Introduction
Coronavirus disease (COVID-2019) pandemic has caused a worldwide
increase of hospitalization from pneumonia and multiorgan failure (1).
During such a difficult time, there was an increased risk of many mental
disorders such as Obsessive-compulsive disorder (OCD) and anxiety among
health care workers (2).
OCD is one of the common mental disorders that people have worldwide and
can have a life-time prevalence of 1.1-3.3%. OCD can have a wide range
of symptoms and can take many forms which might make diagnosis
difficult. OCS usually develops during adolescence and late teens and
the median age is usually around 20 years of age, which makes university
students more susceptible to develop it. Unfortunately, undergraduate
medical students have particular risk due to the nature of their
curriculum that allows less time for leisure and due to the way they are
taught to be more perfect and precise to the degree of obsess a little
more; all these risk factors and others make medical students more prone
to OCD than the general population (3-5). They are also more prone to
have general anxiety disorder (GAD) and burnout from the aforementioned
stressors that cause conflicts in work-life balance (6). COVID-19 adds
up to their stressors by disrupting their pre-clinical and clinical
training and by forcing them to adapt to the new social environment.
This caused medical students to have 61% and 70% higher for anxiety
and depression, respectively (7). A systematic review with meta-analysis
found that anxiety prevalence was about 28% among medical students
during COVID-19 (8). (7, 8)
Particularly in Syria, mental health has already been neglected for
decades, and education has been significantly injured as many facilities
were destroyed during the destruction of the Syrian social structure
(18). There was a destruction of the health facilities and the economy
deteriorated to the extent that poverty reached more than 80% which os
probably worse now during COVID (2).
To study medicine in Syria through the public system which has the
majority of medical students and considered the highest prestigious,
students have to pass year 12 of school with high grades. Then they have
to enter a preparatory school for one year. This year along with year 12
allow students to enter medical schools across Syria as their average
marks are the determinant factors. Subsequently, students must do at
least 2 years of pre-clinical learning and 2 years of clinical working.
Finally, they must do one year of internship that has rotation and can
graduate by doing the national medical exam, so undergraduate medical
school is at least 6 years in total. Medical students in this study were
categorized according to these groups.
Therefore, this study aims to assess the prevalence of anxiety and OCD
among medical students in Syria, during the COVID-19 pandemic after 10
years of war.