• Sanja Manchevska Institute of Physiology, Faculty of Medicine, Ss Cyril and Methodius University, Skopje, R. North Macedonia
  • Jasmina Pluncevic Gligoroska Institute of Physiology, Faculty of Medicine, Ss Cyril and Methodius University, Skopje, R. North Macedonia


COVID-19, medical students, mental health


Introduction: Concern for mental health consequences in general population world­wide has been apparent since the start of the actual pandemic.  

Aim of the study was to assess the impact of COVID-19 related stressors on mental health in junior medical students during December 2020 COVID-19 related lockdown.

Material and methods: The investigation included 275 second-year medical students aged 19-28 years, from the Faculty of Medicine, Ss. Cyril and Methodius University in Skopje during December 2020. Self-administered questionnaire containing standardized instruments for assessment of parameters of psychological distress (BAI, BDI and PSS) were used. COVID-19 related attitudes questionnaire for assessment of status of COVID-19 testing and infection, self-perceived levels of concerns related to academics [COVID-19-AA (academic apprehensions)] and those related to the self and family/friends [COVID-19-GA (general apprehensions)] were included.

Results: The prevalence of anxiety, depression and stress was 74.9%, 43.3% and 78.9%, respectively. Almost 29% of students reported high anxiety, 6.2% had severe depression and 21.45% reported high levels of perceived stress. There was a significant positive correlation between COVID-19 GA score and BAI, BDI и PSS scores (p<0.05). Correlations between the COVID-19 AA scores and scores on BAI, BDI and PSS scales were also statistically significant (p=0.0000). Academic apprehension was found a predictive factor for high anxiety, depression and high stress (R2 = .12, F (1,273) = 38.79, p < .001. β = 1.12, p < .001).

Conclusion: General and academic apprehension related to COVID-19 have negative effects on mental wellbeing in second year medical students. 


Salari N, Hosseinian-Far A, Jalali R, et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Global Health 2020; 16(1): 57. doi:10.1186/s12992-020-00589-w.

Moghanibashi-Mansourieh A. Assessing the anxiety level of Iranian general population during COVID-19 outbreak. Asian J Psychiatr 2020; 51: 102076. doi:10.1016/j.ajp.2020.102076.

Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated Psychological Problems. Asian J Psychiatr 2020; 51: 102092. doi:10.1016/j.ajp.2020.102092.

Zhou SJ, Zhang LG, Wang LL, et al. Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19. Eur Child Adolesc Psychiatry 2020; 29(6): 749-58. doi:10.1007/s00787-020-01541-4.

Saddik B, Hussein A, Sharif-Askari FS, et al. Increased Levels of Anxiety Among Medical and Non-Medical University Students During the COVID-19 Pandemic in the United Arab Emirates. Risk Manag Healthc Policy 2020; 13: 2395-406. doi: 10.2147/RMHP.S273333.

Quek TT, Tam WW, Tran BX, et al. 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.

Manchevska S, Pluncevic-Gligoroska J. The prevalence of high anxiety and substance use in university students in the Republic of Macedonia. Prilozi (Makedon Akad Nauk Umet Odd Med Nauki) 2014; 35(2): 67-74. doi:10.2478/prilozi-2014-0009.

Mancevska S, Pluncevic Gligoroska J, Aleksovska Velickovska L. Levels of anxiety and depression in second year medical students during COVID-19 pandemic spring lockdown in Skopje, North Macedonia. Res Phys Edu, Sport Health 2020; 9(2): 85-91. doi:

Guo AA, Crum MA, Fowler LA. Assessing the Psychological Impacts of COVID-19 in Undergraduate Medical Students. Int J Environ Res Public Health 2021; 18(6): 2952. doi: 10.3390/ijerph18062952.

Safa F, Anjum A, Hossain S, et al. Immediate psychological responses during the initial period of the COVID-19 pandemic among Bangladeshi medical students. Child Youth Serv Rev 2021; 122: 105912. doi: 10.1016/j.childyouth.2020.105912.

Lasheras I, Gracia-García P, Lipnicki DM, et al. Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis [published correction appears in Int J Environ Res Public Health. 2020 Dec 14; 17(24):]. Int J Environ Res Public Health 2020; 17(18): 6603. doi: 10.3390/ijerph17186603.

Saraswathi I, Saikarthik J, Senthil Kumar K, Madhan Srinivasan K, Ardhanaari M, Gunapriya R. Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study. PeerJ 2020; 8: e10164. doi: 10.7717/peerj.10164.

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.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring dep¬ression. Arch Gen Psychiatry 1961; 4: 561-71. doi: 10.1001/archpsyc.1961.01710120031004.

Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24(4): 385-96.

Seedhom AE, Kamel EG, Mohammed ES, Raouf NR. Predictors of Perceived Stress among Medical and Nonmedical College Students, Minia, Egypt. Int J Prev Med 2019; 10: 107. doi: 10.4103/ijpvm.IJPVM_6_18.

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.

Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA 2016; 316(21): 2214-36. doi: 10.1001/jama.2016.17324.

Mancevska S, Bozinovska L, Tecce J, Pluncevik-Gligoroska J, Sivevska-Smilevska E. Depression, anxiety and substance use in medical students in the Republic of Macedonia. Bratisl Lek Listy 2008; 109(12): 568-72.



2021-12-27 — Updated on 2021-12-30




Original Articles