Resilience, Mental Health Impact and COVID-19 Related Mental Health Determinants among Medical Students during COVID-19 Epidemic

Authors

  • Nitchawan Kerdcharoen Department of Psychiatry, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University
  • Varuna Kolkijkovin Department of Psychiatry, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University
  • Jomtian Thaworn Education and student affairs, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University

DOI:

https://doi.org/10.14456/vmj.2021.56

Keywords:

Resilience, mental health, medical students, COVID-19

Abstract

Objective: To study the level of resilience in medical students and how resilience is associated with mental health during COVID-19 epidemic.

Method: This is a cross-sectional descriptive study. The participants are the medical students in the academic year of 2020 from Vajira Hospital. The outcome measures include 1) general personal data and the negative impact encountered during COVID-19 outbreak, 2) Resilience evaluation questionnaire and 3) depression anxiety stress scale (DASS-21). The statistical analyses used include descriptive statistics and analytical statistics, which are Pearson Chi-square, Pearson’s correlation and stepwise multiple regression analysis.

Results: From the total participants of 255, most of them have normal level of resilience. The highest reported mental health impact from COVID-19 outbreak is anxiety. The COVID-19 related academic problems are associated with stress (p=0.002) and depression (p=0.001). Lacking of consultant is associated with anxiety (p=0.009). And personal financial problem is associated with stress (p=0.001). Resilience is inversely related to stress, anxiety and depression (r=-0.471, -0.493 and -0.545 respectively, p<0.01). From stepwise multiple regression analysis, resilience in the domain of will power together with emotional stability can predict stress and anxiety. The variance of stress is 24.5 percent (R2= 0.245, p<0.01). And the variance of anxiety is 27.3 percent (R2= 0.273, p<0.01). Will power domain is the key predictor of stress (β =-0.344, p<0.01) and anxiety (β =-0.321, p<0.01). Will power domain is also the only domain that can statistically predict depression (β =-0.626, p<0.01). The variance of depression is 39.1 percent (R2= 0.391, p<0.01).

Conclusion: Resilience in the domain of will power is the main protective factor against mental health problem in medical students, especially during the COVID-19 epidemic. Therefore, In order to strengthen the ability to cope with stress, medical school should promote resilience enhancing activities, particularly in the will power and emotional stability domains.

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References

Venkatesh A, Edirappuli S. Social distancing in covid-19: what are the mental health implications? BMJ 2020;369:m1379. doi: 10.1136/bmj.m1379.

Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry 2020;7(4):e15-e16. doi: 10.1016/S2215-0366(20)30078-X.

Li SW, Wang Y, Yang YY, Lei XM, Yang YF. Analysis of influencing factors of anxiety and emotional disorders in children and adolescents during home isolation during the epidemic of novel coronavirus pneumonia. Chinese Journal of Child Health 2020;28:1-9.

Demirbatir E, Helvaci A, Yilmaz N, Gul G, Senol A, Bilgel N, et al. The Psychological Well-Being Happiness and Life Satisfaction of Music Students. Psychology 2013;4(11):16-24.

Caoa W, Fanga Z, Houc G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res 2020;287:112934. doi: 10.1016/j.psychres.2020.112934.

Rakkhajeekul S, Krisanaprakornkit T. Mental health survey in medical students in Khon Kaen University. Journal of the Psychiatric Association of Thailand 2008;53:31-40. (in Thai)

Quek TT, Tam WW, Tran BX, Zhang M, Zhang Z, Ho CS, et al. The global prevalence of anxiety among medical students: a metaanalysis. Int J Environ Res Public Health 2019;16(15):2735.

Kumar H, Shaheen A, Rasool I, Shafi M. Psychological distress and life satisfaction among university students. J Psychol Clin Psychiatry 2016;5(3):00283. doi:10.15406/jpcpy.2016.05.00283

Inkaew S, Phalitnontkiet Y, IamSa-at S, Danwattana S. Turning bad into good: Resilience Quotient. Nonthaburi: Bureau of Social Mental Health, Department of Mental Health, Ministry of Public Health. 2009. (in Thai)

Hu T, Zhang D, Wang J. A meta-analysis of the trait resilience and mental health. Personal Individ Differ 2015;76:18–27. doi: 10.1016/j.paid.2014.11.039.

Skrove M, Romundstad P, Indredavik MS. Resilience, lifestyle and symptoms of anxiety and depression in adolescence: the young-HUNT study. Soc Psychiatry Psychiatr Epidemiol 2013;48(3):407–16. doi: 10.1007/s00127-012-0561-2.

Poole JC, Dobson KS, Pusch D. Childhood adversity and adult depression: the protective role of psychological resilience. Child Abuse Negl 2017;64:89–100. doi: 10.1016/j.chiabu.2016.12.012.

Shapero BG, Farabaugh A, Terechina O, DeCross S, Cheung JC, Fava M, et al. Understanding the effects of emotional reactivity on depression and suicidal thoughts and behaviors: moderating effects of childhood adversity and resilience. J Affect Disord 2019;245:419–27. doi: 10.1016/j.jad.2018.11.033.

