101
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Mao Y, Zhang N, Liu J, Zhu B, He R, Wang X. A systematic review of depression and anxiety in medical students in China. BMC MEDICAL EDUCATION 2019; 19:327. [PMID: 31477124 PMCID: PMC6721355 DOI: 10.1186/s12909-019-1744-2] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/05/2019] [Indexed: 05/16/2023]
Abstract
BACKGROUND Medical students in China face severe depression and anxiety because of their difficult circumstances, such as the long length of schooling, academic pressure, and the stress of clinical practice. Although there have been many empirical studies about depression or anxiety in medical students in China, no previous studies have conducted a related systematic review about this topic in English. This analysis can convey the general findings from China to other areas of the world. METHODS A systematic review and meta-analysis of depression or anxiety in medical students and related determinants were conducted. Three Chinese and three English databases were searched for the review, with no restrictions on language. Articles published between January 1, 2000 and April 1, 2018 were included. RESULTS Twenty-one articles investigating a total of 35,160 individual Chinese medical students were included in this review. The prevalence of depression ranged from 13.10 to 76.21% with a mean of 32.74%, and the prevalence of anxiety ranged from 8.54 to 88.30% with a mean of 27.22%. Based on the meta-analysis, gender, grade level, residence, satisfaction with current major and monthly household income per capita were significantly associated with depression. Grade level and satisfaction with current major were significantly associated with anxiety. Other risk factors were identified and described using a narrative approach. CONCLUSION The mean prevalence of depression was 32.74% amongst medical students in China, whereas the mean prevalence of anxiety was 27.22%. The determinants of depression and anxiety included individual factors, social and economic factors, and environmental factors. More measures should be taken towards at-risk medical students based on the identified risk factors.
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Affiliation(s)
- Ying Mao
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Ning Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Jinlin Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Bin Zhu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
- Department of Public Policy, City University of Hong Kong, Hong Kong, 999077 China
| | - Rongxin He
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
| | - Xue Wang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, 710049 China
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102
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The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152735. [PMID: 31370266 PMCID: PMC6696211 DOI: 10.3390/ijerph16152735] [Citation(s) in RCA: 325] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022]
Abstract
Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2–38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety—a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.
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103
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Oliveira LBD, Parreiras JAR, Sebastião ECDO, Silva GND. Increase of binucleated cells in the oral mucosa: a study on the use of psychotropics by students of a Brazilian institution. ACTA ACUST UNITED AC 2019; 65:870-879. [PMID: 31340319 DOI: 10.1590/1806-9282.65.6.870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/19/2019] [Indexed: 12/31/2022]
Abstract
This study aimed to assess the prevalence of medical and nonmedical use of psychiatric medication among undergraduate students of health sciences from a public university in Brasil. Another objective was to determine the frequency of nuclear morphological abnormalities in the buccal mucosa of students using psychiatric drugs. A cross-sectional study based on a Web survey was carried out with 375 health sciences undergraduate students from schools of Pharmacy, Physical Education, Nutrition, and Medicine. Additionally, spontaneous genetic damages in exfoliated cells of the buccal mucosa of 41 individuals by counting micronucleus (MN) and binucleated (BN) cells frequencies were evaluated. The results showed 76 (20.3%) of students reported the use of psychotropic drugs after enrolling in university. The majority of these students were from Pharmacy and Medicine programs, females, aged between 18-25 years old, nonsmokers, alcohol addicts, and with a family history of mental illness. In addition, Medical students, individuals with high-income, who live alone and are in the last period of the program are more likely to use psychotropic drugs. Moreover, exposure to psychiatric medication was able to increase the number of binucleated cells. These results provide evidence that the use of psychoactive drugs is increased in the academic context and may be related to the failure of the cell cycle.
