Severe Psychological Distress Among Medical Students During the COVID-19 Pandemic: Toward a Safer Mental Health

Abstract

Objective: As we learn how to live with the COVID pandemic, understanding this psychological impact of the coronavirus outbreak and its determinants is the first step towards finding solutions. The aim of the study is to examine the status of medical students' mental health and assess psychological distress determinants and pathways in order to suggest adapted strategies to help them. Methods: We performed a convergent parallel mixed-methods analysis of an online survey administered to medical students from March 23 to March 28, 2020. Psychological distress was assessed through the Kessler 6 (K6) questionnaire. Factors associated with severe psychological distress (SPD, K6>13) were identified by multivariable logistic regression. The qualitative part analyzed responses to open-ended questions addressing medical students' perspectives on the impact of the pandemic and relieving factors. Results: 808 medical students completed the survey. Severe psychological distress was reported by 234(28.96%) respondents and was independently associated with: Female sex (OR,2.8;[ 95%CI ,1.791-4.363];P<0.001), clinical study level (OR,0.621;[95%CI,0.437-0.881];P =0.008), Tobacco use (OR, 3.664;[95% CI,1.9 - 7.07];P =0.001), history of psychiatric meds (OR, 2.454 ;[95%CI,1.384 - 4.454];P=0.001) and quarantine (OR, 1.5 ;[95%CI, 1.015 - 2.337];P =0.04). Students submitted a total of 2424 concerns about ways the pandemic affected different areas of their lives and redundants determinants were summarized. Conclusion: During the COVID crisis, 28% of our students experienced severe mental distress due to multifactorial determinants including social and individual psychological and behavioral contributors. This crisis is an opportunity to address the well known mental health morbidities of future physicians and increase the awareness about the important role that medical schools could have as a safety net and support system. Keywords: COVID-19, Medical student, Mental health, Psychological distress, lifting lockdown measures