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Lin YK, Saragih ID, Lin CJ, Liu HL, Chen CW, Yeh YS. Global prevalence of anxiety and depression among medical students during the COVID-19 pandemic: a systematic review and meta-analysis. BMC Psychol 2024; 12:338. [PMID: 38858700 PMCID: PMC11163725 DOI: 10.1186/s40359-024-01838-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/31/2024] [Indexed: 06/12/2024] Open
Abstract
PURPOSE As future physicians, medical students have experienced tremendous pressure during the ongoing COVID-19 pandemic, which is associated with a high risk of depression and anxiety. We aimed to investigate an overview of the prevalence of anxiety and depression among medical students in various countries during the global COVID-19 pandemic, and discuss associated stressors. METHODS We systematically searched CINAHL, EMBASE, MEDLINE, PubMed, and Web of Science for relevant articles from December 1, 2019 to March 15, 2023. We performed meta-analysis using a random-effects model with REML method to calculate the pooled prevalence of anxiety and depression. Begg's and Egger's tests were used to identify the potential risk of publication bias. Meta-regression was used to explore potential sources of heterogeneity. RESULTS We identified 130 studies reporting anxiety and depression among 132,068 medical students during the COVID-19 pandemic. Eight screening tools were identified for anxiety and six for depression. The pooled prevalence of mental health outcomes for anxiety and depression was 45% (95% confidence interval [CI], 40%-49%) and 48% (95% CI, 43%-52%), respectively. The pooled prevalence of mental health outcomes for moderate and severe anxiety and moderate and severe depression was 28% (95% CI, 24%-32%) and 30% (95% CI, 26%-35%), respectively. There was high heterogeneity between studies, with I2 ranging from 99.58%-99.66%. Continent and survey date were included in the meta-regression model. The results of meta-regression revealed that medical students in Asia had a lower prevalence of anxiety, and depression than those in other regions. The survey date (from February to June, 2020) showed a significantly positive correlation with the prevalence of anxiety and depression. CONCLUSIONS We demonstrated the global prevalence of anxiety and depression among medical students during the COVID-19 pandemic. The data highlight that medical students worldwide are at high risk of experiencing anxiety and depression. The reported stressors can be categorized into personal, academic, environmental and cultural, and pandemic factors. Schools and institutions should ensure optimal alternative learning environments for uninterrupted provision of medical education. The appropriate authorities should prioritize the provision of adequate protection for medical students and establish policies to promote new methods of training and education during a disaster, such as via distance learning.
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Affiliation(s)
- Yen-Ko Lin
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Medical Humanities and Education, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Emergency Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Center for Medical Education and Humanizing Health Professional Education, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Ita Daryanti Saragih
- Doctoral student, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Ju Lin
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsin-Liang Liu
- Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Wen Chen
- Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Emergency Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Sung Yeh
- Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Emergency Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Heumann E, Palacio Siebe AV, Stock C, Heinrichs K. Depressive Symptoms Among Higher Education Students in Germany-A Systematic Review and Meta-Analysis. Public Health Rev 2024; 45:1606983. [PMID: 38978768 PMCID: PMC11228579 DOI: 10.3389/phrs.2024.1606983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/20/2024] [Indexed: 07/10/2024] Open
Abstract
Objectives Higher education students in Germany are vulnerable to depressive symptoms. Despite ample evidence, no comprehensive review has recently been conducted. Thus, our systematic review and meta-analysis aims at describing the extent to which students are affected by depressive symptoms. Methods We searched three databases for articles reporting the prevalence rates of depressiveness among students in Germany published between 2002 and 2023. Pooled prevalence rates were calculated using random effects models, both for the overall sample and for subgroups categorized by gender, study setting, assessment instrument, and whether the study was conducted before or during the COVID-19 pandemic. Results The search yielded 992 records. After screening, 60 articles remained for data extraction. About one out of five students (21.1%) exhibits depressive symptoms. Pooled prevalence rates differ between subgroups, with higher rates during the COVID-19 pandemic than before (30.6% versus 18.0%) and with females being more affected than their male counterparts (29.0% versus 23.1%). Conclusion This review underlines the urgency with which the mental health of students should be addressed at the (higher educational) policy level. Clinical Trial Registration: PROPSPERO, Identifier CRD42022384066.
