Medical students in a conflict-affected Lebanese region experience alarming levels of anxiety, depression, and stress, yet resilience provides a degree of protection, with tailored risk-based interventions combining stress-management, resilience training, and healthy lifestyle habits being essential.
Key Findings
Results
The majority of medical students in this Lebanese conflict-affected medical school reported at least mild to moderate symptoms of anxiety and depression.
77% of the 187 participants reported at least mild to moderate anxiety symptoms as measured by the GAD-7
80% of participants reported at least mild to moderate depression symptoms as measured by the PHQ-9
33% reported high perceived stress as measured by the PSS-10
26% reported low resilience as measured by the BRS
Survey was conducted between December 2024 and March 2025 at a Lebanese medical school
Results
Cluster analysis identified three distinct mental health risk groups among medical students: a 'high-risk group', a 'medium-risk group', and a 'low-risk group'.
Clusters were based on anxiety (GAD-7) and depression (PHQ-9) scores
Total sample size was 187 students
Bivariate and multivariable analyses were performed with cluster membership as the dependent variable
An alpha of 0.05 was considered statistically significant
Results
Smoking, social isolation, and high perceived stress were commonly associated with belonging to either the high-risk or medium-risk group.
These factors were identified as common factors significantly associated with both the 'high-risk group' and the 'medium-risk group'
Associations were determined through multivariable analysis
Results were considered significant at alpha = 0.05
Results
Regular participation in extracurricular activities was significantly associated with lower odds of belonging to the high-risk group.
Adjusted OR (95% CI) = 0.04 (0.004; 0.41), p = 0.006
This represents a very strong protective association with membership in the 'high-risk group'
Finding was derived from multivariable logistic regression analysis
Results
High resilience level was associated with lower odds of belonging to the medium-risk group, while irregular exercise was associated with higher odds of belonging to the medium-risk group.
High resilience level: adjusted OR (95% CI) = 0.06 (0.006; 0.61), p = 0.02, associated with lower odds of belonging to the 'medium-risk group'
Irregular exercise: adjusted OR (95% CI) = 3.96 (1.24; 12.7), p = 0.02, associated with higher odds of belonging to the 'medium-risk group'
Resilience was measured using the Brief Resilience Scale (BRS)
El Asmar N, Yazbeck Karam V, Aoun Bahous S, Akiki Z. (2026). Mental health profiles and resilience among medical students in an active conflict zone: a cluster analysis.. Medical education online. https://doi.org/10.1080/10872981.2026.2626139