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Depression, Anxiety, and Stress during COVID-19 Epidemic among Public Health Students in Thailand

By the end of March 2020, the COVID-19 epidemic were widespread in Thailand led to the closures of schools and universities. The home quarantine, social distancing, and other restrictions are likely to have psychological impact on students. This study aimed to estimate the prevalence of depression, anxiety, and stress and determine predictors among undergraduate public health students. A cross-sectional study was conducted at the School of Public Health - Walailak University. Research subjects included 463 students selected by a 2-stage random sampling. A research tool was a self-administered standardized 21-item depression, anxiety, and stress scale. An ordinal logistic regression analysis was executed to determine the predictors of depression, anxiety, and stress. The results showed that the prevalence of depression, anxiety, and stress was 24.8, 31, and 18.8%, respectively. Significant predictors of depression and anxiety were educational environment (OR = 0.35, 95% CI: 0.13 - 0.6;   OR = 0.3, 95% CI: 0.2 - 0.7), and tense feelings during learning (OR = 3.57, 95% CI: 1.9 - 6.6; OR = 0.5, 95% CI: 0.2 - 0.8). Relationship with boy/girlfriends was considered a predictor of depression and stress (OR = 2.5, 95% CI: 1.2 - 4.9; OR = 0.5,95% CI: 0.2 - 0.9). Marital status of parent (OR = 15.5, 95% CI: 1.2 - 192.3) and family provision for learning (OR= 3.1, 95% CI: 1.3 - 7.6) were predictors of depression, and specialized majors (OR = 0.2, 95% CI: 0.1 - 0.7) was a predictor of stress. Noticeable worries about “My physical health”, “Health systems being overloaded”, and “Restricted liberty of movement” are also considered as predictors of depression, anxiety, and stress. The findings are needed to develop a good education environment and counseling services for cases having emotional problems. 
HIGHLIGHTS 
 
Depression, anxiety, and stress account for 24.8, 31, and 18.8 %, respectively among public health students during the COVID-19 pandemic 
Three groups of predictors are related to personal and family relationship, educational environment, and worries about COVID-19 
Establishing psychological support, reducing academic burden to fit learning needs, and improving educational environments should be urgently done 
 
GRAPHICAL ABSTRACT