Evolving Mental Health Dynamics among Medical Students amid COVID-19: A Comparative Analysis of Stress, Depression, and Alcohol Use among Medical Students

Background and Objectives: The ongoing COVID-19 pandemic has posed an array of new challenges for medical students worldwide. Amidst academic rigors, students are confronted with unique stressors, potentially affecting their mental health and substance use. This study aimed to investigate the multifaceted effects of depression, alcohol use, and stress on medical students and discern how these factors have been amplified by the pandemic's circumstances, and to identify predictors of mental distress during the COVID-19 pandemic period. Materials and Methods: Two online anonymous and cross-sectional surveys were conducted at the University of Medicine and Pharmacy "Iuliu Hatieganu" in Romania among medical students in 2018 and in 2022. Data were gathered via online questionnaires distributed through closed student groups on social media platforms, with a total of 1061 participants, to investigate stress, depression, alcohol and drug use, and the impact of the pandemic and online education on mental health, maintaining anonymity and ethical approval. The Medical Student Stress Questionnaire (MSSQ) was employed to measure different aspects of stress, the Beck Depression Inventory (BDI) provided insights into the participants' depressive symptoms, and for the assessment of alcohol consumption habits, the Alcohol Use Disorders Identification Test (AUDIT) was utilized. Results: Our findings showed a significant decrease in mean depression scores (13.81 vs. 11.56, with p < 0.001) from 2018 to 2022. In 2018, students scored significantly higher in the overall stress-related domains. Additionally, being female, facing financial constraints, and being in pre-clinical years emerged as predictors of heightened academic-related stress and depressive symptoms. Students who had experienced the loss of a family member due to COVID-19 exhibited a statistically significant rise in their average BDI score and current anxiety levels. Conclusions: The pandemic, despite introducing new stressors, may have indirectly fostered an increased focus on students' mental health, leading to more refined support mechanisms. Specialized interventions, taking into account gender and financial problems, are needed to address the multifaceted challenges faced by medical students. Our study highlights the ongoing need to nurture both the academic and emotional strength of future medical practitioners.

Psychological profile and mood disturbance of women who gave birth during the COVID-19 pandemic in Romania

OBJECTIVE

This study aimed to outline the emotional profile and the mood disturbance of women who gave birth during Emergency and Alert states in Covid-19 pandemic.

METHODS

A cross-sectional study was carried out to investigate how the emergency and alert states due to Covid-19 affected the emotional profile and the mood disturbance of pregnant women who gave birth during these times. We included 244 postpartum women, divided into two groups: 124 women during the State of Emergency and another 120 women during the State of Alert. After expressing their informed consent, they completed an anonymous questionnaire that collected demographic data and the Profile of Mood States Questionnaire, as well as a follow-up survey. Data analysis was performed using the statistical program SPSS 24.0.

RESULTS

Out of the 300 questionnaires distributed, we collected 244 valid questionnaires. 45.2% of State of Emergency group and 53.3% of State of Alert group experienced Anxiety, 16.9% of State of Emergency group, respectively 18.3% of State of Alert group, Depression, and 25% of State of Emergency group respectively 34.2% of State of Alert group, Distress. Compared to the ideal Iceberg profile, the emotional profile of both groups presented an inverted graph for Anxiety and Depression and much lower values for Vigor. Only 35.5% of State of Emergency group and 16.7% of State of Alert group received information concerning the virus, symptoms, and evolution of the disease from the specialists who monitored their pregnancy and 25.8% of State of Emergency group respectively 11.7% of State of Alert group received information about measures to prevent contamination and infection. Psycho-emotional and mood disturbance was more pronounced among State of Alert group.

CONCLUSIONS

There was a significant psycho-emotional alteration of surveyed women during the pandemic, worsened by the radical measures of the State of Emergency and associated with the major deficiency of care services in supplying valid information and counseling for pregnant women's safety in the State of Alert. There is a highlighted need to pay more attention to the psychological profile of pregnant women and to modernize the health services in this field and adapt them to pandemic situations with the use of modern virtual techniques. In addition, the Romanian health care system should round off the team responsible for the care of mother and child with midwives, internationally recognized very skilled in informing, monitoring, counseling, and support in this field.

