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Medical students’ mental health state during pandemic COVID-19 in Indonesia



Abstract

Introduction: The COVID-19 pandemic has not only had an impact on health problems, but also brought many changes in other aspects of human life, including the education sector. Difficulty in adapting with the learning process can affect the mental health, especially medical students who are quite susceptible to depression and anxiety. We aimed to aims to provide an overview of mental health problems in medical students during the COVID-19 pandemic.

Method: The method used was an online cross-sectional survey using student characteristics instruments, the GAD-7 and PHQ-2 questionnaires. Respondents were 7949 medical students from 49 medical faculties in Indonesia from February to May 2021. All data were analyzed by univariate and bivariate statistics to see the relationship between several variables using SPSS version 22.0.

Results: The majority of respondents were women (69.4%) with an average age of 20.9±2.1 years and domiciled in Java (63.4%). The survey was joined by students from all years of education and the most followed by students in the second year (20.3%). Based on the GAD-7 questionnaire, 3471 respondents (43.7%) experienced symptoms of anxiety (mild, moderate, severe) and the most experienced mild anxiety (29.8%), while from the PHQ-2 questionnaire it was found that 1332 respondents (16.8%) experienced symptoms of depression. Analysis of the mean GAD-7 and PHQ-2 on several factors (gender, year of education, education phase, and place of domicile showed a significant relationship (p<0.05), except for the PHQ-2 score which was not significant for place of domicile (p=0.06).

Conclusion: The results of this survey describe the mental health conditions of medical students in Indonesia during the pandemic. This study emphasizes the importance of early detection, support, and mental health services to improve the ability and resilience of medical students in dealing with various changes during the COVID-19 pandemic.

