Abstract
ObjectiveThe novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. The mental health of medical students under the COVID-19 epidemic has attracted much attention. This study aims to identify subgroups of medical students based on depression and anxiety and explore the influencing factors during the COVID-19 epidemic in China.MethodsA total of 29,663 medical students were recruited during the epidemic of COVID-19 in China. Depression and anxiety symptoms were assessed using Patient Health Questionnaire 9 (PHQ9) and Generalized Anxiety Disorder 7 (GAD7) respectively. Latent class analysis was performed based on depression and anxiety symptoms in medical students. The latent class subtypes were compared using the chi-square test. Multinomial logistic regression was used to examine associations between identified classes and related factors.ResultsIn this study, three distinct subgroups were identified, namely, the poor mental health group, the mild mental health group and the low symptoms group. The number of medical students in each class is 4325, 9321 and 16,017 respectively. The multinomial logistic regression results showed that compared with the low symptoms group, the factors influencing depression and anxiety in the poor mental health group and mild mental health group were sex, educational level, drinking, individual psychiatric disorders, family psychiatric disorders, knowledge of COVID-19, fear of being infected, and participate in mental health education on COVID-19.ConclusionsOur findings suggested that latent class analysis can be used to categorize different medical students according to their depression and anxiety symptoms during the outbreak of COVID-19. The main factors influencing the poor mental health group and the mild mental health group are basic demographic characteristics, disease history, COVID-19 related factors and behavioural lifestyle. School administrative departments can carry out targeted psychological counseling according to different subgroups to promote the physical and mental health of medical students.
Highlights
Since December 2019, a novel coronavirus pneumonia (COVID-19) outbreak has persisted in Wuhan
We focused on symptoms of depression and anxiety for all students using the Chinese versions of the following measurement tools, which have good validity and reliability
The results showed that the Akaike information criterion (AIC), Bayesian information criterion (BIC) and adjusted Bayesian information criterion (aBIC) decreased with an increasing classification number
Summary
Since December 2019, a novel coronavirus pneumonia (COVID-19) outbreak has persisted in Wuhan. The World Health Organization declared that the COVID-19 outbreak constitutes a public health emergency of international concern [1]. The outbreak of the COVID-19 has caused public panic and psychological pressure [2, 3]. To prevent the escalation of the epidemic, schools have taken measures such as extending holidays to ensure that the majority of students are isolated in their current residences and complete their school-related responsibilities remotely [4]. For college students, extended holidays, long-term stays at home, fewer trips out of the home, and an inability to attend school and participate in social activities, may affect their academic performance and lead to their anxiety and depression [5,6,7]
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