The Influence of the COVID-19 Pandemic on the Stress Levels and Occurrence of Stomatoghnatic System Disorders (SSDs) among Physiotherapy Students in Poland

Impact of the Covid-19 pandemic and lockdowns on the education and mental health of physiotherapy students in France: a descriptive cross-sectional study with national online survey

OBJECTIVE

To determine the impact of the SARS-CoV-2 (COVID-19) pandemic and lockdowns on the mental health status, training, perceptions of the physiotherapy profession, and career plans of French physiotherapy students.

DESIGN

A descriptive cross-sectional study was conducted, representing the first and only survey of its kind, using a national online survey.

SUBJECTS

A total of 2678 French physiotherapy students participated in the study.

METHODS

Mental health status was assessed using the validated French versions of established depression, anxiety, and insomnia scales.

RESULTS

The survey revealed that female sex, age below 21 years, living alone, and having a psychiatric history or COVID-19 risk factors were associated with more severe symptoms of depression, anxiety, and insomnia in the surveyed students. In addition, stress, anxiety, and depression induced by the COVID-19 crisis were linked to apprehension about continuing practical training in physiotherapy. These factors also affected students' perceptions of the profession and the initially envisioned mode of practice, particularly among fifth-year students (odds ratio (OR) = 2.25, 95% confidence interval (95% CI) = (1.69, 2.99), p < 0.001). Notably, the pandemic significantly reduced the desire of these students to pursue a career as physiotherapists (adjusted OR (aOR) 1.41 (1.06, 1.86)).

CONCLUSION

French physiotherapy students, especially those in their fifth year, have experienced significant impacts from the COVID-19 pandemic, affecting their mental health, education, perceptions of the physiotherapy profession, and career plans.

Depression and opinion of dental students regarding the hybrid learning model during the COVID-19 pandemic

BACKGROUND

The global spread of COVID-19 forced schools at all educational levels to close, which was repeated in more than 60 countries. In addition, the COVID-19 pandemic has affected the mental health of dental students world wide. This study hypothesizes that the prevalence of depression in dental students from El Salvador is higher than that reported in studies from Europe, Asia, and North America.

METHODS

This study was an online cross-sectional survey performed at the Faculty of Dentistry of the University of Salvador. The PHQ-9 questionnaire was applied to know the level of depression of the students, and a questionnaire focused on learning the opinion of the students on the hybrid teaching model adopted. Approximately 450 students participated in both questionnaires.

RESULTS

Regarding the levels of depression present in the students, 14% had minimal depression, 29% had medium depression, 23% had moderate depression and, 34% had severe depression. The students had an excellent opinion regarding the hybrid learning model.

CONCLUSIONS

The prevalence of depression in dental students in El Salvador seems to be higher than that reported in studies in non-Latin American countries. Therefore, universities must generate care plans for mental health to avoid these harmful effects on students during future contingencies.

Effect of Personality Type on the Occurrence of Temporomandibular Disorders-A Cross-Sectional Study

BACKGROUND

Personality traits are one of the major factors influencing the behavior and functioning of an individual, and they play a crucial role in the development of psychosomatic disorders and diseases. This paper aimed to evaluate the importance of personality traits in temporomandibular disorder (TMDs) development using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five). Moreover, the relationship between personality type and the intensity of dysfunctional changes in the stomatognathic system was assessed using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five).

MATERIAL AND METHODS

The study included a group of 75 adult participants (aged 19-52) with TMD diagnosed according to DC/TMD criteria and a control group of 75 participants without symptoms of dysfunction. The study consisted of a questionnaire and clinical study; the questionnaire included the NEO-FFI psychological questionnaire and a self-authored one. The clinical part consisted of extra- and intraoral dental examinations.

RESULTS

Participants who clenched their teeth showed a greater degree of conscientiousness than those who did not exhibit this symptom (p = 0.048). Presence of headaches was correlated with greater severity of neuroticism (p = 0.001). Moreover, participants with enamel cracks showed a lower intensity of extraversion (p = 0.039), and those with worn hard dental tissues showed a higher intensity of neuroticism (p = 0.03), a lower intensity of conscientiousness (p = 0.01), and a lower intensity of extroversion (p = 0.046). Acoustic symptoms during mandibular movements were found to be linked with a higher level of neuroticism (p = 0.020), a lower level of extraversion (p = 0.035), and a lower level of conscientiousness, whereas pain upon mandibular movements were linked to a lower level of conscientiousness (p = 0.025). Participants with pain upon palpation of the masticatory muscles showed a lower level of conscientiousness (p = 0.01) compared to those without pain symptoms. Episodes of mandibular blockage or problems with its adduction depend on the intensity of conscientiousness (p = 0.007). Moreover, people from the study group with high levels of neuroticism showed lower protrusion values (p = 0.016).

