A longitudinal study on psychological burden of medical students during COVID-19 outbreak and remission period in China

BACKGROUND AND OBJECTIVES: Due to their professional characteristics and future career orientation, medical students have a deeper understanding of COVID-19 and enact disease prevention and control measures, which may cause psychological burden. We aimed to assess the psychological impact during the COVID-19 outbreak period(OP) and remission period(RP) among medical students. METHODS: We surveyed the medical students in Shantou University Medical College twice-during the OP and the RP, surveying psychological burden of COVID-19 lockdowns and its associated factors. 1069 respondents were recruited in OP and 1511 participants were recruited in RP. We constructed nomograms to predict the risk of psychological burden using risk factors that were screened through univariate analysis of the surveyed data set. RESULTS: There was a statistically significant longitudinal increment in psychological burden from OP to RP, and stress as well as cognition in psychological distress were the most dominant ones. Common impact factors of the depression, anxiety and stress included frequency of outdoor activities, mask-wearing adherence, self-perceived unhealthy status and exposure to COVID-19. In addition, the high frequency of handwashing was a protective factor for depression and anxiety. The C-index was 0.67, 0.74 and 0.72 for depression, anxiety and stress, respectively. CONCLUSION: The psychological impact of COVID-19 was worse during the RP than during the OP. Thus, it's necessary to continue to emphasize the importance of mental health in medical students during the pandemic and our proposed nomograms can be useful tools for screening high-risk groups for psychological burden risk in medical students.