{
  "abstract": "The COVID-19 pandemic precipitated an unprecedented mental health crisis among healthcare trainees-a population already burdened by academic and occupational stressors. The mediating role of prior trauma exposure in shaping longitudinal suicide risk trajectories remains critically underexplored. To quantify pandemic-attributable deterioration in mental health and identify independent predictors of escalating suicide risk in a prospective health student cohort. A prospective longitudinal cohort study was conducted across 11 health science disciplines (n = 1401; 86.3% retention). The Depression Anxiety Stress Scale-21 (DASS-21) and Suicide Behaviors Questionnaire-Revised (SBQ-R) were administered pre-pandemic (January 2020) and during the pandemic (January 2022). McNemar's test, multivariable logistic regression, and Generalized Estimating Equations (GEE) were employed. Anxiety prevalence increased from 48.5% before the pandemic to 64.4% during the pandemic, corresponding to an observed absolute risk difference of 15.9 percentage points and a descriptive Number Needed to Harm (NNH) of approximately 7. High suicide risk rose from 12.1% to 15.4% (paired OR = 1.33, 95% CI: 1.16-1.52). History of violence was the strongest predictor of high suicide risk (adjusted OR [aOR] = 3.30, 95% CI: 1.62-6.73), with a significant Time × Violence interaction in GEE modelling (aOR = 1.53, 95% CI: 1.17-1.99), confirming the pandemic as a \"trauma multiplier\". The model demonstrated excellent discrimination (AUC = 0.85). Pandemic conditions disproportionately escalated suicide risk in health students with prior trauma exposure. Universal trauma screening and targeted mental health interventions must be integrated into health science curricula to mitigate compounding risk during future crises.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia.",
    "Department of Nursing, Faculty of Nursing, Universitas Jember, Jember, East Java, Indonesia.",
    "Department of Nursing, Poltekkes Kemenkes Malang, Malang, East Java, Indonesia.",
    "Department of Public Health, Public Health and Health Informatics College, University of Hail, Hail, Saudi Arabia.",
    "Universitas Negeri Malang, Malang, East Java, Indonesia.",
    "Research Center for Environmental and Clean Technologies, National Research and Innovation Agency (BRIN), Jakarta, Indonesia.",
    "Department of Nursing, Universitas Bina Sehat PPNI, Mojokerto, East Java, Indonesia.",
    "Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.",
    "Department of Nursing, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ah Yusuf",
      "orcid": "0000-0002-6669-0767"
    },
    {
      "affs": [
        1
      ],
      "name": "Ronal Surya Aditya",
      "orcid": "0000-0002-4118-7233"
    },
    {
      "affs": [
        2
      ],
      "name": "Fitriana Kurniasari Solikhah",
      "orcid": "0000-0002-7471-8299"
    },
    {
      "affs": [
        3
      ],
      "name": "Reem Lafi AlMutairi"
    },
    {
      "affs": [
        0
      ],
      "name": "Rizki Fitryasari"
    },
    {
      "affs": [
        4
      ],
      "name": "Muhammad Putra Ramadhan"
    },
    {
      "affs": [
        4
      ],
      "name": "Nohan Arum Romadlona"
    },
    {
      "affs": [
        5
      ],
      "name": "Setyo Budi Kurniawan"
    },
    {
      "affs": [
        6
      ],
      "name": "Siti Kotijah"
    },
    {
      "affs": [
        4
      ],
      "name": "Indi Dwi Shofi Yanti"
    },
    {
      "affs": [
        4
      ],
      "name": "Aji Prasetya Wibawa"
    },
    {
      "affs": [
        4
      ],
      "name": "Dhian Kartikasari"
    },
    {
      "affs": [
        4
      ],
      "name": "Andreas Budi Wijaya"
    },
    {
      "affs": [
        1
      ],
      "name": "Alfid Tri Afandi",
      "orcid": "0000-0002-1448-7652"
    },
    {
      "affs": [
        7
      ],
      "name": "Daifallah M Al Razeeni",
      "orcid": "0000-0002-8149-8650"
    },
    {
      "affs": [
        8
      ],
      "name": "Ryka Widyaningtyas"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2p22afnkz5jrv.bib",
  "cited_by": 0,
  "doi": "10.2147/jmdh.s629594",
  "fulltext_url": "https://europepmc.org/articles/PMC13744254",
  "id": "2p22afnkz5jrv",
  "issns": [
    "1178-2390"
  ],
  "landing_url": "https://europepmc.org/article/MED/42999859",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3203|COVID-19 and Mental Health"
    ]
  ],
  "openalex": "W7225193710",
  "pdf_url": "https://europepmc.org/articles/PMC13744254?pdf=render",
  "pmcid": "PMC13744254",
  "pmid": "42999859",
  "published": "2026-11-03",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2p22afnkz5jrv.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:34Z",
      "native_id": "MED:42999859",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42999859"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|COVID-19 and Mental Health",
      "subfield": "psychiatry"
    }
  ],
  "title": "Pandemic-Driven Mental Health Deterioration and Suicide Risk Among Health Science Students: A Longitudinal Cohort Study Unmasking the Trauma Multiplier Effect.",
  "title_text": "Pandemic-Driven Mental Health Deterioration and Suicide Risk Among Health Science Students: A Longitudinal Cohort Study Unmasking the Trauma Multiplier Effect.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:34Z",
  "url": "https://research.draconitic.com/paper/2p22afnkz5jrv",
  "venue": "Journal of multidisciplinary healthcare",
  "versions": []
}