{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T22:34:10Z","timestamp":1792535650355,"version":"4.5.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":63,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Discov Ment Health"],"DOI":"10.1007\/s44192-026-00496-3","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:25:14Z","timestamp":1780082714000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence and predictors of anxiety and depressive symptoms among medical students of Ebonyi State University Abakaliki, Nigeria"],"prefix":"10.1007","volume":"6","author":[{"given":"Edmund N.","family":"Ossai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann N.","family":"Nwuzor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicodemus O.","family":"Obayi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miracle","family":"Onyebara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry Nduka","family":"Ekechi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene I.","family":"Eze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monday N.","family":"Igwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"496_CR1","unstructured":"World Health Organization. Concepts in mental health. Available at https:\/\/www.who.int%3Emental%3Ehealth Accessed 3rd March, 2026."},{"key":"496_CR2","unstructured":"World Health Organization. Executive Board Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. Report by the Secretariat. 2011. Geneva. Available at https:\/\/apps.who.int\/iris\/handle\/10665\/78898. Accessed 3rd February, 2026."},{"issue":"10053","key":"496_CR3","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1016\/S0140-6736(16)31678-6","volume":"388","author":"T Vos","year":"2016","unstructured":"Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. Global, regional and national incidence, prevalence and years lived with disability for 310 diseases and injuries, 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1545\u2013602.","journal-title":"Lancet"},{"issue":"1","key":"496_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.11648\/j.ajpn.20170501.11","volume":"5","author":"MM Alkot","year":"2017","unstructured":"Alkot MM, Alnewirah AY, Bagasi AT, Alshehri AA, Bawazeer NA. Depression among medical versus non-medical students in Umm Al-Qura University, Makkah Al-Mukaramah, Saudi Arabia. Am J Psychiatry Neurosci. 2017;5(1):1\u20135.","journal-title":"Am J Psychiatry Neurosci"},{"key":"496_CR5","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.ajme.2014.06.002","volume":"51","author":"MB Ibrahim","year":"2015","unstructured":"Ibrahim MB, Abdelreheem MH. Prevalence of anxiety and depression among medical and pharmaceutical students in Alexandria University. Alexandria J Med. 2015;51:167\u201373.","journal-title":"Alexandria J Med"},{"key":"496_CR6","doi-asserted-by":"publisher","first-page":"105","DOI":"10.4103\/ijsp.ijsp_166_20","volume":"37","author":"S Mangalesh","year":"2021","unstructured":"Mangalesh S, Dudani S, Dave ND. 2021 Assessment of mental health in Indian medical students during the coronavirus disease-2019 pandemic. Indian J Soc Psychiatry 37: 105\u201310.","journal-title":"Indian J Soc Psychiatry"},{"issue":"1","key":"496_CR7","doi-asserted-by":"publisher","first-page":"95","DOI":"10.4269\/ajtmh.20-1302","volume":"104","author":"H Essangri","year":"2021","unstructured":"Essangri H, Sabir M, Benkabbou A, Majbar MA, Amrani L, Ghannam A, et al. Predictive factors for impaired mental health among medical students during the early stage of the COVID-19 pandemic in Morocco. Am J Trop Med Hyg. 2021;104(1):95\u2013102.","journal-title":"Am J Trop Med Hyg"},{"key":"496_CR8","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12909-016-0841-8","volume":"17","author":"I Heinen","year":"2017","unstructured":"Heinen I, Bullinger M, Kocalevent RD. Perceived stress in first year medical students-associations with personal resources and emotional distress. BMC Med Edu. 2017;17:4.","journal-title":"BMC Med Edu"},{"issue":"1","key":"496_CR9","first-page":"1","volume":"3","author":"EN Ossai","year":"2019","unstructured":"Ossai EN, Alo AT, Onwe BC, Okoro DO, Ezeagu NE, Ogbonnaya LU. Prevalence and predictors of perceived stress: study among medical students of Ebonyi State University Abakaliki. Nigeria AJAAR. 