Depression and hopelessness in pre-clinical medical students

Prevalence of Depression and Generalized Anxiety Among LGBTQ+ Medical Students in Thailand

This study evaluated the prevalence and associated factors of depression and generalized anxiety among LGBTQ+ in five medical schools in Thailand. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively, and multivariable logistic regression was employed to identify associated factors. Of 1,322 students, 412 (31.16%) identified as LGBTQ+. The prevalence for MDD and GAD among LGBTQ+ students were 32.77% and 17.23%, respectively. Significant associated factors for both MDD and GAD were a history of psychiatric illness (AOR for MDD = 2.32, p = .020; AOR for GAD = 3.67, p < .001), educational problems (AOR for MDD = 6.62, p < .001; AOR for GAD = 5.12, p < .001), and dissatisfaction with gender identity or sexual orientation (AOR for MDD = 1.92, p = .019; AOR for GAD = 2.47, p = .005). Additional factors associated with MDD were preclinical years (AOR = 2.30, p = .023), financial struggles (AOR = 2.05, p = .021), and inadequate peer support (AOR = 2.57, p = .044). In conclusion, nearly one-third and one-fifth of Thai LGBTQ+ medical students suffer from MDD and GAD, respectively. Our findings suggest that Thai medical schools should promote LGBTQ+ inclusivity to enhance students' identity satisfaction. Peer support groups should be encouraged, especially for preclinical LGBTQ+ students who face educational and financial challenges.

Pride & prejudice: A scoping review of LGBTQ + medical trainee experiences

PURPOSE

LGBTQ + medical trainees experience significant discrimination. These individuals are stigmatized within a hetero- and cis-normative system, resulting in poorer outcomes in mental health and increased stress regarding career trajectory compared with their hetero- and cis-identifying counterparts. However, literature on the barriers experienced during medical training in this marginalized group is limited to small heterogeneous studies. This scoping review collates and explores prominent themes in existing literature on the personal and professional outcomes of LGBTQ + medical trainees.

METHODS

We searched five library databases (SCOPUS, Ovid-Medline, ERIC, PsycINFO and EMBASE) for studies that investigated LGBTQ + medical trainees' academic, personal, or professional outcomes. Screening and full text review were performed in duplicate, and all authors participated in thematic analysis to determine emerging themes, which were iteratively reviewed to consensus.

RESULTS

From 1809 records, 45 met inclusion criteria (κ = 0.57). Major themes that emerged in the literature included the prevalence of discrimination and mistreatment faced by LGBTQ + medical trainees from colleagues and superiors, concerns regarding disclosure of sexual and/or gender minority identity, and overall negative impacts on mental health including higher rates of depression, substance use, and suicidal ideation. There was a noted lack of inclusivity in medical education and having an LGBTQ + identity had a large impact on career trajectory. Community with peers and mentors was an important determinant of success and belonging. There was a noteworthy lack of research on intersectionality or positive interventions that improved outcomes for this population.

CONCLUSION

This scoping review highlighted important barriers facing LGBTQ + medical trainees, identifying substantial gaps in the existing literature. Research on supportive interventions and predictors of training success is lacking and will be important to foster an inclusive education system. These findings provide critical insights for education leaders and researchers to help create and evaluate inclusive and empowering environments for trainees.

Depression among medical students in Tunisia: Prevalence and associated factors

BACKGROUND

Medical school is known for its lengthy process, which is both physically and emotionally draining. Students' mental balance would shrink as they progress in their medical training. A systematic review and meta-analysis reported that the prevalence of depressive symptoms among medical students remained relatively constant at 27.2%.

AIM

To assess the prevalence of depressive symptoms among Tunisian medical students and evaluate its associated factors.

METHODS

This is a descriptive cross-sectional study that was carried out in the second semester of the academic year 2017/2018, between April 2018 and July 2018 among 1138 medical students. Data were collected using a socio-demographic questionnaire and the Beck Depression Inventory-II (BDI-II).

RESULTS

Sixty-four percent (n = 728) of the participants had depressive symptoms, of which 266 (23.4%) met the criteria for mild, 271 (23.8%) for moderate, and 191 (16.8%) for severe depressive symptoms. Female gender, low socio-economic level, smoking habits and history of mental disorder, performing leisure and physical activities, satisfaction toward a career choice, and happiness perception were the main prognostic factors for depression among medical students. Although academic grades may not be considered a prognostic factor, final-year students appeared to be less depressive than their colleagues.

CONCLUSION

These findings give insight into mental health issues and comorbidities among Tunisian medical students. It is a hopeful request for decision-makers and academic authorities to set serious measures and draw effective interventions to minimize the currency of psychological distress among this subpopulation.

