1 Introduction
Health anxiousness (HA) is outlined as a preoccupation with the thought that one has, or is growing, a severe sickness regardless of medical proof on the contrary (1). People with well being anxiousness (HA) could misread bodily sensations and adjustments as indicators of sickness, doubtlessly resulting in plenty of cognitive, affective, behavioral, and perceptual impairments comparable to issue concentrating, irritability, anxiousness, and issue sleeping (2). HA resembles the somatic symptom dysfunction and sickness anxiousness dysfunction, however these situations are extra extreme, characterised by extreme and impairing preoccupation with having or buying a severe sickness, persistently excessive ranges of hysteria about well being, and extreme health-related behaviors comparable to repeatedly searching for medical care regardless of reassurance from healthcare suppliers (3, 4). On the opposite hand, individuals with HA don’t consider they undergo from a severe sickness however fear about growing one. They could seek the advice of with healthcare professionals repeatedly to hunt reassurance, however are normally in a position to acknowledge that their worries could also be unfounded (5). Hypochondriasis is uncommon however HA impacts 2.1-13.1% of the final inhabitants (6). HA is equally frequent in any respect ages, however it’s extra prevalent amongst adults of their 20s and 30s and girls (7). HA co-occurs with different psychological well being issues and is a prognostic issue for different psychiatric situations (8). Changes in well being views and unhealthy web use patterns could also be answerable for the latest enhance in HA (9). HA can result in severe incapacity and extra medical service utilization, which might put a pressure on medical providers. Identifying individuals with HA and offering them with applicable remedies may also help cut back the burden on healthcare providers and personnel (10).
Healthcare professionals usually tend to report psychological sickness, together with HA, resulting from components comparable to elevated publicity to sufferers’ ache, sickness, and demise, lengthy and irregular working hours, and heavy bodily pressure. The COVID-19 pandemic amplified the stressors confronted by healthcare employees, together with presenting new stressors comparable to the chance of demise and incapacity resulting from COVID-19 (11). This has led to a rise in complaints of stress, despair, and anxiousness amongst healthcare employees, making HA extra frequent on this group (12).
Quite a lot of research have explored HA in healthcare professionals in Iran. Bahmaei et al. (2022) investigated HA amongst 600 medical college students in Iran earlier than and in the course of the COVID-19 pandemic. Initially, 47% of medical college students reported extreme anxiousness, which considerably elevated to 84% in the course of the pandemic. The total HA rating considerably rose in the identical interval (13). Javadi et al. (2022) surveyed 735 healthcare employees and volunteers in Iran throughout April-May 2020, discovering that well being anxiousness was correlated with social well being (14). In a research of 101 healthcare professionals working with COVID-19 sufferers, Mirzabeigi et al. (2021) discovered that anxiousness ranges have been delicate in 72.3%, reasonable in 24.8%, and extreme in 3% of the individuals. Male respondents and those that had witnessed affected person deaths had considerably greater HA scores. HA was additionally greater amongst individuals with much less work expertise (15). Another research by Mousavi et al. (2022) examined HA amongst 340 nurses between April and May 2020, reporting that 91.76% of the individuals skilled reasonable HA. The degree of hysteria was correlated with gender, marital standing, parenting, household relationships, work expertise, and office (16). Hassannia et al. (2020) in contrast the Iranian normal public and healthcare employees with respect to despair and anxiousness in the course of the COVID-19 pandemic, discovering considerably greater prevalence among the many healthcare employees (17). Heidari et al. (2020) discovered that 28.82% of residents of Mashhad, Iran, skilled corona illness anxiousness within the spring of 2020, with considerably greater ranges amongst girls and people with decrease academic attainment (18). Finally, Mohamadzadeh Tabrizi et al. (2022) studied corona illness anxiousness amongst 1131 Iranian nurses from April to May 2020. The outcomes revealed that 33.4% of the individuals skilled reasonable anxiousness and 13.4% skilled extreme anxiousness; anxiousness was additionally negatively correlated with high quality of life (19).
Still, extra analysis is required on HA amongst healthcare employees, particularly in the course of the COVID-19 pandemic. Researchers ought to prioritize this problem to raised perceive and tackle the wants of this susceptible inhabitants (20). During their scientific coaching, medical college students expertise the identical stressors as medical workers and sometimes expertise a phenomenon often called “medical pupil syndrome,” a type of HA characterised by the concern of growing illnesses they research and exhibiting associated signs. A latest research revealed that roughly 11% of medical college students encounter this situation throughout their coaching. However, earlier analysis has reported a considerably greater prevalence, exceeding 70%. This discrepancy highlights the necessity for additional investigation into the components contributing to HA amongst medical college students and the event of efficient interventions to handle this problem (21). To this purpose, this research was performed to check HA in medical and non-medical college students and uncover the correlated components in the course of the COVID-19 pandemic.
