Social Distancing among Medical Students during the 2019 Coronavirus Disease Pandemic in China: Disease Awareness, Anxiety Disorder, Depression, and Behavioral Activities.

Publisher: MDPI Country of Publication: Switzerland NLM ID: 101238455 Publication Model: Electronic Cited Medium: Internet ISSN: 1660-4601 (Electronic) Linking ISSN: 16604601 NLM ISO Abbreviation: Int J Environ Res Public Health Subsets: MEDLINE

Original Publication: Basel : MDPI, c2004-

Awareness* ; Pandemics*/prevention & control ; Social Behavior*; Anxiety Disorders/*epidemiology ; Betacoronavirus/*isolation & purification ; Coronavirus Infections/*epidemiology ; Depression/*epidemiology ; Pneumonia, Viral/*epidemiology ; Students, Medical/*psychology; Adult ; COVID-19 ; China/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/psychology ; Coronavirus Infections/virology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/psychology ; Pneumonia, Viral/virology ; SARS-CoV-2 ; Surveys and Questionnaires ; Young Adult

Background: During the coronavirus disease (COVID-19) pandemic, harsh social distancing measures were taken in China to contain viral spread. We examined their impact on the lives of medical students.
Methods: A nation-wide cross-sectional survey of college students was conducted from 4-12 February 2020. We enrolled medical students studying public health in Beijing and Wuhan to assess their COVID-19 awareness and to evaluate their mental health status/behaviors using a self-administered questionnaire. We used the Patient Generalized Anxiety Disorder-7 and Health Questionnaire-9 to measure anxiety disorders and depression. We used multivariable logistic regression and path analysis to assess the associations between covariates and anxiety disorder/depression.
Results: Of 933 students, 898 (96.2%) reported wearing masks frequently when going out, 723 (77.5%) reported daily handwashing with soap, 676 (72.5%) washed hands immediately after arriving home, and 914 (98.0%) reported staying home as much as possible. Prevalence of anxiety disorder was 17.1% and depression was 25.3%. Multivariable logistic regression showed anxiety to be associated with graduate student status (odds ratio (aOR) = 2.0; 95% confidence interval (CI): 1.2-3.5), negative thoughts or actions (aOR = 1.6; 95% CI: 1.4-1.7), and feeling depressed (aOR = 6.8; 95% CI: 4.0-11.7). Beijing students were significantly less likely to have anxiety than those in the Wuhan epicenter (aOR = 0.9; 95% CI: 0.8-1.0), but depression did not differ. Depression was associated with female students (aOR = 2.0; 95% CI: 1.2-3.3), negative thoughts or actions (aOR = 1.7; 95% CI: 1.5-1.9), and anxiety disorder (aOR = 5.8; 95% CI: 3.4-9.9). Path analysis validated these same predictors.
Conclusions: Despite medical students' knowledge of disease control and prevention, their lives were greatly affected by social distancing, especially in the Wuhan epicenter. Even well-informed students needed psychological support during these extraordinarily stressful times.

Erratum in: Int J Environ Res Public Health. 2020 Dec 28;18(1):. (PMID: 33379414)

J Infect Dis. 2010 Sep 15;202(6):867-76. (PMID: 20677945)
JAMA. 2020 Apr 17;:. (PMID: 32301960)
Medicine (Baltimore). 2019 May;98(18):e15337. (PMID: 31045774)
Psychiatry Res. 2020 Jun;288:112977. (PMID: 32302818)
Asian J Psychiatr. 2020 Apr 10;52:102066. (PMID: 32302935)
Gen Psychiatr. 2020 Mar 6;33(2):e100213. (PMID: 32215365)
BMC Public Health. 2019 Jan 17;19(1):82. (PMID: 30654771)
Lancet. 2020 Feb 8;395(10222):400. (PMID: 32035537)
Int J Environ Res Public Health. 2020 Mar 06;17(5):. (PMID: 32155789)
BMC Med Educ. 2016 Oct 26;16(1):282. (PMID: 27784316)
Lancet. 2017 Dec 17;388(10063):3048-3059. (PMID: 27349358)
J Infect. 2020 Jul;81(1):1-9. (PMID: 32315723)
J Travel Med. 2020 Mar 13;27(2):. (PMID: 32052841)
Patient Educ Couns. 2019 Jan;102(1):93-98. (PMID: 30146406)
Int J Environ Res Public Health. 2020 Apr 30;17(9):. (PMID: 32366034)
Psychiatry Res. 2018 Dec;270:26-33. (PMID: 30243129)
BMC Public Health. 2018 May 16;18(1):632. (PMID: 29769115)
Eur J Epidemiol. 2018 Sep;33(9):811-829. (PMID: 29589226)
Psychol Health Med. 2020 Mar 30;:1-10. (PMID: 32223317)
J Affect Disord. 2020 Apr 15;267:9-16. (PMID: 32063578)
Gen Hosp Psychiatry. 2010 Jul-Aug;32(4):345-59. (PMID: 20633738)
Br J Surg. 2020 May 12;:. (PMID: 32395837)
Med Care. 2008 Mar;46(3):266-74. (PMID: 18388841)
BMC Med Educ. 2019 Sep 2;19(1):327. (PMID: 31477124)
Am J Psychiatry. 2016 Apr 1;173(4):317-8. (PMID: 27035529)
Psychiatry Res. 2020 May;287:112934. (PMID: 32229390)
BMJ. 2020 Jan 31;368:m408. (PMID: 32005727)
PLoS One. 2020 Apr 16;15(4):e0231924. (PMID: 32298385)
Infect Dis Poverty. 2020 Mar 17;9(1):29. (PMID: 32183901)
Psychol Rep. 2016 Oct;119(2):527-38. (PMID: 27488914)
Int J Environ Res Public Health. 2019 Aug 22;16(17):. (PMID: 31443355)
Brain Behav Immun. 2020 Jul;87:40-48. (PMID: 32298802)
Rev Assoc Med Bras (1992). 2017 Jan 1;63(1):21-28. (PMID: 28225885)
Int J Infect Dis. 2020 Feb;91:264-266. (PMID: 31953166)
J Evid Based Complementary Altern Med. 2017 Jan;22(1):68-74. (PMID: 26976087)

81673232 International National Natural Science Foundation of China; 7202009 International Natural Science Foundation of Beijing Municipality; P30MH062294 United States NH NIH HHS

Keywords: COVID-19; China; anxiety disorder; depression; knowledge; medical students; personal protective measures; social distancing

Date Created: 20200718 Date Completed: 20200731 Latest Revision: 20201231

20240628

PMC7399842

10.3390/ijerph17145047

32674285