Keywords: medical student mental health pandemic covid-19 indonesia

References

  1. Chandratre S, Knight C and Dodson L. Supporting Medical Student Mental Health during COVID-19: Strategies Implemented for an Accelerated Curriculum Medical Campus.’, Journal of medical education and curricular development. 2021;8:23821205211006390.
  2. Deng J, Zhou F, Hou W, Silver Z, Wong CY, Chang O, Drakos A, Zuo QK, Huang E. The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry research. 2021;301:113863.
  3. Martínez-Rubio D, Navarrete J and Montero-Marin J. Feasibility, Effectiveness, and Mechanisms of a Brief Mindfulness- and Compassion-Based Program to Reduce Stress in University Students: A Pilot Randomized Controlled Trial. International journal of environmental research and public health. 2021;19(1):154.
  4. Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. Jama. 2010;304(11):1181-90.
  5. Molodynski A. Cultural variations in wellbeing, burnout and substance use amongst medical students in twelve countries. International review of psychiatry (Abingdon, England). England. 2021;33(1–2):37–42.
  6. MacLean L, Booza J, Balon R. The impact of medical school on student mental health. Academic Psychiatry. 2016;40:89-91.
  7. Gazzaz ZJ, Baig M, Al Alhendi BS, Al Suliman MM, Al Alhendi AS, Al-Grad MS, Qurayshah MA. Perceived stress, reasons for and sources of stress among medical students at Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia. BMC medical education. 2018;18(1):1-9.
  8. Kumar B, Shah MA, Kumari R, Kumar A, Kumar J, Tahir A, Siddiqui A. Depression, anxiety, and stress among final-year medical students. Cureus. 2019;11(3).
  9. Abouammah N. Stress among medical students and its consequences on health : A qualitative study. Biomedical Research. 2020;31(1):1–8.
  10. Shao R, He P, Ling B, Tan L, Xu L, Hou Y, Kong L, Yang Y. Prevalence of depression and anxiety and correlations between depression, anxiety, family functioning, social support and coping styles among Chinese medical students. BMC psychology. 2020;8(1):1-9.
  11. Lestari TR. Kebijakan pendidikan kedokteran di Indonesia. Info Singkat Kesejahteraan Sosial. 2012;4(8):9-12.
  12. Ardan M, Rahman FF, Geroda GB. The influence of physical distance to student anxiety on COVID-19, Indonesia. Journal of Critical Reviews. 2020;7(17):1126-32.
  13. Natalia D, Syakurah RA. Mental health state in medical students during COVID-19 pandemic. Journal of education and health promotion. 2021;10.
  14. Ramadianto AS, Kusumadewi I, Agiananda F, Raharjanti NW. Symptoms of depression and anxiety in Indonesian medical students: association with coping strategy and resilience. BMC psychiatry. 2022;22(1):1-1.
  15. Choo K, Spitzer RL, Williams JB. The phq-9. Journal of General Internal Medicine. 2001;16(9):606-13.
  16. Budikayanti A, Larasari A, Malik K, Syeban Z, Indrawati LA, Octaviana F. Screening of generalized anxiety disorder in patients with epilepsy: Using a valid and reliable Indonesian version of generalized anxiety disorder-7 (GAD-7). Neurology research international. 2019.
  17. Nazari N, Safitri S, Usak M, Arabmarkadeh A, Griffiths MD. Psychometric validation of the Indonesian version of the Fear of COVID-19 Scale: Personality traits predict the fear of COVID-19. International journal of mental health and addiction. 2021;23:1-7.
  18. Kroenke K and Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatric Annals. 2002;32(9):509–515.
  19. Caneo C, Toro P, Ferreccio C, Mauco Research Team Claudia Bambs Sandra Cortés Fabio Paredes Andrea Huidobro Pia Venegas Johanna Acevedo. Validity and performance of the patient health questionnaire (PHQ-2) for screening of depression in a rural chilean cohort. Community Mental Health Journal. 2020;56:1284-91.
  20. Levis B, Sun Y, He C, Wu Y, Krishnan A, Bhandari PM, Neupane D, Imran M, Brehaut E, Negeri Z, Fischer FH. Depression Screening Data (DEPRESSD) PHQ Collaboration. 2020.
  21. Onie S, Kirana AC, Mustika NP, Adesla V, Ibrahim R. Assessing the Predictive Validity and Reliability of the DASS-21, PHQ-9 and GAD-7 in an Indonesian Sample. 2020.
  22. Iqbal S, Gupta S, Venkatarao E. Stress, anxiety & depression among medical undergraduate students & their socio-demographic correlates. The Indian journal of medical research. 2015;141(3):354.
  23. Mao Y, Zhang N, Liu J, Zhu B, He R, Wang X. A systematic review of depression and anxiety in medical students in China. BMC medical education. 2019;19(1):1-3.
  24. Tian-Ci Quek T, Tam WS. X. Tran B, Zhang M, Zhang Z, Su-Hui Ho C, Chun-Man Ho R. 2019. The global prevalence of anxiety among medical students: a meta-analysis. International Journal of Environmental Research and Public Health. 2019;16(15):2735.
  25. Gupta P, BK A, Ramakrishna K. Prevalence of depression and anxiety among medical students and house staff during the COVID-19 health-care crisis. Academic Psychiatry. 2021;45(5):575-80.
  26. Ghazawy ER, Ewis AA, Mahfouz EM, Khalil DM, Arafa A, Mohammed Z, Mohammed EN, Hassan EE, Abdel Hamid S, Ewis SA, Mohammed AE. Psychological impacts of COVID-19 pandemic on the university students in Egypt. Health Promotion International. 2021;36(4):1116-25.
  27. Halperin SJ, Henderson MN, Prenner S, Grauer JN. Prevalence of anxiety and depression among medical students during the Covid-19 pandemic: a cross-sectional study. Journal of medical education and curricular development. 2021;8:2382120521991150.
  28. Natalia D, Syakurah RA. Mental health state in medical students during COVID-19 pandemic. Journal of education and health promotion. 2021;10.