The effect of watching lecture videos at 2× speed on memory retention performance of medical students: An experimental study

AIM

This study aimed to determine how watching lecture videos at 1× and 2× speeds affects memory retention in medical students.

METHODS

A posttest-only experimental design was utilized. The participants were 60 Year-1 and Year-2 medical students. The participants were assigned to one of two groups through stratified randomization: Group 1 would watch the video at 1× speed, and Group 2 at 2× speed. Their performance was assessed using a test comprising 20 multiple-choice questions. The test has been applied immediately after watching the video (Immediate test), and, again after one week (Delayed test). Parametric and non-parametric statistical tests were performed.

RESULTS

In the Immediate test, the mean score of the 1× speed group was 11.26 ± 4.06, while 2× speed group's mean score was 10.16 ± 2.46. The difference was not significant t(58) = 1.26, p > .05. In the Delayed test, the mean score of 1× speed group was 9.66 ± 3.94, while 2× speed group's mean score was 8.36 ± 2.80. The difference was not significant t(55) = 1.42, p > .05.

CONCLUSIONS

Watching the video lecture at 2× speed did not impair memory retention in medical students. This may help students to save time in their dense curricula.[Box: see text].

Determinants of Poor Mental Health of Medical Students in Portugal-A Nationwide Study

Medical students are a population that is vulnerable to the development of anxiety, depression, and burnout. This observational cross-sectional study sought to assess the levels of distress and identify precipitating factors in all students enrolled in a Portuguese medical school during the academic year of 2022/23. Students (n = 768) were surveyed via validated instruments to measure anxiety, depression, and burnout. Sociodemographic information was also collected through a questionnaire. The study indicated that almost half of this population had depressive symptoms. No differences were found in distress levels between medical schools, and when comparing curricular years, higher levels of distress were found in the pre-clinical years in comparison to the clinical ones. Burnout, being a woman, the existence of physical health problems, homo- and bisexual orientations, affective family problems, problems with relationships in the academic community, difficulties in academic performance, and daily organization were identified as predictors of distress. On the other hand, satisfaction with the social support received and with academic ratings were identified as protective factors. In conclusion, there is a high prevalence of distress in medical students, which is associated with personal, physical, social, economic, and academic factors. The identification of predictive factors of distress may allow for the early identification of vulnerable students and for intervention and prevention strategies to be defined.

Well-being at a Military Medical School and Implications for Military Retention

INTRODUCTION

Physical and psychological well-being play a critical role in the academic and professional development of medical students and can alter the trajectory of a student's quality of personal and professional life. Military medical students, given their dual role as officer and student, experience unique stressors and issues that may play a role in their future intentions to continue military service, as well as practice medicine. As such, this study explores well-being across the 4 years of medical school at Uniformed Services University (USU) and how well-being relates to a student's likelihood to continue serving in the military and practicing medicine.

METHODS

In September 2019, 678 USU medical students were invited to complete a survey consisting of three sections-the Medical Student Well-being Index (MSWBI), a single-item burnout measure, and six questions regarding their likelihood of staying in the military and medical practice. Survey responses were analyzed using descriptive statistics, analysis of variance (ANOVA), and contingency table analysis. Additionally, thematic analysis was conducted on open-ended responses included as part of the likelihood questions.

RESULTS

Our MSWBI and burnout scores suggest that the overall state of well-being among medical students at USU is comparable to other studies of the medical student population. ANOVA revealed class differences among the four cohorts, highlighted by improved well-being scores as students transitioned from clerkships to their fourth-year curriculum. Fewer clinical students (MS3s and MS4s), compared to pre-clerkship students, indicated a desire to stay in the military. In contrast, a higher percentage of clinical students seemed to "reconsider" their medical career choice compared to their pre-clerkship student counterparts. "Medicine-oriented" likelihood questions were associated with four unique MSWBI items, whereas "military-oriented" likelihood questions were associated with one unique MSWBI item.

CONCLUSION

The present study found that the overall state of well-being in USU medical students is satisfactory, but opportunities for improvement exist. Medical student well-being seemed to have a stronger association with medicine-oriented likelihood items than with military-oriented likelihood items. To obtain and refine best practices for strengthening engagement and commitment, future research should examine if and how military and medical contexts converge and diverge throughout training. This may enhance the medical school and training experience and, ultimately, reinforce, or strengthen, the desire and commitment to practice and serve in military medicine.