CONCLUSION

The intensity of individual personality traits was found to be associated with some TMDs in comparison to healthy controls.

Dental students’ academic performance before and after the Covid-19 pandemic: A retrospective analysis

Delivering quality education to students with fair assessment strategies is a key indicator of an excellent educational institution. The present study explored the impact of the COVID-19 pandemic on the academic performance of dental students in terms of the evaluations/grades awarded to them before and during the pandemic. The targeted groups were dental students, studying in the third year of 2018-2019 and 2020-2021 academic years. The sample size included all male and female students who enrolled and completed the following courses: pre-clinical fixed prosthodontics (SDS333), pre-clinical removal prosthodontics (SDS323), clinical operative dentistry-1 (RDS313), and pre-clinical endodontics (RDS323). Evaluations for students who did not complete the requirements were not included in the statistical analysis. Paired sample statistics were used for comparisons between the different groups at p < 0.05. Results revealed statistically significant differences (p ≤ 0.05) for all the course pairs. It was found that students’ grades for all the courses during the pandemic year were higher compared to the grades before the pandemic. While female students demonstrated the highest mean difference (6.13) before and during the pandemic year for RDS323, males demonstrated the highest mean difference (8.14) for SDS323. However, both male and female students demonstrated the lowest mean difference (0.25 and 2.03, respectively) for SDS333. The grades were higher during the COVID-19 pandemic. Overall, female students achieved higher grades than male students.

Evaluation of Coping Strategies among Students with Type D Personality

Objective: Personality type D may be associated with a predisposition to develop stress under external adverse influences, for example, in the COVID-19 pandemic. Likewise, type D personality is associated with higher burnout levels; thus, it may contribute to the development of diseases symptoms. The current study was designed to examine the coping strategies in young healthy persons with personality type D. Methods: The study included 98 medical students, with 30 being males. The participants completed questionnaires to identify personality type D (DS-14) and the coping strategies. Depending on the results of the DS-14 questionnaire, four subgroups were distinguished with different levels of points on the NA and SI subscales. Results: For persons with type D personality, the escape–avoidance strategy was used more often, the accepting responsibility and self-controlling strategies were less common compared with non-type-D individuals. When type D was adjusted for the NA and SI subscales, the correlation remained only with escape–avoidance strategy. We did not find a synergistic effect of the NA and SI subscales in regard to coping. Conclusions: This study demonstrated a link between personality type D and maladaptive coping strategies. The predominance of the maladaptive coping strategy in type D is a possible point of application for psychosocial training in such individuals that requires further research.

Chronotype Profile, Stress, Depression Level, and Temporomandibular Symptoms in Students with Type D Personality

Background: Despite a growing interest in the types of human circadian activity, different chronotypes and personality-related issues have been rarely studied. It has already been emphasized that ‘stress personality’ is considered a risk factor for certain psychosomatic diseases and may be a temporomandibular disorders (TMDs) predictor. Therefore, an attempt has been made to analyze the chronotypes, stress levels, stress factors, and the occurrence of depression and TMDs in students with type D personalities. People with this personality trait tend to experience negative emotions more—depression, anxiety, anger, or hostility—yet may have a negative image of themselves and report somatic complaints. Aim: The aim of this study was to analyze the importance of the chronotype profile for the level of stress perceived, as well as for the occurrence of depression and TMDs in people with type D personalities. Material and Methods: The study has been conducted on a group of 220 physical therapy students. The study group G1 consisted of 110 participants with type D personalities, the control group G2 consisted of the same number of participants without the stress personality. All participants have been analyzed for the chronotype (MEQ), stress perception (PSS10), the occurrence of depression (Beck scale-BDI), the occurrence of TMDs symptoms and have completed the stress factor assessment questionnaire during the study, followed by DS14 questionnaire—a tool for assessing the prevalence of type D personality. Results: In students with type D personalities (G1), the definitely evening and evening chronotypes have been significantly more predominant than in the control group (G2). A significantly higher number of stressors and TMDs symptoms have been observed in the respondents from the G1 group than in the control group (<0.001). Univariate logistic regression analysis showed that type D personality was strongly associated with a more frequent occurrence of all TMD symptoms. Additionally, a significant influence of the evening chronotype on the occurrence of type D personality was observed. Among the potential confounding variables, female gender and a mild and moderate degree of depression have an impact on the occurrence of type D personality (p < 0.05). In the multivariate model, adjusted with the above-mentioned factors, an increased risk of the type D personality trait was found. Conclusion: The evening chronotype and type D personality may imply greater feelings of stress, greater depression, and more frequent symptoms of TMDs in young adults.

