The psychological impact of storm Daniel on medical students at the University of Derna in Libya: A cross-sectional study

Abstract

Storm Daniel struck northeastern Libya on September 10, 2023, causing severe infrastructure damage and significant human loss. Derna was the most affected city, with the University of Derna suffering extensive damage and the tragic loss of 37 medical students. Medical students face unique psychological and academic stressors, and tend to have higher rates of psychiatric disorders compared to their peers of the same age. This is the first study to investigate the storm's psychological impact on medical students at the University of Derna. The study has a cross-sectional design and lasted from February 1 to March 1, 2024. We used the Generalized Anxiety Disorder-7 (GAD-7) to assess anxiety and the Patient Health Questionnaire-9 (PHQ-9) to assess depression, along with sociodemographic questions in our questionnaire. We included only active students enrolled in the 7-year undergraduate program at the University of Derna. Statistical tests such as the chi-square test and binary logistic regression were used in the analysis. About 225 students completed the survey. The means and standard deviations for GAD-7 and PHQ-9 scores were 9.2 (3.9) and 10.8 (5.0), respectively. The prevalence of anxiety was 42.2% for cases classified as moderate and severe (cut-off ≥10). Depression had a prevalence of 51.1% for cases classified as moderate, moderately severe and severe (cut-off ≥ 10). Suicidal ideation was reported at a rate of 48.9% for "several days" or more and at 16.5% for "more than half of the days" and "nearly every day." Internal displacement following the storm was significantly associated with both anxiety (p = 0.033) and depression (p = 0.003). However, age, gender, year of study, monthly allowance and residence status (living with family or alone) did not show a statistically significant association with either anxiety or depression (p > 0.05 for all variables). Logistic regression analysis identified gender as the only significant predictor of anxiety (p = 0.041) and internal displacement as the sole significant predictor of depression (p = 0.023). Medical students at the University of Derna reported high rates of anxiety, depression and suicidal ideation following Storm Daniel. Internal displacement was significantly associated with both anxiety and depression. These results highlight the need for targeted interventions to address medical students' mental health challenges and improve their overall well-being.

Keywords: Libya; anxiety; depression; medical student; mental health; storm Daniel.

Graphical abstract

Figure 1.

Classification of depression and anxiety based on the severity.

Figure 2.

Prevalence of suicidal ideation among Derna medical students after Storm Daniel.