Prevalence and associated factors of post-traumatic stress disorder in university students infected with COVID-19: a mixed method study
Keywords:
COVID-19, mental health, PTSD, university studentsAbstract
Objective: To determine the prevalence and risk factors associated with post-traumatic stress disorder (PTSD) among university students with COVID-19 and to explore their experiences and consequences of the infection.
Methods: A mixed method among university students in Chiang Mai with COVID-19 infection was divided into two parts; 1) a cross-sectional analytical study using the PTSD checklist for DSM-5 (PCL-5) and multivariate logistic regression analysis for screening for PTSD and identifying associated factors 2) in-depth interviews with content analysis on experiences and consequences of the COVID-19 infection and treatment.
Results: Of 118 participants, 14.4% (95% CI = 8.6 - 22.1) met PTSD criteria (PCL-5 31). PTSD was more likely to develop among those with suicidal ideation (AOR = 8.45, 95% = 1.32 - 54.07), guilt for being infected (AOR = 11.47, 95% CI = 1.23 - 107.37), infection during January - April 2022 compared with April - December 2021 (AOR = 12.00, 95% CI = 1.84 - 78.21), and public stigma (AOR = 12.54, 95% CI = 2.10 - 74.89). PTSD was less likely to develop among those having household monthly income > 50,000 Baht compared with < 20,000 Baht (AOR = 0.08, 95% CI = 0.01 - 0.98) and receiving hospital-based treatments (AOR = 0.05; 95%CI 0.005 - 0.53). The last model had high accuracy in predicting PTSD, with the area under the ROC curve of 0.94 (95% CI = 0.90 - 0.98). In-depth interviews among 10 participants revealed that they experienced anxiety about contracting COVID-19, particularly concerning the possibility of transmitting the disease to their close ones. Additionally, COVID-19 had adverse effects on their physical health and daily life.
Conclusion: Approximately 14.4% of university students with COVID-19 has PTSD. Our findings have highlighted the associated factors of PTSD, which can be useful for university administrators to identify at-risk students and provide them timely assistance in the future related situations.
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