Moderate and severe symptoms of anxiety and depression are increased among female medical students during the COVID-19 pandemic

  1. Carlos Izaias Sartorão Filho
  2. Wilson Conte de Las Villas Rodrigues
  3. Ricardo Beauchamp de Castro
  4. Arlete Aparecida Marçal
  5. Shirlene Pavelqueires
  6. Luiz Takano
  7. Wilson Luis de Oliveira
  8. Carlos Izaias Sartorão Neto

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Abstract

Background: Emotional disorders in medical students are expected and deserve more attention, especially during the COVID-19 Pandemic. Objective: Evaluate anxiety and depression disorders among medical students during the COVID-19 Pandemic. Methods:  A cross-sectional study at a private medical college in Brazil, two months after stay-at-home order and postponed classes due to the COVID-19 Pandemic. A survey among medical students was conducted in May 2020, using questionnaires regarding social and demographic status, the GAD-7 for symptoms of anxiety, and the PHQ-9 for symptoms of depression. Results: A total of 340 of 347 (97.98%) medical students participated. The average GAD-7 score was 9.18 (±4.75), and the average PHQ-9 score was 12.72 (±6.62). The results indicate a significant positive relationship between GAD-7 and females (F=5.816 P=.016). Using a cut-off score of 10 for GAD-7, 157 (46.17%) students were identified with moderate or severe anxiety symptoms. For the PHQ-9 score, using a cut-off of 10 219 (64.41%), students were recognized with moderate or severe symptoms of depression; the results indicate a significant positive relationship between the PHQ-9 and females (F=5.640 P=.018). Conclusion: The analysis demonstrated a significantly higher prevalence of moderate and severe anxiety    and depression symptoms among female medical students during the COVID-19 Pandemic.

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  1. Version published to 10.33448/rsd-v10i6.15406
  2. ScreenIT

    SciScore for 10.1101/2020.06.24.20138925: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The project was approved by the Research Ethics Committee of Institution under report number CAAE: 30718220.5.0000.8547 and all participants were invited to participate after informed consent.
    Consent: The self-reported anonymous on-line survey form was sent via text-message, for each participant, containing informed consent, questionnaires with socio-demographics, educational evaluation and for Anxiety and Depression evaluation to all enrolled medical students of FEMA.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableAn independent sample t-test was conducted to determine whether there is a difference in GAD-7 score for anxiety and PHQ-9 score for depression between males and females.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    (15) Collected data were analyzed with SPSS v 20.0 software (IBM Corp., Armonk, NY).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    (19) Limitations: first, we cannot explain the heterogeneity between other studies, and caution should be taken when interpreting the results. Although the psychometric properties of the GAD-7 were strong, the measure may better serve as a indicator of GAD severity than a screening tool for the presence or absence of GAD. (20) Future studies should investigate the convergent and discriminant validity of the GAD-7 with respect to other criteria (e.g., behavioral, biological, information-processing) that are relevant to the psychopathology of GAD. (20) Second limitation is PHQ-9 is useful only for screening purposes for “current major depressive episode” as a result of its low positive predictive value. (21) Third, we had only 14 students with 30 years old or older, and this is a possible limitation concerning age sampling. Furthermore, we do not consider another variable analysis, like marital status, race, employment status, because the majority enrolled were single, Caucasian, not worker and financially dependent, according to FEMA academic registry. Another limitation is that we do not have a baseline data about mental health disorder regarding medical students of FEMA before COVID-19 pandemic, to be compared. Our quality criteria assessment was not validated to a better understanding about social distancing and financial status of each participant, and in our concerning, this may be a bias, when comparing the results from another cohorts. Our analyses demonstrated a higher...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  3. Version published to 10.1101/2020.06.24.20138925v1 on medRxiv