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Affiliation(s)
- Luiza Barbosa de Oliveira
- Medical School, University Campus Morro do Cruzeiro, Federal University of Ouro Preto, Ouro Preto, MG, Brasil
| | | | - Elza Conceição de Oliveira Sebastião
- Clinical Pharmacy Laboratory, Pharmacy Department, Pharmacy School, University Campus Morro do Cruzeiro, Federal University of Ouro Preto, Ouro Preto, MG, Brasil
| | - Glenda Nicioli da Silva
- Postgraduate Program on Pharmaceutical Sciences (CIPHARMA), Pharmacy School, University Campus Morro do Cruzeiro, Federal University of Ouro Preto, Ouro Preto, MG, Brasil.,Clinical Analysis Department, Pharmacy School, University Campus Morro do Cruzeiro, Federal University of Ouro Preto, Ouro Preto, MG, Brasil
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104
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Pop-Jordanova N. BDI in the Assessment of Depression in Different Medical Conditions. ACTA ACUST UNITED AC 2019; 38:103-111. [PMID: 28593888 DOI: 10.1515/prilozi-2017-0014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
As a common disorder, depression must be diagnosed not only in psychiatric but also in different medical settings, especially in patients with chronic diseases. Beck Depression Inventory is valuable and sensitive self-report inventory used worldwide for assessment depressive symptoms. In this research we present obtained scores of BDI in different group of disorders and we showed that BDI scores are related to the clinical condition, as well as with the age.
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Affiliation(s)
- Nada Pop-Jordanova
- Macedonian Academy of Sciences and Arts, Bul. Krste Misirkov 2, 1000 Skopje
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105
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Zhang K, Wang X, Tu J, Rong H, Werz O, Chen X. The interplay between depression and tuberculosis. J Leukoc Biol 2019; 106:749-757. [PMID: 31254317 DOI: 10.1002/jlb.mr0119-023r] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/19/2019] [Accepted: 06/07/2019] [Indexed: 02/06/2023] Open
Abstract
Depression is a major mental health condition and is expected be the most debilitating and widespread health disorder by 2030. Tuberculosis (TB) is also a leading cause of morbidity and mortality worldwide and interestingly, is a common comorbidity of depression. As such, much attention has been paid to the association between these 2 pathologies. Based on clinical reports, the association between TB and depression seems to be bidirectional, with a substantial overlap in symptoms between the 2 conditions. TB infection or reactivation may precipitate depression, likely as a consequence of the host's inflammatory response and/or dysregulation of the hypothalamic-pituitary-adrenal axis. Nevertheless, few studies have considered whether patients with depression are at a higher risk for TB. In this review, we discuss the hypotheses on the association between depression and TB, highlighting the immuno-inflammatory response and lipid metabolism as potential mechanisms. Improving our understanding of the interplay between these 2 disorders should help guide TB clinical care and prevention both in patients with comorbid depression and in the general population.
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Affiliation(s)
- Kehong Zhang
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China.,Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Jena, Germany
| | - Xin Wang
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China
| | - Jie Tu
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, Chinese Academy of Sciences, Shenzhen, China
| | - Han Rong
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Oliver Werz
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Jena, Germany
| | - Xinchun Chen
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China
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106
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Prevalence of depression and anxiety among college students living in a disaster-prone region. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2018.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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107
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Mental health and quality of life of Brazilian medical students: Incidence, prevalence, and associated factors within two years of follow-up. Psychiatry Res 2019; 274:306-312. [PMID: 30831455 DOI: 10.1016/j.psychres.2019.02.041] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 01/27/2019] [Accepted: 02/17/2019] [Indexed: 11/23/2022]
Abstract
Medical students' mental health and quality of life (QoL) cause growing concern worldwide, but, to date, few longitudinal studies have followed these students. Our objective was to evaluate the incidence, prevalence, and factors associated with quality of life and symptoms of depression, anxiety, and stress of Brazilian medical students who were followed for a period of two years. Students' mental health (DASS-21), QoL (WHOQOL-Bref), and religiousness (DUREL) were evaluated in four different waves(four semesters). A total of 312 (54.2%) medical students responded to all four waves. Medical students demonstrated a high prevalence and incidence of emotional disorders. Almost half of the students presented high levels of depression, anxiety, and stress during the two-year follow-up; approximately one out of five students without symptoms at the baseline were considered new cases and these problems have a cyclical nature. Baseline factors such as depression, anxiety, stress, having low income, being female, being in the early stages of medical training and non-white were associated with poorer mental health and quality of life in the follow-up. Our results show that medical students have a high prevalence and incidence of mental health disorders during their medical training. This data may help educators plan preventive strategies.
