SELF-SYSTEM AND MENTAL HEALTH STATUS AMONG MALAYSIAN YOUTH ATTENDING HIGHER EDUCATIONAL INSTITUTIONS: A NATIONWIDE CROSS-SECTIONAL STUDY Introduction: Mental health disorders (MHDs) are a global health burden with an increasing prevalence. During the COVID-19 pandemic, depression was the commonest MHD, followed by anxiety and stress. This nationwide study aimed to determine the prevalence and associated factors of depression, anxiety and stress among Malaysian students attending higher educational institutions. Methods: A cross-sectional study was conducted from June to December 2021. Institutions were selected via stratified random sampling and students via convenience sampling. A self-administered questionnaire comprising questions on socio-demographic characteristics, academic background, substance abuse, childhood abuse, religiosity and the Depression Anxiety Stress Scale-21 was used. Data were analysed using SPSS version 27; descriptive, point-biserial correlation, chi-square and multiple binary logistic regression analyses were conducted. Results: Sex and adverse childhood experiences significantly predicted all three MHDs (P<0.05). The students from public institutions (odds ratio [OR]=0.71, 95% confidence interval [CI]=0.56–0.90, P=0.004) had a lower risk of depression than those from private institutions. The smokers/vapers (OR=1.43, 95% CI=1.02–2.02, P=0.041) a higher risk of depression than the non-smokers/non-vapers. The social science students (OR=1.29, 95% CI=1.01–1.65, P=0.039) had a higher risk of anxiety than the science students. The students who highly engaged in organisational religious activity (OR=0.91, 95% CI=0.84–0.98, P=0.015) had a lower risk of anxiety than their counterparts. Conclusion: Anxiety is the commonest MHD among Malaysian youth, followed by depression and stress. Childhood abuse is a crucial related factor requiring further attention. Screening, surveillance, preventive measures and comprehensive interventions for MHDs should be initiated among youth.

Introduction: The COVID-19 pandemic has significantly changed the learning environment for medical students and affected their academic achievement. This study aims to determine the student’s clinical competency, learning environment, and its associated factors during the primary care medicine posting amid the COVID-19 pandemic. Methods: This is a cross-sectional study among medical students who had completed primary care medicine posting during the COVID-19 pandemic. Data on socio-demographic, posting characteristics, and students’ learning environment using the Dundee Ready Educational Environment Measure (DREEM) questionnaire and their objective structured clinical examination (OSCE) marks were collected. Independent t-test was used to compare DREEM scores between face-to-face and online groups. Multivariate analysis was used to determine factors associated with clinical competency and DREEM scores with p <0.05 considered significant. Results: A total of 205 students were recruited. Only 9.8% failed OSCE. Face-to-face teaching delivery (OR=3.61, 95 CI =1.03,11.30), face-to-face precept method (OR=1.24, 95 CI =1.12,12.51) and integrated curriculum (OR=5.23, 95 CI =1.03,26.47) were associated with good clinical competency. The total mean DREEM score was 72.94 (SD 28.8), with 89.3% having poor DREEM scores. Students who received face-to-face teaching scored higher in the Student’s Perceptions of Teacher domain compared to online teaching (p =0.036). Conclusion: Face-to-face teaching is preferred for good clinical competence and a learning environment. The impact of experiential learning was huge in our study, and it cannot be replaced by online learning. Furthermore, retraining teachers will improve the online learning experience for the students.