Background: Anxiety is common among university students and previous research has highlighted the association between the COVID-19 pandemic and higher anxiety scores in the public.
Objectives: In this regard, this study aimed to evaluate the effect of the COVID-19 pandemic on the anxiety status of pharmacy students studying in Northern Cyprus and analyze the role of some parameters on the observed anxiety scores.
Methods: Anxiety scores of 185 pharmacy students studying at two universities in Northern Cyprus were evaluated using Beck Anxiety Inventory (BAI) and Generalized Anxiety Disorder-7 (GAD-7) assessments. Additionally, the information of participants was recorded in terms of sociodemographic and educational characteristics, antidepressants and anxiolytic use, and consumption of vitamin-mineral supplements. The questionnaires were distributed during the COVID-19 pandemic from December 11, 2020, to January 4, 2021, online via the Microsoft Teams® platform. It should be mentioned that responses were anonymous.
Results: The mean BAI and GAD-7 scores of pharmacy students were 13.1±11.2 and 10±6.7, respectively. Based on the results, 6% of the students (n=11) revealed potentially concerning levels of anxiety in their BAI responses. Moreover, 31.9% of the pharmacy students (n=59) demonstrated severe anxiety scores on the GAD-7. Positive COVID-19 cases in the family led to statistically significant increases in anxiety on both instruments. Pharmacy students with five years of education (B.Pharm/M.Pharm) showed significantly higher anxiety scores on the BAI. Besides, age correlated negatively with anxiety scores on the GAD-7. Neither antidepressant and anxiolytic use nor vitamin/mineral supplement use were not related to the anxiety scores of participants.
Conclusion: Results of this study demonstrated an alarming anxiety status among pharmacy students during the COVID-19 pandemic period. Diagnosis of a family member with COVID-19 was observed to be critical in triggering the anxiety of pharmacy students. Data from this study should raise awareness to take action plans for the mental well-being of pharmacy students during pandemics.
Regier DA, Kuhl EA, Kupfer DJ. The DSM-5: Classification and criteria changes. World Psychiatry. 2013;12(2):92–8. doi: 10.1002/wps.20050. [PubMed: 23737408].
APA. Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA: American Psychiatric Association; 2013. https://psycnet.apa.org/record/2013-14907-000
Eisenberg D, Gollust SE, Golberstein E, Hefner JL. Prevalence and correlates of depression, anxiety, and suicidality among university students. Am J Orthopsychiatry. 2007;77(4):534–42. doi: 10.1037/0002-9422.214.171.1244.
Zivin K, Eisenberg D, Gollust SE, Golberstein E. Persistence of mental health problems and needs in a college student population. J Affect Disord. 2009;117(3):180–5. doi: 10.1016/j.jad.2009.01.001. [PubMed: 19178949].
Quek TT, Tam WW, Tran BX, Zhang M, Ho CS, Ho HR. The global prevalence of anxiety among medical students: A meta-analysis. Int J Environ Res Public Health. 2019;16(15):2735. doi: 10.3390/ijerph16152735. [PubMed: 31370266].
Maharaj S, Lees T, Lal S. Prevalence and risk factors of depression, anxiety, and stress in a cohort of Australian nurses. Int J Environ Res Public Health. 2018;16(1):61. doi: 10.3390/ijerph16010061. [PubMed: 30591627].
Samreen S, Siddiqui NA, Mothana RA. Prevalence of anxiety and associated factors among pharmacy students in Saudi Arabia: A cross-sectional study. Biomed Res Int. 2020;2020:1–6. doi: 10.1155/2020/2436538. [PubMed: 33163532].
Torales J, O’Higgins M, Castaldelli-Maia JM, Ventriglio A. The outbreak of covid-19 coronavirus and its impact on Global Mental Health. Int J Soc Psychiatry. 2020;66(4):317–20. doi: 10.1177/0020764020915212. [PubMed: 32233719].
Zhang Y, Ma ZF. Impact of the COVID-19 pandemic on Mental Health and quality of life among local residents in Liaoning Province, China: A cross-sectional study. Int J Environ Res Public Health. 2020;17(7):1-12. doi: 10.3390/ijerph17072381. [PubMed: 32244498].