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108
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Nor ZM, Yaacob NN, Mohammad JA. Dimensionality and reliability of USM pre-clinical medical students' guidance and counselling needs questionnaire. J Taibah Univ Med Sci 2019; 14:123-130. [PMID: 31435402 PMCID: PMC6695042 DOI: 10.1016/j.jtumed.2019.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 12/27/2018] [Accepted: 01/05/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE There is no standard mechanism for empathy guidance and counselling for medical students. This study aimed to determine the dimensionality and reliability of a questionnaire developed for establishing guidance and counselling for pre-clinical medical students at Universiti Sains Malaysia (USM). METHODS A cross-sectional study was conducted among undergraduate medical students of the School of Medical Sciences of USM. The proposed USM Medical Students' Guidance and Counselling Needs (USM-MSGCN) questionnaire is a self-administered instrument that consists of 68 initial items developed from the recommendation of medical students, counsellors, and lecturers in the medical education department. To determine the dimensionality (construct validity) and reliability of the questionnaire, exploratory factor analysis and Cronbach's alpha internal consistency reliability analysis were conducted. RESULTS A total of 208 students participated in the study. Factor analysis revealed that the items were not unidimensional; four potential constructs could be extracted from the questionnaire, namely, self-leadership (7 items), communication (5 items), learning (5 items), and psychological coping skills (3 items), with factor loading ranges of 0.56-0.82, 0.56-0.88, 0.65-0.84, and 0.79-0.80, respectively. These domains had the following internal consistency reliability (Cronbach's alpha): 0.89, 0.90, 0.87, and 0.87, respectively; the overall alpha value was 0.93. CONCLUSION Four factors, with 20 items in the USM-MSGCN questionnaire had good validity and reliability values when administered among the pre-clinical medical students.
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Affiliation(s)
- Zarawi M.Z.M.N. Nor
- Department of Medical Education, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Najib N.M. Yaacob
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Jamilah A.M. Mohammad
- Department of Medical Education, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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109
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Tam W, Lo K, Pacheco J. Prevalence of depressive symptoms among medical students: overview of systematic reviews. MEDICAL EDUCATION 2019; 53:345-354. [PMID: 30474128 DOI: 10.1111/medu.13770] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/06/2018] [Accepted: 09/27/2018] [Indexed: 05/19/2023]
Abstract
CONTEXT The prevalence of depressive symptoms among medical students has been found to be higher than among other students because of their longer studying time, higher workload and larger financial burden. Despite the availability of reviews examining this, some have focused solely on one country, whereas others used databases containing papers of solely one language; therefore, the results from reviews might not be comprehensive. Against this background, this overview aims to synthesise the results from all the published systematic reviews of depression among medical students, in order to provide a more accurate result. METHODS A systematic search was conducted of online databases for published systematic reviews or meta-analyses examining the prevalence of depressive symptoms among medical students. The findings of individual studies included in these reviews were extracted and then combined with a random-effects model. Subgroup analysis was conducted by regions. RESULTS A total of 10 studies were selected in this overview, involving 249 primary studies and 162 450 medical students. MEDLINE was the most popular database used in these studies. The overlapping of primary studies in these reviews was appreciably high, except for three studies that focused on specific countries. The overall pooled prevalence was 27.0% (95% CI, 24.7-29.5%). Significant subgroup differences were detected (p < 0.001). The pooled prevalence among studies in the Western Pacific Region was the lowest, 18.9% (95% CI, 11.7-29.0%), whereas that in Africa (40.9%) was the highest (95% CI, 28.8-54.4%). The top five significant factors associated with depressive symptoms were: (i) year of study; (ii) gender; (iii) personal issues; (iv) family relations or issues, and (v) health status. CONCLUSIONS Depression affected around a quarter of medical students in general and 40.9% of students in Africa. It is suggested that medical schools and health authorities should introduce preventive measures to curb the high prevalence of depressive symptoms.
