Depression, Anxiety and Stress Symptoms and Substance Use among Health Care Students in Turkey during the COVID-19 Pandemic

Şeyma Zehra Altunkürek 1 * , Esra Nur Demir 1
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1 Department of Public Health Nursing, Gulhane Faculty of Nursing, University of Health Sciences, Ankara, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 21, Issue 6, pp. 66-72. https://doi.org/10.23950/jcmk/15602
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Author Contributions: Conceptualization, E. N. D., Ş. Z. A.; methodology, E. N. D., Ş. Z. A.; validation, E. N. D., Ş. Z. A.; formal analysis, E. N. D., Ş. Z. A.; investigation, E. N. D., Ş. Z. A.; literature search: E. N. D.; data curation, E. N. D., Ş. Z. A.; writing – original draft preparation, E. N. D., Ş. Z. A.; writing – review and editing, E. N. D., Ş. Z. A.; visualization, E. N. D., Ş. Z. A.; supervision, not applocable; project administration, not applicable; funding acquisition, not applocable. All authors have read and agreed to the published version of the manuscript.

Data Availability: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics approval: The study was approved by the Gülhane University of Health Sciences Scientific Research Ethics Committee (No. 2021/162).

ABSTRACT

Aim: People of all ages worldwide have been physically and psychologically affected by the COVID-19 pandemic. University students may be more vulnerable to the psychological effects of COVID-19 as they may be prone to high levels of stress, anxiety, and depression in general. In this study, we aimed to evaluate the depression, stress and anxiety symptoms of health care students and their attitudes toward substance abuse during the COVID-19 pandemic.
Materials and methods: This was a cross-sectional study involving 1126 university students. The data collection forms consisted of the Descriptive Information Form and the Depression, Anxiety and Stress Scale (DASS). T tests, one-way analysis of variance (ANOVA) and post hoc (Tukey, LSD) analyses were used to analyze the descriptive characteristics of the participants and scale scores.
Results: The mean depression score was 16.280±7.942, the mean anxiety score was 17.837±8.257, and the mean stress score was 17.686±8.247. In this study, statistically significant differences were found in terms of sex, living situation, education level, income level, use of any addictive substance, use of any addictive substance by a relative, changes in substance use during the pandemic period and mean DASS subscale score.
Conclusions: Relationships were found between depression, anxiety and stress symptoms and substance use in health care university students during the pandemic. To help students overcome psychological problems during difficult situations such as the COVID-19 epidemic, it may be useful for health professionals to plan projects to reduce substance addiction.
Keywords: Anxiety, Addiction, COVID-19, Depression, Students, Stress

CITATION

Altunkürek ŞZ, Demir EN. Depression, Anxiety and Stress Symptoms and Substance Use among Health Care Students in Turkey during the COVID-19 Pandemic. J CLIN MED KAZ. 2024;21(6):66-72. https://doi.org/10.23950/jcmk/15602

