Prevalence and associated factors of stress, anxiety and depression among prospective medical students

Uncovering heterogeneity in mental health changes among first-year medical students

INTRODUCTION

The initial year of medical school is linked to a decline in mental health. To assess mental health comprehensively, the dual-factor model posits the consideration of both psychopathology (e.g., depression) and positive mental health (e.g., well-being). Previous mental health research among medical students has primarily examined these two factors independently. This study uses the dual-factor approach for a deeper understanding of mental health changes during the first year of medical school.

METHODS

Students from eight German medical schools (N = 450) were surveyed three times (T0 = entering medical school, T1 = end of the first semester, T2 = end of the second semester) regarding depression (PHQ-9), well-being (subscale of FAHW-12), and general life satisfaction (German Single-Item Scale L1). Latent profile analysis was used to identify distinct mental health groups based on their combinations of psychopathology and positive mental health. We then analysed trajectories descriptively by examining the longitudinal stability and dynamics of mental health group membership during the first year of medical school.

RESULTS

We identified five mental health groups: (1) complete mental health, (2) moderately mentally healthy, (3) symptomatic but content, (4) vulnerable, and (5) troubled. The examination of change trajectories unveiled diverse paths pointing towards both recovery and deterioration. In comparison to the other groups, students belonging to the complete mental health group exhibited greater stability and a higher potential to recover after initial deteriorations in the first semester.

CONCLUSIONS

Our study uncovers distinct mental health trajectories in the first year of medical school, emphasizing the crucial role of initial mental health status. Our findings stress the diverse nature of mental health changes in medical students, underscoring the need for tailored prevention strategies. The implications for research and practice are discussed.

Effect of group impromptu music therapy on improving test anxiety and emotional regulation ability in medical students

Introduction

Test anxiety, a prevalent psychological issue among medical students, can profoundly impact their social, behavioral, and emotional development. This condition is significantly associated with challenges in emotional regulation, and to date, no effective clinical treatment has been established to address it. This study aimed to investigate the potential benefits and effects of group impromptu music therapy (GIMT) on enhancing emotional regulation skills and alleviating test anxiety in medical students.

Methods

A total of 29 participants in the experimental group and 30 participants in the control group were finally included for data analysis. Four weeks prior to the final exams, the experimental group commenced GIMT treatment, while the control group did not receive any intervention. Following the four-week intervention period, both groups were assessed using standardized scales and follow-up semi-structured interviews.

Results

The results revealed that students given the GIMT intervention reported significantly lower levels of test anxiety, as measured by the Test Anxiety Scale (TAS), and experienced fewer difficulties with emotional regulation, as indicated by the Difficulties in Emotion Regulation Scale (DERS). Additionally, these students achieved higher examination scores than the control group. Qualitative data from semi-structured interviews further supported these observations.

Discussion

Collectively, these findings demonstrate that GIMT is an effective method for enhancing the emotional regulation abilities of medical students and for relieving the symptoms of test anxiety, ultimately resulting in better academic performance. The study also indicates that GIMT could be a promising clinical auxiliary method for dealing with test anxiety and should be considered for inclusion in the curriculum of healthcare professional education programs. Nonetheless, more efforts are needed to address the limitations of this method before it can be widely used for clinical practice.

Association of Meal Timing with Sleep Quality and Anxiety According to Chronotype: A Study of University Students

There are several determinants of mental health symptoms, ranging from individual characteristics to social factors. Consistent with patterns in the general population, students with evening characteristics tend to exhibit more anxiety symptoms and poorer sleep quality compared to morning students. Meal timing also appears to affect sleep and may be associated with mental health symptoms. In this context, the aim of the present study was to investigate the association of the timing of the main and last meals of the day with sleep quality and anxiety levels, according to the chronotype of university students. This study was conducted in colleges in São Paulo, Brazil, and involved application of a questionnaire to 162 university students. The questionnaire collected sociodemographic information meal and study times, and included scales assessing eveningness and morningness, sleep quality, and anxiety. Students demonstrating a phase delay in both chronotype and dinner timing exhibited higher levels of anxiety compared to morning-type students. Although no associations were observed between meal timing and sleep quality, sleeping later was associated with poorer sleep quality. The study suggests that evening students and those who eat late at night are more prone to presenting mental health symptoms. More studies are needed to further investigate this association.

Psychosocial Factors Influencing Quality of Life Among Medical Students

OBJECTIVE

This study investigated the influence of psychosocial factors on medical students' quality of life (QOL).

METHODS

A total of 408 medical students participated in this study. We collected data on participants' sociodemographic details, symptoms of depression and Internet addiction, self-esteem, social support, and QOL. QOL was assessed using the World Health Organization Quality of Life-Abbreviated form, which has four domains (physical health, psychological health, social relationships, and environment). A stepwise multiple linear regression model was constructed to identify factors' independent impact on QOL.

RESULTS

Higher levels of depression and Internet addiction were associated with lower scores in all domains of QOL, whereas higher levels of self-esteem and social support were associated with higher scores. Being in third-year versus first-year was associated with higher scores in the physical health and environment domains. Living alone or in dormitories, low or middle socioeconomic status, and insufficient or moderate pocket money were associated with lower scores in the environment domain. Additionally, female students displayed significantly lower scores for physical health, psychological health, and environment than male students, but not for social relationships. There were significant differences in certain domains of QOL due to sociodemographic factors.

CONCLUSION

This study demonstrates the psychosocial factors influencing medical students' QOL. Educational strategies focusing on strengthening self-esteem and social support as well as preventing depression and Internet addiction may contribute to improving medical students' QOL.

Attitudes towards science in higher education: Validation of questionnaire among science teacher candidates and engineering students in Indonesia

In higher education, academic success and failure can be affected by students' affective states, such as their attitudes towards courses and learning. Many studies highlight the role of attitudes in the educational process resulting in a high demand for attitude assessments to plan comprehensive instructional strategies. The present study assessed and compared attitudes towards science in higher education. A total of 296 Indonesian undergraduate students from science teacher training and engineering majors participated in this study by completing the online Attitudes Towards Science Questionnaire (ATSQ). The validation analysis with confirmatory factor analysis and the Rasch model was performed to measure the instrument's properties resulting in a good fit model for the questionnaire's theoretical construct with acceptable individual fit items. Comparing the attitudes of science teacher candidates and engineering students, no significant differences were found in attitude towards science. Both groups revealed moderate attitudes, with higher responses to the science value variable, followed by enjoyment and confidence, anxiety and difficulty, and participation in science learning and activities. However, there were differences in the pattern of correlations between the variables, especially for anxiety and difficulty. The ATSQ has good psychometric properties and therefore can be used in research to assess attitudes towards science. It can stimulate further research in different contexts to confirm empirical evidence and promote attitude development in higher education.

Transforming stress program on medical students' stress mindset and coping strategies: a quasi-experimental study

OBJECTIVE

Stress is a significant concern in medical education, and identifying effective ways to deal with stress may help with students' mental health and professional development. This study aimed to examine the effects of the Transforming Stress Program (TSP) amongst first-year medical students on their stress mindset and coping strategies when confronted with stressors.

METHODS

We conducted a quasi-experimental study at the University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. A total of 409 first-year students at the Faculty of Medicine were divided into intervention group (205 students) and control group (204 students). The 10-week TSP was delivered as an extra-curricular course. The training adopts psychoeducation based on Dialectical Behavioral Therapy with mindfulness as a fundamental practice incorporated into each component of the program. The intervention group received the training in the first semester; the control group received identical program in the second semester. Stress Mindset Measurement and Brief Coping Orientation to Problems Experienced were measured before the intervention (T0), immediately after intervention on Intervention group (T1), and six months after intervention on Intervention group (T2).

RESULTS

At T1, the intervention group showed 65% improvements in stress mindset scores and increases in coping strategies scores in six domains (Problem solving, Social support, Humor, Religion, Venting, and Self-distraction) and decreases in three (Avoidance, Substance use, and Self-blame). The effect sizes were significant in all outcomes (Cohen's d > 0.2). Measurements of the control group did not change significantly in the same period. At T2, effects of the TSP were found decreased in some domains (Avoidance, Substance use, and Self-blame) compared to T1, but largely remained significantly better than T0.

CONCLUSIONS

The TSP is a feasible and effective approach that significantly enhanced medical students' stress mindset and coping strategies. Some effects were still observable 6 months after the intervention. The relatively intensive intervention requires support of the school administration and staff.

