Salud Mental

Effectiveness evaluation of online Mindfulness in mental health and alcohol consumption in medical students during the COVID-19 pandemic

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León Jesús German-Ponciano
María Fernanda Zapata-de la Rosa
Brenda Itzel Molina-Cadena
Yared Sarai Velasco-Gómez
Ángel Alberto Puig-Lagunes

Abstract

Introduction. As a result of the COVID-19 pandemic, the prevalence of stress, anxiety, depression, and alcohol consumption has increased among medical students. Mindfulness is an intervention to decrease these psychopathologies and alcohol consumption; however, evidence has shown unclear results regarding its efficacy.

Objective. To evaluate the effectiveness of an online Mindfulness-based intervention (MBI) on stress, anxiety, and depression symptomatology levels, as well as on alcohol consumption and mindfulness status in medical students during the COVID-19 pandemic.

Method. A quasi-experimental study was conducted on 237 students, obtaining sociodemographic data. In addition the levels of psychopathology, alcohol consumption, and state of mindfulness: were measured pre-and post-intervention through the DASS-21, AUDIT, and MASS instruments. Eight online Mindfulness sessions were conducted once a week for approximately one hour each.

Results. MBI did not reduce levels of psychopathologies or alcohol consumption, nor did the mindfulness status improve. High levels of psychopathologies, dropout rate, and lack of voluntary participation were the main factors limiting the effectiveness of the online MBI.

Discussion and conclusion. The online MBI wasn’t effective among the population under study: we recommend generation strategies where students are involved in and complete intervention programs. Results from this research will help enhance future online mindfulness interventions.
Keywords:
Mindfulness, medical education, anxiety, stress, depression, alcohol consumption

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References

Arenas-Monreal, L., Hernández-Tezoquipa, I., Valdez-Santiago, R., & Bonilla-Fernández, P. (2004). Las instituciones de salud y el autocuidado de los médicos.Salud Pública de México,46(4), 326-332. doi: 10.1590/S0036-36342004000400007

Alsoufi, A., Alsuyihili, A., Msherghi, A., Elhadi, A., Atiyah, H., Ashini, A., … Elhadi, M. (2020). Impact of the COVID-19 pandemic on medical education: Medical students’ knowledge, attitudes, and practices regarding electronic learning. PLoS One, 15(11), e0242905. doi: 10.1371/journal.pone.0242905

Asociación Médica Mundial. (2013). Declaración de Helsinki. Principios éticos para la investigación en seres humanos. (64º Asamblea General).

Ayala, E. E., Omorodion, A. M., Nmecha, D., Winseman, J. S., & Mason, H. R. C. (2017). What Do Medical Students Do for Self-Care? A Student-Centered Approach to Well-Being. Teaching and Learning in Medicine, 29(3), 237-246. doi: 10.1080/10401334.2016.1271334

Ball, S., & Bax, A. (2022). Self-care in Medical Education: effectiveness of health-habits interventions for first-year medical students. Academic Medicine, 77(9), 911-917. doi: 10.1097/00001888-200209000-00023

Caldera-Villalobos, C., Garza-Veloz, I., Martínez-Avila, N., Delgado-Enciso, I., Ortiz-Castro, Y., Cabral-Pacheco, G. A., & Martinez-Fierro, M. L. (2020). The Coronavirus Disease (COVID-19) Challenge in Mexico: A Critical and Forced Reflection as Individuals and Society. Frontiers in Public Health, 8, 337. doi: 10.3389/fpubh.2020.00337

Chmielewski, J., Łoś, K., & Łuczyński, W. (2021). Mindfulness in healthcare professionals and medical education. International Journal of Occupational Medicine and Environmental Health, 34(1), 1-14. doi: 10.13075/ijomeh.1896.01542

Chodkiewicz, J., Talarowska, M., Miniszewska, J., Nawrocka, N., & Bilinski, P. (2020). Alcohol Consumption Reported during the COVID-19 Pandemic: The Initial Stage. International Journal of Environmental Research and Public Health, 17(13), 4677. doi: 10.3390/ijerph17134677

