الفهرس 
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Abstract
As for the academic year 2021/2022, the total number of enrolled students in higher education in Egypt corresponded to around 3.5 million, which was a 2.1 percent increase from the previous year. Undergraduates are thought to be particularly at risk during the transition to university and face the developmental challenge of transitioning to adulthood, with the peak onset of mental health problems occurring before the age of 24 years. In addition, a growing body of evidence suggests that mental health problems are numerous and increasing among students in institutions of higher education, which the majority of young adults attend University students face considerable demands in school and family, resulting in significant psychological stress that may lead to serious disorders and mental health problems. Symptoms of mental disorders range from sub-clinical through severe, it is likely that more than one-third of respondents to a survey done by the WHO suffered from significant distress and that less than one-third suffered from a serious mental disorder. There is compelling evidence that mental health issues during this time can have serious negative effects on a student’s development, including long-term negative effects on later adult health, relationships, and market functioning. Early detection and intervention are essential since mental health issues usually begin in childhood. Addressing student mental health is a top priority for research because of these expensive consequences for both students and universities. Universities are coming under increased pressure to enhance the psychological support services they provide to students. Aim of the Work This work aims to provide a mental health program that acts as a tool for early detection and intervention of mental health problems among Tanta University students and assess students’ needs for mental health services. Patient and Methods This study has been done in Neuropsychiatry Department in corporation with Information Technology Unit, Faculty of Medicine, Tanta University, and in The Center of Psychiatry, Neurology and Neurosurgery, Tanta University. Over a period starting from October 2020 through two academic years 2020/2021 and 2021/2022. The study included medical college students during first, second and third academic years who were 2900 student. Targeted population was Egyptian students of the first three years of program. Inclusion criteria: 5. Egyptian students. 6. Students of Faculity of Medicine Tanta University. 7. Students of First three years of the integrated program. 8. Students must have a willingness to complete study procedures. Exclusion criteria: 1. Students who refuse to engage in the study. 2. Students of programs other than integrated program. Sampling techniques The study sample was a convenient sample from the medical students in the first three academic years (2900). • Summary and Conclusions 110 Study design: Cross sectional, quasi experimental study. Tools of the study: • General Health Questionnaire 28 (GHQ-28) • Mini International Neuropsychiatric Interview Methods of the study: • Communications: - Students were invited to participate in the study through an e- mail provided by information technology (IT) unit - The research also included collaboration with Tanta Students Scientific Association (TSSA). - Special student clinic mail. - WhatsApp phone number. - The insider Tanta: An independent newspaper at Tanta University • Steps of the study Mental health awareness: This was done by serial of flayers to raise awareness of students’ mental health with collaboration of The Insider Tanta Mental Health assessment: Using e-mail, we invited all first-, second-, and third-year medical students of the traditional program to complete GHQ-28 survey that was built on Microsoft forms and directed to students in mentioned grades to determine the possibility of having psychiatric problems. Establishing Mental Health Service: Student psychiatric clinic was established at The Center of Psychiatry, Neurology and Neurosurgery, Tanta University Students needs assessment: Students were asked through the email, which topics would be of interest to you in a universal program for university students’ mental health?’ Results The response rate for the GHQ-28 survey was 25.9% of emailed students completing the questionnaire. The mean GHQ-28 score of 13.78 (SD = 6.88) is considerably higher than general population norms, indicating elevated psychological distress in this student sample. The majority of students (88.16%) scored above the threshold for psychological morbidity and considered as apossible caseness. Examining the GHQ-28 subscales shows the highest distress levels in anxiety/insomnia symptoms (mean 4.64, SD=2.35) with 62.5% scoring positively. Somatic symptoms were also common (mean 3.76, SD=2.43) with 44.55% scoring positively. Severe depression symptoms were less frequently endorsed (mean 3.35, SD=2.06) though still concerning given the 1.6% reporting significant depressive symptoms. Suicidal ideation was assessed separately, with 17.02% of students endorsing some level of suicidal thoughts or attempts. females scored significantly higher than males on the overall GHQ-28 (females: M=14.33, SD=6.71; males: M=12.9, SD=7.07; p=0.006). Analysis of the GHQ-28 subscales showed females scored significantly higher than males on somatic symptoms (females: M=4.0, SD=2.37; males: M=3.37, SD=2.49; p<0.001), anxiety/insomnia symptoms (females: M=4.8, SD=2.23; males: M=4.39, SD=2.51; p=0.019), and severe depression (females: M=3.55, SD=2.04; males: M=3.02, SD=2.05; p<0.001). No significant gender differences were found for social dysfunction or suicidal ideation. Chi-square tests indicated a