The Prevalence and Associated Factors of Academic Stress among Medical Students of King Khalid University: An Analytical Cross-Sectional Study

Medical students are the category of academic population with the highest levels of stress. This study aimed to assess the prevalence of academic stress among medical students in Saudi Arabia and to identify its associated factors. This cross-sectional study was conducted at the College of Medicine at King Khalid University, Abha. The Medical Student Stressor Questionnaire (MSSQ) was used to evaluate the stress caused by different factors. A total of 422 medical students participated in this study. Among the participants, 115 (27.3%) were male and 307 (72.7%) were female. The highest percentage of students were perceiving moderate to severe stress due to academic-related stressors (97.1%), followed by teaching- and learning-related stressors (93.9%) and group activities-related stressors (88.3%). The lowest domain in which students perceived moderate to severe stress was drive and desire-related stressors (65.8%). The mean percentage of students who perceived moderate-to-severe stress in all domains of stressors was 85.5%. We can conclude that medical students have a high degree of stress, and we emphasize the importance of implementing stress management programs to teach students how to handle stress in order to avoid negative effects on their health and academic performance.

The mediating role of psychological capital in the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Although life satisfaction is a predictor of depressive and anxiety symptoms, the mechanisms underlying this association are poorly understood. This study examined how psychological capital (PsyCap), a positive psychological state, mediated the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 583 students. Depressive symptoms, anxiety symptoms, life satisfaction, and PsyCap were measured anonymously. A hierarchical linear regression analysis was performed to explore the effects of life satisfaction on depressive and anxiety symptoms. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between life satisfaction and depressive and anxiety symptoms.

RESULTS

Life satisfaction was positively associated with PsyCap and its four components. There were significant negative associations between life satisfaction, psychological capital, resilience, optimism, and depressive and anxiety symptoms among medical students. Self-efficacy was negatively associated with depressive and anxiety symptoms. Psychological capital (a×b = -0.3201, BCa 95% CI: -0.3899, -0.2446; a×b = -0.2749, BCa 95% CI: -0.3817, -0.1996), resilience (a×b = -0.2103, BCa 95% CI: -0.2727, -0.1580; a×b = -0.1871, BCa 95% CI: -0.2520, -0.1414), optimism (a×b = -0.2100, BCa 95% CI: -0.3388, -0.1150; a×b = -0.1998, BCa 95% CI: -0.3307, -0.0980), and self-efficacy (a×b = -0.0916, BCa 95% CI: 0.0048, 0.11629; a×b = 0.1352, BCa 95% CI: 0.0336, 0.2117) significantly mediated the association between life satisfaction and depressive and anxiety symptoms.

LIMITATIONS

This was a cross-sectional study, and causal relationships between the variables could not be ascertained. Self-reported questionnaire instruments were used for data collection, which may have recall bias.

CONCLUSIONS

Life satisfaction and PsyCap can be used as positive resources to reduce depressive and anxiety symptoms among third-year Chinese medical students during the COVID-19 pandemic. Psychological capital and its components (self-efficacy, resilience, and optimism) partially mediated the relationship between life satisfaction and depressive symptoms, and completely mediated the relationship between life satisfaction and anxiety symptoms. Therefore, improving life satisfaction and investing in psychological capital (especially self-efficacy, resilience, and optimism) should be included in the prevention and treatment of depressive and anxiety symptoms among third-year Chinese medical students. Additional attention is needed to pay for self-efficacy in such disadvantageous contexts.

Predictability of the Development of Insulin Resistance Based on the Risk Factors Among Female Medical Students at a Private College in Saudi Arabia

BACKGROUND

Insulin resistance (IR) is currently an underlying phenomenon in the etiology of most non-communicable diseases. IR has been proposed as the key linking factor for the metabolic syndrome disease cluster of glucose intolerance.

OBJECTIVES

This study's target was to assess the predictability of risk factors for IR among female medical students Methods: A cross-sectional study involving female medical students was carried out. The sample size was 272, and a suitable non-probability sampling method was employed. A correlation test was done, and a P value less than 0.05 is considered statistically significant. Each participant underwent assessment of anthropometric measurements and biochemical testing. For assessing lifestyle, validated questionnaires on physical activity, sleep pattern, dietary pattern, and stress were adopted. The anthropometric data such as height, weight, and waist circumference were collected. Biochemical testing involved estimation of the postprandial capillary blood glucose level on campus. Additionally, systolic blood pressure and diastolic blood pressure were measured.

RESULTS

The association of lifestyle risk factors with waist circumference as an indicator of IR was done where the majority of those with high waist circumference were physically inactive and more prone to stress which was statistically significant when compared to those with normal waist circumference. However, poor sleep and unhealthy diet were high among those with high waist circumference, but they were not statistically significant.

CONCLUSION

The correlation of waist circumference as an indicator of IR was highly significant with body mass index, postprandial blood sugar, systolic blood pressure, and diastolic blood pressure. A series of unhealthy lifestyle habits was contributable to developing obesity and therefore IR among medical students in Saudi Arabia.

Uso de ansiolíticos e antidepressivos entre estudantes de medicina de uma universidade

Objetivou-se identificar o uso de medicamento ansiolítico e/ou antidepressivo e associá-lo às características dos estudantes de medicina de uma universidade. Trata-se de um estudo com 449 estudantes de medicina no interior do estado de São Paulo. O uso de medicamento antidepressivo e/ou ansiolítico era feito por 24,3% dos estudantes, sendo a maior parte do sexo feminino e cursando os dois primeiros anos da faculdade. Não houve associação entre o uso de medicamento e os fatores como: idade, renda, morar com a família, horas de sono, relação com docentes e ter pai e mãe vivos. Observou-se maior chance de fazer terapia entre os estudantes que usavam medicamento (β=1,12, OR=3,07, p<0,001) e uma menor chance de realizar exercício físico (β=-0,051, OR=0,60, p=0,03). Estratégias para o manejo da depressão e da ansiedade devem ser incentivadas e ações para reduzir o estresse durante o curso devem fazer parte de um programa de apoio das universidades. 

Prevalence of depression and anxiety, and attitudes toward seeking help among first-year pharmacy, medical, and nursing students at a Nigerian university

INTRODUCTION

The first year of university study tends to be particularly challenging and exhausting, especially for students in health sciences. This study aimed to explore the prevalence of anxiety and depression among first-year pharmacy, medicine, and nursing students at a Nigerian university as well as their attitudes toward seeking professional support.

METHODS

This study was a cross-sectional descriptive survey among all first-year pharmacy, medicine, and nursing students. Paper-based self-administered questionnaires were used, and they included the Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Attitudes Toward Seeking Professional Psychological Help Scale. Descriptive statistics, Chi-square test, and Pearson correlation were used for data analysis.

RESULTS

The study included 522 students (89% response rate). The prevalence of depression among participants was 71.8%, while the prevalence of anxiety was 61.7%. Only 24.9% of the participants expressed willingness to seek professional psychological help. Attitudes toward getting professional care was inversely related to the prevalence of depression (r = -0.155, P = .01) and anxiety (r = -0.098, P = .05). Age, smoking, alcohol intake, and dietary habits were associated with the occurrence of depression and anxiety. No demographic variables were related to the participants' attitudes toward seeking professional care.

CONCLUSIONS

Depression and anxiety symptoms were very common among health science freshmen. However, the vast majority of students were unwilling to seek help. Students' attitudes toward seeking treatment are influenced by the prevalence of depression and anxiety. Therefore, educational interventions on mental health promotion are recommended.

[Prevalence of depression, anxiety, and associated factors in residents from hospital centers during COVID-19 pandemic]

OBJECTIVE

To determine anxiety and depression frequency in residents from hospital centers during COVID-19 pandemic.

METHODS

A descriptive, observational, cross-sectional study was carried out from June to December 2020. Residents from hospitals of Secretary of Health, Puebla, were identified. The sample included 247 residents, who had an individual interview and answered a questionnaire through CEMEVI (Virtual Medical Center of High Specialty).

RESULTS

17 % of anxiety and 45 % of depression were reported. The most frequent age group was 26 to 31 years; 124 women and 123 men; anesthesiology, internal medicine and pediatrics were the medical specialties with greater depression; internal medicine and pediatrics were the medical specialties with greater anxiety. The risk factors for depression were anxiety (OR = 36.9), record of contact with COVID-19 patients (OR = 2.49 p = 0.035), and parental anxiety record (OR = 2.6, p = 0.009). The medical history of parents with anxiety was risk factor for anxiety (OR = 2.3, p = 0.031).

CONCLUSIONS

Prevalence of depression and anxiety should alert to seek answers to the problem.