2 Method
2.1 Setting and approval
The inclusion standards have been: being at the very least 18 years previous, being a medical pupil (for the medical group) or an undergraduate or graduate pupil (for the non-medical group, together with these finding out engineering, humanities, regulation, and so on.), and entry to WhatsApp or Telegram. To reduce the impact of the stress related to main exams, medical college students needed to have accomplished the questionnaires at the very least a month earlier than and after main exams such because the Comprehensive Basic Medical Sciences Exam. The exclusion standards have been: failure to finish all questionnaires, and a historical past of significant psychological well being situations.
2.2 Data assortment
After acquiring knowledgeable consent and offering assurance relating to the anonymity of the responses, demographic and social info, together with age, gender, marital standing, variety of youngsters, place of residence, and degree of training have been collected utilizing a questionnaire. Personal and household historical past of psychiatric issues, psychiatric treatment use, substance use, historical past of COVID-19 an infection for the respondent or first-degree relations, demise of relations and relations resulting from COVID-19, and COVID-19 vaccination standing have been additionally collected. Finally, the individuals accomplished the Farsi variations of the well being anxiousness stock (HAI) and the corona illness anxiousness scale (CDAS).
2.2.1 Health anxiousness stock
Health anxiousness stock (HAI) was launched in 1989 in its lengthy kind to develop a cognitive mannequin of well being anxiousness and hypochondriasis. The brief type of HAI was developed by Salkovskis and Warwick in 2002, consisting of 18 questions that assess susceptibility to illness, penalties of illness, and normal well being concern. HAI evaluates HA utilizing a number of alternative questions, with every possibility assigned a rating of 0-3. Participants are requested to decide on the reply that the majority intently matches their expertise. Scores <26, 26-34, and >34 are categorized as delicate, reasonable, and extreme well being anxiousness, respectively. The reliability of HAI for the Iranian inhabitants has been confirmed in a research involving 1395 individuals (Cronbach’s α = 0.75) (22).
2.2.2 Corona illness anxiousness scale
2.3 Statistical evaluation
Data evaluation was carried out in SPSS 26 (IBM Statistics, Chicago, IL). Qualitative variables are offered utilizing frequency and share and in contrast utilizing the Chi-square take a look at or Fisher’s precise take a look at. Quantitative variables are offered utilizing imply and customary deviation (SD) and in contrast utilizing the unbiased samples t-test or the Mann-Whitney take a look at. Spearman’s correlation coefficient was used to guage the correlation between complete HAI and CDAS scores. Furthermore, a logistic regression mannequin was utilized to find out the affect of confounding variables on HAI and CDAS scores. All P-values are reported for two-tailed checks and P < 0.05 was thought of statistically vital.
3 Results
A complete of 305 people accomplished the survey in the course of the 12-month knowledge assortment interval (response price: 76.25%). The non-medical college students group consisted of 129 individuals with a imply age of 26.05 ± 9.25 years, whereas the medical college students group consisted of 176 individuals with a imply age of 24.44 ± 2.44 years. In phrases of gender distribution, the medical college students had a better share of females (73.3%) in comparison with the non-medical college students (58.1%), with females being considerably overrepresented within the medical teams (P = 0.005). There have been no statistically vital variations between the 2 teams almost about marital standing, place of residence, historical past of substance use, and private and household historical past of hysteria issues (Table 1).
Table 1. Demographic traits and medical historical past of the individuals.
Regarding COVID-19 variables, a better share of medical college students (86.4%) reported a private historical past of COVID-19 an infection in comparison with non-medical college students (74.4%), with this distinction being statistically vital (P = 0.012). While the distinction in household historical past of COVID-19 was not statistically vital (P = 0.060), there was a major distinction within the share of individuals who reported COVID-19 mortality of their household or amongst relations, with 42.6% of medical college students being affected in comparison with 58.1% of non-medical college students (P = 0.007). Additionally, all medical college students have been vaccinated in opposition to COVID-19, whereas a small share of non-medical college students (5.4%) have been unvaccinated, representing a statistically vital distinction (P = 0.002). Table 1 presents the demographic traits and medical historical past of the individuals.