Coker, A., Coker, O., & Sanni, D. (2018). Sociodemographic correlates and symptoms of depression, anxiety, and stress among a sample of nigerian medical students. Nigerian Journal of Basic and Clinical Science, 15(1), 58-62. doi: 10.4103/njbcs.njbcs_50_16

Constantinou, C. S., Georgiou, M., & Perdikogianni, M. (2017). Medical Students’ Attitudes and Beliefs towards Psychotherapy: A Mixed Research Methods Study. Behavioral Sciences, 7(3), 55. doi: 10.3390/bs7030055

Danilewitz, M., Koszycki, D., Maclean, H., Sanchez-Campos, M., Gonsalves, C., Archibald, D., & Bradwejn, J. (2018). Feasibility and effectiveness of an online mindfulness meditation program for medical students. Canadian Medical Education Journal, 9(4), e15-e25.

Farris, S. R., Grazzi, L., Holley, M., Dorsett, A., Xing, K., Pierce, C. R., & Wells, R. E. (2021). Online Mindfulness May Target Psychological Distress and Mental Health during COVID-19. Global Advances in Health and Medicine, 10, 216495612110024. doi: 10.1177/21649561211002461

Freire, B. R., Castro, P. A. S. V. de, & Petroianu, A. (2020). Alcohol consumption by medical students. Revista da Associação Médica Brasileira, 66(7), 943-947. doi: 10.1590/1806-9282.66.7.943

Givens, J. L., & Tjia, J. (2002). Depressed medical students’ use of mental health services and barriers to use. Academic Medicine, 77(9), 918-921. doi: 10.1097/00001888-200209000-00024

Gloster, A. T., Lamnisos, D., Lubenko, J., Presti, G., Squatrito, V., Constantinou, M., … Karekla, M. (2020). Impact of COVID-19 pandemic on mental health: An international study. PLoS One, 15(12), e0244809. doi: 10.1371/journal.pone.0244809

Godara, M., Silveira, S., Matthäus, H., Heim, C., Voelkle, M., Hecht, M., … Singer, T. (2021). Investigating differential effects of socio-emotional and mindfulness-based online interventions on mental health, resilience, and social capacities during the COVID-19 pandemic: The study protocol. PLoS One, 16(11), e0256323. doi: 10.1371/journal.pone.0256323

Gold, J. A., Johnson, B., Leydon, G., Rohrbaugh, R. M., & Wilkins, K. M. (2015). Mental health self-care in medical students: a comprehensive look at help-seeking. Academic Psychiatry, 39(1), 37-46. doi: 10.1007/s40596-014-0202-z

Huberty, J., Green, J., Glissmann, C., Larkey, L., Puzia, M., & Lee, C. (2019). Efficacy of the Mindfulness Meditation Mobile App “Calm” to Reduce Stress Among College Students: Randomized Controlled Trial. JMIR mHealth and uHealth, 7(6), e14273. doi: 10.2196/14273

Kamboj, S. K., Irez, D., Serfaty, S., Thomas, E., Das, R. K., & Freeman, T. P. (2017). Ultra-Brief Mindfulness Training Reduces Alcohol Consumption in At-Risk Drinkers: A Randomized Double-Blind Active-Controlled Experiment. International Journal of Neuropsychopharmacology, 20(11), 936-947. doi: 10.1093/ijnp/pyx064

Killgore, W. D. S., Cloonan, S. A., Taylor, E. C., Lucas, D. A., & Dailey, N. S. (2021). Alcohol dependence during COVID-19 lockdowns. Psychiatry Research, 296, 113676. doi: 10.1016/j.psychres.2020.113676

Lai, A. Y., Lee, L., Wang, M., Feng, Y., Lai, T. T., Ho, L., … Lam, T. (2020). Mental Health Impacts of the COVID-19 Pandemic on International University Students, Related Stressors, and Coping Strategies. Frontiers in Psychiatry, 11, 584240. doi: 10.3389/fpsyt.2020.584240

Lasheras, I., Gracia-García, P., Lipnicki, D., Bueno-Notivol, J., López-Antón, R., de la Cámara, C., … Santabárbara, J. (2020). Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis. International Journal of Environmental Research and Public Health, 17(18), 6603. doi: 10.3390/ijerph17186603

Ley General de Salud. (1984). Diario Oficial de la Federación. Última Reforma publicada en el Diario Oficial de la Federación el 16-02-2022. (Número 27).