Potential Future Directions in Optimization of Students' Performance Prediction System

Previous studies widely report the optimization of performance predictions to highlight at-risk students and advance the achievement of excellent students. They also have contributions that overlap different fields of research. On the one hand, they have insightful psychological studies, data mining discoveries, and data analysis findings. On the other hand, they produce a variety of performance prediction approaches to assess students' performance during cognitive tasks. However, the synchronization between these studies is still a black box that increases prediction systems' dependency on real-world datasets. It also delays the mathematical modeling of students' emotional attributes. This review paper performs an insightful analysis and thorough literature-based survey to draw a comprehensive picture of potential challenges and prior contributions. The review consists of 1497 publications from 1990 to 2022 (32 years), which reported various opportunities for future performance prediction researchers. First, it evaluates psychological studies, data analysis results, and data mining findings to provide a general picture of the statistical association among students' performance and various influential factors. Second, it critically evaluates new students' performance prediction techniques, modifications in existing techniques, and comprehensive studies based on the comparative analysis. Lastly, future directions and potential pilot projects based on the assumption-based dataset are highlighted to optimize the existing performance prediction systems.

Examining anxiety and stress regarding virtual learning in colleges of health sciences: A cross-sectional study in the era of the COVID-19 pandemic in Saudi Arabia

Background

Stress and anxiety are relatively common, particularly in females and college students. Stress can impact students' overall performance and their physical and mental health. The COVID-19 pandemic has affected all aspects of life and is associated with high levels of psychological distress. It has considerably affected the education sector, not only locally but worldwide, forcing a shift in the education system from on-site to virtual learning. This cross-sectional study was undertaken to evaluate the prevalence of anxiety and stress regarding virtual learning among health sciences college students in the Kingdom of Saudi Arabia (KSA) after introducing blended virtual classes and exams and in-person laboratory training. The study was carried six months after the COVID-19 outbreak.

Methodology

Participants were recruited by convenient sampling and snowballing strategies. Our study was conducted between November 18 and December 6, 2020. Questionnaires were employed; they included the General Anxiety Disorder-7 (GAD-7) scale and focused on the participants' attitudes toward virtual learning. The present research was validated by a pilot study, followed by implementing some amendments.

Results

A total of 418 health sciences college students, aged 18-27 (M = 20.88, SD = 1.97), participated in the study. Our analysis indicated that more than half the sample (51.44%) reported a risk of moderate to severe GAD. Anxiety was recognized more frequently in women (72.09%) than in men (27.91%). Interestingly, our Χ2 analysis revealed an association between marital status and anxiety, with a higher risk of GAD found in single people (compared with married). In addition, we found that the risk of anxiety increased in junior students (1st-3rd year) compared to senior students (4th-6th year).

Conclusion

Our study highlights the need to establish gender-based tailored mental health support systems that provide preventive measures. The study findings also recommend that institutions develop programs and platforms that safely support students to interact and seek guidance, particularly those at higher risk of stress, such as females and first-year students. Overall, our study underlines the need to pursue an understanding of the complicated nature of anxiety disorders..

Coping strategies and chiropractic student perceived stress

OBJECTIVE

To investigate coping strategies adopted by chiropractic college students and how these strategies affect student-perceived stress levels.

METHODS

Four hundred seven (407) 1st-quarter students were recruited during 2014 and 2015. The validated Brief COPE inventory was used to assess coping strategies during the 1st week of classes. Perceived Chiropractic College Stress (PCCS) was assessed via a modification of Vitaliano Perceived Medical School Stress survey instrument. The modified coping instrument was administered during the 1st quarter (PCCS1) and 6 months later during the 3rd quarter (PCCS2).

RESULTS

Mean perceived stress levels were greater after 6 months. Although perceived stress increased more for females than for males over that period, it was not statistically significant. Male and female coping strategies differed only in the preferential use of emotional support by females. Students generally adopted active coping strategies (eg, active coping and planning) rather than avoidant strategies (eg, substance abuse). Regression analysis revealed a moderate positive relationship between avoidant-emotion coping and PCCS1 with a weaker positive correlation between problem-focused coping, sex, and PCCS1. Avoidant-emotion coping also demonstrated a moderate positive correlation with PCCS2. Neither sex nor the 3 coping strategies were predictors of PCCS change (PCCS2 - PCCS1).

CONCLUSION

This study is a starting point for exploring the relationship between perceived stress and coping behaviors in a chiropractic training institution. Students generally used healthy adaptive coping strategies with minimal sex differences. Avoidant-emotion coping appears to be a reliable predictor of PCCS, with sex being a poor predictor.

One-year changes in the prevalence and positive psychological correlates of depressive symptoms during the COVID-19 pandemic among medical science students in northeast of Iran

Objectives

The COVID‐19 pandemic has imposed a significant psychological burden on many across society especially students studying medical sciences. This study intended to investigate the one‐year changes in the prevalence and correlates of depressive symptoms during the COVID‐19 pandemic among medical science students.

Methods

A cross‐sectional study in Shahroud, Iran administering a convenience sampling method (January to February 2021). Online self‐reported questionnaires included Rosenberg Self‐Esteem Scale, Paloutzian‐Ellison Spiritual Well‐Being Questionnaire, Diener's Satisfaction with Life Scale and the University Student Depression Inventory. Data analyzed using descriptive and inferential statistics (Independent t‐test and Multiple Regression Analysis).

Results

A total of 306 medical science students were investigated in this study. The mean scores 1 year after the outbreak of COVID‐19 were for depression (81.25 ± 26.04), spiritual well‐being (80.98 ± 18.06), self‐esteem (26.89 ± 2.20), and life satisfaction (19.68 ± 6.81). The results indicated that depression mean score was significantly higher in post outbreak assessment (71.92 ± 22.94 vs 81.25 ± 26.04) (P < .001). Fifty percentage of changes in depression can be predicted by studied variables. A high score of depression was directly associated with a higher level of self‐esteem. Moreover, increased interest in the field, scores of spiritual well‐being, and life satisfaction were inversely and significantly associated with depression.

Conclusions

Iran's education system has been significantly affected, with the addition to the COVID‐19 pandemic imposing a psychological burden such as depression, exacerbating this within medical science students compared to a year ago. Spiritual well‐being and life satisfaction as positive psychology constructs were recognized as protective factors against depression during the pandemic. Spiritual and social support should be integrated in psychological interventions within university settings for medical science students.

Personality and achievement: A follow-up study

BACKGROUND

The health and well-being of medical students along with their successful progression is an important concern for society. Studies across the world demonstrated a high prevalence of psychiatric morbidity and low self-esteem among medical students requires immediate attention and effective management.

AIM

To compare the symptoms of depression, anxiety, and stress between the groups who have cleared all papers in the first attempt with those who have got supplementary at least in one paper during their MBBS course.

MATERIALS AND METHODS

Raven's Progressive Matrices Scale, Eysenck personality Questionnaire, Sinha's Anxiety Scale, Stress Reaction Check (SRC) List, and 16-Personality Factors questionnaires were used along with performance score was recorded for the objective of the study.

RESULTS

Nonparametric tests, Mann-Whitney and Wilcoxon are used and found that RSPM scores and EPQ Lie-scale scores are statistically different as the P < 0.05. Overall performance and psychological problems association are found out using Spearman's correlation test and it is found that Factor C and Tough poise under 16 PF are significantly correlated.

CONCLUSIONS

The study concluded that there is a significant difference between the abstract reasoning between the two groups of students measured by RSPM. When the students are compared by taking gender as grouping variable the study concluded psychosis, lie scale value is significantly different in the two groups and the mean value is higher in the female group. It is also concluded that the stress level measured by SRC is significantly different and the mean value is higher in the female group. Furthermore, the global factors Tough poise and independence are found to be significantly different in two groups with 16 PF questionnaire.

Depression, anxiety and stress among high school students: A cross-sectional study in an urban municipality of Kathmandu, Nepal

Depression and anxiety are the most widely recognized mental issues affecting youths. It is extremely important to investigate the burden and associated risk factors of these common mental disorders to combat them. Therefore, this study was undertaken with the aim to estimate the prevalence and identify factors associated with depression, anxiety, and stress among high school students in an urban municipality of Kathmandu, Nepal. A cross-sectional study was conducted among 453 students of five randomly selected high schools in Tokha Municipality of Kathmandu. Previously validated Nepali version of depression, anxiety, and stress scale (DASS-21) was used to assess the level of symptoms of depression, anxiety and stress (DAS). Multivariable logistic regression was carried out to decide statistically significant variables of symptoms of DAS at p-value<0.05. The overall prevalence of DAS was found to be 56.5% (95% CI: 51.8%, 61.1%), 55.6% (95%CI: 50.9%, 60.2%) and 32.9% (95%CI: 28.6%, 37.4%) respectively. In the multivariable model, nuclear family type, students from science or humanities faculty, presence of perceived academic stress, and being electronically bullied were found to be significantly associated with depression. Female sex, having mother with no formal education, students from science or humanities faculty and presence of perceived academic stress were significantly associated with anxiety. Likewise, female sex, currently living without parents, and presence of perceived academic stress were significantly associated with stress. Prevention and control activities such as school-based counseling services focusing to reduce and manage academic stress and electronic bullying are recommended in considering the findings of this research.

