Depression and Anxiety among Iranian Medical Students during COVID-19 Pandemic
-
Amin Nakhostin-Ansari
,
Alborz Sherafati
,
Faezeh Aghajani
,
Mohammad Saeid Khonji
,
Reyhaneh Aghajani
,
Nazila Shahmansouri
Abstract
Objective: COVID-19 has spread throughout the world and has become a global pandemic. This situation can cause psychological distress among people, especially health care workers.
This study aimed to determine depression and anxiety levels among Iranian medical students during the COVID-19 pandemic.
Method: In this cross sectional study, we designed an online survey of Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) questionnaires. The survey link was sent to 500 medical clerks and interns studying at Tehran University of Medical Sciences (TUMS).
Results: A total of 64.6% of the students completed the survey. The prevalence of mild to severe anxiety and depression among them was 38.1% and 27.6%, respectively. Anxiety and changes in sleep patterns were the most common symptoms. Higher levels of anxiety were related to female gender, lower grade point average (GPA), and experience of COVID-19 symptoms. Students with lower GPA and prior experience of COVID-19 symptoms were more likely to feel depressed.
Conclusion: Depression and anxiety did not significantly differ among Iranian medical students before and after the COVID-19 outbreak. Somatic symptoms of depression are more common during this pandemic and need particular attention in future similar situations. A higher GPA is related to lower anxiety and depression among medical students.
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15. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-7.
16. Fydrich T, Dowdall D, Chambless DL. Reliability and validity of the Beck Anxiety Inventory. J Anxiety Disord. 1992;6(1):55-61.
17. Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011;63 Suppl 11(0 11):S467-72.
18. Kaviani H, Mousavi A. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J, 66 (2) (2008): 136-40
19. Beck A, Steer R, Brown G. Manual for the beck depression inventory-II. 1996. San Antonio, TX: Psychological Corporation. 1996;2.
20. Beck AT, Steer RA, Brown GK. Beck depression inventory-II. San Antonio. 1996;78(2):490-8.
21. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN. Depress Anxiety. 2005;21(4):185-92.
22. Jafari P, Nozari F, Ahrari F, Bagheri Z. Measurement invariance of the Depression Anxiety Stress Scales-21 across medical student genders. Int J Med Educ. 2017;8:116-22.
23. Vasegh S, Mohammadi MR. Religiosity, anxiety, and depression among a sample of Iranian medical students. Int J Psychiatry Med. 2007;37(2):213-27.
24. Rezaei M, Khormali M, Akbarpour S, Sadeghniiat-Hagighi K, Shamsipour M. Sleep quality and its association with psychological distress and sleep hygiene: a cross-sectional study among pre-clinical medical students. Sleep Sci. 2018;11(4):274-80.
25. Zeng W, Chen R, Wang X, Zhang Q, Deng W. Prevalence of mental health problems among medical students in China: A meta-analysis. Medicine (Baltimore). 2019;98(18):e15337.
26. Ahmed I, Banu H, Al-Fageer R, Al-Suwaidi R. Cognitive emotions: depression and anxiety in medical students and staff. J Crit Care. 2009;24(3):e1-7.
27. Shanafelt T, Ripp J, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. Jama. 2020.
28. Richman JA, Flaherty JA. Gender differences in medical student distress: contributions of prior socialization and current role-related stress. Soc Sci Med. 1990;30(7):777-87.
29. Nahar VK, Davis RE, Dunn C, Layman B, Johnson EC, Dascanio JJ, et al. The prevalence and demographic correlates of stress, anxiety, and depression among veterinary students in the Southeastern United States. Res Vet Sci. 2019;125:370-3.
30. Hammer MR, Wiseman RL, Rasmussen JL, Bruschke JC. A test of anxiety/uncertainty management theory: The intercultural adaptation context. Communication quarterly. 1998;46(3):309-26.
31. Ahmadi J, Ahmadi N, Soltani F, Bayat F. Gender differences in depression scores of Iranian and german medical students. Iran J Psychiatry Behav Sci. 2014;8(4):70-3.
32. Xu J, Xu QH, Wang CM, Wang J. Psychological status of surgical staff during the COVID-19 outbreak. Psychiatry Res. 2020;288:112955.
33. Salk RH, Hyde JS, Abramson LY. Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychol Bull. 2017;143(8):783-822.
34. Kapfhammer HP. Somatic symptoms in depression. Dialogues Clin Neurosci. 2006;8(2):227-39.
2. Paules CI, Marston HD, Fauci AS. Coronavirus infections—more than just the common cold. Jama. 2020;323(8):707-8.
3. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta bio-medica: Atenei Parmensis. 2020;91(1):157-60.
4. Lung FW, Lu YC, Chang YY, Shu BC. Mental Symptoms in Different Health Professionals During the SARS Attack: A Follow-up Study. Psychiatr Q. 2009;80(2):107-16.
