Mixed methods analysis of medical students' symptoms and feelings during a catastrophic period

Background: Social restrictions and isolation during pandemic may have contributed to various physical and emotional disorders. We aimed to assess the perceptions of medical students regarding their emotions, anxiety and depression symptoms, and daily experiences during the pandemic. Methods: a prospective mixed methods study involving students in their 1st to 4th years of medicine at a university in São Paulo, Brazil(2020-2021). Participants completed standardized questionnaires online about anxiety, depression, happiness, and quality of life, and participated in an online focus group. Results: A total of 313 students completed the questionnaires, 200 were involved in the focus group. Women exhibited higher scores for anxiety (p=0.002) and depression (p=0.007); men demonstrated better quality of life (p=0.042). Younger students presented better quality of life (p=0.048) and lower anxiety (p=0.001). The focus groups revealed recurring negative feelings: anxiety, depression, tiredness, loneliness, difficulty managing time and others, resulting in reduced mental and physical health during the pandemic. Coping strategies were discussed, including the adoption of new healthy habits, religious practices, and reconnection with family. Limitations: while there are moderate correlations, the instruments utilized do not provide diagnoses and do not suggest a causal link. Nonparametric processes can cause bias in a correlational study like this one. Conclusion: Depression and anxiety symptoms were more prevalent among females, while quality of life improved for younger and male students. The qualitative analysis enhanced our understanding of the determinants and consequences of students' recurring negative feelings and revealed positive aspects such asgreater proximity to family and religiosity.