Depression, anxiety, stress, and fear of COVID-19 among Bangladeshi medical students during the first wave of the pandemic: a mixed-methods study

Fear of COVID-19 and mental health status among the medical students of a selected medical college in Bangladesh

BACKGROUND

COVID-19 pandemic and mental health of people are related to each other.

AIMS

To assess the relationship between fear of COVID-19 (FCOV) and the psychological status of medical students of Bangladesh.

METHODS

A total of 967 medical students and intern doctors of Sher-E-Bangla Medical College participated in this cross-sectional study. FCOV was measured using the Fear of COVID-19 Scale (FCV-19S). Mental health status was assessed using the Depression Anxiety Stress Scale (DASS-21). Correlation between these two variables was done followed by general linear model to assess the relationship of other covariates with mental health.

RESULTS

FCOV had a highly significant relationship with mental health (DASS-21 and all its components, p < 0.001 for all). Females suffered more from fear than males except the interns. Clinical students, students with middle income groups, students residing with the families, and students having family members in health services exhibited more FCOV compared to their counterparts. When we looked at the DASS-21 and its components, females suffered more from stress. Having family members in health services was related to higher anxiety and stress with higher DASS-21 scores as well. Students who expressed their lives to be affected by COVID-19 had higher DASS-21 and its components compared to those whose lives were not affected as such. Students residing with their families revealed increased stress. FCOV and life affected by COVID-19 were constantly related to DASS-21 and its components (p < 0.001), adjusted for other variables.

CONCLUSIONS

Fear of COVID-19 is associated with poor mental health of medical students.

Mental health status and quality of life among Thai people after the COVID-19 outbreak: a cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on individuals' mental health and well-being worldwide. This study investigated the prevalences of and association between mental health and quality of life (QOL) in Thailand after the COVID-19 outbreak. A cross-sectional study was conducted among Thai individuals aged ≥ 20 years across all regions. Descriptive statistics, chi-square tests, and multiple logistic regression analyses were performed to examine the association between mental health and QOL. A total of 1,133 participants (mean age: 35.1 ± 17.2 years) completed the survey. The prevalence of depression with PHQ-9 instrument was 19.4%. Depression was significantly associated with those who have had family members die from COVID-19 infection (adjusted odds ratio [AOR] 2.27, 95% confidence interval [CI] [1.13-4.52]). The percentages of depression, anxiety, and stress with DASS-21 instrument were 32.4%, 45.4%, and 24.1%, respectively. Smokers and alcohol consumption had approximately 1.5-time higher risk of stress compared with non-smokers and no alcohol consumption (AOR = 1.50, 95% CI [1.01-2.24], AOR = 1.48, 95% CI [1.09-2.02], respectively). An association was observed between socioeconomic factors such as job and income loss and mental health outcomes. Depression, anxiety, and stress were significantly negatively associated with QOL. This study demonstrates a strong association between mental health and QOL among Thai people after the COVID-19 outbreak. The findings underscore the need for interventions targeting lifestyles, including those addressing alcohol consumption and smoking, especially among those who have had family members die from COVID-19 infection and mental health support services that can address depression, anxiety, and stress to improve the overall well-being of the population.

Rate and sociodemographic correlates of depression, anxiety, and stress among domestic and overseas medical students: A cross-sectional observation from a private medical college in Bangladesh

Background

Depression, anxiety, and stress are the commonly encountered mental health conditions among medical students. Overseas environment may add additional burden to the existing environment. However, comparison of the rate and associated factors of depression, anxiety, stress among domestic and overseas students has not been attempted in Bangladesh. We aimed to assess the rate and associated factors of depression, anxiety, stress among domestic and overseas medical students in the country.

Methods

This cross-sectional study was conducted among 360 undergraduate medical students in 2021. Data were collected by self-reporting instruments by a stratified random sampling method by the Depression, Anxiety, and Stress Scale-21 scale. Bivariable and multivariable binary logistic regression analyses were done by computing crude odds ratio and adjusted odds ratio with 95% confidence interval to identify the associated factors.

Results

Among the 360 undergraduate medical students, 181 were domestic and 179 overseas ones. 44.8% of domestic students reported depressive symptoms, 45.3% reported anxiety symptoms, and 33.1% reported stress. On the other hand, half of overseas students experienced depression (50.3%) and anxiety (52.5%), and 41.3% experienced stress. Female medical students were found vulnerable for developing depression, anxiety, and stress than males.

