AUTHOR=Elhadi Muhammed, Buzreg Anis, Bouhuwaish Ahmad, Khaled Ala, Alhadi Abdulmueti, Msherghi Ahmed, Alsoufi Ahmed, Alameen Hind, Biala Marwa, Elgherwi Alsafa, Elkhafeefi Fatimah, Elmabrouk Amna, Abdulmalik Abdulmuez, Alhaddad Sarah, Elgzairi Moutaz, Khaled Ahmed TITLE=Psychological Impact of the Civil War and COVID-19 on Libyan Medical Students: A Cross-Sectional Study JOURNAL=Frontiers in Psychology VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/articles/10.3389/fpsyg.2020.570435 DOI=10.3389/fpsyg.2020.570435 ISSN=1664-1078 ABSTRACT=ObjectiveWe aim to determine the psychological status of medical students during the COVID-19 outbreak and civil war in Libya.MethodsA cross-sectional study was conducted among medical students from 15 medical schools between April 20 and May 1, 2020. The demographic characteristics, generalized anxiety disorder 7-item (GAD-7) scale, and patient health questionnaire (PHQ-9) results were collected.ResultsOf the 3,500 students, 2,430 completed the survey. The mean (± SD) score of anxiety symptoms determined by the GAD-7 was 7.2 (5.1). A total of 268 (11%) students had a GAD-7 score of ≥15, which is indicative of moderate to severe anxiety. A total of 1,568 (64.5%) students showed different degrees of anxiety: mild, 910 (37.5%); moderate, 390 (16%); and severe, 268 (11%). Anxiety was significantly associated with living status and internal displacement (P < 0.05). The mean (+ SD) score of depressive symptoms determined by the PHQ-9 was 9.7 (6.3). A total of 525 (21.6%) students had a PHQ-9 score of ≥15, which is indicative of moderate to severe depression. A total of 1,896 (88%) students were diagnosed with mild (PHQ ≥ 5) depression. Suicidal ideation was present in 552 patients (22.7%). Depression was only statistically associated with the year of study (P = 0.009).ConclusionThese data highlight that medical students in Libya are at risk for depression, especially under the current stressful environment of the civil war and the COVID-19 outbreak.