive symptoms in dental students.

METHODS

PUBMED, SCOPUS, and EMBASE databases were search up to January 2020 with the following focused questions: "What is the prevalence of self-reported depression symptom in dental students?" and "Are sex and years of educational training associated with self-reported depressive symptom in dental students?". Observational studies that applied a questionnaire assessing depression were eligible. Standard mean differences (SMD) and pooled odds ratios (OR) were calculated for the questionnaires' scores and self-reported depressive symptom, respectively.

RESULTS

Fifty-eight studies were included, and 15 different questionnaires were used. The prevalence of self-reported depressive symptoms/at least mild depression ranged from 2.75% to 89.84%, and the pooled overall prevalence was 29% (95% confidence interval [CI]: 26-34). Meta-analysis showed significantly lower scores in the questionnaires for self-reported depressive symptoms of male students (SMD: -0.22; 95% CI: -0.42 - -0.03). Conversely, no significant difference was detected for the OR of self-reported depressive symptom in the comparison between sex (OR: 1.11 - 95% CI: 0.77-1.62). Similarly, no significant difference was observed for the different school years regardless of the analytical strategy used.

CONCLUSION

It was concluded that female dental students presented more self-reported depressive symptoms, but no difference is demonstrated during the years of dental education.

The magnitude of COVID-19 related stress, anxiety and depression associated with intense mass media coverage in Saudi Arabia

The Coronavirus Disease 2019 (COVID-19) has resulted in catastrophic consequences in many aspects of life; including negative psychological effects. We aimed to assess the mental health status of a group of Saudi population during this pandemic. Also, we aimed to assess the effect of the intensive media coverage of the pandemic news on mental health status. A questionnaire was distributed online to test depression, anxiety, and stress (using the DASS-21 scale) and their relationship to certain variables. A total of 215 respondents were included. Higher mental health prevalence rates were reported in non-Saudi participants compared to Saudi ones (i.e., 50.74% vs. 30.40%; 34.23% vs. 13.51% and 59.70% vs. 27.70%; for depression, anxiety and stress, respectively). About 55.8% of the participants felt the extensive coverage in the media of COVID-19 news, which caused higher mental sufferings. Higher mental health prevalence rates were reported in females compared to males participants (i.e., 56.97% vs. 23.25%; 30.23% vs. 13.17% and 54.65% vs. 26.35%; for depression, anxiety and stress, respectively). Reasonable following of the COVID-19 news; and less exposure to the pandemic information could help in reducing the mental health issues related to the ongoing pandemic. Special care and attention should be paid to females and younger people who seem to be particularly affected during the era of COVID-19.

Psychological Impact of the COVID-19 Pandemic on Dental Interns in Riyadh, Saudi Arabia: A Cross-sectional Survey

BACKGROUND

Dental profession is labeled as a high-risk profession, due to which dental care professionals are under tremendous pressure during the outbreak of COVID-19 pandemic. The aim of this study was to assess the psychological impact of the COVID-19 pandemic on dental interns in Riyadh, Saudi Arabia.

MATERIALS AND METHODS

A cross-sectional study was conducted among dental interns from different universities in Riyadh, Saudi Arabia. The data were collected using a validated Depression, Anxiety and Stress Scale-21 Items (DASS-21) questionnaire. Descriptive statistics were presented using frequencies (n) and percentages (%). Chi-square and Fisher exact tests were used to assess the association between sociodemographic data (age, gender, nationality, marital status, and history of physical and mental illness) and levels of depression, anxiety, and stress. A p < 0.05 was considered as statistically significant.

RESULTS

A total of 160 dental interns were invited to participate in this survey; out of which 110 participants responded yielding a response rate of 78%. The mean age of the study participants was 25.1 years. About 65% of the participants were female. Only 14.5% of the subjects reported having a past history of physical or mental illness. Depression, anxiety, and stress were identified in 11.9%, 7.3%, and 0.9% of the dental interns, respectively. Demographic characteristics did not appear to influence depression, anxiety, or stress levels (p > 0.05).

CONCLUSION

The outbreak of COVID-19 pandemic has affected the mental health of dental interns. The presence of depression, anxiety, and stress among dental interns highlights the need for special intervention and support programs to promote mental health and well-being among dental interns.

HOW TO CITE THIS ARTICLE

Khanagar SB, Alfadley A. Psychological Impact of the COVID-19 Pandemic on Dental Interns in Riyadh, Saudi Arabia: A Cross-sectional Survey. Int J Clin Pediatr Dent 2020;13(5):508-512.

Overview of the Saudi National Mental Health Survey

OBJECTIVES

To present background information for the Saudi National Mental Health Survey (SNMHS) on the Saudi mental healthcare delivery system and previous epidemiological research on the prevalence and treatment of mental disorders in the Kingdom of Saudi Arabia (KSA).