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Affiliation(s)
- Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kenneth Lo
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA
- Department of Cardiology, Guangdong General Hospital, Guandong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - João Pacheco
- Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitória, Espírito Santo, Brazil
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110
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Shyness, alcohol use disorders and ‘hangxiety’: A naturalistic study of social drinkers. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.10.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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111
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Francis B, Gill JS, Yit Han N, Petrus CF, Azhar FL, Ahmad Sabki Z, Said MA, Ong Hui K, Chong Guan N, Sulaiman AH. Religious Coping, Religiosity, Depression and Anxiety among Medical Students in a Multi-Religious Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E259. [PMID: 30658450 PMCID: PMC6352239 DOI: 10.3390/ijerph16020259] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/30/2018] [Accepted: 01/15/2019] [Indexed: 12/20/2022]
Abstract
Medical students are vulnerable to depression and anxiety due to the nature of their academic life. This study aimed to determine the prevalence of depressive and anxiety symptoms among medical students and the association between religious coping, religiosity and socio-demographic factors with anxiety and depressive symptoms. A cross sectional design was used for this study. Scales used were the Malay version of the Duke Religious Index (DUREL-M), the Malay version of the Brief Religious Coping Scale (Brief RCOPE) and the Malay version Hospital and Anxiety Depression Scale (HADS-M). 622 students participated in this study. They scored moderately on the organized (mean: 3.51) and non-organized religious (mean: 3.85) subscales of the DUREL, but had high intrinsic religiosity (mean: 12.18). The prevalence of anxiety and depressive symptoms were 4.7% and 17.4% respectively, which is lower than local as well as international data. Islam, negative religious coping and the presence of depressive symptoms were significantly associated with anxiety symptoms. Only the presence of anxiety symptoms was significantly associated with depressive symptoms. Negative religious coping, rather than positive religious coping, has significant association with depressive and anxiety symptoms. Redirecting focus towards negative religious coping is imperative to boost mental health outcomes among medical students.
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Affiliation(s)
- Benedict Francis
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Jesjeet Singh Gill
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Ng Yit Han
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | | | - Fatin Liyana Azhar
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Zuraida Ahmad Sabki
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Mas Ayu Said
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
- Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
- University of Malaya Centre of Addiction Sciences, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Koh Ong Hui
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Ng Chong Guan
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
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112
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Machado L, Souza CTND, Nunes RDO, de Santana CN, Araujo CFD, Cantilino A. Subjective well-being, religiosity and anxiety: a cross-sectional study applied to a sample of Brazilian medical students. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2018; 40:185-192. [DOI: 10.1590/2237-6089-2017-0070] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/31/2017] [Indexed: 01/07/2023]
Abstract
Abstract Objective: To assess associations between subjective well-being (SWB), religiosity, anxiety and other factors in a sample of Brazilian medical students from a public university in northeastern Brazil. Methods: The present study followed a cross-sectional, observational, analytical approach. Data were collected by administering a self-applicable questionnaire composed of questions focused on sociodemographic data and based on the Satisfaction With Life Scale (SWL), Positive Affect and Negative Affect Scale (PANAS), Penn State Worry Questionnaire (PSWQ), and the Duke Religiosity Index (DUREL). Results: The sample comprised 417 medical school students (73.54% of all the enrolled students). The medical students assessed presented a medium level of satisfaction with life, low mean positive emotion levels and high anxiety/uneasiness levels. Surprisingly, lower anxiety and intrinsic religiosity (IR) scores were associated with higher scores in the two SWB parameters (positive emotions and satisfaction with life). Furthermore, the factors leisure activities, good sleep quality, financial support, age, and gender were associated with the highest SWB scores (with emotional and cognitive components, or with only one of these two components). Conclusions: Data in the current study corroborated the negative association between SWB and anxiety; however, in opposition to the literature, they also evidenced a negative association between SWB and IR. In addition, the present research signaled the need for creating preventive intervention programs to increase SWB through positive psychological techniques and/or to decrease anxiety by applying, for instance, cognitive-behavioral therapy paradigms and/or mindfulness techniques to medical students.