Japanese medical learners' achievement emotions: Accounting for culture in translating Western medical educational theories and instruments into an asian context

Medical learners' achievement emotions during educational activities have remained unexamined in Asian cultural contexts. The Medical Emotion Scale (MES) was previously developed to assess achievement emotions experienced by North American medical learners during learning activities. The goal of this study was to create and validate a Japanese version of the Medical Emotion Scale (J-MES). We translated the MES into Japanese and conducted two initial validation studies of the J-MES. In the first pilot study, we asked five, native-Japanese, second-year medical students to assess their emotions with the J-MES during a computer-based clinical reasoning activity. Each participant was then interviewed to assess the clarity and suitability of the items. In a second, larger study, 41 Japanese medical students were recruited to assess the psychometric properties of the J-MES. We also conducted individual, semi-structured interviews with ten of these participants to explore potential cultural features in the achievement emotions of Japanese students. The first pilot study demonstrated that the J-MES descriptions were clear, and that the scale captured an appropriate range of emotions. The second study revealed that the J-MES scale's profiles and internal structure were largely consistent with control-value theory. The achievement emotions of pride, compassion, and surprise in the J-MES were found to be susceptible to cultural differences between North American and Japanese contexts. Our findings clearly demonstrated the scoring capacity, generalizability, and extrapolability of the J-MES.

Sex Differences in Psychological Status and Fatigue of Frontline Staff After the COVID-19 Outbreak in China: A Cross-Sectional Study

Background: The coronavirus disease 2019 (COVID-19) is spreading globally, and it is significant to pay attention to the mental health of frontline staff in this pandemic. This study is aimed to explore the sex difference among the frontline staff in demographics, characteristics of mental state, and the potential relationship between them. Method: A total of 2,614 Chinese frontline staff were recruited. The Self-Rating Anxiety Scale (SAS) and the Patient Health Questionnaire-9 (PHQ-9) were used for assessing the mental status of frontline staff, and the Fatigue Self-Assessment Scale (FSAS) was used for detecting fatigue. Result: The prevalence rate of anxiety for female frontline staff is higher than that of male (P = 0.003), and the prevalence rate of depression is similar between them (P = 0.091). After comparing the risk factors of unhealthy mental state between different sexes, it is found that family income below 100,000 [depression: odds ratio (OR) 1.37; 95% CI, 1.08-1.73; anxiety: OR 1.99; 95% CI, 1.44-2.75], unsupported of family (depression: OR 10.94; 95% CI, 1.39-85.79; anxiety: OR 11.92; 95% CI, 3.80-37.36), and marriage (depression: OR 1.67; 95% CI, 1.15-2.43) are risk factors for male, and total fatigue (depression: OR 2.96; 95% CI, 1.46-6.02) is risk factor for female. Conclusions: This study found that depression and anxiety are widespread among the frontline staff of COVID-19, and anxiety showed a higher prevalence rate among female frontline staff. From the sex difference in risk factors, the focus of psychological interventions may differ between genders. Men with low family income, unsupported by family or marriage, and women with a high score of total fatigue required particular attention to their psychological status.

Medical Students' Personalities: A Critical Factor for Doctor-Patient Communication

The aim of this study was to assess the level of creativity and personality traits and their mutual influence on medical students using the DECAS and BWAS. We performed a prospective descriptive study on 119 medical students from Târgu Mureș, Romania between November 2020 and July 2021, who answered questions relating to the BWAS and DECAS scales to evaluate their creativity and personality traits. Our findings pointed out a reverse correlation between age and both the original and revised BWAS (r = -0.2037, p = 0.0263; r = -0.1931, p = 0.0354). In terms of extraversion, we found a significant positive correlation for both openness (r = 0.3032, p = 0.0008) and emotional stability (r = 0.2868, p = 0.0016) and a negative correlation between extraversion and agreeability (r = -0.2394, p = 0.0087). Regarding creativity, we found positive correlations between emotional stability and both the original and revised BWAS (r = 0.20, p = 0.0279; r = 0.20, p = 0.0245). Medical students' creativity might be positively influenced by emotional stability and seems to decrease with age. Higher extraversion scores could be related to increased openness and emotional stability as well as decreased agreeability.

The mediating role of students' academic resilience in the relationship between self-efficacy and test anxiety

BACKGROUND

There is growing acknowledgment that medical education can be a stressful experience for students and may have a devastating effect on their psychological well-being. The present article, therefore, aimed at investigating students' academic resilience as a mediating variable in self-efficacy-test anxiety relation.

MATERIALS AND METHODS

In this cross-sectional correlational study, a convenience sample of 243 medical students was selected and participated, three prevalidated questionnaires were applied, that is, general self-efficacy questionnaire, academic resilience questionnaire, and test anxiety questionnaire. To analyze the data, Pearson's correlation coefficient as well as structural equation modeling (SEM) were used.

RESULTS

According to Pearson's coefficients, self-efficacy was found to be positively correlated with academic resilience (r = 0.437, P ≤ 0.01) and negatively with test anxiety (r = -0.475, P ≤ 0.01). SEM results also indicated that self-efficacy positively impacts on academic resilience (β = 0.43, P < 0.001) and negatively on test anxiety (β = -0.37, P < 0.001). In addition, results demonstrated the mediating role of academic resilience in self-efficacy-test anxiety relationship (β = -0.108, P < 0.001).

CONCLUSION

This study showed that academic resilience could play a mediating role in students' self-efficacy-test anxiety relationship.

Prevalence of stress, stressors, and coping strategies among medical undergraduate students in a medical college of Mumbai

BACKGROUND

Stress is a subjective experience which creates an obstacle in a person's path of achieving his or her goals. It creates negative outcomes among the population. Medical curriculum is very vast and stressful. As doctors are the very important part of society, medical students must be allowed to learn their trade in a stress-free environment. The present study aimed to assess the perceived stress, various sources of stress among medical undergraduate students, and the coping strategies adopted.

MATERIALS AND METHODS

This was a cross-sectional study conducted among medical under-graduate students studying at a tertiary care hospital situated in Mumbai city of Maharashtra between January and June 2018. Using purposive sampling technique, a total of 450 medical students from 1^st year to final year were invited to participate in the study. A self-administered questionnaire consisting of sociodemographic details and perceived stress scale questions was used. Logistic regression analysis was carried out to assess the determinants of stress. Odds ratio, 95% confidence interval was calculated. P < 0.05 was considered statistically significant.

RESULTS

The overall response rate was 79.11%, with 356 out of 450 students returning the questionnaire. Among 356 participants, 324 participants (91%) were suffering from high levels of stress. Factors such as curriculum vastness, frequency of examination, competition with peer, performance in examinations, worry about future, loneliness, relation with opposite sex, and quality of food played a major role in creating additional stress.

CONCLUSIONS

The perceived stress was higher among female medical students. Academic factors are greater perceived cause of stress in medical students in this study. A substantial proportion of medical undergraduate students were found to be stressed which necessitates appropriate and timely interventions. Reframing the academic curriculum along with examination and evaluation patterns, incorporating extracurricular activities, and establishment of counselling cells in the institution is the need of the hour.

Improvement of the management of mental well-being and empathy in Chinese medical students: a randomized controlled study

BACKGROUND

Among Chinese medical students, there is a high prevalence of mental health-related issues and low empathy. Effective strategies to improve this situation are lacking. This study aims to investigate the efficacy of the intervention courses designed to enhance the mental health and empathy of senior Chinese medical students.

METHODS

A total of 146 3rd - and 4th -year medical students were randomized to an intervention group (n = 74) and a control group (n = 72). A pilot study including 5 pre-clinical students and 5 interns was first carried out to determine the themes and content of the intervention courses. The designed courses were delivered in the intervention group once a month three times, while the control group had no specific intervention. Five self-assessment questionnaires, including the General Self-Efficacy (GSE) scale, Medical Outcomes Study Short Form 8 (SF-8), Patient Health Questionnaire-9 (PHQ-9), Maslach Burnout Inventory (MBI), and Jefferson Scale of Empathy-Health Care Provider Student version (JSE-HPS), were completed by the students before and one month after the courses to evaluate their levels of self-efficacy (SE), quality of life (QoL), depression, burnout, and empathy, respectively. Qualitative data were collected via e-mail two years after the intervention.