5. Maunder RG, Lancee WJ, Balderson KE, Bennett JP, Borgundvaag B, Evans S, et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis. 2006;12(12):1924-32.
6. Lu W, Wang H, Lin Y, Li L. Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study. Psychiatry Res. 2020;288:112936.
7. Zhang WR, Wang K, Yin L, Zhao WF, Xue Q, Peng M, et al. Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China. Psychother Psychosom. 2020;89(4):242-50.
8. Chen Y, Zhou H, Zhou Y, Zhou F. Prevalence of self-reported depression and anxiety among pediatric medical staff members during the COVID-19 outbreak in Guiyang, China. Psychiatry Res. 2020;288:113005.
9. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976.
10. Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry. 2020;7(3):e14.
11. Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020;52:102066.
12. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934.
13. Jalili M, Mirzazadeh A, Azarpira A. A survey of medical students' perceptions of the quality of their medical education upon graduation. Ann Acad Med Singapore. 2008;37(12):1012-8.
14. Loh LC, Ali AM, Ang TH, Chelliah A. Impact of a spreading epidemic on medical students. Malays J Med Sci. 2005;12(2):43-9.
15. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-7.
16. Fydrich T, Dowdall D, Chambless DL. Reliability and validity of the Beck Anxiety Inventory. J Anxiety Disord. 1992;6(1):55-61.
17. Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011;63 Suppl 11(0 11):S467-72.
18. Kaviani H, Mousavi A. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J, 66 (2) (2008): 136-40
19. Beck A, Steer R, Brown G. Manual for the beck depression inventory-II. 1996. San Antonio, TX: Psychological Corporation. 1996;2.
20. Beck AT, Steer RA, Brown GK. Beck depression inventory-II. San Antonio. 1996;78(2):490-8.
21. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN. Depress Anxiety. 2005;21(4):185-92.
22. Jafari P, Nozari F, Ahrari F, Bagheri Z. Measurement invariance of the Depression Anxiety Stress Scales-21 across medical student genders. Int J Med Educ. 2017;8:116-22.
23. Vasegh S, Mohammadi MR. Religiosity, anxiety, and depression among a sample of Iranian medical students. Int J Psychiatry Med. 2007;37(2):213-27.
24. Rezaei M, Khormali M, Akbarpour S, Sadeghniiat-Hagighi K, Shamsipour M. Sleep quality and its association with psychological distress and sleep hygiene: a cross-sectional study among pre-clinical medical students. Sleep Sci. 2018;11(4):274-80.
25. Zeng W, Chen R, Wang X, Zhang Q, Deng W. Prevalence of mental health problems among medical students in China: A meta-analysis. Medicine (Baltimore). 2019;98(18):e15337.
26. Ahmed I, Banu H, Al-Fageer R, Al-Suwaidi R. Cognitive emotions: depression and anxiety in medical students and staff. J Crit Care. 2009;24(3):e1-7.
27. Shanafelt T, Ripp J, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. Jama. 2020.
28. Richman JA, Flaherty JA. Gender differences in medical student distress: contributions of prior socialization and current role-related stress. Soc Sci Med. 1990;30(7):777-87.
29. Nahar VK, Davis RE, Dunn C, Layman B, Johnson EC, Dascanio JJ, et al. The prevalence and demographic correlates of stress, anxiety, and depression among veterinary students in the Southeastern United States. Res Vet Sci. 2019;125:370-3.
30. Hammer MR, Wiseman RL, Rasmussen JL, Bruschke JC. A test of anxiety/uncertainty management theory: The intercultural adaptation context. Communication quarterly. 1998;46(3):309-26.
31. Ahmadi J, Ahmadi N, Soltani F, Bayat F. Gender differences in depression scores of Iranian and german medical students. Iran J Psychiatry Behav Sci. 2014;8(4):70-3.
32. Xu J, Xu QH, Wang CM, Wang J. Psychological status of surgical staff during the COVID-19 outbreak. Psychiatry Res. 2020;288:112955.
33. Salk RH, Hyde JS, Abramson LY. Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychol Bull. 2017;143(8):783-822.
34. Kapfhammer HP. Somatic symptoms in depression. Dialogues Clin Neurosci. 2006;8(2):227-39.
| Files | ||
| Issue | Vol 15 No 3 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v15i3.3815 | |
| PMCID | PMC7603582 | |
| PMID | 33193771 | |
| Keywords | ||
| Anxiety Coronavirus Depression Medical Pandemics Students | ||
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How to Cite
1.
Nakhostin-Ansari A, Sherafati A, Aghajani F, Khonji MS, Aghajani R, Shahmansouri N. Depression and Anxiety among Iranian Medical Students during COVID-19 Pandemic. Iran J Psychiatry. 2020;15(3):228-235.