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113
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Sarafim-Silva BAM, Duarte GD, Sundefeld MLMM, Biasoli ÉR, Miyahara GI, Bernabé DG. Childhood trauma is predictive for clinical staging, alcohol consumption, and emotional symptoms in patients with head and neck cancer. Cancer 2018; 124:3684-3692. [DOI: 10.1002/cncr.31597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Bruna Amélia M. Sarafim-Silva
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Gabrielle D. Duarte
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Maria Lúcia M. M. Sundefeld
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Éder Ricardo Biasoli
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Glauco I. Miyahara
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Daniel Galera Bernabé
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
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114
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Hilger-Kolb J, Diehl K, Herr R, Loerbroks A. Effort-reward imbalance among students at German universities: associations with self-rated health and mental health. Int Arch Occup Environ Health 2018; 91:1011-1020. [DOI: 10.1007/s00420-018-1342-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/16/2018] [Indexed: 11/30/2022]
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115
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The Impact of Behavioral and Psychological Factors on Physical Fitness in Medical and Nursing Students. Holist Nurs Pract 2018; 32:125-132. [PMID: 29642126 DOI: 10.1097/hnp.0000000000000265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Physical activity improves general health and quality of life. A stressful academic environment can increase both physical and mental health disruptions in medical and nursing students, negatively impacting physical activity and fitness. We explored the relationship between the fitness profiles of 202 medical and graduate nursing students with self-reported levels of general and emotional health to elucidate the role of the psychosocial factors involved in choosing to exercise.
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116
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January J, Madhombiro M, Chipamaunga S, Ray S, Chingono A, Abas M. Prevalence of depression and anxiety among undergraduate university students in low- and middle-income countries: a systematic review protocol. Syst Rev 2018; 7:57. [PMID: 29636088 PMCID: PMC5894225 DOI: 10.1186/s13643-018-0723-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/27/2018] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Depression and anxiety symptoms are reported to be common among university students in many regions of the world and impact on quality of life and academic attainment. The extent of the problem of depression and anxiety among students in low- and middle-income countries (LMICs) is largely unknown. This paper details methods for a systematic review that will be conducted to explore the prevalence, antecedents, consequences, and treatments for depression and anxiety among undergraduate university students in LMICs. METHODS Studies reporting primary data on common mental disorders among students in universities and colleges within LMICs will be included. Quality assessment of retrieved articles will be conducted using four Joanna Briggs critical appraisal checklists for prevalence, randomized control/pseudo-randomized trials, descriptive case series, and comparable cohort/case control. Meta-analysis of the prevalence of depression and anxiety will be conducted using a random effects model which will generate pooled prevalence with their respective 95% confidence intervals. DISCUSSION The results from this systematic review will help in informing and guiding healthcare practitioners, planners, and policymakers on the burden of common mental disorders in university students in LMICs and of appropriate and feasible interventions aimed at reducing the burden of psychological morbidity among them. The results will also point to gaps in research and help set priorities for future enquiries. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017064148.