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Affiliation(s)
- Eileen Heumann
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ana Valentina Palacio Siebe
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
| | - Katherina Heinrichs
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Benner AD, Harrington MK, Kealy C, Nwafor CE. The COVID-19 pandemic and adolescents' and young adults' experiences at school: A systematic narrative review. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024. [PMID: 38509818 DOI: 10.1111/jora.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/27/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024]
Abstract
The COVID-19 pandemic upended the lives of adolescents and young adults across the globe. In response to the pandemic onset, educational institutions were forced to pivot to online learning, a new teaching and learning format for most secondary and university students. This systematic narrative review summarizes findings from 168 publications spanning 56 countries on students' educational outcomes and school climate as well as the internal assets and contextual supports that promoted academic well-being during the pandemic. Our findings suggest that young people commonly reported declines in their academic-related outcomes and school-based relationships due to the COVID-19 pandemic. Internal assets (e.g., intrinsic motivation and self-efficacy) and contextual supports (i.e., relationships with teachers, peers, and parents) promoted academic well-being during the pandemic. Next steps for research on young people's academic well-being during the pandemic are suggested.
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Affiliation(s)
- Aprile D Benner
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Madeline K Harrington
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Carmen Kealy
- School of Education, University of Galway, Galway, Ireland
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Hajduk M, Tiedemann E, Romanos M, Simmenroth A. Neuroenhancement and mental health in students from four faculties - a cross-sectional questionnaire study. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc9. [PMID: 38504866 PMCID: PMC10946206 DOI: 10.3205/zma001664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/31/2023] [Accepted: 11/29/2023] [Indexed: 03/21/2024]
Abstract
Background Students face great challenges at the beginning of and during their studies. Competitive experience, exam anxiety, and especially the new performance requirements often cause test anxiety and stressful experiences. The extent of substance use in terms of neuroenhancement (NE) is unclear. Evidence shows associations between NE, increased stress levels, and mental health. Objectives We aim to determine the prevalence of NE and alcohol and tobacco use among college students. We also investigate the associations between NE and ADHD, anxiety, depression, and stress experience. Methods In spring 2021, an anonymous online cross-sectional survey was conducted among students of medicine, dentistry, business economics, and business informatics in Würzburg. The survey included the instruments ASRS (ADHD), PSS-10 (stress), PHQ-4 (depression and anxiety), and AUDIT-C (alcohol comsumption), as well as questions about consumption patterns, prior knowledge, and reasons for NE. Results Of the 5564 students who were invited to participate, 1010 completed the questionnaire (18.2%). Of these, 12.4% indicated NE for the studied period. NE was used in particular during preparations for exams, to enhance performance, and/or to regulate emotions, most commonly through caffeine tablets, cannabis, and methylphenidate. NE was associated with risky use of alcohol or tobacco, and to a lesser extent with ADHD symptoms and stress experience.Conclusions: Students are at risk of substance abuse and NE. Effective stress management and prevention approaches as well as low-threshold services are needed to identify and support students with risk profiles.
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Affiliation(s)
- Maurice Hajduk
- University Medical Centre Würzburg, Institute of General Practice, Würzburg, Germany
| | - Elena Tiedemann
- University Medical Centre Würzburg, Institute of General Practice, Würzburg, Germany
| | - Marcel Romanos
- University Medical Centre Würzburg, Clinic and Polyclinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany
| | - Anne Simmenroth
- University Medical Centre Würzburg, Institute of General Practice, Würzburg, Germany
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Korn L, Zigdon A, Davidovitch N. Academic distress among undergraduate students during COVID-19: the relevance of SES and help-seeking behaviors. Front Psychol 2023; 14:1181009. [PMID: 37377710 PMCID: PMC10291245 DOI: 10.3389/fpsyg.2023.1181009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/17/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction Academic distress has been frequently reported following the COVID-19 pandemic. This study estimates academic distress among undergraduate students, characterizes its nature in relation to economic, social, and health indicators, and examines the level of request for help following mental distress. Students with higher levels of academic distress were expected to show lower socio-economic status, lower social connections, and lower wellbeing indices. Methods A cross-sectional study based on a structured anonymous questionnaire was delivered online to more than 1,400 undergraduate students from one university in Israel (women, 66.7%). Results Academic distress was reported by 27.1% of the sample. Students who reported academic distress were more likely to report stress, negative psycho-somatic symptoms, changes in weight since COVID-19, low self-esteem, depressive symptoms, higher COVID-19 concerns, and higher security situation concerns. A hierarchic logistic regression model showed that the probability of reporting academic distress was 2.567 times higher (p < 0.001 95% CI [1.702, 3.871]) for those who reported lower family economic status before COVID-19 and 2.141 times higher (p = 0.004 95% CI [1.284, 3.572]) for those who highly reported depressive symptoms. In contrast, only 15.6% of those who reported academic distress sought help from academic authorities. Discussion The significant associations of academic distress with health indices indicate that the self-reported distress was real and highly related to adverse health measures. A comprehensive, collaborative model that integrates psychological, economic, and social aspects of intervention is required in times of crisis within academic institutions.