METHODS

Archival information and the results of a literature review are presented.

RESULTS

KSA is the largest sovereign nation in the Middle East and the largest free market economy in the Middle East and North Africa. A national mental health policy has been in existence since 2006, but mental health spending still is less than in most other high-income countries. The Ministry of Health has recently begun developing a new healthcare system based on a patient-centered model of care that will integrate care of mental disorders with care of physical disorders. Previous epidemiological research on mental disorders in KSA has been limited, making the SNMHS important for policy planning purposes to obtain accurate estimates of prevalence, treatment, and barriers to treatment.

CONCLUSIONS

The SNMHS will provide valuable information for policy planning purposes on the burden of untreated mental disorders in KSA and barriers to treatment.

Anxiety and Its Association with Preparation for Future Specialty: A Cross-Sectional Study Among Medical Students, Saudi Arabia

Background

Anxiety disorders are a significant global health concern with destructive morbidity and mortality. Medical school is a stressful environment worldwide. This study measures the prevalence of anxiety symptoms among clinical-year medical students in Saudi Arabia. As well as to explore its association with students’ sociodemographic factors, academic performance, issues experienced by them during the study of medicine, and their perceived readiness for their future specialties.

Methods

The generalized anxiety disorder (GAD-7) tool along with a sociodemographic questionnaire was distributed to 523 clinical-year medical students (fourth, fifth and sixth years) from the Imam Abdulrahman Bin Faisal University, Saudi Arabia, in this cross-sectional study. Data analysis was performed with SPSS version 23 and it included the Chi-Square or Fisher’s exact tests for bivariate analysis, and the multivariable logistic regression to account for confounders.

Results

The prevalence of anxiety symptoms as measured by the GAD-7 was found to be 31.7%. Of these, 14.3% had severe symptoms. Only 4.4% students went to a healthcare professional and were diagnosed with psychiatric problems. Logistic regression analysis revealed that the odds of anxiety was higher among females and students who had perceived psychological problems. However, students’ grade point average (GPA) and perceived readiness for their future specialty were not statistically significant with anxiety symptoms.

Conclusion

Anxiety was highly prevalent among clinical-year medical students included in this study. This urges periodic mental health screening, proper diagnosis of high-risk individuals in medical schools, and early interventions through confidential access to mental health services.

Life satisfaction of Taiwanese dental graduates received residencies in the U.S.: a cross-sectional study

BACKGROUND

Each year, more than 200 international dental graduates start U.S. specialty trainings to become specialists. It is unknown if their life satisfaction is associated with any dental career-related factor before residencies (e.g. dental school class rank, research experience, or private practice experience) and after residencies (e.g. staying in the U.S., teaching status, workplace, or board certification). This cross-sectional study aimed to identify these potential factors by surveying Taiwanese dental graduates who pursued U.S. residencies.

METHODS

Life satisfaction was measured with a structured questionnaire, Satisfaction With Life Scale (SWLS), which includes five statements on a 5-point Likert scale. Online surveys were sent out to 290 Taiwanese dental graduates who were known to pursue U.S. residencies. T-test, one way analysis of variance, and multivariable adjusted generalized linear model (GLM) were used to assess the differences of mean SWLS scores from different variables.

RESULTS

Surveys were completed by 158 dentists. Mean SWLS score of 125 specialists was higher (p = 0.0007) than the score of 33 residents. For the 125 specialists, multivariable adjusted GLM demonstrated better life satisfaction was positively associated with multiple independent factors, such as having research experience, being ranked in the top 26 ~ 50% of the class in dental school, starting U.S. residency within 4 years after dental school, starting residency before year 1996, and specializing in endodontics (vs. periodontics). Life satisfaction was not associated with any factors after residency (e.g. staying in the U.S. afterwards, teaching status, or workplace), but better mean life satisfaction score was significantly associated with being American specialty board certified (p < 0.001) for the specialists in the 26 ~ 75% of their class in dental school. For the 33 residents, better mean life satisfaction score was associated with better dental school class rank in both bivariate (p = 0.020) and multivariable adjusted GLM (p = 0.004) analyses.

CONCLUSIONS

The life satisfaction of Taiwanese dental graduates pursuing U.S. residencies might be associated with some professional factors, such as research experience, dental school class rank, residency timing, specialty type, and specialty board certification. We hope our results may provide some objective information on making career decisions for international dental graduates/students who are preparing for U.S. residency.

Assessment of minor psychiatric morbidity, stressors, and barriers of seeking help among medical students at the University of Khartoum, Khartoum, Sudan

Introduction

Medical education can be stressful and a source of psychiatric morbidity for medical students with the potential of causing serious professional and personal negative consequences. With the limited studies investigating this issue in Sudan, this study aimed at assessing psychiatric morbidity, determine stressors, evaluate mental health care seeking behavior and barriers to seeking help among medical students in Khartoum, Sudan.

