Mental Health Outcomes and Psychological Support among University Students during the COVID-19 Pandemic in Egypt

Shaimaa Baher Abdel-Aziz; Maha Emadeldin; Salah Hassan Al Hanafy; Tarek Twafik Amin

doi:10.3889/oamjms.2022.6930

Authors

Shaimaa Baher Abdel-Aziz Department of Public Health, Faculty of Medicine Al Kasr EL Aini, Cairo University, Giza, Egypt https://orcid.org/0000-0002-6133-2370
Maha Emadeldin Department of Psychiatry, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
Salah Hassan Al Hanafy Department of Communication for Development Specialist, UNICEF, Maadi, Egypt
Tarek Twafik Amin Department of Public Health, Faculty of Medicine Al Kasr EL Aini, Cairo University, Giza, Egypt https://orcid.org/0000-0003-2502-110X

DOI:

https://doi.org/10.3889/oamjms.2022.6930

Keywords:

University students, COVID-19 pandemic, Mental health, Psychological support

Abstract

Background: COVID-19 pandemic has demonstrated the impact of a major public health emergency on mental health. Objective: To assess psychological impact among university students and train them to raise mental health awareness among their peers during the pandemic. Methods: This cross-sectional online survey was carried out over the period of July to September 2020. Study participants were medical and paramedical university students representing students’ union alliance of the Egyptian Youth Initiative (EYI). Non-probability sampling method was used for recruiting the study participants. Key mental health outcomes investigated two weeks prior to the survey were posttraumatic stress symptoms (PTSS), symptoms of depression, anxiety, insomnia, and perceived stress. Based on the preliminary analysis of the online questionnaires. A PhD qualified psychiatrist was assigned to develop the online psychosocial support to the volunteers’ students (N=60) to become facilitators for raising mental awareness among peers and train them how to handle stress. Results: Of the 115 students, 42.6% experienced moderate to severe depression, 21.7% were afflicted with moderate to severe anxiety and 62.7% suffered from sub-threshold to severe insomnia. Perceived Stress Scale analysis showed moderate levels of stress among the study participants. A significant difference was detected between pre and posttest mean scores of the PSS (P=0.001) eight weeks after the training program for psychological support. Conclusions: The findings of this study showed that young people suffered of more than one psychological problems and highlighted the urgent need to develop interventions and preventive strategies to address mental health of college students.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Brennan R, Hajjeh R, Al-Mandhari A. Responding to health emergencies in the Eastern Mediterranean region in times of conflict. Lancet. 2020;399(10332):e20-2. https://doi.org/10.1016/S0140-6736(20)30069-6 PMid:32135078 DOI: https://doi.org/10.1016/S0140-6736(20)30069-6

Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):300-2. https://doi.org/10.1016/S2215-0366(20)30073-0 PMid:32085840 DOI: https://doi.org/10.1016/S2215-0366(20)30073-0

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(2):175-6. https://doi.org/10.30773/pi.2020.0047 PMid:32093461 DOI: https://doi.org/10.30773/pi.2020.0047

Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet. 2020;395(10227):912-20. https://doi.org/10.1016/S0140-6736(20)30460-8 PMid:32112714 DOI: https://doi.org/10.1016/S0140-6736(20)30460-8

Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020;52:102066. https://doi.org/10.1016/j.ajp.2020.102066 PMid:32302935 DOI: https://doi.org/10.1016/j.ajp.2020.102066

Unger K. Handbook on Supported Education: Providing Services for Students with Psychiatric Disabilities. Charleston, SC: BookSurge Publishing; 2007.