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Affiliation(s)
- Liat Korn
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel, Israel
| | - Avi Zigdon
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel, Israel
| | - Nitza Davidovitch
- Department of Education Studies, Faculty of Social Sciences, Ariel University, Ariel, Israel
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Halfmann M, Wetzel L, Castioni N, Kiefer F, König S, Schmieder A, Koopmann A. The impact of COVID-19 pandemic on mental burden and quality of life in medical students - results of an online survey. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc21. [PMID: 37361244 PMCID: PMC10285365 DOI: 10.3205/zma001603] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/09/2023] [Accepted: 02/06/2023] [Indexed: 06/28/2023]
Abstract
Objectives Changes in academic conditions due to the COVID-19 pandemic are potential stressors for medical students and can make them vulnerable for the development of psychiatric disorders.Previous pandemics had a negative impairment on well-being due to social isolation and the perceived threat, an increase in fear, anger and frustration and an increase in post-traumatic stress disorder among health professionals. Therefore, this study examines the impact of the COVID-19 pandemic on medical students' mental health and possible psychological consequences. Methods In this anonymous online survey (online 12/01/2021-03/31/2022), we examined the impact of COVID-19 pandemic on mental health of 561 German medical students aged between 18 und 45 years. Perceived anxiety and burden were assessed retrospectively from spring 2020 to autumn 2021. Changes in symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), quality of life was assessed using the WHO Quality of Life Questionnaire (WHOQOL BREF). Results Anxiety and burden showed wavelike courses with higher scores in autumn, winter and spring. The scores for depression and anxiety increased after the outbreak of the COVID-19 pandemic compared to the time before (p<.001). Results of a multifactorial ANOVA showed, that previous psychiatric illness (p<.001), being in the first two years of studies (p=.006), higher burden (p=.013) and greater differences in symptoms of depression (p<.001) were associated with a decreased quality of life in medical students. Conclusion The COVID-19 pandemic has a negative impact on mental health of medical students and their actual quality of life. Therefore, medical faculties should establish specific support to prevent the development of psychiatric sequelae probably resulting in long-term medical leaves.