Özdin S, Bayrak Özdin Ş. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int J Soc Psychiatry. 2020;66(5):1-8. doi: 10.1177/0020764020927051. [PubMed: 32380879].
Smith L, Jacob L, Yakkundi A, McDermott D, Armstrong NC, Barnett Y, et al. Correlates of symptoms of anxiety and depression and mental wellbeing associated with covid-19: A cross-sectional study of UK-based respondents. Psychiatry Res. 2020;291:113138. doi: 10.1016/j.psychres.2020.113138. [PubMed: 32562931].
Hyland P, Shevlin M, McBride O, Murphy J, Karatzias T, Bentall RP, et al. Anxiety and depression in the Republic of Ireland during the Covid‐19 pandemic. Acta Psychiatr Scand. 2020;142(3):249–56. doi: 10.1111/acps.13219. [PubMed: 32716520].
Alqudah A, Al‐Smadi A, Oqal M, Qnais EY, Wedyan M, Abu Gneam M, et al. About anxiety levels and anti‐anxiety drugs among quarantined undergraduate Jordanian students during Covid‐19 pandemic. Int J Clin Pract. 2021;75(7): e14249. doi: 10.1111/ijcp.14249. [PubMed: 33884714].
Wang X, Chen H, Liu L, Liu Y, Zhang N, Sun Z, et al. Anxiety
and sleep problems of college students during the
outbreak of covid-19. Front Psychiatry. 2020;11:1-7. doi: 10.3389/fpsyt.2020.588693. [PubMed: 33329134].
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. doi: 10.1016/j.psychres.2020.112934. [PubMed: 32229390].
Kaparounaki CK, Patsali ME, Mousa D-PV, Papadopoulou EVK, Papadopoulou KKK, Fountoulakis KN. University students’ mental health amidst the COVID-19
quarantine in Greece. Psychiatry Res. 2020;290:113111. doi: 10.1016/j.psychres.2020.113111. [PubMed: 32450416].
Sultanoglu N, Baddal B, Suer K, Sanlidag T. Current situation of covid-19 in Northern Cyprus. East Mediterr Health J. 2020;26(6):641–5. doi: 10.26719/emhj.20.070. [PubMed: 32621497].
Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(6):893–7. doi: 10.1037/0022-006x.56.6.893. [PubMed: 3204199].
Lemay V, Hoolahan J, Buchanan A. Impact of a yoga and meditation intervention on students' stress and Anxiety Levels. Am J Pharm Educ. 2019;83(5):747-52. doi: 10.5688/ajpe7001. [PubMed: 31333265].
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006;166(10):1092-7. doi: 10.1001/archinte.166.10.1092. [PubMed: 16717171].
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. doi: 10.2196/22817. [PubMed: 32897868].
Olaimat AN, Aolymat I, Elsahoryi N, Shahbaz HM, Holley RA. Attitudes, anxiety, and behavioral practices regarding covid-19 among university students in Jordan: A cross-sectional study. Am J Trop Med Hyg. 2020;103(3):1177–83. doi: 10.4269/ajtmh.20-0418. [PubMed: 32662398].
Islam MA, Barna SD, Raihan H, Khan MN, Hossain MT. Depression and anxiety among university students during the COVID-19 pandemic in Bangladesh: A web-based cross-sectional survey. Plos One. 2020;15(8):e0238162. doi: 10.1371/journal.pone.0238162. [PubMed: 32845928].
Rogowska AM, Kuśnierz C, Bokszczanin A. examining anxiety, life satisfaction, General Health, stress and coping styles
during COVID-19 pandemic in Polish sample of university students. Psychol Res Behav Manag. 2020;13:797–811. doi: 10.2147/prbm.s266511. [PubMed: 33061695].
Alrasheedy AA, Abdulsalim S, Farooqui M, Alsahali S, Godman B. Knowledge, attitude and practice about coronavirus disease (COVID-19) pandemic and its psychological impact on students and their studies: A cross-sectional study among pharmacy students in Saudi Arabia. Risk Manag Healthc Policy. 2021;14:729–41. doi: 10.2147/rmhp.s292354. [PubMed: 33654441].
