GLOBAL PSYCHIATRY ARCHIVES

Objective:  The COVID-19 pandemic has affected the mental health and well-being of millions of people across the globe. This study aimed to assess the severity of depression, anxiety and stress level among persons who sought teleconsultation during the lockdown period in Kashmir, India.
Materials and methods: This cross-sectional study was carried out from 21 March to 31 May 2020 in Kashmir, India. A call line was set up for people with mental health concerns and participants who signed up for the service were included in the study. The mental health services were provided by a team via teleconsultation. The Depression, Anxiety and Stress Scale (DASS-21) questionnaire was used to assess the severity of distress.
Results: A total of 293 people were interviewed during the teleconsultation service. The mean age was 37.10 (± 10.54) years, the majority had moderate depression, 125 (42.7%), followed by extreme severe depression, 95 (32.4%). The mean depression score on the DASS-21 scale was 13.52 ± 4.13. A total of 276 (94.2%) patients had severe anxiety following lockdown with a mean anxiety score of 14.04 ± 9.23. Also, 96 (32.8%) of people had mild stress with a mean stress score of 12.82 ± 7.32.
Conclusion: The severity of depression, anxiety and stress was high in our study population highlighting the need to provide critical mental health services. Teleconsultations could be an alternative approach to provide such services in areas with public health emergencies and where medical infrastructure is limited.

Objectives
This study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school. There is a paucity of data on social support among medical students in Pakistan; an important predictor of depressive symptoms. Therefore, this study was also aimed to demonstrate the direct and indirect impact of social support in alleviating depressive symptoms in the study sample.


Methods
This observational cross-sectional study was conducted in Lahore, Pakistan, where a total of 400 students at a medical school were approached between 1st January to 31st March 2018 to participate in the study. The study sample comprised of medical and dental students enrolled at a privately financed Pakistani medical and dental school. The participants responded to a self-administered survey comprising of five parts: a) demographics, b) Pittsburgh Sleep Quality Index (PSQI), c) Patient Health Questionnaire-9 (PHQ-9), d) Multidimensional Scale of Perceived Social Support (MSPSS) and e) Perceived Stress Scale-4 (PSS-4). All data were analysed using SPSS v. 20. Linear regression analysis was used to reveal the predictors of depression.


Results
In total, 353 medical students participated, yielding a response rate of 88.25%. Overall, poor sleep quality was experienced by 205 (58.1%) students. Mild to severe depression was reported by 83% of the respondents: mild depression by 104 (29.5%), moderate depression by 104 (29.5%), moderately severe depression by 54 (15.3%) and severe depression by 31 (8.8%) respondents. Subjective sleep quality, sleep latency, daytime dysfunction and stress levels were significantly associated with depression symptoms. Social support was not significantly associated with depressive symptoms in the regression model (Beta = -0.08, P < 0.09); however, it acted as a significant mediator, reducing the strength of the relationship between depressive symptoms and sleep quality and stress.


Conclusions
According to our study, a large proportion of healthcare (medical and dental) students were found to be suffering from mild to moderate depression and experienced poor sleep quality. It is concluded that social support is an important variable in predicting depressive symptomatology by ameliorating the effects of poor sleep quality and high stress levels.