RESULTS

Compared to the control group, the intervention group showed significantly higher scores for empathy (111.0 [IQR 102.0, 118.0] vs. 106.0 [IQR 93.0, 111.5]; P = .01) and QoL (32.0 [IQR 28.0, 35.0] vs. 29.5 [IQR 26.0, 34.0]; P = .04). The rate of depression was significantly lower in the intervention group than in the control group (13.5 % vs. 29.2 %; chi-square test, P = .02). However, no significant differences in self-efficacy (25.6 ± 4.8 vs. 24.3 ± 6.3; P = .16) or burnout (27.0 % vs. 34.7 %; Chi-square test, P = .31) were observed between the two groups.

CONCLUSIONS

The intervention courses had a positive impact on mental well-being and empathy in senior Chinese medical students, which might help provide novel information for their incorporation into the medical school curriculum.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02645643; Date of registration: 05/01/2016.

Perceived stress and its predictors, stressors and coping strategies among undergraduate pharmacy students in northern Nigeria

INTRODUCTION

Pharmacy education may be associated with stress due to the nature of its curriculum and expectations of high-quality services from students on graduation. This study evaluated perceived stress and its predictors, stressors, and coping strategies among undergraduate pharmacy students in northern Nigeria.

METHODS

This was a prospective longitudinal study conducted at three randomly selected pharmacy schools in northern Nigeria. The validated 10-item Perceived Stress Scale was used to assess participant stress at the beginning (Time₁) and middle (Time₂) of the semester. Data were analyzed with descriptive statistics, a paired sample t-test, point-biserial correlations, and multivariate linear regression at P < .05.

RESULTS

The stress scores at Time₁ and Time₂ of the 866 participants were 18.3 ± 6.0 and 19.3 ± 5.4, respectively. Most participants at both Time₁ and Time₂ had moderate stress (76.6% and 79.6%, respectively). The multivariate regression analyses revealed gender, marital status, year of study, and access to education funds as significant predictors of stress. Major stressors identified were academic-related (76.3%) and environment-related (24.6%). Time management (69.6%) and relaxation (46.1%) were the major coping strategies.

CONCLUSIONS

Moderate stress was observed among the majority of participants. Identified predictors of stress, stressors, and coping mechanisms were similar to those previously reported in other countries. Although most pharmacy students adopt positive strategies to mitigate stress, pharmacy educators should further adopt holistic initiatives to help students reduce their stress.

The roles of emotional intelligence, neuroticism, and academic stress on the relationship between psychological distress and burnout in medical students

BACKGROUND

Stress and burnout commonly threaten the mental health of medical students in Malaysia and elsewhere. This study aimed to explore the interrelations of psychological distress, emotional intelligence, personality traits, academic stress, and burnout among medical students.

METHODS

A cross-sectional study was conducted with 241 medical students. Validated questionnaires were administered to measure burnout, psychological distress, emotional intelligence, personality traits, and academic stress, respectively. A structural equation modelling analysis was performed by AMOS.

RESULTS

The results suggested a structural model with good fit indices, in which psychological distress and academic stress were noted to have direct and indirect effects on burnout. The burnout levels significantly increased with the rise of psychological distress and academic stress. Neuroticism was only found to have significant indirect effects on burnout, whereby burnout increased when neuroticism increased. Emotional intelligence had a significant direct effect on lowering burnout with the incremental increase of emotional intelligence, but it was significantly reduced by psychological distress and neuroticism.

CONCLUSION

This study showed significant effects that psychological distress, emotional intelligence, academic stress, and neuroticism have on burnout. Academic stress and neuroticism significantly increased psychological distress, leading to an increased burnout level, while emotional intelligence had a significant direct effect on reducing burnout; however, this relationship was compromised by psychological distress and neuroticism, leading to increased burnout. Several practical recommendations for medical educators, medical students, and medical schools are discussed.

Prevalence and predictors of work-related depression, anxiety, and stress among waiters: A cross-sectional study in upscale restaurants

Background

Poor mental health often interrupts people’s regular activities making them unable to work effectively resulting in poor performance and high turnover intention. We examined the prevalence and predictors of depression, anxiety and stress among waiters in upscale restaurants.

Methods

This descriptive cross-sectional study involved 384 waiters in upscale restaurants in the Accra Metropolis. Data were collected using a pre-tested questionnaire which embedded DASS-21 (Cronbach Alpha = 0.815). The analysis included descriptive and inferential statistics using STATA 15. Statistical significance was set at p-value <0.05 at 95% confidence interval.

Results

The prevalence of depression was 38.3%, while anxiety and stress were 52.3% and 34.4% respectively. Females (AOR = 1.69, 95%CI = 1.02–2.79), waiters who foresee a better remuneration (AOR = 3.09, 95%CI = 1.95–4.87), consume caffeine (AOR = 1.44, 95%CI = 0.90–2.32), and use non-prescription drugs (AOR = 2.22, 95%CI = 1.39–3.55) were more likely to have depression. Females (AOR = 1.86, 95%CI = 1.17–2.96), those who foresee better remuneration (AOR = 2.85, 95%CI = 1.82–4.49), and those who use non-prescription drugs (AOR = 2.13, 95%CI = 1.38–3.28) were more likely to have anxiety. Females (AOR = 1.74, 95%CI = 1.01–2.99), waiters who are positive of career success (AOR = 1.70, 95%CI = 0.99–2.91), who foresee better remuneration (AOR = 2.99, 95%CI = 1.85–4.83), consume caffeine (AOR = 1.54, 95%CI = 0.93–2.54), and who use non-prescription drugs (AOR = 3.16, 95%CI = 1.93–5.17) were more likely to be stressed.

Conclusion

There is a high prevalence of poor mental health among waiters. Urgent intervention by hospitality stakeholders is needed to improve their working conditions and psychosocial health to accelerate progress towards the Sustainable Development Goal of promoting mental health and wellbeing.

Prevalence and factors associated with depression, anxiety and stress among healthcare workers of Trinidad and Tobago during COVID-19 pandemic: a cross-sectional study

OBJECTIVES

To determine the prevalence and factors associated with depression, anxiety and stress among healthcare workers (HCWs) during COVID-19 pandemic.

DESIGN

Cross-sectional online survey.

SETTING

HCWs from four major hospitals within the Regional Health Authorities of Trinidad and Tobago.

PARTICIPANTS

395 HCWs aged ≥18 years.

MAIN OUTCOME MEASURES

Depression, anxiety and stress scores.

RESULTS

Among the 395 HCWs, 42.28%, 56.2% and 17.97% were found to have depression, anxiety and stress, respectively. In the final stepwise regression model, contact with patients with confirmed COVID-19, p<0.001 (95% CI 3.072 to 6.781) was reported as significant predictors of depression. Further, gender, p<0.001 (95% CI 2.152 to 5.427) and marital status, p<0.001 (95% CI 1.322 to 4.270) of the HCWs were considered to be correlated with anxiety. HCWs who had contact with patients with suspected COVID-19 had lower depression, p<0.001 (95% CI -5.233 to -1.692) and stress, p<0.001 (95% CI -5.364 to -1.591).

CONCLUSIONS

This study has depicted the prevalence and evidence of depression, anxiety and stress among HCWs during the COVID-19 pandemic. The findings of the study will serve as supportive evidence for the timely implementation of further planning of preventative mental health services by the Ministry of Health, for frontline workers within the public and private health sectors.

The Mediating Role of Stress Perception in Pathways Linking Achievement Goal Orientation and Depression in Chinese Medical Students

Mental health problems are frequent obstacles in medical students’ careers as doctors. Given that previous studies overlook the mediation of stress perception, the current study expanded previous goal orientation researches by addressing an unexplored mechanism. This study aims to examine the mediational roles of stress perception (perceived stressors and stress-related cognition) on the relationship between achievement goal orientation and depression in medical students. A total of 1,015 Chinese 2-year medical students completed a multi-section questionnaire. Hypotheses were examined by structural equation modeling. The findings suggest that performance-avoidance goal orientation and perceived stressors both demonstrated direct facilitative effects on depression, whereas stress-related cognition demonstrated direct obstructive effects on depression. Both perceived stressors and stress-related cognition mediated the relationship between achievement goal orientation and depression. The findings spark a new perspective on motivational intervention that assist students in adopting mastery-approaching strategy as well as ways of coping with stressful academic situations. Identifying students with achievement goal orientation and providing them with the appropriate supportive services may help them to manage stress and mitigate or prevent depression.

