Journal of Education and Health Promotion

Assessment of the psychological impact of COVID‑19 pandemic on undergraduate medical students in India

Document Type : Original Article

Authors

. Amit Kumar Shreevastava
. Manisha Mavai 1
. Pragati Sheel Mittal 2
. Ranjana Verma 2
. Daljit Kaur 3
. Bharti Bhandari 4

1 Department of Physiology, Government Medical College, Bharatpur, Rajasthan, Uttar Pradesh, India

2 Department of Anatomy, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India

3 Department of Transfusion Medicine, All India Institute of Medical Sciences, Raibareilly, Uttar Pradesh, India

4 Department of Physiology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India

Abstract
BACKGROUND: Medical students who are prone to psychological stress due to their overburdened 
curriculum, are at an increased risk of getting adversely affected by the pandemic. The present study 
was planned to assess the anxiety level among undergraduate medical students across the country 
using generalized anxiety disorder scale (GAD‑7).
MATERIALS AND METHODS: In this online survey, anonymous data was collected through Google 
forms from undergraduate students from all the phases of MBBS course across the country from 
August 15, 2020, to October 15, 2020. Section I collected various demographic information, section 
II included GAD‑7 questionnaire for assessing anxiety and section III had open‑ ended questions 
about their impending fear, uncertainties, and apprehensions. The data was expressed in percentage 
and association among the variables was determined using Chi‑square test. Thematic analysis of 
the open‑ended responses was done.
RESULTS: Among the sample of 1208 students, 81% were from urban areas. During the pandemic, 
77% were residing with their parents and 71% parents having stable jobs. Eighty percent students had 
no relative diagnosed with COVID‑19, whereas 52% students had family members with comorbidity. 
The GAP score showed mild, moderate, and severe anxiety in 27, 24, and 16% students, respectively. 
Anxiety was significantly associated with rural setting and with COVID‑19 positive or comorbid family 
member (P < 0.05). Open ended responses revealed that majority of the students were finding it 
difficult to cope with the academic stress at home but still did not want to join back.
CONCLUSION: With such a high incidence of anxiety among medical students, it is pertinent to 
safeguard the mental health and implement efficient approaches to upkeep the scholastic, physical, 
emotional, and professional well‑being of medical students during such vulnerable times.

Keywords

Anxiety
COVID‑19
generalized anxiety disorder‑7
medical students
psychological stress
1. Available from: https://www.mha.gov.in/sites/default/files/
PR_NationalLockdown_26032020_0.pdf. [Last assessed on 
2020 Nov 2020].
2. Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushal V. Study 
of knowledge, attitude, anxiety & perceived mental healthcare 
need in Indian population during COVID‑19 pandemic. Asian J 
Psychiatry 2020;51:102083.
3. Usher K, Bhullar N, Jackson D. Life in the pandemic: Social 
isolation and mental health. J Clin Nurs 2020;29:2756‑7.
4. AcBehera S, Paluri SS, Mishra A. Mental health status of students 
pursuing professional training: A questionnaire‑based study. 
J Edu Health Promot 2021;10:399.
5. Natalia D, Syakurah RA. Mental health state in medical students 
during COVID‑19 pandemic. J Edu Health Promot 2021;10:208.
6. Balachandran AK, Alagarsamy S, Mehrolia S. Hike in student 
suicides – Consequence of online classes? Asian J Psychiatr 
2020;54:102438.
7. Lathabhavan R, Griffiths M. First case of student suicide in 
India due to the COVID‑19 education crisis: A brief report and 
preventive measures. Asian J Psychiatr 2020;53:102202.
8. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for 
assessing generalized anxiety disorder: The GAD‑7. Arch Intern 
Med 2006;166:1092‑7.
9. Swinson RP. The GAD‑7 scale was accurate for diagnosing 
generalised anxiety disorder. Evid Based Med 2006;11:184.
10. Rutter LA, Brown TA. Psychometric properties of the 
Generalized Anxiety Disorder Scale‑7 (GAD‑7) in outpatients 
with anxiety and mood disorders. J Psychopathol Behav Assess 
2017;39:140‑6.
11. Duan L, Zhu G. Psychological interventions for people affected 
by the COVID‑19 epidemic. Lancet Psychiatry 2020;7:300‑2.
12. Shah K, Kamrai D, Mekala H, Mann B, Desai K, Patel RS. 
Focus on mental health during the coronavirus (COVID‑19) 
pandemic: Applying learnings from the past outbreaks. Cureus 
2020;12:e7405.
13. Brenneisen Mayer F, Souza Santos I, Silveira PS, Itaqui Lopes MH, 
de Souza AR, Campos EP, et al. Factors associated to depression 
and anxiety in medical students: A multicenter study. BMC Med 
Educ 2016;16:282.
14. Wang C, Zhao H. The impact of COVID‑19 on anxiety in Chinese 
university students. Front Psychol 2020;11:1168.
15. Xiao C. A novel approach of consultation on 2019 novel 
coronavirus (COVID‑19)‑related psychological and mental 
problems: Structured letter therapy. Psychiatry Investig 
2020;17:175‑6.
16. Sherina MS, Rampal L, Kaneson N. Psychological stress 
among undergraduate medical students. Med J Malaysia 
2004;59:207‑11.
17. Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: 
Causes, consequences, and proposed solutions. Mayo Clin Proc 
2005;80:1613‑22.
18. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review 
of depression, anxiety, and other indicators of psychological 
distress among U.S. and Canadian medical students. Acad Med 
2006;8:354‑73.
19. Quek TT, Tam WW, Tran BX, Zhang M, Zhang Z, Ho CS, et al.
The global prevalence of anxiety among medical students: 
A meta‑analysis. Int J Environ Res Public Health 2019;16:2735.
20. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The 
psychological impact of the COVID‑19 epidemic on college 
students in China. Psychiatry Res 2020;287:112934.
21. Saddik B, Hussein A, Sharif‑Askari FS, Kheder W, Temsah MH, 
Koutaich RA, et al. Increased levels of anxiety among medical 
and non‑medical university students during the COVID‑19 
pandemic in the United Arab Emirates. Risk Manag Healthc 
Policy 2020;13:2395‑406.
22. SundaraswamyVG, Thimizarasan R, Lalal RH, Sundarasamy VG, 
Thamizharasan R, Lalan RH. Psychological impact of COVID‑19 
on medical college students. Eur J Mol Clin Med 2020;7:435‑43.
23. Naaz A, Saad M. A cross sectional study to estimate the 
psychological stress level in medical students during COVID‑19 pandemic. Public Health Rev Int J Public Health Res 2021;8:01‑6.
24. Chinna K, Sundarasen S, Khoshaim HB, Kamaludin K, 
NurunnabiM, Baloch GM, et al. Psychological impact of COVID‑19 
and lock down measures: An online cross‑sectional multicounty 
study on Asian university students. PLoS One 2021;16:e0253059.
25. Tang B, Bragazzi NL, Li Q, Tang S, Xiao Y, Wu J. An 
updated estimation of the risk of transmission of the novel 
coronavirus (2019‑nCov). Infect Dis Model 2020;5:248‑55.
Journal of Education and Health Promotion
Volume 12, Issue 6
July 2022
Pages 1-7

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