Latent class analysis of depression and anxiety among medical students during COVID-19 epidemic

Abstract

Objective The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. The mental health of medical students under the COVID-19 epidemic has attracted much attention. This study aims to identify subgroups of medical students based on depression and anxiety and explore the influencing factors during the COVID-19 epidemic in China. Methods A total of 29,663 medical students were recruited during the epidemic of COVID-19 in China. Depression and anxiety symptoms were assessed using Patient Health Questionnaire 9 (PHQ9) and Generalized Anxiety Disorder 7 (GAD7) respectively. Latent class analysis was performed based on depression and anxiety symptoms in medical students. The latent class subtypes were compared using the chi-square test. Multinomial logistic regression was used to examine associations between identified classes and related factors. Results In this study, three distinct subgroups were identified, namely, the poor mental health group, the mild mental health group and the low symptoms group. The number of medical students in each class is 4325, 9321 and 16,017 respectively. The multinomial logistic regression results showed that compared with the low symptoms group, the factors influencing depression and anxiety in the poor mental health group and mild mental health group were sex, educational level, drinking, individual psychiatric disorders, family psychiatric disorders, knowledge of COVID-19, fear of being infected, and participate in mental health education on COVID-19. Conclusions Our findings suggested that latent class analysis can be used to categorize different medical students according to their depression and anxiety symptoms during the outbreak of COVID-19. The main factors influencing the poor mental health group and the mild mental health group are basic demographic characteristics, disease history, COVID-19 related factors and behavioural lifestyle. School administrative departments can carry out targeted psychological counseling according to different subgroups to promote the physical and mental health of medical students.

The impact of the COVID-19 pandemic on the mental health and academic performance of medical postgraduates

“…None had a severe depression disorder. This indicated that most medical students had strong psychological adjustment abilities and adaptability during the pandemic period, which is consistent with previous studies ( 18 , 36 ). Another reason for this might be the enhanced prevention and control behaviors of postgraduates.…”

Use of latent profile analysis and k-means clustering to identify student anxiety profiles

“…Guo L et al identified three latent classes of health behaviour reported by people at high risk of stroke, and this study had significance for the promotion of adaptive health behaviour in individuals at high risk of stroke [ 23 ]. Liu et al categorized medical students based on their depression and anxiety symptoms and suggested that school administrative departments carry out targeted psychological counselling based on different subgroups to promote the physical and mental health of medical students [ 10 ]. Warren CM et al employed LPA to identify whether psychosocial factors clustered together in different patterns among early adolescents and suggested that adolescents engaging in obesogenic and substance use behaviours may share common profiles of psychosocial risk [ 24 ].…”

“…Ideally, mental health promotion and prevention interventions would be tailored to the differing needs of distinct student subgroups rather than treating all students as a homogeneous group [ 7 , 9 ]. There is a substantial body of evidence regarding subgroup identification in mental health [ 10 – 12 ]. However, these studies seldom focus on adolescents.…”

Influencing factors of anxiety and depression of discharged COVID-19 patients in Wuhan, China

“…Moreover, the findings of this study indicated that RD with a history of psychological or emotional counseling before infection might be at higher risk of anxiety. Evidence suggested that individuals with a history of psychological counseling might have experienced psychological distress before, and the distress was more likely to reoccur due to COVID-19 infection among RD [ 78 , 79 ]. This finding suggested that more attention should be paid to the mental health of RD with a history of psychological or emotional counseling, and it is essential to prevent the reoccurrence of psychological problems among this population.…”