Abstract
To date, little is known about the long-term trajectory of generalized anxiety disorder (GAD) symptoms in health professions (HP) students over the course of the pandemic. Like health professionals in general, HP students may have a significantly greater susceptibility to GAD symptoms due to their involvement in the health care system and the associated specific stressors and risks during the COVID-19 pandemic. The HEalth in Students during the Corona pandemic study (HES-C) provided the opportunity to investigate the long-term course of GAD symptoms with eight measurement points over 14 months in 9380 HP and non-HP students in Switzerland between March 2020 and June 2021. We employed logistic regression models with clustered sandwich standard errors to estimate unadjusted and adjusted prevalence of GAD symptoms. In the full model, we adjusted for age, gender, nationality, social status, social support, self-efficacy, and COVID-19 symptoms in the past 4 weeks. At baseline, the estimated adjusted GAD symptom prevalence was 17.6% (95% CI = 14.4–20.7) in HP students and 24.4% (95% CI = 22.3–26.5) in their peers. With the peak of the second SARS-CoV-2 infection wave in October/November 2020, GAD symptom prevalence substantially increased and then remained stable over time, despite changes in the epidemiological situation and its associated containment measures. At the last follow-up in June 2021, GAD symptom prevalence in HP and non-HP students was 22.9% (95% CI = 16.3–29.5) and 36.9% (95% CI = 32.9–40.9), respectively. Absolute differences in GAD symptom prevalence between student groups over all eight measurement points ranged from 6.2% to 14.9% (all p < 0.05). Non-HP students are identified as a specifically vulnerable group. Accordingly, target group-specific public health campaigns and interventions should be developed with the aim to strengthen their resources, reducing GAD symptoms, and preventing chronification.
Highlights
The rapid and global spread of SARS-CoV-2 infections since the early 2020s has posed fundamental, existential challenges to governments, scientists, and the public
Interaction terms between time and faculty were statistically not significant, indicating that health professions (HP) students share the same trajectory of generalized anxiety disorder (GAD) symptoms over time that we found for non-HP students, i.e., HP students experienced a decrease in GAD symptoms at the first follow-up at M2 as compared to their baseline GAD, and from the fourth follow-up (M4) on were always more likely to report GAD symptoms as compared to baseline
Further adjusting for gender and age (Table 3, Model 2), parents’ social status and nationality (Table 3, Model 3), self-efficacy, social support, and COVID-19 symptoms (Table 3, model 4), we consistently found HP students as compared to their peers were less likely to report GAD symptoms (Model 2: odds ratios (ORs) = 0.57; 95% CI = 0.44–0.73; Model 3: OR = 0.59; 95% CI = 0.45–0.77; Model 4: OR = 0.67; 95% CI = 0.50–0.89)
Summary
The rapid and global spread of SARS-CoV-2 infections since the early 2020s has posed fundamental, existential challenges to governments, scientists, and the public. In their efforts to contain the spread of the virus, governments have drastically restricted civil liberties, imposing measures, such as curfews, quarantines, assembly bans, and mandatory home offices. Since the first wave of SARS-CoV-2 infection reached Switzerland in March/April. 2020, the country has been hit by a second and third wave in September/October 2020.
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