Mental burden among Chinese undergraduate medical students: A prospective longitudinal study before, during, and after the COVID-19 outbreak

Abstract

BackgroundIncreasing evidence indicated a clear association between COVID-19 pandemic and mental health. This study aimed to assess the dynamic change of mental burden during and after the COVID-19 outbreak and related predictive factors among Chinese undergraduate medical students.MethodsThis longitudinal survey was conducted among Chinese undergraduate medical students before, during, and after the COVID-19 outbreak. We focused on COVID-19 related mental burdens including psychological distress, stress reaction, and insomnia symptoms, and defined the sum score of the three specific mental burden indexes as the overall mental burden index. The prevalence of specific and overall mental burdens and their changing patterns at two phases of the pandemic (during vs. after the COVID-19 outbreak) were measured. In addition, multinomial logistic regressions were used to assess the associations between the psychosocial status before the pandemic and specific and overall mental burden changing patterns.ResultsOur findings showed that the prevalence of overall mental burden increased (from 27.46 to 37.28%) after the COVID-19 outbreak among the 863 Chinese undergraduate medical students who participated in the surveys at baseline, during, and after the COVID-19 outbreak. Specifically, the prevalence of stress reaction symptoms decreased (from 10.90 to 3.60%), while the rates of psychological distress (from 28.06 to 37.95%) and insomnia symptoms (from 12.54 to 20.71%) increased. Participants, with obsessive-compulsive symptoms, somatic symptoms, internet addiction, childhood adversity, stressful life events, and being neurotic were found to have a higher risk of developing mental burden in at least one survey (during or after the COVID-19 outbreak). Healthy family function and being extravert were found to positively impact mental burden.ConclusionPsychological distress, stress reaction and insomnia symptoms have been prevalent among Chinese undergraduate medical students during the COVID-19 outbreak, and the prevalence of overall mental burden increased after the COVID-19 outbreak. Some students, especially those with the risk factors noted above, exhibited persistent or progression symptoms. Continued mental health care was in demand for them even after the COVID-19 outbreak.

Depression, anxiety, and stress in medical students in Peru: a cross-sectional study

“…While there is extensive documented evidence about the impact of COVID-19 on the mental health of medical students ( 29–32 ), little or nothing has been explored about the persistence of the impact of the pandemic when they have already returned to face-to-face classes at their universities worldwide ( 33–36 ) even more so in Latin American countries like Peru, severely hit by the pandemic. Medical students have constantly been exposed to stressful and anxious factors, particularly due to exposure to SARS-CoV-2 during clinical rotations upon returning to their face-to-face classes.…”

COVID-19–Related Insomnia Populations Research and Management Strategies: A Review

“…Moreover, a survey data from China on 863 medical college students showed that psychological distress, stress reaction and insomnia symptoms were prevalent, and insomnia symptoms remarkably increased (from 12.54% to 20.71%) during the COVID-19 outbreak. 72 During the COVID-19 pandemic recovery period, nonmedical college students in the universities of Shandong Province, China, had more mental health problems and more risk factors than medical students. 73 In addition, other studies from China and Croatia pointed out that these nonmedical students require additional attention and recovery programs to alleviate the increased incidence of insomnia and depression related to COVID-19 when compared with medical college students.…”

“…Risk factors for COVIDRI among college students during home study were upcoming graduation, disharmonious family relationships and poor adaptability to online education. Moreover, a survey data from China on 863 medical college students showed that psychological distress, stress reaction and insomnia symptoms were prevalent, and insomnia symptoms remarkably increased (from 12.54% to 20.71%) during the COVID-19 outbreak 72 . During the COVID-19 pandemic recovery period, nonmedical college students in the universities of Shandong Province, China, had more mental health problems and more risk factors than medical students 73 .…”

Randomized controlled trial for the efficacy of three versus five sessions of grief counseling on the psychological aspects following COVID-19 bereavement: A study protocol

“…We know that COVID-19 has many physical and mental consequences, including lung, kidney and liver complications, drug-related complications, depression, anxiety, and psychological distress (11)(12)(13)(14). The high prevalence of psychological distress, stress reaction, insomnia symptoms, and the increased burden of mental disorders during the pandemic provide evidence for the serious impact of COVID-19 on mental health (15,16).…”