Pandemic-Related Experiences and Psychosocial Risk Associations Among U.S. Medical Students
Keywords:COVID-19, Medical education, Professional burnout, Anxiety, Depression
Background: Since the start of the COVID-19 global pandemic there has been a profound impact on the psychosocial health of medical professionals, with heightened risk reported on measures of depression, anxiety, and stress relative to non-healthcare professionals. However, there is limited data on the impact of COVID-19 on the psychosocial health of U.S. undergraduate medical students. The current cross-sectional study aims to examine associations between pandemic-related experiences and psychosocial risk among a sample of medical students attending a Northeastern U.S. allopathic medical school.
Methods: One-hundred and seventy-nine students (42.6% of the study body) completed an online survey during the COVID-19 pandemic that included sociodemographic characteristics, the 30-item Brief Epidemic-Pandemic Impacts Inventory (EPII-B), the 2-item Patient Health Questionnaire (PHQ-2), the 2-item Generalized Anxiety Disorder (GAD-2), and the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5).
Results: Rates of serious adverse pandemic-related experiences (e.g., increased conflict, less physical activity, frequent substance use) were as high as 37.5%. Students with a greater number of adverse pandemic-related experiences reported more time with COVID-19 positive patients and were more likely to screen positive for depression, anxiety, and PTSD (rs from 0.25 – 0.34, all ps < 0.01).
Conclusion: These findings suggest the need for other U.S. medical schools to evaluate and address medical student mental health during the COVID-19 public health crisis.
Cucinotta D., Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-160.
Wang C., Pan R., Wan X., Tan Y., Xu L., Ho C.S., et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729.
Bendau A., Plag J., Kunas S., Wyka S., Ströhle A., Petzold M.B. Longitudinal changes in anxiety and psychological distress, and associated risk and protective factors during the first three months of the COVID?19 pandemic in Germany. Brain Behav. 2020;11(2):e01964.
Spoorthy S.M., Pratapa K.S., Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian J Psychiatr. 2020;51:102119.
Pappa S., Ntella V., Giannakas T., Giannakoulis V.G., Papoutsi E., Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-907.
Bergmann C., Muth T., Loerbroks A. Medical students’ perceptions of stress due to academic studies and its interrelationships with other domains of life: a qualitative study. Med Educ Online. 2019;24(1):1603526.
Wolf T.M. Stress, coping and health: enhancing well-being during medical school. Med Educ. 1994;28(1):8-17.
Schwenk T.L., Davis L., Wimsatt L.A. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010;304(11):1181-1190.
Halperin S.J., Henderson M.N., Prenner S., Grauer J.N. Prevalence of Anxiety and Depression Among Medical Students During the Covid-19 Pandemic: A Cross-Sectional Study. J of Med Educ and Curric Dev. 2021;8:1-7.
Saraswathi, I., Saikarthik, J., Senthil Kumar, K., Madhan Srinivasan, K., Ardhanaari, M., Gunapriya, R. Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study. PeerJ. 2020;8:e10164.
Stacey A., D’Eon M., Madojemu G. Medical student stress and burnout: Before and after COVID-19. Can Med Educ J. 2020;11(6):204-205.
Grasso D.J, Briggs-Gowen M.J., Ford J.D., Carter A.S. Epidemic-Pandemic Impacts Inventory. University of Connecticut School of Medicine. 2020.
Grasso D.J., Briggs-Gowen M.J., Carter A.S., Goldstein B.L., Ford J.D. Profiling COVID-related experiences in the United States with the Epidemic-Pandemic Impacts Inventory: Linkages to psychosocial functioning. Brain and Behav. 2021;00:e02197.
Shah A., Darling M., Arstein-Kerslake O., Morgan T., Tovrea A.V., Young J., et al. Measuring the Impact of COVID-19 on Siyan Mental Health Patients Using the Epidemic-Pandemic Impacts Inventory: Survey Study. JMIR Form Res. 2021;5(7):e29952.
Kroenke K., Spitzer R.L., Williams J.B. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284-1292.
Kroenke K., Spitzer R.L., Williams J.B.W., Monahan P.O., Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146(5):317-325.
Prins A., Bovin M.J., Smolenski D.J., Marx B.P., Kimerling R., Jenkins-Guarnieri M.A., et al. The Primary Care PTSD Screen for DSM-5 (CS-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample. J Gen Intern Med. 2016;31(10):1206-1211.
IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp.
Wickham S.R., Amarasekara N.A., Bartonicek A., Conner T.S. The Big Three Health Behaviors and Mental Health and Well-Being Among Young Adults: A Cross-Sectional Investigation of Sleep, Exercise, and Diet. Front Psychol. 2020;11:3339.
Christiansen J., Qualter P., Friis K., Pedersen S.S., Lund R., Andersen C.M., et al. Associations of loneliness and social isolation with physical and mental health among adolescents and young adults. Perspect Pub Health. 2021;141(4):226-236.
Baticulon R.E., Sy J.J., Alberto N.R., Baron M.B., Mabulay R.E., Rizada L.G., et al. Barriers to Online Learning in the Time of COVID-19: A National Survey of Medical Students in the Philippines. Med Sci Educ. 2021;31:615—626.
Mousa O.Y., Dhamoon M.S., Lander S., Dhamoon A.S. The MD Blues: Under-Recognized Depression and Anxiety in Medical Trainees. PLoS One. 2016;11(6):e0156554.
MacLean L., Booza J., Balon R. The Impact of Medical School of Student Mental Health. Acad Psychiatry. 2016;40(1):89-91.
Huckins J.F., DaSilva A.W., Wang W., Hedlund E., Rogers C., Nepal S.K., et al. Mental Health and Behavior of College Students During the Early Phases of the COVID-19 Pandemic: Longitudinal Smartphone and Ecological Momentary Assessment Study. J Med Internet Res. 2020;22(6):e20185
Son C., Hegde E., Smith A., Wang X., Sasangohar F. Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study. J Med Internet Res. 2020;22(9):e21279.
How to Cite
Copyright (c) 2020 Nathaniel A. Jenkins, Damion J. Grasso
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to email@example.com
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to firstname.lastname@example.org