3.1 Health anxiousness
Table 2 presents the info on HA among the many individuals. The “Susceptibility to illness” subscale didn’t present a major distinction between the 2 teams, with imply scores of three.90 ± 3.27 for non-medical college students and 4.05 ± 2.66 for medical college students (P = 0.299). However, there was a statistically vital distinction (P = 0.037) within the “Consequences of illness” subscale; medical college students had a better imply rating (5.01 ± 2.70) in comparison with non-medical college students (4.54 ± 3.28). The “General well being concern” subscale didn’t present a major distinction between the 2 teams (P = 0.156), with imply scores of 5.60 ± 2.69 for medical college students and 5.17 ± 3.16 for non-medical college students (Table 2).
Table 2. Analysis of responses to HAI, in contrast between medical and non-medical college students.
3.2 Corona illness anxiousness
Table 3 presents the info on corona illness anxiousness ranges among the many individuals. The majority of each teams reported delicate ranges of hysteria, with 56.8% of medical college students and 58.1% of non-medical college students falling into this class. Similarly, comparable numbers reported reasonable psychological signs within the two teams. Only a small proportion reported extreme psychological signs (1.1% for medical college students and 1.6% for non-medical college students), with no statistically vital distinction between the teams (P = 0.917). In phrases of bodily signs, most individuals in each teams skilled delicate ranges, with 85.2% of medical college students and 75.2% of non-medical college students falling into this class. The share of individuals with reasonable bodily signs was greater amongst non-medical college students (23.3%) in comparison with medical college students (13.6%). However, the proportion of people reporting extreme bodily signs was low and an identical (0.7%) for each teams, with no statistically vital distinction between the teams (P = 0.088). Regarding total COVID-19 anxiousness ranges measured by the full rating, most college students in each teams exhibited delicate anxiousness. Specifically, 92.0% of medical college students and 93.8% of non-medical college students fell into the delicate class for the full rating. A reasonable degree of complete anxiousness was extra prevalent amongst medical college students (7.4%) in comparison with their non-medical counterparts (4.7%). Severe complete anxiousness scores have been comparatively unusual, with solely 0.6% of medical college students and 1.6% of non-medical college students falling into this class. However, the distinction within the distribution of complete anxiousness scores was not statistically vital (P = 0.439) (Table 3).
Table 3. Analysis of responses to CDAS.
3.3 Correlation between HAI and CDAS and confounding components
Correlation evaluation revealed a reasonable however vital constructive correlation between complete CDAS and HAI scores (P<0.001, r=0.30). Table 4 presents the outcomes of logistic regression evaluation to research the results of gender (feminine) and group (non-medical pupil) as confounding variables on complete HAI and CDAS scores. Being feminine was considerably related to greater odds ratio (OR) for HAI (OR = 4.55, 95% CI = 1.73-11.90, P = 0.002), indicating that feminine respondents confronted roughly 4.5 instances higher threat in comparison with males. Being a non-medical pupil was considerably correlated with decrease HAI scores (OR = 0.01, 95% CI = 0.29-1.90, P < 0.001), suggesting that non-medical college students face comparatively decrease HA. Regarding the impact of confounding variables on CDAS, the outcomes point out that gender was not considerably related to CDAS (P = 0.695 and P = 0.534, respectively). In distinction, being a non-medical pupil was considerably related to decrease CDAS scores (OR = 0.05, 95% CI = 0.44-2.84, P < 0.001), indicating decrease odds of corona illness anxiousness for non-medical college students (Table 4).
Table 4. Logistic regression evaluation for the impact of confounding variables.
4 Discussion
This research evaluated HA amongst medical and non-medical college students in the course of the COVID-19 pandemic. Although the 2 teams have been comparable in lots of regards, the considerably greater share of medical college students (86.4%) reporting a private historical past of COVID-19 an infection in comparison with non-medical college students (74.4%) might be attributed to the elevated publicity of medical college students to healthcare settings and sufferers throughout their scientific coaching. This remark aligns with earlier research that spotlight the elevated threat of COVID-19 an infection amongst healthcare employees in Malaysia and Iran (25–27). Interestingly, whereas the distinction in household historical past of COVID-19 between the 2 teams was not statistically vital, a better proportion of non-medical college students (58.1%) reported COVID-19 mortality of their household or amongst relations in comparison with medical college students (42.6%). This discovering might doubtlessly be defined by the upper probability of medical college students being extra knowledgeable about COVID-19 prevention measures and having higher entry to healthcare sources, which can have decreased the chance of extreme outcomes or mortality amongst their relations and relations.