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. https://doi.org/10.1016/j.psychres.2020.112934 PMid:32229390 DOI: https://doi.org/10.1016/j.psychres.2020.112934

Wang C, Zhao H. The impact of COVID-19 on anxiety in Chinese university students. Front Psychol. 2020;11:1168. https://doi.org/10.3389/fpsyg.2020.01168 PMid:32574244 DOI: https://doi.org/10.3389/fpsyg.2020.01168

Bruffaerts R, Mortier P, Kiekens G, Auerbach RP, Cuijpers P, Demyttenaere K, et al. Mental health problems in college freshmen: prevalence and academic functioning. J Affect Disord. 2018;225:97-103. https://doi.org/10.1016/j.jad.2017.07.044 PMid:28802728 DOI: https://doi.org/10.1016/j.jad.2017.07.044

Orgilés M, Morales A, Delvecchio E, Mazzeschi C, Espada JP. Immediate psychological effects of the COVID-19 quarantine in youth from Italy and Spain. PsyArXiv. 2020;6(11):1-13. https://doi.org/10.1017/s0033291720001841 DOI: https://doi.org/10.3389/fpsyg.2020.579038

Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P. The lancet commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553-98. https://doi.org/10.1016/S0140-6736(18)31612-X PMid:30314863 DOI: https://doi.org/10.1016/S0140-6736(18)31612-X

Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry. 2020;7(3):e14. https://doi.org/10.1016/s2215-0366(20)30047-x DOI: https://doi.org/10.1016/S2215-0366(20)30047-X

Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. J Trauma Stress. 2015;28(6):489-98. https://doi.org/10.1002/jts.22059 PMid:26606250 DOI: https://doi.org/10.1002/jts.22059

Kroenke K, Spitzer RL, Williams JB. The PHQ- 9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13. https://doi.org/10.1046/j.1525-1497.2001.016009606.x PMid:11556941 DOI: https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med. 2006;166(10):1092-7. https://doi.org/10.1001/archinte.166.10.1092 PMid:16717171 DOI: https://doi.org/10.1001/archinte.166.10.1092

Toussaint A, Hüsing P, Gumz A, Wingenfeld K, Härter M, Schramm E, et al. Sensitivity to change and minimal clinically important difference of the 7-item generalized anxiety disorder questionnaire (GAD-7). J Affect Disord. 2020;265:395-401. https://doi.org/10.1016/j.jad.2020.01.032 PMid:32090765 DOI: https://doi.org/10.1016/j.jad.2020.01.032

Morin CM, Belleville G, Bélanger L, Ivers H. The Insomnia Severity Index: Psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34(5):601-8. https://doi.org/10.1093/sleep/34.5.601 PMid:21532953 DOI: https://doi.org/10.1093/sleep/34.5.601

Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, editors. The Social Psychology of Health. Newbury Park, CA: Sage; 1988.

Zeng Y, Wang G, Xie C, Hu X, Reinhardt JD. Prevalence and correlates of depression, anxiety and symptoms of stress in vocational college nursing students from Sichuan, China: A cross-sectional study. Psychol Health Med. 2019;24(7):798-811. https://doi.org/10.1080/13548506.2019.1574358 PMid:30714819 DOI: https://doi.org/10.1080/13548506.2019.1574358

Fitzpatrick O, Biesma R, Conroy RM, McGarvey A. Prevalence and relationship between burnout and depression in our future doctors: A cross-sectional study in a cohort of preclinical and clinical medical students in Ireland. BMJ Open. 2019;9(4):e023297. https://doi.org/10.1136/bmjopen-2018-023297 PMid:31048421 DOI: https://doi.org/10.1136/bmjopen-2018-023297

Liu X, Liu J, Zhong X. Psychological state of college students during COVID-19 epidemic. SSRN J. 2020. 2814. https://doi.org/10.2139/ssrn.3552814. DOI: https://doi.org/10.2139/ssrn.3552814

Acharya L, Jin L, Collins W. College life is stressful today - emerging stressors and depressive symptoms in college students. J Am Coll Health. 2018;66(7):655-64. https://doi.org/10.1080/07448481.2018.1451869 PMid:29565759 DOI: https://doi.org/10.1080/07448481.2018.1451869

Martin JM. Stigma and student mental health in higher education. High Educ Res Dev. 2010;29(3):259-274. https://doi.org/10.1080/07294360903470969 DOI: https://doi.org/10.1080/07294360903470969

Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199-207. https://doi.org/10.1056/NEJMoa2001316 PMid:31995857 DOI: https://doi.org/10.1056/NEJMoa2001316

Boehnert J. Find expert insight and analysis, from coronavirus to climate change, in our daily newsletter. Surviving climate change means transforming both economics and design. 2020;2020:1-7.