Socio-demographic and educational factors associated with Depression, Anxiety and Stress among Health Professions students

Depression, anxiety and stress are the most prevalent mental health problems among health professions' students. The study was aimed to explore the socio-demographic and educational factors associated with depression, anxiety and stress among health professions' students. Using non-random purposeful sampling, 366 health professions' students studied in 2018/19 were surveyed via a self-reported questionnaire that included Depression, Anxiety and Stress Scale (DASS-21) and questions on sociodemographic and educational characteristics. The majority of respondents were from the School of Medicine (59.8%), with 116 males and 250 females. Sleep duration, communication problems with teaching staff, feelings of inferiority to friends and family problems were determined to be independent predictors of depression in the current study. Communication problems with teaching staff, feelings of inferiority to friends and family problems were important predictors of anxiety. Further, we found that feelings of inferiority to friends and family problems were found to be important risk factors for stress. Our results suggest that the overall prevalence of depression, anxiety and stress among health professions' students were considerably high. All students having a severe mental health issues should be supported by the student counselling centre and expert clinicians in order to confirm the diagnosis and implement subsequent treatment strategies.

Depressive symptoms associated with loneliness and physical activities among graduate university students in Bangladesh: findings from a cross-sectional pilot study

In low-resource settings like Bangladesh, there is a dearth of research on the mental health of university students. This pilot study aimed to identify the prevalence of depressive symptoms, loneliness, and physical activities as well as the associated factors of depressive symptoms among graduate students in a public university of Bangladesh.

This cross-sectional study was carried out among 323 graduate students between February 2019 and May 2019. By the convenience sampling technique, data were collected by a pretested, structured questionnaire. Depressive symptoms were assessed by the validated Patient Health Questionnaire-9 (PHQ-9) tool with a cut-off score of ≥10 vs. less; University of California, Los Angeles (UCLA) loneliness scale was applied to assess loneliness, International Physical Activity Questionnaire (IPAQ) scale was used to measure physical activity level.

The overall prevalence of depressive symptoms was 52% and about 43% of participants felt most lonely. About 32.8% of students were involved in low physical activity. Being female, from lower income families, having poor academic performance, experiencing shorter sleep time, lower physical activity, and being lonely were potential risk factors for depressive symptoms among graduate university students. A positive correlation was found between loneliness and depressive symptoms of students (r = 0.367, p < 0.001).

The higher prevalence of depressive symptoms among Bangladeshi graduate university students suggests the need for situation analysis, confirmatory clinical diagnosis, in-depth qualitative explorations, and large-scale surveys to explore the burden of such disorders and design appropriate low-intensity interventions like implementing student counselling service, offering mental assistance or other mental health support program in the country.

Assessment of use of psychoactive and other non-prescription drugs among students of selected tertiary institutions in Ekiti State South West Nigeria - A baseline study

Background

Substance abuse is causing increasing threats to the stability of young minds, from teenage to the older youths and is an issue of public health concern in Nigeria. This study was carried out to determine the prevalence of drug abuse among students of tertiary institutions in Ekiti State.

Methodology

A comparative cross-sectional survey was carried out among students in tertiary institutions in Ekiti state with participants selected from Year 1 to Year 4. Data collection tool was the WHO questionnaire (STASSIS). Data was analysed to obtain descriptive and inferential data, Kruskal-Wallis test and chi square were used for analysis of variance and test of association.

Result

The majority of the students reported low use of all the drugs (64–90.1%) though moderate to high use were reported for: alcohol 35.1%, marijuana 15.7%, heroine 15.3%, tobacco 13.8% and cocaine 10.2%. There was a significant association between student's moderate to high use and university type. Students in private universities reported more use, especially heroine. Difference in substance use across the four years surveyed was significant with final year students (400 level) showing highest use.

Conclusion

Tertiary students in Ekiti state are low users of psychoactive substances with a prevalence of 60–91%. Moderate to high prevalence of 10–31% was reported with alcohol as the substance with highest usage. Substance use varied significantly with university type with highest prevalence in the private institution and students at different academic levels with final year students being the highest users.

College students' stress and health in the COVID-19 pandemic: The role of academic workload, separation from school, and fears of contagion

The COVID-19 pandemic has unhinged the lives of people across the globe. In particular, more than 30 million Chinese college students are home-schooling, yet there is little understanding of how academic workload, separation from school, and fears of contagion lead to a decrease in their health. This study examined the relationships between Chinese college students' three critical stressors and two types of health in the COVID-19 pandemic context. We used a three-wave lagged design with a one-week interval. All the constructs were assessed by self-report in anonymous surveys during the COVID-19 pandemic. College students were asked to report their demographic information, academic workload, separation from school, fears of contagion, perceived stress, and health. The results of this study showed that academic workload, separation from school, and fears of contagion had negative effects on college students' health via perceived stress. In the COVID-19 crisis, multiple prevention and control measures focusing on college students may lead them to have different degrees of stress and health problems. Our results enrich the literature on stress and health and offer novel practical implications for all circles of the society to ensure students' health under the context of the COVID-19 epidemic.

Anxiety and Stress Among Undergraduate Medical Students of Haramaya University, Eastern Ethiopia

BACKGROUND

The perceived stress and anxiety among medical students have bleak consequences on their academic performances, physical, and psychological wellbeing. However, there is a dearth of reliable epidemiological studies in Ethiopia on medical student's experience of stress and anxiety. Therefore, this study was aimed to determine the prevalence and identify factors associated with stress and anxiety among undergraduate medical students of Haramaya University, Eastern Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted from May 13 to June 12, 2019 among 523 participants selected by simple random sampling technique. Data were collected by using structured questionarie through self-adminstered method. Data were entered by Epidata version 3.1 and analyzed using Stastical Package for Social Science(SPSS) version 22. Bivariableand multivariable logistic regression analysis were conducted to identify factors associated with anxiety and stress. Adjusted Odd Ratio (AOR) and 95% Confidence Interval(CI) was used to show the strength of association, and P-value of 0.05 was used to declare statistical significance.

RESULTS

The prevalence of stress was 44% (95% CI: 40.2%-48.2%) and anxiety was 48.9% (95% CI: 44.6%-53.3%) among undergraduate medical students of Haramaya University. Being female (AOR=1.90, 95% CI: 1.28-2.81) and living off-campus (AOR=1.75, 95% CI: 1.12-2.73) were factors significantly associated with both stress and anxiety. Whereas, alcohol use (AOR=2.26, 95% CI: 1.50-3.50) and smoking cigarette (AOR=3.50, 95% CI: 1.58-7.73) linked with stress. The poor psychosocial support (AOR=1.93, 95% CI: 1.20-3.20) was significantly associated with anxiety.

CONCLUSION

Substantially a higher level of stress and anxiety was reported. Being female and living off-campus were linked with both stress and anxiety. Where as, alcohol use and smoking cigarette were associated with stress and poor psychological support was significantly associated with anxiety.

More Depression-Related Public Concern After the Suicide of a Pop Star in China: Evidence From the Online Big Data Platform

Background: In China, we have seen dramatic increases in public concern over depression and mental health after the suicide of some famous persons. The objective of this study is to investigate the changes of search-engine query patterns to monitor this phenomenon based on the tragic suicide of a young Chinese pop star, Kimi Qiao. Methods: The daily search volume for depression was retrieved from both the Baidu Index (BDI) and the Sina MicroBlog Index (SMI). Besides, the daily BDI for suicide, schizophrenia, obsessive-compulsive disorder, common cold, stomach cancer, and liver cancer were collected for comparison. According to the time of Qiao's suicide, all data were divided into two periods (i.e., Period One from 1 September 2015 to 31 August 2016 while Period Two ranged from 1 October 2016 to 30 September 2017). The paired t-test was used to compare the differences in search volumes between two periods. The Pearson correlation analysis was used to estimate correlations between the BDI and SMI for depression. Results: The average BDI for depression, BDI for suicide, and SMI for depression in Period Two were significantly higher than in Period One (p < 0.05). There was a strong positive correlation between the BDI and SMI for depression (r = 0.97, p < 0.001). And no significant difference in BDI for other diseases between the two periods was found. Conclusions: The changes of search-engine query patterns indicated that the celebrity's suicide might be able to improve the netizens' concern about depression in China. The study suggests publishing more practical knowledge and advice on depression through the Internet and social media, to improve the public's mental health literacy and help people to cope with their depressive symptoms appropriately.

