The hidden crisis: COVID-19 and impact on mental health of medical students in Pakistan

Abstract

Background Medical students have faced an enormous disruption to their lives due to the COVID-19 pandemic. The study aimed to assess the impact of COVID-19 on medical student’s psychological well-being in Pakistan. Following ethical approval, an online survey developed in collaboration with World Psychiatric Association (WPA) was distributed among medical students of 5 Medical colleges in the Punjab province of Pakistan between August and September 2020. Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and Risk Assessment Suicidality Scale (RASS) were used to assess psychological well-being. Data was analyzed using SPSS 26.0. Results Eleven hundred medical students responded, 756 (69%) being females. More than 2/3rd admitted that their emotional state got worse in relation to appearance of anxiety, insecurity, and sadness, compared to before the outbreak of COVID-19. Prevalence of anxiety and depressive symptoms were 48.6% and 48.1%, respectively. Female medical students, pre-clinical students, and those with a previous psychiatric history reported experiencing more anxiety and depression symptoms (P value < 0.001). One in five medical students thought that it would be better if they were dead, and 8% admitted to often think of committing suicide during the past 2 weeks. RASS and subscales (intention, life, and history) scores were higher in females and students with previous psychiatric problems. Conclusion Our findings underscore that the impact of COVID-19 on medical students has been significant; hence, it is crucial for medical colleges to employ strategies to maintain the student’s well-being with safeguards like reassurance, support, and confidential student-centered psychiatric services. The use of virtual platforms (websites, email) to educate and screen students by staff members can create a positive impact. The limitations of this study include cross-sectional design, the possibility of selective participation being web-based survey, response bias, and the possibility of reluctance of students to report mental health problems due to stigma.

Impact of the COVID-19 pandemic on the clinical training of last year medical students in Mexico: a cross-sectional nationwide study

“…This could have deleterious effects on their confidence and capability to care for patients and their autonomy as physicians. Additionally, studies have shown higher rates of mental health disorders during the pandemic [ 6 , 7 ]. With campus and hospital-based teaching suspended, medical students are unable to participate in bedside training.…”

COVID’S Impact on Medical Students’ Performance

“…Studies carried out in Pakistan [7][8][9][10] showed that there was an increase in anxiety, stress, and depression and a decrease in academic performance in medical students during the pandemic. According to Baloch et al 7 , a baseline increase in anxiety, stress, depression, and disrupted sleep patterns during the lockdown all contributed to poor mental status in medical students.…”

“…9 The last Pakistani research for this discussion showed that more than 2/3 rd of their participants had worsened emotional and mental state. 10 When the participants compared their mental health with pre-COVID times, it had altered significantly with more anxiety, sadness, and insecurity after the lockdown. Female medical students were more affected than males, and students which a previous psychiatric history experienced more symptoms of depression and anxiety.…”

WPA Working Group on Medical Students: current initiatives and future priorities

“…The study included 69% female and 31% male medical students, with approximately 25% reporting past psychiatric issues. One of the most concerning observations was that one in five medical students thought that it would be better if they were dead and 8% often thought about suicide during the past 2 weeks 8 . It is imperative that medical schools develop strategies and support systems to maintain medical student well‐being.…”