Cornine A. Reducing nursing student anxiety in the clinical setting: An integrative review. Nurs Educ Perspect. 2020;41(4):229-34. https://doi.org/10.1097/01.NEP.0000000000000633 PMid:32102067 DOI: https://doi.org/10.1097/01.NEP.0000000000000633

Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-3. https://doi.org/10.1016/S0140-6736(20)30185-9 PMid:31986257 DOI: https://doi.org/10.1016/S0140-6736(20)30185-9

Ayittey FK, Ayittey MK, Chiwero NB, Kamasah JS, Dzuvor C. Economic impacts of Wuhan 2019-nCoV on China and the world. J Med Virol. 2020;92(5):473-5. https://doi.org/10.1002/jmv.25706 PMid:32048740 DOI: https://doi.org/10.1002/jmv.25706

Moreno E, Muñoz-Navarro R, Medrano LA, González-Blanch C, Ruiz-Rodríguez P, Limonero JT, et al. Factorial invariance of a computerized version of the GAD-7 across various demographic groups and over time in primary care patients. J Affect Disord. 2019;252:114-21. https://doi.org/10.1016/j.jad.2019.04.032 PMid:30981054 DOI: https://doi.org/10.1016/j.jad.2019.04.032

Morin CM, LeBlanc M, Daley M, Gregoire JP, Merette C. Epidemiology of insomnia: Prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Med. 2006;7:123-30. https://doi.org/10.1016/j.sleep.2005.08.008 PMid:16459140 DOI: https://doi.org/10.1016/j.sleep.2005.08.008

Son C, Hegde S, Smith A, Wang X, Sasangohar F. Effects of COVID-19 on college students’ mental health in the United States: Interview survey study. J Med Internet Res 2020;22(9):e21279. https://doi.org/10.2196/21279 PMid:32805704 DOI: https://doi.org/10.2196/21279

Albert PR. Why is depression more prevalent in women? J Psychiatry Neurosci. 2015;40(4):219-21. https://doi.org/10.1503/jpn.150205 PMid:26107348 DOI: https://doi.org/10.1503/jpn.150205

Fessell D, Goleman D. How Healthcare Personnel Can Take Care of Themselves. USA: HBR; 2020.

COVID-19 Projections. Institute for Health Metrics and Evaluation. Seattle, WA: University of Washington. Available from: https://covid19.healthdata.org/united-states-of-america.

De Girolamo G, Cerveri G, Clerici M, Monzani E, Spinogatti F, Starace F, et al. Mental health in the coronavirus disease 2019 emergency-the Italian response. JAMA Psychiatry. 2020;77(9):974-6. https://doi.org/10.1001/jamapsychiatry.2020.1276 PMid:32352480 DOI: https://doi.org/10.1001/jamapsychiatry.2020.1276

Zhou J, Liu L, Xue P, Yang X, Tang X. Mental health response to the COVID-19 outbreak in China. Am J Psychiatry. 2020;177(7):574-5. https://doi.org/10.1176/appi.ajp.2020.20030304 PMid:32375540 DOI: https://doi.org/10.1176/appi.ajp.2020.20030304

Shore JH, Waugh M, Calderone J, Donahue A, Rodriguez J, Peters D, et al. Evaluation of telepsychiatry-enabled perinatal integrated care. Psychiatr Serv. 2020;71(5):427-32. https://doi.org/10.1176/appi.ps.201900143 PMid:32019433 DOI: https://doi.org/10.1176/appi.ps.201900143

Weissbecker I, Roshania R, Cavallera V, Mallow M, Leichner A, Antigua J, et al. Integrating psychosocial support at Ebola treatment units in Sierra Leone and Liberia. Intervention. 2018;16(2):69-78. https://doi.org/10.4103/INTV.INTV_8_18 DOI: https://doi.org/10.4103/INTV.INTV_8_18

Wilkinson RG, Pickett K. The Spirit Level: Why More Equal Societies Almost Always do Better. London: Allen Lane; 2009.