Vaccination standing knowledge revealed that each one medical college students have been vaccinated in opposition to COVID-19, whereas a small share (5.4%) of non-medical college students remained unvaccinated. This discrepancy might be attributed to the obligatory vaccination insurance policies applied in lots of medical establishments and healthcare settings, in addition to the heightened consciousness and emphasis on vaccination amongst medical college students resulting from their academic background and make contact with with healthcare professionals. Moreover, the vaccine roll-out in Iran prioritized healthcare employees resulting from their publicity to COVID-19 threat.
At the identical time, our outcomes confirmed no vital distinction between the teams in complete HAI rating. This discovering means that whereas medical college students have extra data about illness penalties, this information doesn’t translate into greater total HA, contradicting the speculation that elevated illness data results in elevated anxiousness. Several research have been performed in the course of the COVID-19 pandemic to check psychological well being between medical and non-medical college students, and their findings recommend that medical college students had comparatively decrease ranges of hysteria within the UAE, China, and the United Kingdom (36–38). The findings of a research involving Croatian medical, non-medical, and regulation college students contradict the notion that medical college students are extra inclined to hunt help resulting from hypochondriacal ideas (39). Aligned with this end result, a research of 214 medical and 821 non-medical college students in China utilizing the well being anxiousness questionnaire (HAQ) confirmed that HA is considerably decrease in medical college students (40). A latest research performed in Mexico utilizing the affected person well being questionnaire-9 (PHQ-9) and the final anxiousness dysfunction (GAD) scale studies that non-medical college students had extra anxiousness and depressive signs than medical college students in the course of the COVID-19 pandemic (41).
The contradictory findings relating to HA in medical and non-medical college students might stem from variations in research populations, methodologies, evaluation instruments, and contexts. While medical college students’ illness data could heighten perceptions of penalties, it might additionally present higher coping methods and mitigate anxiousness. Factors like stage of training, curriculum, and availability of psychological well being sources might affect noticed anxiousness ranges as effectively. Cultural, regional, and circumstantial variations, such because the COVID-19 pandemic, may additionally contribute to divergent outcomes. Reconciling these contradictions requires additional analysis exploring the interaction between medical data, scientific publicity, coping mechanisms, and psychological well-being.
We discovered that almost all of individuals from each teams reported delicate ranges of COVID-19 anxiousness, with no statistically vital variations within the distribution of psychological signs or total anxiousness scores. This discovering means that, regardless of the various academic backgrounds and publicity to healthcare settings, the pandemic’s psychological impression was comparatively comparable for medical and non-medical college students. Interestingly, the info on bodily signs revealed {that a} greater proportion of non-medical college students (23.3%) skilled reasonable ranges of bodily signs in comparison with medical college students (13.6%). This remark might be linked to the higher understanding of COVID-19 signs and the potential affect of medical data on the interpretation and administration of bodily manifestations amongst medical college students. In phrases of corona illness anxiousness, a research investigating the psychological impression of the outbreak on medical and non-medical college students in China discovered that whereas medical college students thought of COVID-19 to be extra severe, they scored decrease on the impression of occasion scale-revised (IES-R) and skilled much less anxiousness and despair in comparison with non-medical college students (36). Similarly a latest work from Pakistan utilizing the corona anxiousness scale (CAS) revealed that non-clinical workers scored greater than scientific workers (42). In line with our findings, a latest research by Nadeem et al. (2020) utilizing the CDAS questionnaire demonstrated that Pakistani healthcare employees have delicate coronavirus illness anxiousness however report decrease ranges of hysteria resulting from COVID-19 in comparison with the final inhabitants (43). However, a research performed on 385 Ecuadorean individuals reported excessive ranges of hysteria in each medical and non-medical college students, with a better prevalence determine for medical college students (44). Furthermore, a latest research revealed excessive ranges of corona disease-induced anxiousness amongst Portuguese undergraduate college students (45). These findings contradict our outcomes, which point out delicate COVID-19 anxiousness amongst college students. It is value noting that our research was performed about 1.5 years after the outbreak started, in a context the place college students had gained higher consciousness of the illness and most had been vaccinated in opposition to COVID-19 at the very least as soon as. These components could assist reconcile the discrepancies between our outcomes and people of different research.