2019;3(1):1\u20139.","journal-title":"Nigeria AJAAR"},{"issue":"1","key":"496_CR10","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/1472-6920-7-26","volume":"7","author":"CT Sreeramareddy","year":"2007","unstructured":"Sreeramareddy CT, Shankar PR, Binu VS, Mukhopadhyay C, Ray B, Menezes RG. Psychological morbidity, sources of stress and coping strategies among undergraduate medical students of Nepal. BMC Med Educ. 2007;7(1):26.","journal-title":"BMC Med Educ"},{"issue":"6","key":"496_CR11","doi-asserted-by":"publisher","first-page":"e0253295","DOI":"10.1371\/journal.pone.0253295","volume":"16","author":"K Seetan","year":"2021","unstructured":"Seetan K, Al-Zubi M, Rubbai Y, Athamneh M, Khamees A, Radaideh T. Impact of COVID-19 on medical students\u2019 mental wellbeing in Jordan. PLoS ONE. 2021;16(6):e0253295.","journal-title":"PLoS ONE"},{"key":"496_CR12","doi-asserted-by":"publisher","first-page":"71","DOI":"10.11604\/pamj.2021.40.71","volume":"40","author":"EN Ossai","year":"2021","unstructured":"Ossai EN, Eze II, Onyenakazi RC, Ugebe E, Eze B, Obasi O. How large is the burden of depression in a medical school? A cross-sectional study among medical students in Nigeria. Pan Afr Med J. 2021;40:71. https:\/\/doi.org\/10.11604\/pamj.2021.40.71.","journal-title":"Pan Afr Med J"},{"key":"496_CR13","first-page":"86","volume":"8","author":"MSB Yusoff","year":"2013","unstructured":"Yusoff MSB, Mat Pa MN, Esa AR, Abdul Rahim AF. Mental health of medical students before and during medical education: a prospective study. J Taibah Univ Med Sci. 2013;8:86\u201392.","journal-title":"J Taibah Univ Med Sci"},{"issue":"11","key":"496_CR14","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1001\/jama.2010.1300","volume":"304","author":"TL Schwenk","year":"2010","unstructured":"Schwenk TL, Davis L, Wimsatt LA. Depression, stigma and suicidal ideation in medical students. JAMA. 2010;304(11):1181\u201390.","journal-title":"JAMA"},{"key":"496_CR15","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1097\/ACM.0b013e318221e615","volume":"86","author":"M Neumann","year":"2011","unstructured":"Neumann M, Edelha\u2019\u2019user F, Tauschel D, Fischer MR, Wirtz M, Woopen C, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med. 2011;86:996\u20131009.","journal-title":"Acad Med"},{"issue":"7","key":"496_CR16","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1002\/pon.1627","volume":"19","author":"LF Brown","year":"2010","unstructured":"Brown LF, Kroenke K, Theobald DE, Wu J, Tu W. The association of depression and anxiety with health related quality of lifein cancer patients with depression and pain. Psychooncology. 2010;19(7):734\u201341.","journal-title":"Psychooncology"},{"issue":"2","key":"496_CR17","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/s40596-016-0526-y","volume":"41","author":"MR Wolf","year":"2017","unstructured":"Wolf MR, Rosenstock JB. Inadequate sleep and exercise associated with burnout and depression among medical students. Acad Psychiatry. 2017;41(2):174\u20139.","journal-title":"Acad Psychiatry"},{"issue":"1","key":"496_CR18","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/1753-2000-1-8","volume":"1","author":"M Basker","year":"2007","unstructured":"Basker M, Moses PD, Russell S, Russell PS. The psychometric properties of Beck depressin inventory for adolescent depression in a primary-care paediatric setting in India. Child Adolesc Psychiatry Mental Health. 2007;1(1):6.","journal-title":"Child Adolesc Psychiatry Mental Health"},{"key":"496_CR19","doi-asserted-by":"crossref","unstructured":"Qureshi MF, Sadiq S, Mohammed D, Lakhani M, Shah M, Tariq N. Does sector matter in house officers performance: a cross-sectional study. MedEdPublish. 2019:8.","DOI":"10.15694\/mep.2019.000135.1"},{"key":"496_CR20","unstructured":"Stanford Medicine. Patient Health Questionnaire (PHQ-9). Available at https:\/\/med.stanford.edu%3EPHQ9iddate08.03.pdf. Accessed 10th August, 2024."