A comparative study on the psychological health status of pre-clinical medical students enrolled through different admission tests

Objective

Methods

Results

Conclusions

Comparison between Personality, Emotional, and Educational Outcomes of Multiple Mini Interviews and Personal Interview

Objectives

This study investigated the outcomes of multiple mini interviews and personal interview on personality traits, emotional intelligence, perceived educational environment, and stressors.

Methods

This is a comparative cross-sectional study on two cohorts of pre-clinical medical students who were selected by multiple mini interviews and personal interview, respectively. Their personality traits, emotional intelligence, perceived educational environment, and perceived stressors were measured using different measurement tools.

Results

Multiple mini interviews and personal interview demonstrated a similar ability to recruit medical students with a high level of emotional intelligence. The main advantage of personal interviews over multiple mini interviews in terms of personality traits is that it recruited candidates who had a higher level of conscientiousness trait. The main advantage of multiple mini interviews over personal interview on the educational environment is that medical students chosen by multiple mini interviews had a higher level of satisfaction with social aspects of medical training. Regardless of admission processes, the medical students were equally vulnerable to psychological distress due to various stressful events throughout medical training particularly related to academic loads.

Conclusions

This study provided evidence to support the outcomes that multiple mini interviews and personal interview have on medical students’ emotional intelligence, personality traits, perceived educational environment, and perceived stressors during the pre-clinical medical training. Interestingly, personal interview had a better outcome on conscientiousness while multiple mini interviews had a better outcome on the social aspect.

Appraising the degree of physical activities among male students at a Saudi medical school

Objectives

This study aimed to assess the degree of physical activity among male medical students. We also investigated the association between their physical activity and academic performance.

Methods

In this cross-sectional study, we distributed the International Physical Activity Questionnaire among male medical students of the first year through the fourth year by using a convenient sampling technique. Physical activity was measured by using the Metabolic Equivalent Task (MET) score. The demographic variables included academic year and age of the participants.

Results

The study included 317 students; of those, 219 were pre-clinical (first and second year), and 98 were clinical (third and fourth year) students. According to the MET score, the degree of physical activity was categorized into three groups. As many as 140 (44%) students were classified as highly active (MET>3000) and 98 (34%) moderately active (MET 600–3000), while 69 (22%) students were inactive (MET<600). The second-year students had a higher degree of inactivity than others (p = 0.004). Additionally, there was a significant difference in the amount of siting time during the week, with a higher median sitting time by second-year students than by third- and fourth-year students (p = 0.001).

Conclusion

In our study, most male medical students showed moderate or high physical activity. However, second-year students were physically inactive. Hence, the reason for such inactivity among second-year students should be explored. This study calls for the implementation of university-level programs that can motivate students to participate in physical activities.

Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis

The novel coronavirus disease (COVID-19) pandemic has brought a great deal of pressure for medical students, who typically show elevated anxiety rates. Our aim is to investigate the prevalence of anxiety in medical students during this pandemic. This systematic review and mini meta-analysis has been conducted following the PRISMA guidelines. Two researchers independently searched PubMed on 26 August 2020 for cross-sectional studies on medical students during the COVID-19 outbreak, with no language restrictions applied. We then performed a manual search to detect other potentially eligible investigations. To the 1361 records retrieved in the initial search, 4 more were added by manual search on medRxiv. Finally, eight studies were finally included for qualitative and quantitative analysis, which yielded an estimated prevalence of anxiety of 28% (95% CI: 22-34%), with significant heterogeneity between studies. The prevalence of anxiety in medical students is similar to that prior to the pandemic but correlates with several specific COVID-related stressors. While some preventive and risk factors have been previously identified in a non-pandemic context, knowledge and cognitions on COVID-19 transmission, treatment, prognosis and prevention negatively correlate with anxiety, emerging as a key preventive factor that may provide a rationale for why the levels of anxiety have remained stable in medical students during the pandemic while increasing in their non-medical peers and the general population. Other reasons for the invariability of anxiety rates in this population are discussed. A major limitation of our review is that Chinese students comprised 89% the total sample, which could compromise the external validity of our work.

The magnitude of COVID-19 related stress, anxiety and depression associated with intense mass media coverage in Saudi Arabia

The Coronavirus Disease 2019 (COVID-19) has resulted in catastrophic consequences in many aspects of life; including negative psychological effects. We aimed to assess the mental health status of a group of Saudi population during this pandemic. Also, we aimed to assess the effect of the intensive media coverage of the pandemic news on mental health status. A questionnaire was distributed online to test depression, anxiety, and stress (using the DASS-21 scale) and their relationship to certain variables. A total of 215 respondents were included. Higher mental health prevalence rates were reported in non-Saudi participants compared to Saudi ones (i.e., 50.74% vs. 30.40%; 34.23% vs. 13.51% and 59.70% vs. 27.70%; for depression, anxiety and stress, respectively). About 55.8% of the participants felt the extensive coverage in the media of COVID-19 news, which caused higher mental sufferings. Higher mental health prevalence rates were reported in females compared to males participants (i.e., 56.97% vs. 23.25%; 30.23% vs. 13.17% and 54.65% vs. 26.35%; for depression, anxiety and stress, respectively). Reasonable following of the COVID-19 news; and less exposure to the pandemic information could help in reducing the mental health issues related to the ongoing pandemic. Special care and attention should be paid to females and younger people who seem to be particularly affected during the era of COVID-19.

The prevalence of psychological distress and its association with coping strategies among medical interns in Malaysia: A national-level cross-sectional study

INTRODUCTION

The prevalence of psychological distress is increasing worldwide. Stressful working environments and high expectations in medical practice put doctors at high risk of depression, anxiety, and stress, especially among medical interns. Effective coping strategies may reduce psychological distress in the clinical setting. This study aimed to determine the prevalence of psychological distress and its association with coping strategies among medical interns in Malaysia.

METHOD

A total of 431 medical interns at 26 Malaysian Ministry of Health hospitals participated in this cross-sectional study in 2017. Self-administered questionnaires consisting of sociodemographic characteristics, items from DASS and BRIEF COPE were used. Descriptive analysis was done followed by further analysis with chi-square and Spearman correlation tests.

RESULTS

The prevalence of stress, anxiety, and depression was 29.7%, 39.9%, and 26.2%, with a significantly higher prevalence among female and younger interns. Three-quarters of them (73.1%) applied problem-focused strategies as the main coping mechanism. Emotion-focused coping strategies showed a significant but weak correlation with anxiety and stress whereas avoidance-based coping strategies were significantly correlated with depression, anxiety, and stress.

DISCUSSION

Medical internship is a highly grueling period. Besides emphasizing clinical competency, internship training should also impart the practice of healthy coping mechanisms. The vulnerable groups of females and younger interns should be taught positive coping skills so that they are empowered to handle any stressors on their personal and professional lives. Optimum psychological wellbeing of the medical interns can improve the overall work performance and quality of care for patients.

Anxiety and Its Association with Preparation for Future Specialty: A Cross-Sectional Study Among Medical Students, Saudi Arabia

Background

Anxiety disorders are a significant global health concern with destructive morbidity and mortality. Medical school is a stressful environment worldwide. This study measures the prevalence of anxiety symptoms among clinical-year medical students in Saudi Arabia. As well as to explore its association with students’ sociodemographic factors, academic performance, issues experienced by them during the study of medicine, and their perceived readiness for their future specialties.

Methods

The generalized anxiety disorder (GAD-7) tool along with a sociodemographic questionnaire was distributed to 523 clinical-year medical students (fourth, fifth and sixth years) from the Imam Abdulrahman Bin Faisal University, Saudi Arabia, in this cross-sectional study. Data analysis was performed with SPSS version 23 and it included the Chi-Square or Fisher’s exact tests for bivariate analysis, and the multivariable logistic regression to account for confounders.

Results

The prevalence of anxiety symptoms as measured by the GAD-7 was found to be 31.7%. Of these, 14.3% had severe symptoms. Only 4.4% students went to a healthcare professional and were diagnosed with psychiatric problems. Logistic regression analysis revealed that the odds of anxiety was higher among females and students who had perceived psychological problems. However, students’ grade point average (GPA) and perceived readiness for their future specialty were not statistically significant with anxiety symptoms.

Conclusion

Anxiety was highly prevalent among clinical-year medical students included in this study. This urges periodic mental health screening, proper diagnosis of high-risk individuals in medical schools, and early interventions through confidential access to mental health services.