Li, W., Howard, M. O., Garland, E. L., McGovern, P., & Lazar, M. (2017). Mindfulness treatment for substance misuse: A systematic review and meta-analysis. Journal of Substance Abuse Treatment, 75, 62-96. doi: 10.1016/j.jsat.2017.01.008

Meo, S. A., Abukhalaf, A. A., Alomar, A. A., Sattar, K., & Klonoff, D. C. (2020). COVID-19 Pandemic: Impact of Quarantine on Medical Students’ Mental Wellbeing and Learning Behaviors. Pakistan Journal of Medical Sciences, 36(COVID19-S4), S43-S48. doi: 10.12669/pjms.36.covid19-s4.2809

Morledge, T. J., Allexandre, D., Fox, E., Fu, A. Z., Higashi, M. K., Kruzikas, D. T., … Reese, P. R. (2013). Feasibility of an Online Mindfulness Program for Stress Management—A Randomized, Controlled Trial. Annals of Behavioral Medicine, 46(2), 137-148. doi: 10.1007/s12160-013-9490-x

Nasui, B. A., Popa, M., Buzoianu, A. D., Pop, A. L., Varlas, V. N., Armean, S. M., & Popescu, C. A. (2021). Alcohol Consumption and Behavioral Consequences in Romanian Medical University Students. International Journal of Environmental Research and Public Health, 18(14), 7531. doi: 10.3390/ijerph18147531

O’Byrne, L., Gavin, B., & McNicholas, F. (2020). Medical students and COVID-19: the need for pandemic preparedness. Journal of Medical Ethics, 46(9), 623-626. doi: 10.1136/medethics-2020-106353

Picton, A. (2021). Work-life balance in medical students: self-care in a culture of self-sacrifice. BMC Medical Education, 21(1), 8. doi: 10.1186/s12909-020-02434-5

Pitchot, W., & Dor, B. (2019). Complications psychiatriques liées à l’alcoolisme. [Psychiatric complications associated with alcoholism]. Revue Médicale de Liège, 74(5-6), 300-303.

Puig-Lagunes, Á. A., Vargas-Álvarez, J. E., Salinas-Méndez, L. E., Ricaño-Santos, K. A., & Puig-Nolasco, Á. (2020). Prevalencia de depresión, ansiedad y estrés académico entre estudiantes de medicina, durante distintos periodos de estrés. Atención Familiar, 27(4), 165-171. doi: 10.22201/fm.14058871p.2020.4.76891

Ramón-Arbués, E., Gea-Caballero, V., Granada-López, J. M., Juárez-Vela, R., Pellicer-García, B., & Antón-Solanas, I. (2020). The Prevalence of Depression, Anxiety and Stress and Their Associated Factors in College Students. International Journal of Environmental Research and Public Health, 17(19), 7001. doi: 10.3390/ijerph17197001

Rodriguez, M. L., Corse, A. K., & Rosen, L.D. (2017). Mental Health Services Use Among Medical Students: Perceived Stigma and Barriers to Care. Medical Science Educator, 27(2), 267-272. doi: 10.1007/s40670-017-0392-6

Román, F., Santibáñez, P., & Vinet, E. V. (2016). Uso de las Escalas de Depresión Ansiedad Estrés (DASS-21) como Instrumento de Tamizaje en Jóvenes con Problemas Clínicos. Acta de Investigación Psicológica, 6(1), 2325-2336. doi: 10.1016/s2007-4719(16)30053-9

Sanchez, T., Peña, E., & Ng, B. (2020). Mental health in the age of COVID-19, a Mexican experience. Indian Journal of Psychiatry, 62(Suppl 3), S377-S379. doi: 10.4103/psychiatry.indianjpsychiatry_1048_20