Examining the Associations between COVID-19-Related Psychological Distress, Social Media Addiction, COVID-19-Related Burnout, and Depression among School Principals and Teachers through Structural Equation Modeling

This study aims to investigate the relationships between COVID-19-related psychological distress, social media addiction, COVID-19-related burnout, and depression. The research, which was designed according to the relational survey model, was conducted with the participation of 332 school principals and teachers who received graduate education in the field of educational administration. Research data were collected through online surveys and then structural equation modeling (SEM) was used to test and analyze the proposed hypotheses. The study’s findings revealed that COVID-19-related psychological distress strongly predicted COVID-19-related burnout. In this context, as the psychological distress associated with COVID-19 increased, the sense of burnout associated with COVID-19 also increased. However, it was found that burnout associated with COVID-19 significantly and positively predicted depression. SEM results revealed that COVID-19-related psychological distress directly affected COVID-19-related burnout, depression, and social media addiction. In addition, it was determined that an indirect effect of COVID-19-related burnout and social media addiction exists in the relationship between COVID-19-related psychological distress and depression.

The Changes in Stress Coping, Alcohol Use, Cigarette Smoking and Physical Activity during COVID-19 Related Lockdown in Medical Students in Poland

The ongoing COVID-19 pandemic has significantly limited social contacts, thus contributing to deepening isolation. Therefore, SARS-CoV-2 exerted on humanity not only a physical impact but also a psychological one, often increasing the feeling of stress. The long-term effects of such a state could include the management of depression, so our study aimed to analyze groups of medical students in different periods of the pandemic (at the beginning of the pandemic, after half a year of the pandemic, after one year of the pandemic) in order to assess the impact of this situation on coping with stress. The impact of the pandemic on the development of stress factors such as alcohol consumption and smoking was also studied. The level of physical activity in the context of coping with an uncertain situation was also assessed. The impact of the above-mentioned factors on the behavior of students, including the Mini-COPE questionnaire, AUDIT test, the Fagerström test and the IPAQ questionnaire was analyzed. It has been shown that as the pandemic and the lockdown progressed, patients consumed more often or larger amounts of alcohol, smoked more cigarettes, and levels of physical activity decreased. All these factors may have had some impact on the deterioration of coping with stress among the respondents, which would indicate that the COVID-19 pandemic significantly contributed to an increase in the sense of stress among the students.

The Importance of Type D Personality in the Development of Temporomandibular Disorders (TMDs) and Depression in Students during the COVID-19 Pandemic

Background: a type D personality is a factor in a person’s susceptibility to general mental stress, especially during the COVID-19 pandemic. Although many studies were conducted on the relationships among stressful situations, an individual’s personality, depression, and the occurrence of various diseases, e.g., cardiovascular disease or cancer, there are no analogous data on people with temporomandibular disorders (TMDs). Aim: the assessment of TMDs and depression symptoms in students with type D personality. Material and Methods: the research was carried out with the participation of 240 physiotherapy students. The study group (G1) consisted of 120 participants with type D personalities, the control group (G2) consisted of the same number of participants, without “stress” personalities. All subjects were assessed for the occurrence of TMD symptoms, as well as for depression and anxiety symptoms, using the Beck Depression Inventory (BDI), based on the proprietary questionnaire. Results: in students with type D personality symptoms, TMDs occurred significantly more often and in greater number (p = 0.00) than in those without stress personalities. The exception was the symptom of increased muscle tension, which showed no statistical difference (p = 0.22). Among the 240 respondents, depression was found in 128 people (53.3%). In the group of students with type D personalities, depression was significantly more frequent than in the group without type D personalities (p = 0.00). In participants with depression, TMD symptoms were more common, i.e., headaches, neck, and shoulder girdle pain, TMJ acoustic symptoms, increased masticatory muscle tension, teeth clenching, and teeth grinding. There was no significant difference between the incidence of depression and TMJ pain and jaw locking. There was a significant interaction between the occurrence of headaches and acoustic symptoms and the occurrence of depression. For headache and depression interactions, the OR was >1; based on the results, we may assume that a headache depends more on the occurrence of depression rather than it being a symptom of a TMJ disorder in people with type D personalities. Conclusion: type D personality and depression may contribute to the development of TMD symptoms.