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Affiliation(s)
- Marie Halfmann
- Central Institute of Mental Health (CIMH), Department of Addictive Behavior and Addiction Medicine, Mannheim, Germany
- University of Heidelberg, Feuerlein Centre on Translational Addiction Medicine (FCTS), Heidelberg, Germany
| | - Lea Wetzel
- Central Institute of Mental Health (CIMH), Department of Addictive Behavior and Addiction Medicine, Mannheim, Germany
- University of Heidelberg, Feuerlein Centre on Translational Addiction Medicine (FCTS), Heidelberg, Germany
| | - Noah Castioni
- Central Institute of Mental Health (CIMH), Department of Addictive Behavior and Addiction Medicine, Mannheim, Germany
- University of Heidelberg, Feuerlein Centre on Translational Addiction Medicine (FCTS), Heidelberg, Germany
| | - Falk Kiefer
- Central Institute of Mental Health (CIMH), Department of Addictive Behavior and Addiction Medicine, Mannheim, Germany
- University of Heidelberg, Feuerlein Centre on Translational Addiction Medicine (FCTS), Heidelberg, Germany
| | - Sarah König
- University Hospital Würzburg, Institute for Medical Teaching and Medical Education Research, Würzburg, Germany
| | - Astrid Schmieder
- University Hospital Würzburg, Clinic for Dermatology, Venereology and Allergology, Würzburg, Germany
| | - Anne Koopmann
- Central Institute of Mental Health (CIMH), Department of Addictive Behavior and Addiction Medicine, Mannheim, Germany
- University of Heidelberg, Feuerlein Centre on Translational Addiction Medicine (FCTS), Heidelberg, Germany
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Peng P, Hao Y, Liu Y, Chen S, Wang Y, Yang Q, Wang X, Li M, Wang Y, He L, Wang Q, Ma Y, He H, Zhou Y, Wu Q, Liu T. The prevalence and risk factors of mental problems in medical students during COVID-19 pandemic: A systematic review and meta-analysis. J Affect Disord 2023; 321:167-181. [PMID: 36341802 PMCID: PMC9613786 DOI: 10.1016/j.jad.2022.10.040] [Citation(s) in RCA: 56] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/16/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND This meta-analysis and systematic review aimed to evaluate the global prevalence and risk factors of mental problems (i.e., depression, anxiety, stress, sleep disorder, posttraumatic stress disorder (PTSD), burnout, psychological distress, and suicidal ideation) among medical students during the COVID-19 pandemic. METHOD We searched PubMed, Embase, Web of Science, psycARTICLES, PsycINFO, CNKI, and Wan Fang for studies on the prevalence of mental problems among medical students from January 1, 2020, to April 1, 2022. The pooled prevalence was calculated by random-effect models. We performed a narrative review to identify the risk factors. RESULTS The meta-analysis included 201 studies (N = 198,000). The prevalence of depression (41 %, 95 % CI, 37-45 %,), anxiety (38 %,95 % CI, 34 %-42 %), stress (34 %, 95 % CI, 27 %-42 %), sleep disorder (52 %, 95 % CI, 44 %-60 %), psychological distress (58 %, 95 % CI, 51 %-65 %), PTSD (34 %, 95 % CI, 22 %-46 %), suicidal ideation (15 %, 95 % CI, 11 %-18 %) and burnout (38 %, 95 % CI, 25 %-50 %) was high. The major risk factors were being female, being junior or preclinical students, exposure to COVID-19, academic stress, psychiatric or physical disorders history, economic trouble, fear of education impairment, online learning trouble, fear of infection, loneliness, low physical activity, low social support, problematic internet or smartphone use, and young age. LIMITATIONS Most studies were cross-sectional. Few studies provided a reasonable response rate, suggesting potential selection bias. CONCLUSIONS The study demonstrated a high prevalence and risk factors for mental problems during COVID-19, calling for mental health services. Our findings are valuable for college and health authorities to identify high-risk students and provide targeted intervention.
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Affiliation(s)
- Pu Peng
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yuzhu Hao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yueheng Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Shubao Chen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yunfei Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Qian Yang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xin Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Manyun Li
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yingying Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Li He
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Qianjin Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yuejiao Ma
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Haoyu He
- Department of Psychology, College of Education, Hunan First Normal University, Changsha 410205, China
| | - Yanan Zhou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China,Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital), Changsha, China
| | - Qiuxia Wu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Tieqiao Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Melchior M, Florence AM, Davisse-Paturet C, Falissard B, Galéra C, Hazo JB, Vuillermoz C, Warszawski J, Dione F, Rouquette A. Labor market participation and depression during the COVID-19 pandemic among young adults (18 to 30 years): A nationally representative study in France. Front Public Health 2022; 10:904665. [PMID: 36353287 PMCID: PMC9638096 DOI: 10.3389/fpubh.2022.904665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/26/2022] [Indexed: 01/22/2023] Open