Methods

This was a cross-sectional study with data collection for a period of one month, during the survey. Following ethical clearance and administrative approval, 644 students who gave consent were selected randomly from the university of Khartoum’s faculty of medicine. The “12-General Health Questionnaire (GHQ12)” was used as a tool to assess prevalence of psychiatric morbidity, determine stressors and evaluate barriers to seeking mental health care among students for a period of a month.

Results

The overall prevalence of psychiatric morbidity was 56% (n = 356). The mean score of the GHQ12 was 6.7. There was a statistically significant association between GHQ12-score and level of study (in medical school), age, student’s income (student financial allowance). Stressors mostly experienced by students were fear of academic failure, dissatisfaction with academic performance and examination stress. The most frequent barriers to seeking mental health care elicited by participants were fear of stigmatization 63% (n = 401), preference for dealing with the problem alone 60% (n = 379), fear of the unknown 59% (n = 365) and failure to recognize symptoms 58% (n = 366).

Conclusion

Psychiatric morbidity is commonly experienced by students in medical school as can be seen from the high prevalence (56%). The reported high figures of psychiatric morbidity among medical school students points to the urgency for interventions to address this problem with potential for negative sequelae (personal and professional). Our findings suggest that interventions to improve the social and economic conditions of students in medical school as well as addressing stigma related to mental health and educating students to recognize signs and symptoms of psychiatric morbidity while making help accessible might go a long way to address this challenge.

Psychological Stress and Stressors Among Clinical Dental Students at Shiraz School of Dentistry, Iran

OBJECTIVE

The purpose of this study was to assess the level of psychological stress and the perceived stressors among the undergraduate clinical dental students of Shiraz School of Dentistry.

MATERIALS AND METHODS

This study was conducted during the second semester of the academic year 2018-2019 at Shiraz School of Dentistry, Shiraz University of Medical Sciences, Iran. The study group consisted of 150 dental clinical students. The participants were surveyed via the validated Depression, Anxiety, and Stress Scale (DASS-21) and the Dental Environment Stress (DES) questionnaires. One-way ANOVA, post hoc Tukey's test, repeated measure ANOVA, Holm-Sidak's test, and t-test were performed to analyze the data after the normality of the data was checked by Kolmogorov-Smirnov test. The P values of less than 0.05 were considered as statistically significant.

RESULTS

No significant differences were observed among the dental students with different academic levels in terms of depression and anxiety scores (P=0.057 and 0.154, respectively). The lowest and highest stress scores were observed among the sixth- and fifth-year students, respectively (P values <0.05). The scores of the stressors associated with the academic factors were significantly higher than those of the other domains (P<0.05) except for that of the clinical education domain (P=0.070). The females showed significantly higher DES scores (P values <0.05).

CONCLUSION

The highest and lowest stress levels were observed among the fifth- and sixth-year students, respectively. The primary sources of stress were academic factors and clinical education. The females expressed higher levels of stress in certain areas of dental training.

Prevalence of Mental Distress and Associated Factors among Samara University Students, Northeast Ethiopia

BACKGROUND

Empirical findings have indicated that higher institution students experience a higher prevalence of mental distress compared to the general population. Understanding the magnitude and associated factors of mental distress in university students would be helpful to practitioners and policymakers in Ethiopia. The aim of the present study was to examine the prevalence and associated factors of mental distress among Samara university students, Northeast Ethiopia.

METHODS

Institution based cross-sectional study design was conducted in Samara university from December to June 2018. A simple random sampling technique was employed to select the study participants. Self-Reporting Questionnaire-20 (SRQ-20) was used to measure the mental distress of students. Multivariable logistic regression modeling was used to examine the association between sociodemographic and psychosocial factors with the mental distress of students.

RESULTS

The proportion of students with mental distress were found to be 53.2% (95% confidence interval [CI]: 48.0%, 58.0%). Female students were more likely to be mentally distressed compared to male students (adjusted odds ratio [AOR]: 4.66; 95% CI: 2.81, 7.71). Ever khat use (AOR: 3.09; 95% CI: 1.74, 5.50) and poor sleep quality (AOR: 2.23; 95% CI: 1.12, 3.66) were significantly associated with mental distress of students.

CONCLUSION

Our study indicates that the proportion of mental distress was found to be higher among Samara university students as compared to previously published studies in Ethiopia. Female students, ever khat users and those with poor sleep quality were associated with mental distress. There is a need for evidence-based interventional strategies such as self-help measures, sleep hygiene and peer support, as well as professional mental health services as part of student health services that would be helpful to reduce the burden of mental distress of students.