Impact of the COVID-19 Pandemic and Psychosocial Coping Strategies in Health Sciences Students at the University of Seville: A Pilot Study

The new infection by coronavirus has supposed a challenge to all health systems worldwide, affecting our psychosocial health. Education as we knew it has changed, which is why university students, attending Health Sciences courses in this case, have been affected by the pandemic. This study aimed to analyze the impact of the preventative measures and restrictions associated with COVID-19 on multiple mental health and psychological well-being indicators in Health Sciences students at the University of Seville. A descriptive and cross-sectional pilot study in the University of Seville by means of an online questionnaire elaborated was conducted. Of the final sample (n = 68), more than 60% of the students acknowledged having received specific training by their university and/or health institution where they perform practices on COVID-19 measures; however, they negatively emphasized not having received psychosocial aid or support in most of the cases (94.12%). As the health situation imposed by COVID-19 is considered long-lasting, the proposal is to plan short- and long-term strategies for promotion and intervention in the mental health of students and future health care workers.

Type D Personality and Stomatognathic System Disorders in Physiotherapy Students during the COVID-19 Pandemic

Background: A person’s response to stressors is largely dependent on their personality traits that affect the way stress is controlled and relieved. This article is a quantitative analysis assessing the importance of the distressed personality in the development of stomatognathic system disorders (SSDs) in physiotherapy students during the COVID-19 pandemic. Objective: The goal of the research was to assess the presence of type D personality in students with symptoms of stomatognathic system disorders. Material and Method: The research was carried out among 300 physiotherapy students. The data were collected using the form of the occurrence of symptoms of SS disorders developed for the purpose of the study and the standardized psychological DS14 questionnaire. Results: In a group of 300 students, the presence of type D personality was found in 160 people (53.3%). People with type D personality had symptoms of SS disorders more often than the group without stressful personality traits. There was a significant difference between the groups regarding all the examined symptoms. In the group of people with type D personality, the most frequently reported symptoms of SS disorders included: headache (51.3%), pain in the neck and shoulder girdle (43.1%), and teeth clenching (35.6%). As many as 70% of the respondents in the group with symptoms of SS disorders (P1) had type D personality, whereas in the asymptomatic group (P2) this result was 23.3%. There was a significant difference between the groups (p = 0.00). Statistically significantly higher values of both D personality dimensions were observed in women than in men with symptoms of SS disorders. In people reporting symptoms of SS disorders, higher average values were observed in both dimensions of type D personality. There were significant differences between the groups. Conclusion: type D personality may contribute to the development of symptoms of stomatognathic disorders.

Anxiety, Depression and Risk of Post-Traumatic Stress Disorder in Health Workers: The Relationship with Burnout during COVID-19 Pandemic in Italy

During the COVID-19 pandemic, healthcare workers (HW) have faced an extremely difficult work environment, with an increased workload and traumatic events. Our study aimed to investigate the impact of COVID-19 pandemic on HW’s mental wellbeing. We analyzed the correlations between levels of burnout and other mental health disorders and we searched for the presence of specific risk factors of post-traumatic symptomatology related to the pandemic. A structured an on-line questionnaire and validated instruments were completed by a sample of HW from some hospitals in Genoa, Italy. Anxious, depressive, post-traumatic and other psychological symptoms were assessed and risk factors, related to the pandemic, were considered. Then, we investigated the correlation between levels of burnout and the risk of developing psychopathology. A total of 731 HW were screened, and we found increased levels of anxiety (61%), depression (62%), PTSD (34%) and high levels of burnout; especially emotional exhaustion (37%). A statistically significant association between burnout and insomnia, depression, anxiety, and post-traumatic symptoms was demonstrated. This study indicates that during the COVID-19 pandemic, HW showed high levels of psychological distress and that burnout is an important predictor of sufferance. These findings support the idea to provide psychological and psychiatric support for HW.