Yadav P, Tewari A, Arora P, Jose NA, Mahla VP, Tripathi A. To compare psychological distress, intolerance to uncertainty and resilience in people quarantined for COVID-19 pandemic and in health care providers in a tertiary care hospital. Int J of Adv Res 2020;8:242-9. doi: 10.21474/IJAR01/11286.

Anyan F, Hjemdal O. Adolescent stress and symptoms of anxiety and depression: resilience explains and differentiates the relationships. J Affect Disord 2016;203:213–20. doi: 10.1016/j.jad.2016.05.031.

Leonie R. Perceived stress, depression and anxiety in university students: the role of resilience [Dissertation]. Netherland: University of Twente; 2019.

Wu Y, Sang ZQ, Zhang XC, Margraf J. The relationship between resilience and mental health in Chinese college students: a longitudinal cross-lagged analysis. Front Psychol 2020;11:108. doi: 10.3389/fpsyg.2020.00108.

Pollack MH, Stein MB, Davidson JR, Ginsberg DL. New challenges for anxiety disorders: where treatment, resilience, and economic priority converge. CNS Spectr 2004;9:1–4. doi: 10.1017/S1092852900027097.

Anderson MS. Factors of resiliency and depression in adolescents [Dissertation]. La Crosse: University of Wisconsin-La Crosse; 2012. p.65.

Department of Mental Health. Resilience quotient assessment. Bangkok: Department of Health Service Support, Ministry of Health; 2007. (in Thai)

Oei TP, Sawang S, Goh YW, Mukhtar F. Using the Depression Anxiety Stress Scale 21 (DASS-21) across cultures. Int J Psychol 2013;48(6):1018-29.

Sriyarat K, Jiebna V. Relationships between Resilience Quotient (RQ) and perceived self – efficacy and academic achievement in psychiatric nursing practicum course of senior nursing students, Thai Red Cross College of Nursing. The Journal of Psychiatric Nursing and Mental Health 2015;29:76-92. (in Thai)

Somkittikanon P, Muksrinak P, Seebuaban K. Relationships between Resilience Quotient and learning outcome of psychology courses of psychology students, Saint Louis College. Journal of The Royal Thai Army Nurses 2017;18(3):160-9. (in Thai)

Saraswathi I, Saikarthik J, Senthil Kumar K, Madhan Srinivasan K, Ardhanaari M, Gunapriya R. 2020. 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. Pee J 2020;8:e10164. doi: 10.7717/peerj.10164.

Rayakeaw R, Satayasai W. 4-6th year medical students’ stress: Case study at medical center, Buddhachinaraj Hospital, Phitsanulok. Thammasat Medical Journal 2013;13:17-23. (in Thai)

Yusoff MS, Abdul Rahim AF, Baba AA, Ismail SB, Mat Pa MN, Esa AR. Prevalence and associated factors of stress, anxiety and depression among prospective medical students. Asian J Psychiatr 2013;6(2):128-33.

Vaidya PM, Mulgaonkar KP. Prevalence of depression anxiety and stress in undergraduate medical students and its correlation with academic performance. Indian J Occup Ther 2007;39:7-10.

Phativarakorn P. Mental health in medical students of Faculty of Medicine, Chulalongkorn University [dissertation]. Bangkok: Chulalongkorn University; 2015. (in Thai)

Taneja N, Sachdeva S, Dwivedi N. Assessment of depression, anxiety, and stress among medical students enrolled in a medical college of New Delhi, India. Indian J Soc Psychiatry 2018;34:157-62.

Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Glob Health 2020;16:57.doi:10.1186/s12992-020-00589-w.

Chang J, Yuan Y, Wang D. Mental health status and its influencing factors among college students during the epidemic of COVID-19. Nan Fang Yi Ke Da Xue Xue Bao 2020;40(2):171–6.

Sartorao Filho CI, De Las Villas Rodrigues WC, De Castro RB, Marcal AA, Pavelqueires S, Takano L, et al. Impact of covid-19 pandemic on mental health of medical students: a crosssectional study using GAD-7 and PHQ-9 questionnaires. MedRxiv 2020. doi: https://doi.org/10.1101/2020.06.24.20138925.

van der Merwe LJ, Botha A, Joubert G. Resilience and coping strategies of undergraduate medical students at the University of the Free State. S Afr J Psychiatry 2020;26:1471. doi: 10.4102/sajpsychiatry.v26i0.1471.

Published

2021-11-30

How to Cite

Kerdcharoen, N., Kolkijkovin, V., & Thaworn, J. (2021). Resilience, Mental Health Impact and COVID-19 Related Mental Health Determinants among Medical Students during COVID-19 Epidemic. Vajira Medical Journal : Journal of Urban Medicine, 65(Supplement November), S101–116. https://doi.org/10.14456/vmj.2021.56