REFERENCES

  • Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020; 382(8): 727–733. https://doi.org/10.1056/NEJMoa2001017.
  • Bhattarai A, Karki B. COVID-19 pandemic and mental health issues. J Lumbini Med Coll. 2020; 8(1): 181–182.
  • World Health Organization. Conflict in Israel and the Occupied Palestinian Territory. Geneva, Switzerland: World Health Organization; 2022.
  • Rogowska AM, Pavlova I, Kuśnierz C, Ochnik D, Bodnar I, Petrytsa P. Does physical activity matter for the mental health of university students during the COVID-19 pandemic? J Clin Med. 2020; 9(11): 3494. https://doi.org/10.3390/jcm9113494.
  • Xiong, J, Lipsitz O, Nasri F, Lui L, Gill H, Phan L, Chen-Li D, Iacobucci M, Ho R, Majeed A, McIntyre R. Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of Affective Disorders. 2020; 277: 55–64. https://doi.org/10.1016/j.jad.2020.08.001
  • Sahu P. Closure of universities due to coronavirus disease 2019 (COVID-19): impact on education and mental health of students and academic staff. Cureus. 2020; 12(4): e7541. https://doi.org/10.7759/cureus.7541.
  • Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID-19). Drug Discov Ther. 2020; 14(1): 58–60. https://doi.org/10.5582/ddt.2020.01012.
  • Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020; 17(5): 1729. https://doi.org/10.3390/ijerph17051729.
  • Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F. Investigating mental health of US college students during the COVID-19 pandemic: cross-sectional survey study. J Med Internet Res. 2020; 22(9): e22817. https://doi.org/10.2196/22817.
  • Lin CY. Social reaction toward the 2019 novel coronavirus (COVID-19). Soc Health Behav. 2020; 3(1): 1–2. https://doi.org/10.4103/SHB.SHB_11_20.
  • Asici E, Günlü A. Üniversite öğrencilerinin gözünden COVID-19 salgini: Nitel bir araştirma. Gençlik Araştirmalari Dergisi. 2021; 9(Özel Sayi): 1–25. https://doi.org/10.52528/genclikarastirmalari.770078
  • Hamaideh SH, Al‐Modallal H, Tanash MA, Hamdan‐Mansour A. Depression, anxiety and stress among undergraduate students during COVID‐19 outbreak and “home‐quarantine”. Nursing Open. 2022; 9(2): 1423–1431. https://doi.org/10.1002/nop2.918
  • Recchi E, Ferragina E, Helmeid E, Pauly S, Safi M, Sauger N, Schradie J. The “eye of the hurricane” paradox: an unexpected and unequal rise of well-being during the COVID-19 lockdown in France. Res Soc Stratif Mobil. 2020; 68: 100508. https://doi.org/10.1016/j.rssm.2020.100508.
  • Kimhi S, Eshel Y, Marciano H, Adini B. A renewed outbreak of the COVID-19 pandemic: a longitudinal study of distress, resilience, and subjective well-being. Int J Environ Res Public Health. 2020; 17(21): 7743. https://doi.org/10.3390/ijerph17217743,
  • Mack DL, DaSilva AW, Rogers C, Hedlund E, Murphy EI, Vojdanovski V, Plomp J, Wang W, Nepal SK, Holtzheimer PE, Wagner DD, Jacobson NC, Meyer ML, Campbell AT, Huckins JF. Mental health and behavior of college students during the COVID-19 pandemic: longitudinal mobile smartphone and ecological momentary assessment study, part II. J Med Internet Res. 2021; 23(6): e28892. https://doi.org/10.2196/28892.
  • Bourion-Bédès S, Tarquinio C, Batt M, Tarquinio P, Lebreuilly R, Sorsana C, Legrand K, Rousseau H, Baumann C. Psychological impact of the COVID-19 outbreak on students in a French region severely affected by the disease: results of the PIMS-CoV 19 study. Psychiatry Res. 2021; 295: 113559. https://doi.org/10.1016/j.psychres.2020.113559.
  • Bourion-Bédès S, Tarquinio C, Batt M, Tarquinio P, Lebreuilly R, Sorsana C, Legrand K, Rousseau H, Baumann C. Stress and associated factors among French university students under the COVID-19 lockdown: the results of the PIMS-CoV 19 study. J Affect Disord. 2021; 283: 108–114. https://doi.org/10.1016/j.jad.2021.01.041.
  • Dogan-Sander E, Kohls E, Baldofski S, Rummel-Kluge C. More depressive symptoms, alcohol and drug consumption: increase in mental health symptoms among university students after one year of the COVID-19 pandemic. Frontiers in Psychiatry. 2021; 12: 790974. https://doi.org/10.3389/fpsyt.2021.790974.
  • Gritsenko V, Skugarevsky O, Konstantinov V, Khamenka N, Marinova T, Reznik A, Isralowitz R. COVID 19 fear, stress, anxiety, and substance use among Russian and Belarusian university students. International journal of mental health and addiction. 2021; 19: 2362–2368. https://doi.org/10.1007/s11469-020-00330-z.
  • Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated psychological problems. Asian Journal of Psychiatry. 2020; 51: 102092. https://doi.org/10.1016/j.ajp.2020.102092.
  • Akin A, Çetin B. The depression anxiety and stress scale (DASS): the study of validity and reliability. Educ Sci Theory Pract. 2007; 7(1): 260–268.