Abstract
Objective To examine the relationship between young adults' labor force participation and depression in the context of the COVID-19 pandemic. Design setting participants Data come from the nationally-representative EPICOV cohort study set up in France, and were collected in 2020 and 2021 (3 waves of online or telephone interviews: 02/05/2020-12/06/2020; 26/10/2020-14/12/2020; 24/06/2021-09/08/2021) among 2,217 participants aged 18-30 years. Participants with prior mental health disorder (n = 50) were excluded from the statistical analyses. Results Using Generalized Estimating Equation (GEE) models controlled for participants' socio-demographic and health characteristics and weighted to be nationally-representative, we found that compared to young adults who were employed, those who were studying or unemployed were significantly more likely to experience depression assessed using the PHQ-9 (multivariable ORs, respectively: OR: 1.29, 95% CI 1.05-1.60 and OR: 1.50, 1.13-1.99). Stratifying the analyses by age, we observed that unemployment was more strongly associated with depression among participants 25-30 years than among those who were 18-24 years (multivariable ORs, respectively, 1.78, 95% CI 1.17-2.71 and 1.41, 95% CI 0.96-2.09). Being out of the labor force was, to the contrary, more significantly associated with depression among participants 18-24 years (multivariable OR: 1.71, 95% CI 1.04-2.82, vs. 1.00, 95% CI 0.53-1.87 among participants 25-30 years). Stratifying the analyses by sex, we found no significant differences in the relationships between labor market characteristics and depression (compared to participants who were employed, multivariable ORs associated with being a student: men: 1.33, 95% CI 1.01-1.76; women: 1.19, 95% CI 0.85-1.67, multivariable ORs associated with being unemployed: men: 1.60, 95% CI 1.04-2.45; women: 1.47, 95% CI 1.01-2.15). Conclusions and relevance Our study shows that in addition to students, young adults who are unemployed also experience elevated levels of depression in the context of the COVID-19 pandemic. These two groups should be the focus of specific attention in terms of prevention and mental health treatment. Supporting employment could also be a propitious way of reducing the burden of the COVID-19 pandemic on the mental health of young adults.
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Affiliation(s)
- Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France,*Correspondence: Maria Melchior
| | - Aline-Marie Florence
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - Camille Davisse-Paturet
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France
| | - Bruno Falissard
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France,AP-HP Paris-Saclay, Epidemiology and Public Health Department, Le Kremlin-Bicêtre, France
| | - Cédric Galéra
- INSERM, Bordeaux Population Health Center, UMR1219, Bordeaux, France
| | | | - Cécile Vuillermoz
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - Josiane Warszawski
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France,AP-HP Paris-Saclay, Epidemiology and Public Health Department, Le Kremlin-Bicêtre, France
| | - Fallou Dione
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France
| | - Alexandra Rouquette
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France,AP-HP Paris-Saclay, Epidemiology and Public Health Department, Le Kremlin-Bicêtre, France
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Caldirola D, Daccò S, Cuniberti F, Grassi M, Alciati A, Torti T, Perna G. First-onset major depression during the COVID-19 pandemic: A predictive machine learning model. J Affect Disord 2022; 310:75-86. [PMID: 35489559 PMCID: PMC9044654 DOI: 10.1016/j.jad.2022.04.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND This study longitudinally evaluated first-onset major depression rates during the pandemic in Italian adults without any current clinician-diagnosed psychiatric disorder and created a predictive machine learning model (MLM) to evaluate subsequent independent samples. METHODS An online, self-reported survey was released during two pandemic periods (May to June and September to October 2020). Provisional diagnoses of major depressive disorder (PMDD) were determined using a diagnostic algorithm based on the DSM criteria of the Patient Health Questionnaire-9 to maximize specificity. Gradient-boosted decision trees and the SHapley Additive exPlanations technique created the MLM and estimated each variable's predictive contribution. RESULTS There were 3532 participants in the study. The final sample included 633 participants in the first wave (FW) survey and 290 in the second (SW). First-onset PMDD was found in 7.4% of FW participants and 7.2% of the SW. The final MLM, trained on the FW, displayed a sensitivity of 76.5% and a specificity of 77.8% when tested on the SW. The main factors identified in the MLM were low resilience, being an undergraduate student, being stressed by pandemic-related conditions, and low satisfaction with usual sleep before the pandemic and support from relatives. Current smoking and taking medication for medical conditions also contributed, albeit to a lesser extent. LIMITATIONS Small sample size; self-report assessment; data covering 2020 only. CONCLUSIONS Rates of first-onset PMDD among Italians during the first phases of the pandemic were considerable. Our MLM displayed a good predictive performance, suggesting potential goals for depression-preventive interventions during public health crises.
