Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
BMC Psychol. 2024 Jun 10;12(1):338. doi: 10.1186/s40359-024-01838-y.
PURPOSE: As future physicians, medical students have experienced tremendous pressure during the ongoing COVID-19 pandemic, which is associated with a high risk of depression and anxiety. We aimed to investigate an overview of the prevalence of anxiety and depression among medical students in various countries during the global COVID-19 pandemic, and discuss associated stressors. METHODS: We systematically searched CINAHL, EMBASE, MEDLINE, PubMed, and Web of Science for relevant articles from December 1, 2019 to March 15, 2023. We performed meta-analysis using a random-effects model with REML method to calculate the pooled prevalence of anxiety and depression. Begg's and Egger's tests were used to identify the potential risk of publication bias. Meta-regression was used to explore potential sources of heterogeneity. RESULTS: We identified 130 studies reporting anxiety and depression among 132,068 medical students during the COVID-19 pandemic. Eight screening tools were identified for anxiety and six for depression. The pooled prevalence of mental health outcomes for anxiety and depression was 45% (95% confidence interval [CI], 40%-49%) and 48% (95% CI, 43%-52%), respectively. The pooled prevalence of mental health outcomes for moderate and severe anxiety and moderate and severe depression was 28% (95% CI, 24%-32%) and 30% (95% CI, 26%-35%), respectively. There was high heterogeneity between studies, with I ranging from 99.58%-99.66%. Continent and survey date were included in the meta-regression model. The results of meta-regression revealed that medical students in Asia had a lower prevalence of anxiety, and depression than those in other regions. The survey date (from February to June, 2020) showed a significantly positive correlation with the prevalence of anxiety and depression. CONCLUSIONS: We demonstrated the global prevalence of anxiety and depression among medical students during the COVID-19 pandemic. The data highlight that medical students worldwide are at high risk of experiencing anxiety and depression. The reported stressors can be categorized into personal, academic, environmental and cultural, and pandemic factors. Schools and institutions should ensure optimal alternative learning environments for uninterrupted provision of medical education. The appropriate authorities should prioritize the provision of adequate protection for medical students and establish policies to promote new methods of training and education during a disaster, such as via distance learning.
目的：作为未来的医生，医学生在持续的 COVID-19 大流行期间经历了巨大的压力，这与患抑郁症和焦虑症的风险较高有关。我们旨在调查全球 COVID-19 大流行期间各国医学生焦虑和抑郁的总体患病率，并讨论相关压力源。
方法：我们系统地检索了 CINAHL、EMBASE、MEDLINE、PubMed 和 Web of Science，以获取 2019 年 12 月 1 日至 2023 年 3 月 15 日期间的相关文章。我们使用随机效应模型和 REML 方法进行荟萃分析，以计算焦虑和抑郁的总体患病率。采用贝氏检验和埃格检验来识别潜在的发表偏倚风险。采用元回归来探索潜在的异质性来源。
结果：我们确定了 130 项研究，这些研究报告了 COVID-19 大流行期间 132068 名医学生的焦虑和抑郁情况。确定了 8 种焦虑筛查工具和 6 种抑郁筛查工具。焦虑和抑郁的心理健康结局的汇总患病率分别为 45%（95%置信区间，40%-49%）和 48%（95%置信区间，43%-52%）。中度和重度焦虑以及中度和重度抑郁的心理健康结局的汇总患病率分别为 28%（95%置信区间，24%-32%）和 30%（95%置信区间，26%-35%）。研究之间存在高度异质性，I 范围为 99.58%-99.66%。元回归模型纳入了大陆和调查日期。元回归的结果表明，亚洲医学生的焦虑和抑郁患病率低于其他地区。调查日期（2020 年 2 月至 6 月）与焦虑和抑郁的患病率呈显著正相关。
结论：我们展示了 COVID-19 大流行期间全球医学生的焦虑和抑郁患病率。数据表明，全世界的医学生都有较高的焦虑和抑郁风险。报告的压力源可分为个人、学术、环境和文化以及大流行因素。学校和机构应为医学生提供最佳的替代学习环境，以确保医学教育的不间断提供。有关当局应优先为医学生提供充分的保护，并制定政策，在灾难期间推广新的培训和教育方法，例如远程学习。
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