Factors associated with anxiety/depression in medical students during social distancing due to Covid-19

Abstract: Introduction: Medical training involves stressors and possible triggers of mental disorders. Objective: Our study aims to determine the prevalence and factors associated with signs and symptoms of anxiety and depression in medical students during social distancing measures imposed due to the COVID-19 pandemic. Method: A cross-sectional study was conducted between May and June 2020 among medical students from higher education institutions in Pernambuco state, Brazil. An online questionnaire was created using Google Forms containing sociodemographic and clinical characteristics and the Hospital Anxiety and Depression Scale (EHAD). For statistical analysis, multivariate analysis was performed and the risk ratio (RR) and its 95% confidence interval (95%CI) were calculated, considering the significance coefficient (p) <0.05. Result: The variables associated with a higher risk of anxiety signs and symptoms were female gender, decreasing/increasing smoking habit, increasing/not changing drug consumption, decreasing/not practicing leisure, lack of preparation by the university for distance learning, distance learning in place before the pandemic and decline in academic performance compared to previous periods. As for depression, there was a greater risk of increasing/not changing the use of medications, decreasing leisure time, university not being prepared for distance learning, declining academic performance and brown skin colour. Conclusion: Different factors related to the signs and symptoms of anxiety and depression were identified in the period of social distancing resulting from the COVID-19 pandemic.

摘要：引言：医学培训过程中存在应激源，同时可能成为精神障碍的诱发因素。研究目的：本研究旨在明确巴西伯南布哥州高等教育院校的医学生在新型冠状病毒肺炎（COVID-19）疫情期间实施社交距离措施时，焦虑与抑郁症状体征的患病率及其相关影响因素。研究方法：本研究于2020年5月至6月间开展横断面研究，研究对象为巴西伯南布哥州高等教育院校的医学生。研究采用谷歌表单（Google Forms）编制在线调查问卷，内容涵盖社会人口学特征、临床特征以及医院焦虑抑郁量表（Hospital Anxiety and Depression Scale, EHAD）相关内容。统计分析采用多因素分析方法，计算风险比（risk ratio, RR）及其95%置信区间（95% confidence interval, 95%CI），检验水准设定为p<0.05。研究结果：与焦虑症状体征高风险相关的变量包括女性性别、吸烟习惯增减不定、药物使用量增加或无变化、休闲活动减少或未开展、高校未做好远程教学准备、疫情前已推行的远程教学模式，以及相较此前学期学业表现下滑。针对抑郁症状，相关高风险因素包括药物使用量增加或无变化、休闲时间减少、高校未做好远程教学准备、学业表现下滑以及棕肤色人群。研究结论：本研究在COVID-19疫情导致的社交隔离期间，明确了与医学生焦虑及抑郁症状体征相关的多项影响因素。