Fischbein R, Bonfine N. Pharmacy and medical students’ mental health symptoms, experiences, attitudes and help-seeking behaviors. Am J Pharm Educ. 2019;83(10):7558. doi: 10.5688/ajpe7558. [PubMed: 32001889].
Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of Coronavirus Disease 2019 (covid-19) in some regions of
China. Psychol Health Med. 2020;26(1):13–22. doi: 10.1080/13548506.2020.1746817. [PubMed: 32223317].
Mazza C, Ricci E, Biondi S, Colasanti M, Ferracuti S, Napoli C, et al. A nationwide survey of psychological distress among
Italian people during the covid-19 pandemic: Immediate psychological responses and associated factors. Int J
Environ Res Public Health. 2020;17(9):3165. doi: 10.3390/ijerph17093165. [PubMed: 32370116].
Naser AY, Dahmash EZ, Al‐Rousan R, Alwafi H, Alrawashdeh HM, Ghoul I, et al. Mental health status of the general population, healthcare professionals, and university students during 2019 coronavirus disease outbreak in Jordan: A cross‐sectional study. Brain Behav. 2020;10(8):e01730. doi: 10.1002/brb3.1730. [PubMed: 32578943].
Salman M, Asif N, Mustafa ZU, Khan TM, Shehzadi N, Tahir H, et al. Psychological impairment and coping strategies during the COVID-19 pandemic among students in Pakistan: A cross-sectional analysis. Disaster Med Public Health Prep. 2020;16(3):920–6. doi: 10.1017/dmp.2020.397. [PubMed: 33087206].
Silva RG, Figueiredo-Braga M. Evaluation of the relationships among happiness, stress, anxiety, and depression in pharmacy students. Curr Pharm Teach Learn. 2018;10(7):903–10. doi: 10.1016/j.cptl.2018.04.002. [PubMed: 30236427].
Nakhostin-Ansari A, Sherafati A, Aghajani F, Khonji MS, Aghajani R, Shahmansouri N. Depression and anxiety among Iranian medical students during COVID-19 pandemic. Iran J Psychiatry. 2020;15(3):228-35. doi: 10.18502/ijps.v15i3.3815. [PubMed: 33193771].
Nahar VK, Davis RE, Dunn C, Layman B, Johnson EC, Dascanio JJ, et al. The prevalence and demographic correlates of stress, anxiety, and depression among veterinary students in the Southeastern United States. Res Vet Sci. 2019;125:370–3. doi: 10.1016/j.rvsc.2019.07.007. [PubMed: 31377419].
Cooke R, Bewick BM, Barkham M, Bradley M, Audin K. Measuring, monitoring and managing the psychological well-being of first year university students. Br J Guid. Couns. 2006;34(4):505–17. doi: 10.1080/03069880600942624.
Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol. 2008;43(8):667–72. doi: 10.1007/s00127-008-0345-x.
Wang C, Zhao H, Zhang H. Chinese college students have higher anxiety in new semester of online learning during COVID-19: A machine learning approach. Front Psychol. 2020;11:587413. doi: 10.3389/fpsyg.2020.587413. [PubMed: 33343461].
Helmy YA, Fawzy M, Elaswad A, Sobieh A, Kenney SP, Shehata AA. The COVID-19 pandemic: A comprehensive review of taxonomy, genetics, epidemiology, diagnosis, treatment, and control. J Clin Med. 2020;9(4):1225. doi: 10.3390/jcm9041225. [PubMed: 32344679].
Daei Sorkhabi A, Sarkesh A, Daei Sorkhabi A, Entezari-Maleki T, Rashedi J, Bannazadeh Baghi H. Vitamin supplementation as a potential adjunctive therapeutic approach for covid-19: Biological and clinical plausibility. J Basic Clin Physiol Pharmacol. 2021;33(1):55–77. doi: 10.1515/jbcpp-2021-0111. [PubMed: 34380185].
Yaseen MO, Jamshaid H, Saif A, Hussain T. Immunomodulatory role and potential utility of various nutrients and dietary components in SARS-COV-2 infection. Int J Vitam Nutr
Res. 2022;92(1):35–48. doi: 10.1024/0300-9831/a000715. [PubMed: 34100300].