},{"key":"496_CR21","unstructured":"National HIVcurriculum. Generalized Anxiety Disorder 7-item (GAD-7). Available at https:\/\/www.hiv.uw.edu%3Epage%3Emental-health-screening. Accessed 10th August, 2024."},{"key":"496_CR22","unstructured":"University of California San Diego. Oslo Social Support Scale (OSSS-3). Available at https:\/\/emerge.ucsd.edu Accessed 19th August, 2024."},{"issue":"6","key":"496_CR23","doi-asserted-by":"publisher","first-page":"e0286338","DOI":"10.1371\/journal.pone.0286338","volume":"18","author":"JP Zila-Velasque","year":"2023","unstructured":"Zila-Velasque JP, Grados-Espinoza P, Regalado-Rodriguez KM, Sosa-Nunez F, Alcarraz-Jaime A, Cortez-Soto AG, et al. Socio-demographic and educational factors associated with mental health disorders in medical students of clinical years: A multicenter study in Peru. PLoS ONE. 2023;18(6):e0286338. https:\/\/doi.org\/10.1371\/journal.pone.0286338.","journal-title":"PLoS ONE"},{"key":"496_CR24","unstructured":"Huarcaya-Victoria J, Elera-Fitzcarrald C, Crisol-Deza D, Villanueva-Zuniga L, Pacherres A, Torres A, et al. Factors associated with mental health in Peruvian medical students during the COVID-19 pandemic: a multicentre quantitative study. Revista Colombiana de Psiquiatria; 2021."},{"key":"496_CR25","doi-asserted-by":"publisher","first-page":"1991","DOI":"10.3390\/healthcare11141991","volume":"11","author":"V D\u2019Alva-Teixeira","year":"2023","unstructured":"D\u2019Alva-Teixeira V, Pico-Perez M, Morgado P. Determinants of poor mental health of medical students in Portugal- A nationwide study. Healthcare. 2023;11:1991. https:\/\/doi.org\/10.3390\/healthcare11141991.","journal-title":"Healthcare"},{"issue":"11","key":"496_CR26","doi-asserted-by":"publisher","first-page":"e0188187","DOI":"10.1371\/journal.pone.0188187","volume":"12","author":"A Tran","year":"2017","unstructured":"Tran A, Tran L, Geghre N, Darmon D, Rampal M, Brandone D, et al. Health assessment of French university students and risk factors associated with mental health disorders. PLoS ONE. 2017;12(11):e0188187. https:\/\/doi.org\/10.1371\/journal.pone.0188187.","journal-title":"PLoS ONE"},{"key":"496_CR27","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1186\/s13104-019-4713-2","volume":"12","author":"AM Al-Khani","year":"2019","unstructured":"Al-Khani AM, Sarhandi MI, Zaghloul MS, Ewid M, Saquib N. A cross sectional survey on sleep quality, mental health and academic performance among medical students in Saudi Arabia. BMC Res Notes. 2019;12:665. https:\/\/doi.org\/10.1186\/s13104-019-4713-2.","journal-title":"BMC Res Notes"},{"key":"496_CR28","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s12909-022-03158-4","volume":"22","author":"A Picton","year":"2022","unstructured":"Picton A, Greenfield S, Parry J. Why do students struggle in their first year of medical school? A qualitative study of student voices. BMC Med Educ. 2022;22:100. https:\/\/doi.org\/10.1186\/s12909-022-03158-4.","journal-title":"BMC Med Educ"},{"key":"496_CR29","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1186\/s12888-022-04482-1","volume":"22","author":"F Chen","year":"2022","unstructured":"Chen F, Chen J, Chen B, Mofatteh M, Wen C, Wellington J, et al. Mental health status of medical students during postgraduate entrance examination. BMC Psychiatry. 2022;22:829. https:\/\/doi.org\/10.1186\/s12888-022-04482-1.","journal-title":"BMC Psychiatry"},{"issue":"2","key":"496_CR30","doi-asserted-by":"publisher","first-page":"157","DOI":"10.4103\/ijsp.ijsp_114_17","volume":"34","author":"T Neha","year":"2018","unstructured":"Neha T, Sandeep S, Nidhi D. Assessment of depression, anxiety and stress among medical students enrolled in a medical college in New Delhi, Indian. Indian J Social Psychiatry. 2018;34(2):157\u201362. https:\/\/doi.org\/10.4103\/ijsp.ijsp_114_17.","journal-title":"Indian J Social Psychiatry"},{"issue":"3","key":"496_CR31","doi-asserted-by":"publisher","first-page":"488","DOI":"10.3390\/healthcare10030488","volume":"10","author":"S Phomprasith","year":"2022","unstructured":"Phomprasith S, Karawekpanyawong N, Pinyopornpanish K, Jiraporncharoen W, Maneeton B, Phinyo P, et al. Prevalence and associated factors of depression in medical students in a Northern Thailand University; a cross-sectional study. Healthcare. 