Conclusions

The study revealed higher rates of depression, anxiety, and stress among overseas undergraduate medical students enrolled in a private medical school of Bangladesh. Private medical college authorities could consider special services for overseas students to ensure adequate psychosocial support.

Suicidal behaviours and associated factors among medical students in Bangladesh: a protocol for systematic review and meta-analysis (2000-2024)

INTRODUCTION

Suicidal behaviour is common among medical students, and the prevalence rates might vary across various regions. Even though various systematic reviews have been conducted to assess suicidal behaviours among medical students in general, no review has ever assessed or carried out a sub-analysis to show the burden of suicidal behaviours among Bangladeshi medical students.

METHODS AND ANALYSIS

The research team will search the PubMed (Medline), Scopus, PsycINFO and Google Scholar databases for papers published between January 2000 and May 2024 using truncated and phrase-searched keywords and relevant subject headings. Cross-sectional studies, case series, case reports and cohort studies published in English will be included in the review. Review papers, commentaries, preprints, meeting abstracts, protocols and letters will be excluded. Two reviewers will screen the retrieved papers independently. Disagreements between two reviewers will be resolved by a third reviewer. Exposure will be different factors that initiate suicidal behaviours among medical students. The prevalence of suicidal behaviours (suicidal ideation, suicide plans and suicide attempts) in addition to the factors responsible, and types of suicide method will be extracted. Narrative synthesis and meta-analysis will be conducted and the findings will be summarised. For enhanced visualisation of the included studies, forest plots will be constructed. Heterogeneity among the studies will be assessed and sensitivity analysis will be conducted based on study quality. Included studies will be critically appraised using Joanna Briggs's Institutional critical appraisal tools developed for different study designs.

ETHICS AND DISSEMINATION

The study will synthesise evidence extracted from published studies. As the review does not involve the collection of primary data, ethical approval will not be required. Findings will be disseminated orally (eg, conferences, webinars) and in writing (ie, journal paper).

PROSPERO REGISTRATION NUMBER

CDR 42023493595.

Mental Health of Medical Students After Combating the COVID-19 Epidemic: A Cross-sectional Study in Vietnam

OBJECTIVES

This study was conducted to investigate the prevalence of mental health (MH) symptoms and associated factors among medical students who were engaged in combating the coronavirus disease 2019 (COVID-19) epidemic in 4 provinces/cities of Vietnam.

METHODS

A cross-sectional study with 580 participants was conducted at a medical university in Northern Vietnam. MH was assessed using the 21-item Depression, Anxiety, and Stress Scale, which was previously standardized in Vietnam. Data were collected through a structured self-administered questionnaire. Multivariate logistic regression was employed to examine the association between MH symptoms and relevant factors.

RESULTS

Out of a total of 2703 medical students, 21.5% responded to the questionnaire. Among the 580 respondents, the prevalence rates of depression, anxiety, and stress were 43.3%, 44.0%, and 24.7%, respectively. Factors significantly associated with self-reported depression included being female and having a COVID-19 infection. Similarly, being female and having a COVID-19 infection were significantly associated with self-reported anxiety. Factors associated with self-reported stress included being female, having a personal or family history of MH symptoms, working more than 8 hr/day, and having a COVID-19 infection.

CONCLUSIONS

COVID-19 has adversely impacted the MH of medical students. Our findings are valuable in their potential to motivate universities, MH professionals, and authorities to offer mental healthcare services to this group. Furthermore, there is a pressing need for training courses designed to equip future healthcare workers with the skills to manage crises effectively.

Arts therapies for mental disorders in COVID-19 patients: a comprehensive review

Background and objective

The COVID-19 global pandemic has necessitated the urgency for innovative mental health interventions. We performed a comprehensive review of the available literature on the utility and efficacy of arts therapies in treating mental health problems, with special emphasis on their deployment during the COVID-19 pandemic, aiming to provide some evidence for the application of this therapy.

Methods

The potential studies were systematically sourced from five authoritative databases: PubMed, Embase, the Cochrane Library, Web of Science, and the CNKI database. The evaluation of these studies was conducted based on stringent criteria, including validity, suitability, therapeutic potential, and consistency. Each piece of included literature was meticulously scored in accordance with these criteria, thus ensuring the inclusion of only the most robust studies in this review. The data from these Randomized Controlled Trials (RCTs) were carefully extracted using the PICO(S) framework, ensuring a comprehensive and systemic approach to data collection. In order to emphasize the variability in the effects of differing arts therapies on COVID-19-induced psychiatric disturbances, the sourced literature was systematically categorized and scrutinized based on distinct modalities.