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Affiliation(s)
- James January
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Box A178, Avondale, Harare, Zimbabwe
- Department of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Munyaradzi Madhombiro
- Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Shalote Chipamaunga
- Department of Health Professions Education, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Sunanda Ray
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Box A178, Avondale, Harare, Zimbabwe
| | - Alfred Chingono
- Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Melanie Abas
- Institute of Psychiatry, King’s College London, London, UK
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Paton LW, Tiffin PA, Smith D, Dowell JS, Mwandigha LM. Predictors of fitness to practise declarations in UK medical undergraduates. BMC MEDICAL EDUCATION 2018; 18:68. [PMID: 29622041 PMCID: PMC5887261 DOI: 10.1186/s12909-018-1167-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 03/19/2018] [Indexed: 05/28/2023]
Abstract
BACKGROUND Misconduct during medical school predicts subsequent fitness to practise (FtP) events in doctors, but relatively little is known about which factors are associated with such issues during undergraduate education. This study exploits the newly created UK medical education database (UKMED), with the aim of identifying predictors of conduct or health-related issues that could potentially impair FtP. The findings would have implications for policies related to both the selection and support of medical students. METHODS Data were available for 14,379 students obtaining provisional registration with the General Medical Council who started medical school in 2007 and 2008. FtP declarations made by students were available, as were various educational and demographic predictor variables, including self-report 'personality measures' for students who participated in UK Clinical Aptitude Test (UKCAT) pilot studies. Univariable and multivariable logistic regression models were developed to evaluate the predictors of FtP declarations. RESULTS Significant univariable predictors (p < 0.05) for conduct-related declarations included male gender, white ethnicity and a non-professional parental background. Male gender (OR 3.07) and higher 'self-esteem' (OR 1.45) were independently associated with an increased risk of a conduct issue. Female gender, a non-professional background, and lower self-reported 'confidence' were, among others, associated with increased odds of a health-related declaration. Only 'confidence' was a significant independent predictor of a health declaration (OR 0.69). Female gender, higher UKCAT score, a non-professional background and lower 'confidence' scores were significant predictors of reported depression, and the latter two variables were independent predictors of declared depression. CONCLUSIONS White ethnicity and UK nationality were associated with increased odds of both conduct and health-related declarations, as were certain personality traits. Students from non-professional backgrounds may be at increased risk of depression and therefore could benefit from targeted support. The small effect sizes observed for the 'personality measures' suggest they would offer little potential benefit for selection, over and above those measures already in use.
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Affiliation(s)
- Lewis W. Paton
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD UK
| | - Paul A. Tiffin
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD UK
| | - Daniel Smith
- General Medical Council, Regent’s Place, London, NW1 3JN UK
| | - Jon S. Dowell
- School of Medicine Deanery, University of Dundee, Dundee, DD1 9SY UK
| | - Lazaro M. Mwandigha
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD UK
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118
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Liao L. The physician as person framework: How human nature impacts empathy, depression, burnout, and the practice of medicine. CANADIAN MEDICAL EDUCATION JOURNAL 2017; 8:e92-e96. [PMID: 29354202 PMCID: PMC5766224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Troubling trends of depression, burnout, and declines in empathy have been demonstrated amongst residents. I argue that while interventions in medical education are helpful, a new perspective on the issue requires a more fundamental understanding of this problem. Rather than training physicians to act in certain ways, we must first recognize that physicians are first and foremost people. This core principle forms the basis of the framework that educators can use to help learners. Five areas of humanity with implications for physicians are discussed: 1) Physicians and patients share their humanity; 2) People are self-integrated in both personal and professional lives; 3) People are dynamic, thoughtful, and emotional; 4) People are finite; and 5) People are moral beings. Recognizing these can mitigate various factors contributing to current struggles. I also discuss practical implications of this framework to help residents flourish.