2022;10(3):488. https:\/\/doi.org\/10.3390\/healthcare10030488.","journal-title":"Healthcare"},{"issue":"4","key":"496_CR32","doi-asserted-by":"publisher","first-page":"e115333","DOI":"10.5812\/ijpbs-115333","volume":"16","author":"F Ghaedi-Heidari","year":"2022","unstructured":"Ghaedi-Heidari F, Lohrasbi F, Chaharsoughi NT, Samsamshariat S, Sarbijan FR. The relationship between anxiety, resilience and post-traumatic growth of the medical students in COVID-19 pandemic in Iran. Iran J Psychiatry Behav Sci. 2022;16(4):e115333. https:\/\/doi.org\/10.5812\/ijpbs-115333.","journal-title":"Iran J Psychiatry Behav Sci"},{"issue":"3","key":"496_CR33","doi-asserted-by":"publisher","first-page":"844","DOI":"10.4314\/ahs.v17i3.27","volume":"17","author":"H Kerebih","year":"2017","unstructured":"Kerebih H, Ajaeb M, Hailesilassie H. Common mental disorders among medical students in Jimma University, Southwest Ethiopia. Afri Health Sci. 2017;17(3):844\u201351.","journal-title":"Afri Health Sci"},{"issue":"2","key":"496_CR34","doi-asserted-by":"publisher","first-page":"69","DOI":"10.17711\/SM.0185-3325.2023.010","volume":"46","author":"DX Pacheco-Tobon","year":"2023","unstructured":"Pacheco-Tobon DX, Bautista-So toE, Arellano-Ramirez C, Oroz co-Garcia D, Ramos-Ruiz L, Herbales-Martinez E. An assessment of mental health of Mexican and Colombian medical students during the COVID-19 pandemic. Salud Mental. 2023;46(2):69\u201382.","journal-title":"Salud Mental"},{"key":"496_CR35","first-page":"116","volume":"39","author":"M Akdemir","year":"2022","unstructured":"Akdemir M, Aktekin MR, Senol YY, Sonmez Y, Doganavsargil Baysal O, Mamakli S, et al. Depression and psychological distress in medical students: a prospective study. Arch Neuropsychiatry. 2022;39:116\u201322.","journal-title":"Arch Neuropsychiatry"},{"key":"496_CR36","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1186\/s12888-017-1382-3","volume":"17","author":"SN Ngasa","year":"2017","unstructured":"Ngasa SN, Sama CB, Dzekem BS, Nforchu KN, Tindong M, Aroke D, et al. Prevalence and factors associated with depression among medical students in Cameroon: a cross sectional study. BMC Psychiatry. 2017;17:216. https:\/\/doi.org\/10.1186\/s12888-017-1382-3.","journal-title":"BMC Psychiatry"},{"key":"496_CR37","doi-asserted-by":"publisher","first-page":"640","DOI":"10.3390\/healthcare12060640","volume":"12","author":"AM Alshahrani","year":"2024","unstructured":"Alshahrani AM, Al-Shahrani MS, Miskeen E, Alharthi MH, Alamri MMS, Alqahtani MA, et al. Prevalence of depressive symptoms and its correlates among male medical students at the University of Bisha, Saudi Arabia. Healthcare. 2024;12:640. https:\/\/doi.org\/10.3390\/healthcare12060640.","journal-title":"Healthcare"},{"key":"496_CR38","first-page":"587","volume":"8","author":"J Amaliyar","year":"2019","unstructured":"Amaliyar J, Solanki N. Assessment of mental health in medical students of GMERS Medical College, Patan, Gujarat. Int J Med Sci Public Health. 2019;8:587\u2013601.","journal-title":"Int J Med Sci Public Health"},{"key":"496_CR39","first-page":"e006","volume":"46","author":"AC Cardoso","year":"2022","unstructured":"Cardoso AC, Barbosa LA, Quintanilha LF, Avena KD. Prevalence of common mental disorders among medical students during COVID-19 pandemic. Revista Brasileira de Educacao Med. 2022;46:e006.","journal-title":"Revista Brasileira de Educacao Med"},{"issue":"2","key":"496_CR40","doi-asserted-by":"publisher","first-page":"356","DOI":"10.3889\/oamjms.2015.068","volume":"3","author":"A Oku","year":"2015","unstructured":"Oku A, Oku O, Owoaje E, Monjok E. An assessment of mental health status of undergraduate medical trainees in the University of Calabar, Nigeria: a cross-sectional study. Open Access Maced J Med Sci. 2015;3(2):356\u201362.","journal-title":"Open Access Maced J Med Sci"},{"key":"496_CR41","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1186\/s12888-022-04174-w","volume":"22","author":"G Rtbey","year":"2022","unstructured":"Rtbey G, Shumet S, Birhan B, Salelew E. Prevalence of mental distress and associated factors among medical students of University of Gondar, Northwest Ethiopia: a cross sectional study. BMC Psychiatry. 