Results

Out of the 7,250 sourced articles, 16 satisfied the inclusion conditions. The therapies were predominantly meditation (n = 7), supplemented by individual studies on color therapy (n = 3), music therapy (n = 2), and single studies on horticultural therapy, dance therapy, mindfulness and music therapy, and yoga and music therapy (n = 4 collectively). These various forms of arts therapies had a positive short to medium-term impact on the mental health of COVID-19 patients. Besides improving patients' physical and mental health, these therapies can also be employed to mitigate mental health issues among healthcare professionals.

Conclusion

The COVID-19 pandemic has profound and long-lasting implications for public mental health. Diverse forms of arts therapies are potentially effective in addressing related psychiatric symptoms. The integration of artificial intelligence might further enhance the efficacy and scalability of arts therapies in future implementations.

Predictors of mental health problems during the COVID-19 outbreak in Egypt in 2021

Background

With the widespread outbreak of the coronavirus (COVID-19) pandemic, many countries, including Egypt, have tried to restrict the virus by applying social distancing and precautionary measures. Understanding the impact of COVID-19-induced risks and social distancing measures on individuals' mental health will help mitigate the negative effects of crises by developing appropriate mental health services. This study aimed to investigate the most contributing factors that affected individuals' mental health and how individuals' mental health has changed over the lockdown period in Egypt in 2021.

Methods

The study draws on a nationally representative sample from the combined COVID-19 MENA Monitor Household Survey conducted by the Economic Research Forum. The data were collected in Egypt by phone over two waves in February 2021 and June 2021. The total number of respondents is 4,007 individuals. The target population is mobile phone owners aged 18-64 years. The 5-item World Health Organization Well-Being Index (WHO-5) is used to assess the individuals' mental health over the past 2 weeks during the pandemic. Penalized models (ridge and LASSO regressions) are used to identify the key drivers of mental health status during the COVID-19 pandemic.

Results

The mean value of mental health (MH) scores is 10.06 (95% CI: 9.90-10.23). The average MH score for men was significantly higher than for women by 0.87. Rural residents also had significantly higher MH scores than their urban counterparts (10.25 vs. 9.85). Middle-aged adults, the unemployed, and respondents in low-income households experienced the lowest MH scores (9.83, 9.29, and 9.23, respectively). Individuals' mental health has deteriorated due to the negative impacts of the COVID-19 pandemic. Regression analysis demonstrated that experiencing food insecurity and a decrease in household income were independent influencing factors for individuals' mental health (p < 0.001). Furthermore, anxiety about economic status and worrying about contracting the virus had greater negative impacts on mental health scores (p < 0.001). In addition, women, middle-aged adults, urban residents, and those belonging to low-income households were at increased risk of poor mental health (p < 0.05).

Conclusion

The findings reveal the importance of providing mental health services to support these vulnerable groups during crises and activating social protection policies to protect their food security, incomes, and livelihoods. A gendered policy response to the pandemic is also required to address the mental pressures incurred by women.

COVID-19 may have increased global support for universal health coverage: multi-country observational study

Introduction

The multiple risks generated by the COVID-19 pandemic intensified the debate about healthcare access and coverage. Whether the burden of disease caused by the coronavirus outbreak changed public opinion about healthcare provision remains unclear. In this study, it was specifically examined if the pandemic changed support for governmental intervention in healthcare as a proxy to support for universal health coverage (UHC). It also examined which psychological factors related to the socioeconomic interdependence exposed by the pandemic may be associated with a potential change.

Methods

Online survey data was collected over 18 months (from March 2020 to August 2021) across 73 countries, containing various social attitudes and risk perceptions related to COVID-19. This was a convenience sample composed of voluntary participants (N = 3,176; age 18 years and above).

Results

The results show that support for government intervention in healthcare increased across geographical regions, age groups, and gender groups (an average increase of 39%), more than the support for government intervention in other social welfare issues. Factors related to socioeconomic interdependence predicted increased support for government intervention in healthcare, namely, social solidarity (ß = 0.14, p < 0.0001), and risk to economic livelihood (ß = 0.09, p < 0.0001). Trust in the government to deal with COVID-19 decreased over time, and this negative trajectory predicted a demand for better future government intervention in healthcare (ß = -0.10, p = 0.0003).

Conclusion

The COVID-19 pandemic may have been a potential turning point in the global public support for UHC, as evidenced by a higher level of consensus that governments should be guarantors of healthcare.