The prevalence of depressive and anxiety symptoms among first-year and fifth-year medical students during the COVID-19 pandemic: a cross-sectional study

BackgroundMedical students have higher risk of psychological disorders due to the relatively stressful environment. Educators are becoming increasingly aware of the impact of stresses on the students general well-being. The objective of the current study was to examine the prevalence of and risk factors for depressive and anxiety symptoms among first-year and fifth-year medical students. Additionally, we aimed to determine whether the COVID-19 pandemic has affected students' mental well-being.MethodsA cross-sectional study was performed at the College of Medicine at King Saud University between September 2020 and January 2021. The target population was first-year and fifth-year medical students. Depressive symptoms were screened using the 9-item Patient Health Questionnaire (PHQ-9), while anxiety symptoms were screened using the 7-item Generalized Anxiety Disorder assessment (GAD-7). Students were also directly asked about the effect of the COVID-19 pandemic on their mental well-being. Outcomes were compared between groups using the chi-squared test and Student's t test. Multivariate logistic regression analysis was performed to identify factors associated with depressive and anxiety symptoms.ResultsA total of 182 medical students were included. Depressive symptoms (52.9% versus 35.8%, p = 0.020) and anxiety symptoms (35.6% versus 26.3%, p = 0.176) were higher in the first-year students than in the fifth-year students. Approximately 19.2% of the students were worried about acquiring COVID-19, 49.4% were worried about academic performance, and 30.8% were feeling sad, depressed or anxious during the COVID-19 pandemic. Independent risk factors for depressive symptoms included having concomitant anxiety, being worried about acquiring COVID-19, being worried about academic performance, and feeling sad, depressed or anxious. Independent risk factors for anxiety included having a lower grade point average and having concomitant depressive symptoms.ConclusionMedical students have an alarmingly high prevalence of depressive and anxiety symptoms, which might have been negatively impacted by the COVID-19 pandemic. There is a need for a special mental health program targeting new and current medical students.