2022;22:523.","journal-title":"BMC Psychiatry"},{"issue":"2","key":"496_CR42","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1080\/10401334.2016.1146611","volume":"28","author":"G Thompson","year":"2016","unstructured":"Thompson G, McBride RB, Hosford CC, Halaas G. Resilience among medical students: the role of coping style and social support. Teach Learn Med. 2016;28(2):174\u201382. https:\/\/doi.org\/10.1080\/10401334.2016.1146611.","journal-title":"Teach Learn Med"},{"issue":"1","key":"496_CR43","first-page":"1","volume":"4","author":"MN Nwikpo","year":"2021","unstructured":"Nwikpo MN, Anierobi EI, Okeke AN, Etodike CE. Maternal educational attainment factor on academic achievements of in-school adolescents in Anambra state, Nigeria. Int J Manage Social Sci Peace Confl Stud (IJMSSPCS). 2021;4(1):1\u201316.","journal-title":"Int J Manage Social Sci Peace Confl Stud (IJMSSPCS)"},{"key":"496_CR44","unstructured":"Oni AA, Adetoro JA. Influence of mothers\u2019 educational attainment on motivational levels, moral behaviours, health conditions and academic performance of children in Lagos state of Nigeria. 2013. Available at https:\/\/www.researchgate.net%3Epublication%3E36371183. Accessed 4th January 2026."},{"issue":"1","key":"496_CR45","first-page":"45","volume":"37","author":"EN Ossai","year":"2020","unstructured":"Ossai EN. Impact of COVID-19 on medical education and the challenges: how prepared is Nigeria. Pan Afr Med J. 2020;37(1):45. 10.11604pamj.supp.2020.37.1.24915.","journal-title":"Pan Afr Med J"},{"issue":"3","key":"496_CR46","doi-asserted-by":"publisher","first-page":"e00550667","DOI":"10.1136\/bmjgh-2021-005067","volume":"6","author":"EN Ossai","year":"2021","unstructured":"Ossai EN, Ogbuoji O. Redressing the impact of COVID-19 on medical education in Africa: the need for collective action. BMJ Glob Health. 2021;6(3):e00550667. https:\/\/doi.org\/10.1136\/bmjgh-2021-005067.","journal-title":"BMJ Glob Health"}],"container-title":["Discover Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s44192-026-00496-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44192-026-00496-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44192-026-00496-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T23:14:28Z","timestamp":1785453268000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s44192-026-00496-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["496"],"URL":"https:\/\/doi.org\/10.1007\/s44192-026-00496-3","relation":{},"ISSN":["2731-4383"],"issn-type":[{"value":"2731-4383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"assertion":[{"value":"31 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All methods used in the study were carried out in accordance with relevant guidelines and regulations including the Declaration of Helsinki and the National Code for Health Research Ethics in Nigeria. Ethical approval for the study was obtained from the Research Ethics Committee of Ebonyi State University Abakaliki, Nigeria. (Reference number: EBSU\/DRIC\/UREC\/Vol.08\/003). The students were required to sign a written informed consent form before participating in the study. Participation in the study was voluntary and all the information provided through the questionnaire was kept confidential. The questionnaires had no identifiers and the students were assured that they were free to withdraw from the study without any form of victimization even after giving consent. The students with severe anxiety and depressive symptoms were referred to the psychiatry unit of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria where the students receive their clinical training. Each respondent in the study signed a written informed consent form before participation.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"142"}}