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新型冠状病毒肺炎疫情期间医学生心理问题的发生率及影响因素:系统评价和荟萃分析。

The prevalence and risk factors of mental problems in medical students during COVID-19 pandemic: A systematic review and meta-analysis.

机构信息

Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.

Department of Psychology, College of Education, Hunan First Normal University, Changsha 410205, China.

出版信息

J Affect Disord. 2023 Jan 15;321:167-181. doi: 10.1016/j.jad.2022.10.040. Epub 2022 Oct 28.

Abstract

BACKGROUND

This meta-analysis and systematic review aimed to evaluate the global prevalence and risk factors of mental problems (i.e., depression, anxiety, stress, sleep disorder, posttraumatic stress disorder (PTSD), burnout, psychological distress, and suicidal ideation) among medical students during the COVID-19 pandemic.

METHOD

We searched PubMed, Embase, Web of Science, psycARTICLES, PsycINFO, CNKI, and Wan Fang for studies on the prevalence of mental problems among medical students from January 1, 2020, to April 1, 2022. The pooled prevalence was calculated by random-effect models. We performed a narrative review to identify the risk factors.

RESULTS

The meta-analysis included 201 studies (N = 198,000). The prevalence of depression (41 %, 95 % CI, 37-45 %,), anxiety (38 %,95 % CI, 34 %-42 %), stress (34 %, 95 % CI, 27 %-42 %), sleep disorder (52 %, 95 % CI, 44 %-60 %), psychological distress (58 %, 95 % CI, 51 %-65 %), PTSD (34 %, 95 % CI, 22 %-46 %), suicidal ideation (15 %, 95 % CI, 11 %-18 %) and burnout (38 %, 95 % CI, 25 %-50 %) was high. The major risk factors were being female, being junior or preclinical students, exposure to COVID-19, academic stress, psychiatric or physical disorders history, economic trouble, fear of education impairment, online learning trouble, fear of infection, loneliness, low physical activity, low social support, problematic internet or smartphone use, and young age.

LIMITATIONS

Most studies were cross-sectional. Few studies provided a reasonable response rate, suggesting potential selection bias.

CONCLUSIONS

The study demonstrated a high prevalence and risk factors for mental problems during COVID-19, calling for mental health services. Our findings are valuable for college and health authorities to identify high-risk students and provide targeted intervention.

摘要

背景

本荟萃分析和系统评价旨在评估 COVID-19 大流行期间医学生的心理健康问题(即抑郁、焦虑、压力、睡眠障碍、创伤后应激障碍 (PTSD)、倦怠、心理困扰和自杀意念)的全球患病率和风险因素。

方法

我们检索了 PubMed、Embase、Web of Science、psycARTICLES、PsycINFO、CNKI 和万方,以获取 2020 年 1 月 1 日至 2022 年 4 月 1 日期间关于医学生心理健康问题患病率的研究。使用随机效应模型计算汇总患病率。我们进行了叙述性综述以确定风险因素。

结果

荟萃分析纳入了 201 项研究(N=198000)。抑郁(41%,95%CI,37-45%)、焦虑(38%,95%CI,34%-42%)、压力(34%,95%CI,27%-42%)、睡眠障碍(52%,95%CI,44%-60%)、心理困扰(58%,95%CI,51%-65%)、PTSD(34%,95%CI,22%-46%)、自杀意念(15%,95%CI,11%-18%)和倦怠(38%,95%CI,25%-50%)的患病率较高。主要风险因素为女性、低年级或临床前学生、接触 COVID-19、学业压力、精神或躯体障碍病史、经济困难、担心学业受损、在线学习困难、担心感染、孤独、低身体活动量、低社会支持、网络或智能手机使用问题以及年龄较小。

局限性

大多数研究为横断面研究。很少有研究提供了合理的应答率,提示存在潜在的选择偏倚。

结论

研究表明 COVID-19 期间医学生心理健康问题的患病率较高,存在多种风险因素,需要提供心理健康服务。研究结果为高校和卫生当局识别高风险学生并提供针对性干预提供了依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5540/9613786/769ca790f0f3/gr1_lrg.jpg

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