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Gender Differences in Stress, Anxiety, and Depression Perceived by Osteopathic Medical Students Within the Context of the COVID-19 Pandemic
Herr, V. [1]
Emanuel, J. [1]
Farid, A. [1]
Morris, A. [1]
Balentine, J. [3]
Blazey, W. [3]
Krishnamachari, B. [4]

Journal: Journal of Osteopathic Medicine Date: 2022/12, 122(12):Pages: A120-A121. doi: Subito , type of study: cohort study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2022-2000/html)

Keywords:

anxiety [37]
cohort study [51]
covid-19 [76]
depression [48]
gender [25]
medical students [402]
osteopathic medicine [1540]
stress [82]
USA [1086]

Abstract:

Statement of Significance: Females are more likely to experience psychological distress than males,1 with research supporting sociological, cognitive, and biological causes.2 Medical students also have higher levels of stress,3 depression, and anxiety.4 The Coronavirus 2019 (COVID-19) pandemic and the resulting isolation of students are predicted to exacerbate this problem.3 Research is currently lacking on the causal factors behind gender differences in mental health among medical students in the context of COVID-19. Research Methods: This is a repeated-measures survey study with osteopathic significance. The study population consists of students enrolled at an osteopathic school, specifically the New York Institute of Technology College of Osteopathic Medicine (NYITCOM). All participants were recruited via email and NYITCOM students in their first or second year. Participants received surveys via REDCap during the 2019-2020 (Cohort 1) and 2020-2021 (Cohort 2) academic years. Cohort 1 was surveyed six times over the academic school year. Cohort 2 was surveyed four times over the academic school year. Initially, 206 participants were part of the study. Exclusion criteria included participants whose gender was classified as non-binary and those who did not complete a survey after initial recruitment. The survey contained questions about demographics and measurements of stress, such as the Perceived Stress Scale 10 (PSS-10), Depression Anxiety Stress Scale 21 (DASS-21), and the Medical Education Hassles Scale-R (MEHS-R) questionnaires. To further investigate the effects of certain stressor types on participants, individual stressors from the MEHS-R questionnaire were grouped based on commonly shared themes. The resulting categories were School, Transportation, Social, Financial, Household Chores/Personal Time Commitments, Health/Appearance, and Environmental stressors. The scores of the individual stressors were combined in each category, and the mean scores were determined to evaluate the effect of each stressor type on individuals. Jamovi was the statistical software used to analyze our data. To assess the differences in questionnaire scores between genders, a student’s t-test was performed at each interval of Cohort 1 and Cohort 2 combined, with these scores analyzed as continuous variables. The alpha value used was 0.05. Data Analysis/Results: After 13 were excluded, 193 participants remained, with 52 females and 51 males in Cohort 1 and 55 females and 35 males in Cohort 2. A combined analysis of both cohorts showed females consistently scored higher on the PSS-10 scale than males, and this difference was statistically significant at all four times (p.05). Conclusion: The results showed that female medical students scored significantly higher than male medical students on almost all mental health screening tools. This indicates that female medical students have higher levels of stress, anxiety, and depression than their male counterparts. In addition, when the specific categories were assessed, females appeared disproportionately affected by social, academic, and environmental stressors and those regarding their personal time commitments and health/appearance. In contrast, males showed relatively higher stress levels relating to transportation and finances. Future research could explore why these stressors affect osteopathic medical students differently depending on their gender. This study’s results signify that the existing trend of higher psychological stress in females persists in our group of osteopathic medical students, and the Covid-19 pandemic did not alter these gender differences. Because it has been shown that both females and medical students are groups individually more susceptible to adverse mental health outcomes, this study further supports the notion that female medical students are a particularly vulnerable group, suggesting they may need more resources than males perhaps tailored to their gender-specific stressors. Future research on how to mitigate these stressors would be an appropriate next step that could benefit the future cohorts of osteopathic student physicians. A limitation of this study includes the accuracy of the participants’ responses due to the length of each questionnaire which may have caused participants to experience fatigue when answering the survey. Additionally, the participants’ responses may have been altered due to their particular mood on the day they took the survey resulting in their answers inaccurately reflecting their mental health. There were also fewer males than females in the study group, which may have skewed the data.

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