Association of Covid-19 pandemic-related stress and depressive symptoms among international medical students

Abstract

Background The outbreak of Covid-19 had negative impacts on the mental stress and induced psychological distress among university students worldwide. This study proposed a moderated mediation model, and hypothesized that the Covid-19 pandemic-related stress was positively related to depressive symptoms among international medical students. Methods An online survey on stress and depressive symptoms of international students was conducted in a medical university. Questions on Covid-19 pandemic-related stress, Patient Health Quesionnaire-9, Simplified Coping Style Questionnaire and the Perceived Social Support Scale were used as measurements, and model analyses were conducted using Hayes’ PROCESS macro for SPSS. Results It was found that 9.83%, 3.08% and 2.12% students had mild, moderate and severe depressive symptoms, respectively, and the positive association between Covid-19 pandemic-related stress and depressive symptoms was significant (β = 0.27, t = 6.87, P < 0.01). Negative coping was also significantly correlated to depressive symptoms (β = 0.26, t = 6.60, P < 0.01), and partially mediated the association between Covid-19 pandemic-related stress and depressive symptoms. Perceived social support had a negative association with depressive symptoms (β=-0.26, t=-6.25, P < 0.01), played a negative moderating role in the relationship between negative coping and depressive symptoms, and moderated the indirect effect of Covid-19 pandemic-related stress on depressive symptoms via negative coping. Conclusions Results of the study suggested that under the background of continuing pandemic, intervention or prevention of mental health problem is urgently needed for the international students, and depression may be alleviated through reducing negative coping and increasing perceived social support.

Stress and depressive symptoms in university students in Hong Kong under the pandemic: Moderating effect of positive psychological attributes

“…Results of the present study support Hypotheses 1a and 1b, suggesting that students’ stresses related to COVID-19 and the “social event” positively predicted depression. This observation is in line with the existing literature arguing that COVID-19-related stress or stressors were associated with increased depression in adolescents ( Ellis et al, 2020 ) and university students ( Rudenstine et al, 2021 ; Lu et al, 2022 ). However, it is noteworthy that there are inconsistent findings in the literature.…”

“…In adolescents, Ellis et al (2020) reported that COVID-19 stress was associated with increased loneliness and depressive symptoms. In college students, Lu et al (2022) found that COVID-19 stress was positively associated with symptoms of depression. Galanza et al (2021) showed that COVID-19-related fear predicted three mental illness indicators, including depression, stress, and anxiety.…”

Comparison of Multinational Medical School Students Experiences in the Face of the COVID-19 Pandemic: A Qualitative Analysis

“…14 Supporting our hypothesis, these meta-analysis findings could indicate that international students who perceived higher levels of pandemic related stress may have had a negative impact on their academic performance in medical school. 15 . However, even though mental health IJMS was a common theme, it was only listed in responses as 27.3% for the international students and 1.7% for the United States students.…”

“…This finding also confirms our hypothesis and current literature, that perceived social support is a protective factor and influences the mental health status of the medical student. 15 It is worth noting, United States medical students had political critiques of how COVID was handled at the beginning of the pandemic which was not seen in the international responses. As reported, the government plays an important role in reducing mental health disparities with efficient intervention and appropriate policy changes.…”

Perceived stress, pain, sleep quality and mindfulness as their regulator among adult students

“…Relevance of the topic was formulated in times of COVID-19 pandemic, as it brought additional stress to people. For example, this perceived stress can negatively impact learning engagement and academic outcomes of university students (Lu et al, 2022;Sfeir et al, 2022). At the same time, mindfulness can become a regulator that helps reduce the level of perceived stress (Castillo-Sánchez et al, 2022;Xu et al, 2022).…”