Factors associated with the mental health status of medical students during the COVID-19 pandemic: a cross-sectional study in Japan

Abstract

ObjectiveThe COVID-19 pandemic had a substantial impact on university students, including those in medical schools, with disruption in routine education causing significant psychological distress. The objective of this study was to evaluate the factors associated with psychological distress among medical students during the period of enforced home quarantine from March through May 2020.DesignA cross-sectional study.SettingOne Japanese medical school.Participants571 medical students.Primary and secondary outcome measuresSelf-administered electronic questionnaires including the K-6 scale for psychological distress, the Rosenberg Self-Esteem Scale (RSES) for self-esteem and the General Self-Efficacy Scale (GSES) for self-efficacy were distributed. To assess the determinant factor for psychological distress, variables such as sex, grade in school, living conditions, and RSES and GSES scores were evaluated in regression analysis.Results163 respondents (28.5%) scored ≥5 on the K-6 scale, indicating a significant degree of psychological distress. Logistic regression revealed that a higher score on RSES (p<0.001) and GSES (p<0.01) was an independent factor associated with lower levels of psychological distress. Multiple regression analysis focusing on students with a K-6 score ≥5 revealed that higher scores on RSES correlated with lower levels of psychological distress. By contrast, those with higher GSES scores also scored higher for indicators of psychological distress.ConclusionsThis study identified that self-efficacy and self-esteem were both influential factors for predicting psychological distress during the current COVID-19 pandemic. Medical schools should provide support for mental health and educational initiatives directed at enhancing self-esteem and self-efficacy, with a focus on improving personal resilience. In emergency situations, such as that faced in response to the COVID-19 pandemic, initial programmes might target students with higher levels of self-efficacy. By contrast, under routine situations, these efforts should be directed towards students with lower self-esteem as primary means to prevent depression.

COVID-19 Pandemic Affects the Medical Students’ Learning Process and Assaults Their Psychological Wellbeing

“…The study shows a very high proportion (93.1%) of undergraduate and postgraduate medical students having some degree of psychological problem while only 17% of them had any history of psychiatric illness in the pre-pandemic period; this assault on psychiatric wellbeing during the pandemic period is in accord with studies on medical students in Pakistan [ 19 ], UK [ 20 ], Japan [ 21 ], India [ 22 ], Morocco [ 23 ] and nursing students in Indonesia [ 18 ]. Also, several studies reflect increased stress, anxiety, and depression as an influence of the COVID-19 epidemic among all strata of society, including the general public [ 5 , 6 , 17 ], health care workers [ 3 , 8 ], older adults [ 24 ] and students of all categories [ 25 ], In contrast, a study from Iran [ 26 ] shows only 27.6% of medical students having depression.…”

“…While there are few studies throwing light on the psychological impact of the COVID-19 pandemic on medical students. [ 18 , 19 , 20 , 21 , 22 , 23 ].…”

Impacts of the Covid‐19 pandemic on the health of university students

“…[79][80][81][82] To date, pre-existing high levels of self-efficacy and physical exercise have emerged as positive determinants of student mental health resilience. 19,66,[83][84][85] There is even evidence that student performance in examinations may have improved during lockdown and this further demonstrates the heterogeneous impacts of the pandemic on the student experience. 86 It may be some time though before we fully appreciate the long-term ramifications of the Covid-19 pandemic for student mental health as it is now becoming established that psychiatric complications are a feature of Long-Covid; a chronic syndrome where 10%-20% patients do not fully recover from Covid-19 even several months after their initial infection.…”

“…There is now a large body of published, peer-reviewed research papers assessing the impacts of the pandemic on university students, the majority of these are surveys investigating topics such as student adaptations to online learning, [9][10][11][12][13][14][15][16] Covid-19 impacts on mental health, 4,5,[17][18][19][20][21][22][23][24][25][26] or less frequently, both of these factors in parallel. [27][28][29][30] Other studies that have taken a broader approach to understand how the pandemic has altered academic, societal, health, lifestyle and behavioural elements of the student experience.…”

A Framework for Assuring the Safety, Training, Evaluation, and Wellness of Radiation Oncology Residents During the COVID-19 Pandemic (ASTEROiD-COVID19)

“…(13) The various effects of the coronavirus pandemic increase the risk of further negative psychological effects in an already high-risk population as evidenced by several recent publications examining this issue in medical students. (14,15) Efforts are needed to ensure resident wellness remains a priority throughout this disruption. We acknowledge that resident wellness is a growing area of research interest and how to best promote resident wellness and resiliency is unknown.…”