Pandemic-Driven Mental Health Deterioration and Suicide Risk Among Health Science Students: A Longitudinal Cohort Study Unmasking the Trauma Multiplier Effect.
9 affiliations
- 1Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia.
- 2Department of Nursing, Faculty of Nursing, Universitas Jember, Jember, East Java, Indonesia.
- 3Department of Nursing, Poltekkes Kemenkes Malang, Malang, East Java, Indonesia.
- 4Department of Public Health, Public Health and Health Informatics College, University of Hail, Hail, Saudi Arabia.
- 5Universitas Negeri Malang, Malang, East Java, Indonesia.
- 6Research Center for Environmental and Clean Technologies, National Research and Innovation Agency (BRIN), Jakarta, Indonesia.
- 7Department of Nursing, Universitas Bina Sehat PPNI, Mojokerto, East Java, Indonesia.
- 8Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
- 9Department of Nursing, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia.
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.
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BibTeX
@article{yusuf2026pandemicdriven,
title = {{Pandemic-Driven Mental Health Deterioration and Suicide Risk Among Health Science Students: A Longitudinal Cohort Study Unmasking the Trauma Multiplier Effect.}},
author = {Ah Yusuf and Ronal Surya Aditya and Fitriana Kurniasari Solikhah and Reem Lafi AlMutairi and Rizki Fitryasari and Muhammad Putra Ramadhan and Nohan Arum Romadlona and Setyo Budi Kurniawan and Siti Kotijah and Indi Dwi Shofi Yanti and Aji Prasetya Wibawa and Dhian Kartikasari and Andreas Budi Wijaya and Alfid Tri Afandi and Daifallah M Al Razeeni and Ryka Widyaningtyas},
journal = {Journal of multidisciplinary healthcare},
year = {2026},
month = nov,
doi = {10.2147/jmdh.s629594},
url = {https://europepmc.org/article/MED/42999859},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Pandemic-Driven Mental Health Deterioration and Suicide Risk Among Health Science Students: A Longitudinal Cohort Study Unmasking the Trauma Multiplier Effect.
AU - Ah Yusuf
AU - Ronal Surya Aditya
AU - Fitriana Kurniasari Solikhah
AU - Reem Lafi AlMutairi
AU - Rizki Fitryasari
AU - Muhammad Putra Ramadhan
AU - Nohan Arum Romadlona
AU - Setyo Budi Kurniawan
AU - Siti Kotijah
AU - Indi Dwi Shofi Yanti
AU - Aji Prasetya Wibawa
AU - Dhian Kartikasari
AU - Andreas Budi Wijaya
AU - Alfid Tri Afandi
AU - Daifallah M Al Razeeni
AU - Ryka Widyaningtyas
PY - 2026
DA - 2026/11/03
JO - Journal of multidisciplinary healthcare
DO - 10.2147/jmdh.s629594
UR - https://europepmc.org/article/MED/42999859
AB - 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.
SN - 1178-2390
ER -