Depression and anxiety of medical students at Kunming Medical University during COVID-19: A cross-sectional survey

An isolation strategy was used to control the transmission and rapid spread of COVID-19 in Yunnan. As a result, students were supposed to stay at home and disrupted their outside activities. It led to a detrimental influence on students' mental health. The purpose of this study was to investigate the prevalence and risk factors of depression and anxiety among medical students and to provide ideas for the prevention of depression and anxiety in medical students. A cross-sectional survey was conducted among 2,116 medical students at Kunming Medical University from July 8 to July 16, 2020. Participants' demographic and living conditions were collected. Depression and anxiety were measured using the Patient Health Questionnaire 9 and General Anxiety Disorder-7, respectively. Uni- and multivariate logistic regression analyses were performed to detect risk factors associated with depression and anxiety. The prevalence rates of depression and anxiety among medical students were 52.5 and 29.6%, respectively. Depression was more likely to be caused by low grades, lack of physical exercise, drug use, irregular diet, extensive screen time on mobile phones, being greatly affected by the COVID-19 pandemic, and inadaptability to offline courses. Anxiety was more likely to be caused by lack of physical exercise, drug use, irregular diet, and inadaptability to offline courses. Depression and anxiety are highly comorbid. Our study showed predictive factors for depression and anxiety and identified a major mental health burden on medical students during the COVID-19 outbreak. More targeted measures should be taken to improve the mental state of students to reduce the incidence of depression and anxiety.

Screening of substance use and mental health problems among Spanish medical students: A multicenter study

BACKGROUND

This study aimed to determine the prevalence of substance consumption and mental health problems among Spanish medical students, and their association with sociodemographic factors.

METHODS

A multicentre cross-sectional study was conducted. Self-reported data on sociodemographic and clinical characteristics were collected, including BDI-II, PHQ-9, brief STAI, and single-item academic burnout (IUBA).

RESULTS

Overall, 1265 students (74.2% female) completed the survey. Of them, 37.4% scored positive for depressive symptoms, as measured by the BDI-II, and more than half (53%) by the PHQ-9. Suicidal ideation was reported by about 12% whilst high levels of state and trait anxiety were informed by 28.8% and 29.4% of the students. The prevalence of burnout was 40.2%. Female and pre-clinical students reported significantly (p < 0.01) higher rates of depressive, anxiety, and burnout symptoms. Alcohol, energy drinks, and tobacco were the most frequently used substances. Total scores of self-reported mental health problems negatively correlated (p < 0.001) with objective academic results and positively correlated (p < 0.02) with the number of substances consumed in the last 30 days.

LIMITATIONS

Research-based on self-reported data could favour information bias due to the social desirability effect and memory error.

CONCLUSIONS

A high prevalence of substance consumption and several mental health problems was found among medical students, especially females. The relevant influence of academic-related factors on students' well-being may be a call for medical schools to implement initiatives aimed to improve students' ability to detect, address, and seek help for their mental health issues.

Associations Between Academic Stress and Depressive Symptoms Mediated by Anxiety Symptoms and Hopelessness Among Chinese College Students

Purpose

Patients and Methods

Results

Conclusion

Associations between family social circumstances and psychological distress among the university students of Bangladesh: To what extent do the lifestyle factors mediate?

BACKGROUND

While there is a growing body of empirical studies focusing on the social and behavioral predictors of psychological health, the mechanisms that may underlie the reported associations have not been adequately explored. This study aimed to examine the association of social and lifestyle factors with psychological distress, and the potential mediating role of the lifestyle factors in the estimated associations between social circumstances and psychological distress.

METHODS

A total of 742 tertiary level students (53% females) from a range of socio-economic backgrounds and multiple educational institutions participated in this cross-sectional study. The 12-items General Health Questionnaire (GHQ-12) was utilized for measuring psychological distress. Data related to students' socio-demographic characteristics, family social circumstances, and lifestyle factors were also collected. Modified Poisson regression analysis was used to estimate the risk ratios (RR) and their 95% confidence intervals (CI).

RESULTS

The multivariable regression analysis suggests heightened risks of psychological distress associated with low parental Socio-Economic Position (SEP) (RR: 1.36; 95% CI: 1.07, 1.76), childhood poverty (RR: 1.31; 95% CI: 1.11, 1.55), and living away from the family (RR: 1.28; 95% CI: 1.07, 1.54). Among the lifestyle factors, past smoking, physical inactivity, inadequate fruit intake, and poor sleep quality were strongly associated with psychological distress and these associations persisted when the family social circumstances and lifestyle factors were mutually adjusted for. The lifestyle factors did not considerably mediate the estimated associations between family social circumstances and psychological distress.

CONCLUSION

The social and lifestyle factors operated independently to increase students' risk of psychological distress. Accordingly, while promoting students' healthy lifestyles may reduce the overall burden of psychological distress, any equity initiative aiming to minimize the social inequalities in psychological health should be targeted to improving the living conditions in early life.