Sancho, M., De Gracia, M., Rodríguez, R. C., Mallorquí-Bagué, N., Sánchez-González, J., Trujols, J., … Menchón, J. M. (2018). Mindfulness-Based Interventions for the Treatment of Substance and Behavioral Addictions: A Systematic Review. Frontiers in Psychiatry, 9, 95. doi: 10.3389/fpsyt.2018.00095

Schuman-Olivier, Z., Trombka, M., Lovas, D. A., Brewer, J. A., Vago, D. R., Gawande, R., … Fulwiler, C. (2020). Mindfulness and Behavior Change. Harvard Review of Psychiatry, 28(6), 371-394. doi: 10.1097/hrp.0000000000000277

Sekhar, P., Tee, Q. X., Ashraf, G., Trinh, D., Shachar, J., Jiang, A., … Turner, T. (2021). Mindfulness-based psychological interventions for improving mental well-being in medical students and junior doctors. Cochrane Database of Systematic Reviews, 12(12), CD013740. doi: 10.1002/14651858.cd013740.pub2

Shuai, R., Bakou, A. E., Hardy, L., & Hogarth, L. (2020). Ultra-brief breath counting (mindfulness) training promotes recovery from stress-induced alcohol-seeking in student drinkers. Addictive Behaviors, 102, 106141. doi: 10.1016/j.addbeh.2019.106141

Soares, F. R. R., Farias, B. R. F. de, & Monteiro, A. R. M. (2019). Consumption of alcohol and drugs and school absenteeism among high school students of public schools. Revista Brasileira de Enfermagem, 72(6), 1692-1698. doi: 10.1590/0034-7167-2018-0828

Testino, G. (2020). Are Patients With Alcohol Use Disorders at Increased Risk for Covid-19 Infection? Alcohol and Alcoholism, 55(4), 344-346. doi: 10.1093/alcalc/agaa037

Thistlethwaite, J., Quirk, F., & Evans, R. (2010). Medical students seeking medical help: A qualitative study. Medical Teacher, 32(2), 164-166. doi: 10.3109/01421590903434177

Walsh, K. M., Saab, B. J., & Farb, N. A. (2019). Effects of a Mindfulness Meditation App on Subjective Well-Being: Active Randomized Controlled Trial and Experience Sampling Study. JMIR Mental Health, 6(1), e10844. doi: 10.2196/10844

Wielgosz, J., Goldberg, S. B., Kral, T. R. A., Dunne, J. D., & Davidson, R. J. (2019). Mindfulness Meditation and Psychopathology. Annual Review of Clinical Psychology, 15(1): 285-316. doi: 10.1146/annurev-clinpsy-021815-093423

Witkiewitz, K., & Bowen, S. (2010). Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention. Journal of Consulting and Clinical Psychology, 78(3), 362-374. doi: 10.1037/a0019172

Witkiewitz, K., Litten, R. Z., & Leggio, L. (2019). Advances in the science and treatment of alcohol use disorder. Science Advances, 5(9), eaax4043. doi: 10.1126/sciadv.aax4043

Yang, E., Schamber, E., Meyer, R. M. L., & Gold, J. I. (2018). Happier Healers: Randomized Controlled Trial of Mobile Mindfulness for Stress Management. The Journal of Alternative and Complementary Medicine, 24(5), 505-513. doi: 10.1089/acm.2015.0301

Zanon, C., Brenner, R. E., Baptista, M. N., Vogel, D. L., Rubin, M., Al-Darmaki, F. R., … Zlati, A. (2021). Examining the Dimensionality, Reliability, and Invariance of the Depression, Anxiety, and Stress Scale–21 (DASS-21) Across Eight Countries. Assessment, 28(6), 1531-1544. doi: 10.1177/1073191119887449

Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2014). Mindfulness-based interventions in schools-A systematic review and meta-analysis. Frontiers in Psychology, 5, 603 doi: 10.3389/fpsyg.2014.00603