  29. Manea L, Gilbody S, Hewitt C, North A, Plummer F, Richardson R, Thombs BD, Williams B, McMillan D. Identifying depression with the PHQ-2: A diagnostic meta-analysis. Journal of Affective Disorders. 2016;203:382-95.
  30. Anand P, Bhurji N, Williams N, Desai N. Comparison of PHQ-9 and PHQ-2 as screening tools for depression and school related stress in inner city adolescents. Journal of Primary Care & Community Health. 2021;12:21501327211053750.
  31. Ngasa SN, Sama CB, Dzekem BS, Nforchu KN, Tindong M, Aroke D, Dimala CA. Prevalence and factors associated with depression among medical students in Cameroon: a cross-sectional study. BMC psychiatry. 2017;17(1):1-7.
  32. Puthran R, Zhang MW, Tam WW, Ho RC. Prevalence of depression amongst medical students: A meta‐analysis. Medical education. 2016;50(4):456-68.
  33. Arun P, Ramamurthy P, Thilakan P. Indian medical students with depression, anxiety, and suicidal behavior: why do they not seek treatment?. Indian journal of psychological medicine. 2022;44(1):10-6.
  34. Essangri H. Predictive Factors for Impaired Mental Health among Medical Students during the Early Stage of the COVID-19 Pandemic in Morocco. The American journal of tropical medicine and hygiene. 2021;104(1):95–102.
  35. Pacheco JP, Giacomin HT, Tam WW, Ribeiro TB, Arab C. Bezerra IMet al. Mental health problems among medical students in Brazil: a systematic review and meta-analysis. Rev Bras Psiquiatr. 2017;39:369-78.
  36. Zeng W, Chen R, Wang X, Zhang Q, Deng W. Prevalence of mental health problems among medical students in China: A meta-analysis. Medicine. 2019;98(18).
  37. Enns SC, Perotta B, Paro HB, Gannam S, Peleias M, Mayer FB, Santos IS, Menezes M, Senger MH, Barelli C, Silveira PS. Medical students’ perception of their educational environment and quality of life: is there a positive association?. Academic Medicine. 2016;91(3):409-17.
  38. Donner NC, Lowry CA. Sex differences in anxiety and emotional behavior. Pflügers Archiv-European Journal of Physiology. 2013;465:601-26.
  39. Altemus M, Sarvaiya N and Neill Epperson C. Sex differences in anxiety and depression clinical perspectives.’, Frontiers in neuroendocrinology. 2014;35(3):320–330.
  40. Bassols AM, Okabayashi LS, Silva AB, Carneiro BB, Feijó F, Guimarães GC, Cortes GN, Rohde LA, Eizirik CL. First-and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms?. Brazilian Journal of Psychiatry. 2014;36:233-40.
  41. Zis P. Medical Studies during the COVID-19 Pandemic: The Impact of Digital Learning on Medical Students’ Burnout and Mental Health., International journal of environmental research and public health. 2021;18(1):349.
  42. Fruehwirth JC, Biswas S and Perreira KM. The Covid-19 pandemic and mental health of first-year college students: Examining the effect of Covid-19 stressors using longitudinal data. PloS one. 2021;16(3):e0247999.
  43. Schindler AK, Polujanski S, Rotthoff T. A longitudinal investigation of mental health, perceived learning environment and burdens in a cohort of first-year German medical students’ before and during the COVID-19 ‘new normal’. BMC Medical Education. 2021;21:1-1.
  44. Sujarwoto, Saputri RAM, Yumarni T. Social Media Addiction and Mental Health Among University Students During the COVID-19 Pandemic in Indonesia. International journal of mental health and addiction. 2021;1–15.
  45. Argo TM, Kurniawan A, Liem JA, Sugianto JO, Michael RJ, Tanuwijaya NV, Agatha L, Wonsono B, Rivami DS. Profile and factors associated with depression, anxiety, and stress in Indonesian people during Covid-19 pandemic. Medicinus. 2021;8(3):131-40.
  46. Auerbach RP, Alonso J, Axinn WG, Cuijpers P, Ebert DD, Green JG, Hwang I, Kessler RC, Liu H, Mortier P, Nock MK. Mental disorders among college students in the World Health Organization world mental health surveys. Psychological medicine. 2016;46(14):2955-70.
  47. Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. Jama. 2010;304(11):1181-90.
  48. Nishimura Y, Ochi K, Tokumasu K, Obika M, Hagiya H, Kataoka H, Otsuka F. Impact of the COVID-19 pandemic on the psychological distress of medical students in Japan: cross-sectional survey study. Journal of medical Internet research. 2021;23(2):e25232.
  49. O'Byrne L, Gavin B, Adamis D, Lim YX, McNicholas F. Levels of stress in medical students due to COVID-19. Journal of Medical Ethics. 2021;47(6):383-8.
  50. Slavin S. Medical student mental health: Challenges and opportunities. Medical Science Educator. 2018;28(Suppl 1):13-5.
  51. Zis P, Artemiadis A, Bargiotas P, Nteveros A, Hadjigeorgiou GM. Medical studies during the COVID-19 pandemic: the impact of digital learning on burnout and mental health. 2020.
  52. Abubakar A, Ma'ruf MF, Mizfaruddin M, Yusuf F, Maghfirah D, Muhsin M. Anxiety to COVID-19 pandemic amongst university students is related with gastrointestinal symptoms. Bali Medical Journal. 2021;10(2):847-50.

How to Cite

Primatanti, P. A., Turana, Y. ., Sukarya, W. S. ., Wiyanto, M. ., & Duarsa, A. B. S. . (2023). Medical students’ mental health state during pandemic COVID-19 in Indonesia. Bali Medical Journal, 12(2), 1295–1301. https://doi.org/10.15562/bmj.v12i2.4104
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Putu Asih Primatanti
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Yuda Turana
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Wawang S. Sukarya
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Marwito Wiyanto
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Artha Budi Susila Duarsa
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