We noticed a gentle however vital constructive correlation between complete HAI and CDAS scores, suggesting that people with greater ranges of well being anxiousness usually tend to expertise elevated anxiousness particularly associated to the COVID-19 pandemic. A research of 1638 Iranians revealed the same correlation between HA and COVID-19 anxiousness (28). Another research, performed in Portugal utilizing the despair, anxiousness, and stress scale-21 (DASS-21), and the coronavirus anxiousness scale (CAS), additionally discovered a statistically vital correlation between normal anxiousness and COVID anxiousness (46). In the current analysis, feminine respondents confronted roughly 4.5 instances higher odds of HA, which is in keeping with earlier analysis indicating a better prevalence of hysteria issues amongst girls generally, and in the course of the COVID-19 pandemic particularly, probably because of the potential affect of organic and social components (47–49). Being a non-medical pupil was considerably related to decrease odds of each well being anxiousness and corona illness anxiousness. This discovering aligns with the sooner discussions, highlighting the potential affect of medical data and publicity to scientific settings on the notion of illness penalties and subsequent anxiousness ranges.
The literature on the connection between area of research and HA accommodates contradictory proof relating to the prevalence of HA amongst medical and non-medical college students. The causes for these discrepancies are usually not totally understood however could also be associated to using completely different evaluation instruments for measuring HA, the completely different demographics of medical and non-medical college students in every research, cultural variations, and completely different baseline anxiousness ranges. The current research discovered wide-spread anxiousness amongst medical and non-medical college students, with vital variations between the 2 teams in some sub-scales. The Mann-Whitney take a look at didn’t discover vital variations between medical and non-medical college students with respect to HAI, and the Chi-square take a look at didn’t reveal any variations with respect to CDAS lessons. In distinction, the outcomes of logistic regression evaluation point out the protecting impact of being a non-medical pupil. The seemingly contradictory findings may be reconciled by understanding the completely different analytical focuses of those strategies. The Mann-Whitney and Chi-square checks evaluate normal rating distributions with out adjusting for different components, whereas logistic regression assesses the probability of hysteria, adjusting for covariates like gender. Together, these analyses point out that, though well being anxiousness ranges could not differ total, non-medical college students are much less more likely to expertise excessive well being anxiousness when confounding components are thought of.
5 Conclusion
The current research highlights the prevalence of well being anxiousness amongst medical and non-medical college students. Notably, our outcomes point out that medical and non-medical college students expertise comparable ranges of total well being anxiousness, however completely different ranges of hysteria relating to the results of sickness. We additionally discovered that being male and finding out non-medical majors exert protecting results in opposition to well being anxiousness. Our findings underscore the significance of psychoeducation and psychological well being consciousness in healthcare and academic settings. Furthermore, efforts to scale back stress and burnout, and promote wholesome coping mechanisms and stress administration methods are advisable to enhance total pupil well-being. These findings emphasize the necessity for focused interventions and assist methods inside academic applications to handle the distinctive challenges confronted by completely different pupil populations and promote a balanced perspective on well being and illness, fostering resilience and psychological well-being amongst future professionals. Moreover, additional analysis is required to elucidate the impact of area of research on well being anxiousness.
Data availability assertion
Ethics assertion
This research was accredited by the Ethics Committee of Mashhad University of Medical Sciences (MUMS) (license plate: IR.MUMS.MEDICAL.REC.1400.317). The analysis was performed in accordance with native laws and institutional necessities. All individuals supplied written knowledgeable consent to take part within the research.
Author contributions
MN: Conceptualization, Methodology, Project administration, Resources, Writing – authentic draft, Writing – overview & enhancing. MF: Conceptualization, Methodology, Writing – overview & enhancing. HMo: Data curation, Investigation, Writing – authentic draft. NM: Formal Analysis, Methodology, Writing – overview & enhancing. ME: Formal Analysis, Methodology, Writing – authentic draft, Writing – overview & enhancing. HMi: Data curation, Investigation, Writing – authentic draft.
Funding
Acknowledgments
This research was primarily based on a thesis by Hanieh Mohammadi for the Doctor of Medicine (MD) diploma (thesis no. P10051).
Conflict of curiosity
Publisher’s observe
Abbreviations
HA, well being anxiousness; HAI, well being anxiousness stock; CDAS, Corona illness anxiousness scale; OR, odds ratio; SHAI, brief well being anxiousness stock; HAQ, well being anxiousness questionnaire; PHQ-9, affected person well being questionnaire-9; GAD, generalized anxiousness dysfunction; CAS, corona anxiousness scale; DASS-21, despair, anxiousness, and stress scale-21.
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