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Affiliation(s)
- Lester Liao
- Department of Pediatrics, University of Alberta, Alberta, Canada
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119
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Fawzy M, Hamed SA. Prevalence of psychological stress, depression and anxiety among medical students in Egypt. Psychiatry Res 2017; 255:186-194. [PMID: 28575777 DOI: 10.1016/j.psychres.2017.05.027] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 05/04/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
Abstract
Poor psychological health in medical students has been reported nationwide. This study estimated the prevalence of depression, anxiety and stress symptoms among medical students who were enrolled in a public university in Upper Egypt and determine the association of these morbidities with the students' basic socio-demographic variables. This cross-sectional study included 700 students. A self-administered, questionnaire for the socio-demographic characteristics, Depression Anxiety Stress Scale (DASS 21) and Pittsburgh Sleep Quality Index (PSQI) questionnaire were used for assessment. High frequencies of depression (65%), anxiety (73%) and stress (59.9%) were reported. Stress scores were significantly higher than depression and anxiety (P=0.001). 55.7% were poor sleepers. In univarate analysis, females, those living in the University campus/students' residence facility, in the preclinical years and with lower academic achievement had higher scores of DASS and PSQI compared to their comparative partners. Significant correlations were reported between stress with depression, anxiety and PQSI scores (P=0.0001). In multivariate analysis, stress scores were significantly associated with female sex, depression and anxiety scores. We conclude that depression, anxiety and stress symptoms are common in medical students of Assiut University relative to other schools and female gender was significantly correlated with these findings.
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Affiliation(s)
- Mohamed Fawzy
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Sherifa A Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt.
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120
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Peleias M, Tempski P, Paro HBMS, Perotta B, Mayer FB, Enns SC, Gannam S, Pereira MAD, Silveira PS, Santos IS, Carvalho CRF, Martins MA. Leisure time physical activity and quality of life in medical students: results from a multicentre study. BMJ Open Sport Exerc Med 2017; 3:e000213. [PMID: 28761706 PMCID: PMC5530174 DOI: 10.1136/bmjsem-2016-000213] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2017] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND/AIM We evaluated the association between leisure time physical activity (PA) and quality of life (QoL) in medical students. Our hypothesis was that there was a positive association between volume of PA and various domains of perception of QoL. METHODS Data were evaluated from a random sample of 1350 medical students from 22 Brazilian medical schools. Information from participants included the WHO Quality of Life questionnaire-short form (WHOQOL-BREF), a questionnaire specifically designed to evaluate QoL in medical students (VERAS-Q) and questions for both global QoL self-assessment and leisure time PA. According to the amount of metabolic equivalents (METs) spend during PA, volunteers were divided into four groups, according to the volume of PA: (a) no PA; (b) low PA, ≤540 MET min/week; (c) moderate PA, from 541 to 1260 MET min/week and (d) high PA, > 1261 MET min/week. RESULTS Forty per cent of the medical students reported no leisure time PA (46.0% of females and 32.3% of males). In contrast, 27.2% were classified in the group of high PA (21.0% of females and 34.2% of males). We found significant associations between moderate and high levels of PA and better QoL for all measurements. For low levels of PA, this association was also significant for most QoL measurements, with the exceptions of WHOQOL physical health (p=0.08) and social relationships (p=0.26) domains. CONCLUSION We observed a strong dose-effect relationship between the volume of leisure time PA and QoL in both male and female medical students.
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Affiliation(s)
- Munique Peleias
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Tempski
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Helena BMS Paro
- Department of Obstetrics and Gynecology, Federal University of Uberlandia, Uberlandia, Brazil
| | - Bruno Perotta
- Evangelical Medical School of Parana, Curitiba, Brazil
| | - Fernanda B Mayer
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Sylvia C Enns
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Silmar Gannam
- University of the City of São Paulo, Sao Paulo, Brazil
| | | | - Paulo S Silveira
- Department of Pathology, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Itamar S Santos
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Celso RF Carvalho
- Department of Physical Therapy, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Milton A Martins
- Center for Development of Medical Education, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Departments of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
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