Alcohol Consumption and Behavioral Consequences in Romanian Medical University Students

Alcohol consumption is a major public health problem facing universities. The objectives of the present study were to investigate alcohol consumption and the behaviors associated with it among Romanian university medical students, with particular reference to sex differences, behavioral consequences, and lifestyle patterns. We performed a cross-sectional study on 722 medical students (60.4% females; 39.6% males); the participants filled out a validated questionnaire containing the following items co-occurring with alcohol consumption: smoking, illicit drug use, energy drink consumption, and other behavioral drinking consequences. Physical activity was estimated using the IPAQ questionnaire. We statistically analyzed the interrelation between alcohol consumption and target factors. The present study showed a high percentage of at-risk drinkers among male (15.0%) and female medical students (14.9%) in the studied group. Male students reported higher illicit drug use and physical activity than female students, but the at-risk female drinkers' group consumed more drugs than the low-risk female drinkers. Both male and female drinkers engaged in other risky behaviors correlated with drinking (e.g., smoking, low academic performance, and driving a car after drinking). Public health policies, strategies, and interventions should be initiated to reduce alcohol consumption and associated behaviors in medical students.

Effects of ethanol, nicotine and caffeine gestational exposure of female rats on lung and brain tissues in fetuses: morphological and biological study

AIM

The purpose of this study was to evaluate the implications of toxic exposure on pregnancy, by exploring the oxidant-antioxidant balance and the histopathological (HP) changes of fetal organs.

MATERIALS AND METHODS

Our study was performed on fetuses of gestating rats exposed to ethanol, nicotine and caffeine. HP tissue analysis of fetuses' brain and lung samples were performed. Brain and lung homogenates were quantitatively analyzed to determine the oxidant-antioxidant balance [malondialdehyde (MDA), protein carbonylation (PC), glutathione (GSH) and thiol groups (-SH)].

RESULTS

An increase in cerebral pro-oxidant capacity was observed for alcohol exposure groups through increased MDA levels (p<0.001), as compared to controls. An increase in pulmonary and cerebral pro-oxidant capacity was observed for nicotine and caffeine study groups, through increased PC levels (p<0.001). Lower GSH levels indicate a decrease in brain antioxidant defenses in alcohol, nicotine and caffeine groups. Alcohol and nicotine exposure in pregestational and gestational periods caused neuronal hypoplasia in hippocampus and brainstem congestion. Caffeine registered negligible differences as compared to controls.

CONCLUSIONS

In our experimental model for gestational exposure to chemical agents, alcohol was the strongest teratogenic agent in rat brain samples. No significant changes were observed in lung samples. Results indicate an increase in oxidative stress as a result of alcohol and nicotine consumption during gestation in rats.

Attitudes toward mentally ill patients: a comparison between Romanian and international medical students

Background

Stigmatizing attitudes to mental illness, and especially schizophrenia, are not limited to the general population but are also common among health professionals. Health professionals are in a position to model health related attitudes both in the general public and patients. Medical students are an interesting group to focus upon, since they are future health professionals and correcting stigmatizing attitudes is still possible during their educational curriculum.

Methods

This study investigated the attitude toward mental illness in medical students at the Iuliu Hatieganu University of Medicine and Pharmacy. We surveyed first year students, since they have not yet received specific classes or internships in psychiatry; 322 students from the Romanian and English sections participated, representing a response rate of 94.7%. The questionnaire consisted of the Romanian and English versions of Link’s Social Distance Scale towards people with mental illness scale.

Results

Overall, medical students had a relatively negative attitude towards people with mental illness, with moderate social distance and stereotypical attitudes. The level of personal contact with people with mental illness was correlated with positive attitudes. International students had scored lower then Romanian students on social distance toward mentally ill patients.

Conclusions

Medical education can play an important role in the attitudes of students toward mental illness. Medical students have stigmatizing attitudes about mentally ill patients. Personal contact with people suffering from mental illness might contribute to a positive attitude from the medical students toward mentally ill patients.