Welfare and well-being: towards mental health-promoting welfare systems

Medical students' attitudes towards well-being and welfare: a systematic review protocol

INTRODUCTION

Medical education poses serious stressors on medical students, as they report overall higher rates of psychiatric comorbidities compared with students enrolled in other university-level courses. The high rates of poor well-being reported should be considered a concern, as students represent the future workforce of healthcare professionals. Although there has been an increased interest towards well-being and burn-out in medical students, there is still much to be elucidated. Indeed, there is an overall lack of understanding of which attitudes medical students have towards well-being and welfare, something that could be used to develop targeted practice to improve medics' quality of life and reduce overall burn-out.This review will aim at evaluating and reporting the current research available on medical students' attitudes towards well-being and welfare. We will take into account which countries have published data on the topic, and we will analyse papers written during the COVID-19 period separately, giving this particular time frame a separate outlook.

METHODS AND ANALYSIS

This systematic review protocol has been developed following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. A systematic search including "medical students" AND "wellbeing" AND "perceptions" was carried out on MEDLINE, Embase and Scopus databases. The Mixed Method Appraisal Tool will be used to assess the quality of the available studies and risk of bias. Studies will be screened using predetermined inclusion and exclusion criteria. Data will be summarised narratively and in tabular forms. A narrative subgroup analysis of the COVID-19 period will be carried out, and a country-wise approach will be used to describe which areas have published relevant studies.

ETHICS AND DISSEMINATION

This will be the first systematic review looking at the reported attitudes that medical students have towards well-being and welfare. This will provide an account of the available data on the topic, and a starting point to understand where further research is needed in the future.

PROSPERO REGISTRATION NUMBER

CRD42023471022.

Self-stigma and bipolar disorder: A systematic review and best-evidence synthesis

BACKGROUND

Bipolar disorder is a severe and chronic mental illness characterized by recurrent major depressive episodes and mania or hypomania. In addition to the burden of the disease and its consequences, self-stigma can impact people with bipolar disorder. This review investigates the current state of research in self-stigma in bipolar disorder.

METHODS

An electronic search was carried out until February 2022. Three academic databases were systematically searched, and best-evidence synthesis was made.

RESULTS

Sixty-six articles were related to self-stigma in bipolar disorder. Seven key themes were extracted from these studies: 1/ Comparison of self-stigma in bipolar disorder and other mental illnesses, 2/ Sociocultural context and self-stigma, 3/ Correlates and predictors of self-stigma, 4/ Consequences of self-stigma, 5/ Treatments and self-stigma, 6/ Management of self-stigma, and 7/ Self-stigma and recovery in bipolar disorder.

LIMITATIONS

Firstly, a meta-analysis could not be performed due to the heterogeneity of the studies. Secondly, limiting the search to self-stigma has excluded other forms of stigma that also have an impact. Thirdly, the under-reporting of negative or nonsignificant results due to publication bias and unpublished studies might have limited the accuracy of this reviews' synthesis.

CONCLUSION

Research on self-stigma in persons with bipolar disorder has been the focused on different aspects, and interventions to reduce self-stigmatization have been developed, but evidence of their effectiveness is still sparse. Clinicians need to be attentive to self-stigma, its assessment, and its empowerment in their daily clinical practice. Future work is required to establish valid strategies to fight self-stigma.