Depression among undergraduate medical and engineering students: A comparative study

OBJECTIVE

To study the depression among medical and engineering students of different medical and engineering colleges in Karachi, Pakistan.

METHODS

A comparative cross-sectional study was conducted at different medical and engineering colleges of Karachi from 1st March 2018 till 30th August 2018. Sample size of 362 was calculated by using software SPSS version 22. A close ended, self-administered, modified form of standardized questionnaire was used which comprised of two parts. First part included collection of socio-demographic data, second part had questions for the assessment of depression. Hamilton Depression Scale (HAM-D) was utilized in scoring the depression level in the study subjects.

RESULTS

In engineering and medical colleges 82.87% and 56.9% students were found depressed repeatedly. The result was highly statistically significant. Overall, 109 (30.1%) students were normal, 114 (31.5%) were suffering from mild, 67 (18.5%) moderate, 32 (8.8%) severe and 40 (11.0%) had very severe depression.

CONCLUSION

In the present study, rate of depression was higher in engineering students as compared to medical students. It is recommended in future that qualitative studies of the causes of depression reducing interventions need to be encouraged in professional program, especially in engineering students.

Depression in Mexican medical students: A path model analysis

Background

Depression is a mental health disorder present in medical students that foster cumulative disadvantages throughout life and that may compromise patient care. Yet, in Mexico there is a dearth of research concerning prediction models for depression in this population.

Methods

The aim of this cross-sectional study was to develop and test a path model analysis of depression in 103 freshmen Mexican medical students ages 18–23 years old selected non-randomly. Anxiety, emotion dysregulation, and coping skills were used as factors influencing depression. Mexican self-report scales were used as assessment measures.

Results

Main results showed that anxiety and emotion dysregulation had a significant direct influence on depression. Emotion dysregulation had a significant direct effect on coping skills and anxiety, while anxiety had a significant direct effect on problem drinking and alcohol problems. Fit indexes obtained indicate an excellent adjustment to data. R square indicates that 53.7% of the variance in depression can be explained by this model.

Limitations

The results are exploratory rather than confirmatory. The sample size was not large enough and the research focused on only Mexican freshmen medical students. Other factors associated to depression in medical students were not considered.

Conclusions

The current research provides unique findings in terms of a model of depression in Mexican medical students through which it is possible to design and implement interventions that decrease depression, thus positively affecting their well-being, their future careers as medical doctors and their abilities to serve the society adequately, especially in the context of Latin American cities.

Promoting Resilience in Medicine: The Effects of a Mind-Body Medicine Elective to Improve Medical Student Well-being

Background

Poor mental health is common among medical students. In response, some medical schools have implemented wellness interventions. The University of Florida College of Medicine recently introduced a mind–body medicine elective, Promoting Resilience in Medicine (PRIMe), based on the Georgetown University School of Medicine course. PRIMe teaches meditation techniques including mindfulness, biofeedback, art, and journaling in a faculty-facilitated small group setting.

Methods

First- and second-year medical students (N = 24) who participated in the 11-week elective (3 cohorts over 2 years) completed anonymous surveys regarding their experiences. Measures included the Freiberg Mindfulness Inventory (FMI), Perceived Stress Scale-10 item (PSS-10), and a series of multiple-choice and free-response questions developed for this study. The study was approved by the University of Florida Institutional Review Board.

Results

Among students with available pre- and posttest scores, the average PSS-10 score at pretest was 14.4 (SD = 6.17, range = 3–26) and at posttest was 14.2 (SD = 4.17, range = 8–22), suggesting no change in perceived stress. However, average scores on the FMI improved from 34.4 (SD = 6.10, range = 24–47) at pretest to 41.8 (SD = 4.81, range = 33–49) at posttest. The overwhelming majority of participants (95.8%) described the course as “definitely” worth it. The greatest improvements were noted in mindfulness, relationships with peers, and having a safe place in medical school to receive support. Learning mindfulness/meditation skills and increasing social support were noted as the primary factors impacting student well-being.

Conclusion

A mind–body medicine elective course may be a practical method to improve medical student well-being and improve ability to care for patients. Future studies should include follow-up testing to determine if benefits are sustained over time. In addition, more work is needed to understand the cost–benefit of providing instruction in mind–body medicine techniques to all medical students.

Prevalence of depression and anxiety and correlations between depression, anxiety, family functioning, social support and coping styles among Chinese medical students

Background

Medical students experience depression and anxiety at a higher rate than the general population or students from other specialties. While there is a growing literature on the high prevalence of depression and anxiety symptoms and about potential risk factors to the prevalence of depression and anxiety symptoms among medical students, there is a paucity of evidence focused on the prevalence of depression and anxiety symptoms and associations with family function, social support and coping styles in Chinese vocational medicine students. This study aims to investigate the prevalence of depression and anxiety symptoms among Chinese medical students and assess the correlation between depression/anxiety symptoms and family function, social support and coping styles.

Methods

A sample of 2057 medical students from Chongqing Medical and Pharmaceutical College in China was investigated with a self-report questionnaire, which included demographic information, Zung self-rating depression scale, Zung Self-Rating Anxiety Scale, Family APGAR Index, Social Support Rating Scale and Trait Coping Style Questionnaire.

Results

The prevalence of depression and anxiety symptoms among the medical students was 57.5 and 30.8%, respectively. Older students(≥20 years) experienced higher levels of depression and anxiety. More depression and anxiety symptoms were exhibited among students with big financial burden, big study-induced stress and poor sleep quality. Students with large employment pressure showed more anxiety symptoms. Students who live alone or had bad relationship with their lovers or classmates or friends showed higher depression and anxiety scores. Depression and anxiety symptoms had highly significant correlations with family functioning, social support and coping style.

Conclusions

Academic staffs should take measures to reduce depression and anxiety among medical students and to provide educational counseling and psychological support for students to cope with these problems.

Prevalence and Socio-Demographic Correlates of Mental Health Problems Among Iranian Health Sciences Students

OBJECTIVE

The primary objective of the present study was to compare the mental health status of Iranian medical vs other health sciences students and to examine how demographic factors relate to their mental health problems.

METHODS

A total of 560 medical and other health sciences students (250 (44.6%) males and 310 (55.4%) females) were recruited from Iran University of Medical Sciences. Data were obtained by self-administered questionnaire, including questions on socio-demographic characteristics. The Beck Depression Inventory, Beck Anxiety Inventory, General Health Questionnaire, and WHO well-being index were used to assess mental health status of students.

RESULTS

Ten percent of students had BDI scores consistent with clinically significant depression (6.6% mild, 1.8% moderate, 1.6% severe), and 28.7% had BAI scores consistent with clinically significant anxiety (20.7% mild, 7.1% moderate, 0.9% severe). Kurdish students had an odds ratio (OR) of 2.71 (95% CL, 1.22-6.02) for mild to severe depression symptoms when compared to Persian students. The prevalence of distressed health sciences students and poor psychological well-being was 13.4% and 14.1%, respectively. Maternal education gave an OR of 0.57 (0.35-0.93) for anxiety symptoms, after adjustment for all other factors. The possibility of general psychiatric morbidity was significantly lower in students who studied medicine (OR, 0.40 (0.21-0.71)). Being born in the capital city was associated with better psychological well-being (OR, 0.48 (0.26-0.86)).

CONCLUSIONS

Ethnicity, birthplace, discipline, and maternal educational level were major determinants of mental health status among health sciences students. Further research should be undertaken to determine the prevalence of psychological disorders using more reliable diagnostic interview.

Ansiedad, depresión y actividad autónoma en estudiantes de enfermería, en el estado de Guanajuato, México

Nuestro objetivo fue estudiar las relaciones entre actividad autonómica, ansiedad y depresión de estudiantes de enfermería, siguiendo un diseño correlacional y un muestreo intencional; se aplicaron los inventarios de ansiedad y depresión de Beck, así como el perfil psicofisiológico del estrés. Fueron incluidas 133 personas de primero, tercero y quinto semestre de una universidad de Guanajuato, México. El índice promedio de ansiedad fue de 23.17 (nivel moderado). La media de depresión fue de 7.9 (nivel mínimo). No se encontraron relaciones significativas entre ansiedad y depresión (rs = 0.077, p = 0.380), ni entre estas emociones y el nivel de actividad autonómica (p = 0.05). En el perfil psicofisiológico se encontraron correlaciones entre los índices obtenidos en la primera condición y los de la última (rs = 0.844, p < 0.05). La ansiedad y la depresión son muy prevalentes, pero son necesarios más estudios para clarificar las relaciones que hay entre ellos y la actividad autonómica de estudiantes universitarios.