  • Almhdawi KA, Alazrai A, Obeidat D, Altarifi AA, Oteir AO, Aljammal AH, Arabiat AA, Alrabbaie H, Jaber H, Almousa KM. Healthcare students’ mental and physical well-being during the COVID-19 lockdown and distance learning. Work. 2021; 70(1): 3–10. https://doi.org/10.3233/WOR-205309.
  • Cam HH, Ustuner Top F, Kuzlu Ayyildiz T. Impact of the COVID-19 pandemic on mental health and health-related quality of life among university students in Turkey. Current Psychology. 2022; 41(2): 1033–1042. https://doi.org/10.1007/s12144-021-01674-y
  • Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD, Khursheed M, Gupta K, Kashyap D, Uniyal R. Depression, anxiety and stress among Indians in times of COVID-19 lockdown. Community Ment Health J. 2021; 57(1): 42–48. https://doi.org/10.1007/s10597-020-00664-x.
  • Cam HH, Ustuner Top F, Kuzlu Ayyildiz T. Impact of the COVID-19 pandemic on mental health and health-related quality of life among university students in Turkey. Current Psychology. 2022 Feb; 41(2): 1033-42. https://doi.org/10.1007/s12144-021-01674-y.
  • Talapko J, Perić I, Vulić P, Pustijanac E, Jukić M, Bekić S, Meštrović T, Škrlec I. Mental health and physical activity in health-related university students during the COVID-19 pandemic. Healthcare. 2021; 9 (7): 801. https://doi.org/10.3390/healthcare9070801.
  • Škrlec I, Talapko J, Pustijanac E, Meštrović T. Depression, anxiety, stress and physical activity in health-related university students during COVID-19. Medical Sciences Forum. 2021; 4 (1): 43. https://doi.org/10.3390/ECERPH-3-09028.
  • Wathelet M, Duhem S, Vaiva G, Baubet T, Habran E, Veerapa E, Debien C, Molenda S, Horn M, Grandgenèvre P, Notredame Ch-E, D’Hondt F. Factors Associated With Mental Health Disorders Among University Students in France Confined During the COVID-19 Pandemic. JAMA Netw. Open. 2020; 3: e2025591. https://doi.org/10.1001/jamanetworkopen.2020.25591.
  • Schlichtiger J, Brunner S, Steffen J, Huber BC. Mental health impairment triggered by the COVID-19 pandemic in a sample population of German students. J. Investig. Med. 2020; 68: 1394–1396. https://doi.org/10.1136/jim-2020-001553.
  • Soltan MR, Soliman SS, Dawoud ME. A study of anxiety, depression and stress symptoms among Fayoum medical students during COVID-19 lockdown, Egypt. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2021; 57(1): 1–6. https://doi.org/10.1186/s41983-021-00377-2.
  • SartoraoFilho CI, Rodrigues WC, de Castro RB, Marcal AA, Pavelqueires S, Takano L, de Oliveira WL, Neto CI. Impact of Covid-19 pandemic on mental health of Medical students: A cross-sectional study using GAD-7 and PHQ- 9 questionnaires. medRxiv. 2020. Available from: https://www.medrxiv.org/content/10.1101/2020.06.24.20138925v1. https://doi.org/10.1101/2020.06.24.20138925.
  • Pesen A, Mayda AS. Depression, anxiety, stress levels and related factors of medical faculty students. Sak Med J. 2020; 10(2): 240–252.
  • Aylie NS, Mekonen MA, Mekuria RM. The psychological impacts of COVID-19 pandemic among university students in bench-sheko zone, South-West Ethiopia: a community-based cross-sectional study. Psychol Res Behav Manag. 2020; 13: 813–821. https://doi.org/10.2147/PRBM.S275593
  • Karaca A, Yildirim N, Ankarali H, Açikgöz F, Akkuş D. Nursing students' perceived levels of clinical stress, stress responses and coping behaviors. J Psychiatr Nurs. 2017; 8(1): 32–39. https://doi.org/10.14744/phd.2017.22590
  • Lester D. College student stressors, depression, and suicidal ideation. Psychol Rep. 2014; 114(1): 293–296. https://doi.org/10.2466/12.02.PR0.114k10w7.
  • Sever M, Özdemir S. The experience of being a student during the coronavirus (COVID-19) process: a photovoice study. Community Soc Work. 2020; 31: 1653–1679. https://doi.org/10.33417/tsh.778615.
  • Bashir TF, Hassan S, Maqsood A, Khan ZA, Issrani R, Ahmed N, Bashir EF. The psychological impact analysis of novel COVID-19 pandemic in health sciences students: a global survey. Eur J Dent. 2020; 14(S 01): S91-6. https://doi.org/10.1055/s-0040-1721653.
  • Bulgan C, Demirel G. Evaluation of alcohol, substance and antidepressant drug use of university students during the COVID-19 pandemic. Anatolian Current Medical Journal. 2023; 5(1): 1–6. https://doi.org/10.38053/acmj.1169944.
  • Jodczyk AM, Kasiak PS, Adamczyk N, Gębarowska J, Sikora Z, Gruba G, Mamcarz A, Śliż D. PaLS Study: Tobacco, alcohol and drugs usage among Polish University students in the context of stress caused by the COVID-19 pandemic. International Journal of Environmental Research and Public Health. 2022; 19(3): 1261. https://doi.org/10.3390/ijerph19031261.
  • Fila-Witecka K, Senczyszyn A, Kołodziejczyk A, Ciułkowicz M, Maciaszek J, Misiak B, Szczes ́niak D, Rymaszewska J. Lifestyle Changes among Polish University Students during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health. 2021; 18(18): 9571. https://doi.org/10.3390/ijerph18189571.