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Affiliation(s)
- Daniela Caldirola
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy; Humanitas San Pio X, Personalized Medicine Center for Anxiety and Panic Disorders, Via Francesco Nava 31, 20159 Milan, Italy.
| | - Silvia Daccò
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Francesco Cuniberti
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy,Humanitas San Pio X, Personalized Medicine Center for Anxiety and Panic Disorders, Via Francesco Nava 31, 20159 Milan, Italy
| | - Massimiliano Grassi
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Alessandra Alciati
- Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy,Humanitas Clinical and Research Center, IRCCS, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Tatiana Torti
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,ASIPSE School of Cognitive-Behavioral-Therapy, Milan, Italy
| | - Giampaolo Perna
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy,Humanitas San Pio X, Personalized Medicine Center for Anxiety and Panic Disorders, Via Francesco Nava 31, 20159 Milan, Italy
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Learning Outcomes of a Hybrid Online Virtual Classroom and In-Person Traditional Classroom during the COVID-19 Pandemic. SUSTAINABILITY 2022. [DOI: 10.3390/su14095263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This paper explores the effects of using a hybrid virtual/traditional classroom, a blended teaching and learning approach, on undergraduate learning outcomes during the initial stage of the COVID-19 pandemic. The study aimed to investigate the prominent problems that appeared in the process of online teaching and learning and to measure the impact of the COVID-19 pandemic on undergraduates’ learning outcomes in public universities in China. The field of specialization of the subjects of this study is under the rubric of social science and higher education. We designed and conducted a pilot survey to identify students’ perspectives on the key issues and experiences of the use of distance-learning through an online virtual classroom in the initial phase of the COVID-19 pandemic. In addition, we applied a binary logistic regression model to real data from two different economics course exams to measure the short-term impacts of using the two different learning environments on the undergraduates’ performance outcomes. The results indicate a statistically significant negative impact of using virtual classrooms on undergraduate learning outcomes. By contrast, in-person traditional classrooms had more desirable learning outcomes. Moreover, the hybrid approach proved to be more effective than the use of online virtual classrooms alone.
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Kim HS, Ahn J, Lee J, Hong Y, Kim C, Park J, Chung S. The Mediating Effect of Reassurance-Seeking Behavior on the Influence of Viral Anxiety and Depression on COVID-19 Obsession Among Medical Students. Front Psychiatry 2022; 13:899266. [PMID: 35770057 PMCID: PMC9234214 DOI: 10.3389/fpsyt.2022.899266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Healthcare workers experienced great psychological burden due to the continuation of the COVID-19 pandemic. During the pandemic, medical healthcare workers experienced greater instances of insomnia, anxiety, depression, somatization, and obsessive-compulsive symptoms than the general population. This study aimed to explore the association between viral anxiety and obsession with COVID-19 among medical students with reassurance-seeking behavior as a mediator. METHODS In October 2021, an online survey was conducted among medical students at the University of Ulsan College of Medicine. The clinical characteristics of 162 participants and their responses to rating scales, including stress and anxiety to viral Epidemics-6 items (SAVE-6), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Patient Health Questionnaire-9 items (PHQ-9), and Obsession with COVID-19 scale were collected. RESULTS Medical students' obsession with COVID-19 was based on the PHQ-9 (β = 0.15, p = 0.01), SAVE-6 (β = 0.43, p < 0.001), and CRBS (β = 0.38, p < 0.001) scores (adjusted R2 = 0.49, F = 39.9, p < 0.001). Mediation analysis showed that medical students' viral anxiety and depression directly influenced their obsession with COVID-19, and their reassurance-seeking behavior partially mediated the effects of depression or viral anxiety on obsession with COVID-19. CONCLUSIONS Medical students' viral anxiety and depression may affect their obsession with COVID-19, and reassurance-seeking behaviors may mediate this. Therefore, medical students should adopt adaptive coping strategies to prevent high levels of viral anxiety and recurrent reassurance-seeking behavior.
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Affiliation(s)
- Hyun Sub Kim
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Junseok Ahn
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Jukab Lee
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Youjin Hong
- Department of Psychiatry, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
| | - Changnam Kim
- Department of Psychiatry, Samsung Changwon Hospital, Sungkyunkwan University of Medicine, Changwon, South Korea
| | - Jangho Park
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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