significantly greater proportion of females versus males scored above the clinical cutoff on the somatic symptoms subscale (49% vs 37%, p=0.002) and severe depression subscale (36% vs 28%, p=0.002). Regarding students who visted the clinic the mean age of participants was 21.55 years (SD=1.86 years, range 19-26 years). The sample consisted of 74 males (24.18%) and 232 females (75.82%). With respect to residency, 149 participants were from urban areas (48.69%) and 157 were from rural areas (51.31%). Regarding academic year, 101 participants (33.00%) were in the 1st year, 118 (38.56%) were in the 2nd year, and 87 (28.43%) were in the 3rd year. For method of invitation to the clinic, 65 participants (21.24%) were invited by official mail, 199 (65.03%) were invited by TSSA, and 42 (13.72%) were invited by friends with over all 2 students needed inpatient services. WhatsApp was the most common contact method (used by 57.5% of clinic visitors), followed by direct walk-in visits (40.5%), and mobile phone contact (19.9%). Email was not used by any participants. Participants attended a mean of 4 clinic visits over the study period, with a range of 1 to 5 visits. Quantitative analysis of contact preferences and visit frequency provides insights into patient engagement patterns in this clinical setting. Regarding students who have been assessed in the clinic depression was the most prevalent diagnosis (32.35%), followed by anxiety disorders (15.68%), counseling for social problems (11.76%), and adjustment disorders (7.51%). A range of other mood, anxiety, trauma-related, obsessive-compulsive, personality, psychotic, and substance use disorders were represented at lower frequencies. These diagnostic results provide insights into the profile of mental health conditions among young adult clinic visitors in this setting. Among male clinic visitors, the most prevalent diagnoses were counseling for social problems (25.67%), depression (17.56%), anxiety disorders (16.21%), and substance use disorders (13.51%). A range of other mood, anxiety, obsessive-compulsive, psychotic, and somatic symptom disorders were represented at lower frequencies in this subsample.. Among female clinic visitors, the most prevalent diagnoses were depression (37.07%), anxiety disorders (15.52%), adjustment disorders (9.05%), and obsessive compulsive disorder (7.76%). A range of other mood, anxiety, trauma-related, personality, psychotic, and obsessive-compulsive disorders were represented at lower frequencies in this subsample Significantly more females vs. males were diagnosed with major depressive disorder (37.07% vs 17.56%, p=0.002). In contrast, significantly more males vs. females received counseling for social problems (25.67% vs 7.33%, p<0.001). Males also had higher rates of bipolar disorders compared to females (12.16% vs 5.17%, p=0.038). Notably, substance use disorders were only diagnosed in males (13.51% vs 0%, p<0.001). Additionally, obsessive compulsive disorder was more prevalent among females than males (7.76% vs 4.34%, p=0.047), as were personality disorders (5.6% vs 0%, p=0.043). There were no significant differences between males and females in the distribution of anxiety disorders, adjustment disorders, schizophrenia spectrum disorders, panic disorders, somatic symptom disorders, posttraumatic stress disorder, illness anxiety disorder, trichotillomania, or attention deficit hyperactivity disorder (all p>0.05). The prevalence of major depressive disorder significantly increased with more advanced academic standing, with respective rates of 26.73% (1st year), 24.58% (2nd year), and 49.43% (3rd year) (p<0.001). Additionally, illness anxiety disorder demonstrated a similar pattern, only being diagnosed in 3.45% of 3rd year students, versus no 1st or 2nd year students ( p=0.022). In contrast, no significant differences emerged between academic years for anxiety disorders, counseling for social problems, adjustment disorders, bipolar disorders, obsessive compulsive disorder, personality disorders, schizophrenia spectrum disorders, panic disorders, somatic symptom disorders, posttraumatic stress disorder, trichotillomania, attention deficit hyperactivity disorder, or substance use disorders (all p>0.05). Schizophrenia spectrum disorders demonstrated a significant association with rural residency, with respective rates of 0% (urban) and 3.82% (rural) (p=0.016). Additionally, posttraumatic stress disorder was only diagnosed among rural participants, with a prevalence of 3.18% versus 0% in the urban group (p=0.028). In contrast, no significant differences were found between urban and rural groups for major depressive disorder, anxiety disorders, counseling for social problems, adjustment disorders, bipolar disorders, obsessive compulsive disorder, personality disorders, panic disorders, somatic symptom disorders, illness anxiety disorder, trichotillomania, attention deficit hyperactivity disorder, or substance use disorders (all p>0.05). Academic deterioration was reported in 51 participants (16.66% of total sample). Among these 51 students with academic deterioration, major depressive disorder was the most prevalent diagnosis (n=26, 50.9% of academically deteriorated subsample). Other common diagnoses were bipolar disorders (n=12, 23.5%), anxiety disorders (n=6, 11.7%), personality disorders (n=4, 7.8%), schizophrenia spectrum disorders (n=2, 3.9%), and substance use disorders (n=1, 1.9%). Students were asked what topics they would be interested in in a mental health program for university students. 37 (16.82%) of students gave the answer of providing electronic services in diagnosis and treatment; 88 (40%) participants gave the answer of more efforts to raise awareness of mental health; and 95 (43.18%) of students’ answers were promoting counselling services.