Correlations between psychological symptoms and social relationships among medical undergraduates in Anhui Province of China

Relationship between attention deficit hyperactive disorders with life satisfaction among medical students in city of Hail, KSA

BACKGROUND

Attention deficit hyperactive disorder (ADHD) begins in childhood, and its symptoms persist into adulthood. Students with ADHD symptoms will be at increased risk of antisocial behavior, depression, and loss of inhibition. This study determines the relationship between ADHD and life satisfaction level among medical students in the city of Hail, KSA.

MATERIALS AND METHODS

This is a cross-sectional study that was conducted in a public-sector medical college. A total of 200 students were recruited through stratified cluster sampling. Validated, structured scales of ADHD and life satisfaction were used, and known psychiatric disorders among students were excluded from the study. Correlation and linear regression analyses were used to determine the relationship between ADHD and life satisfaction and identify the determinants of ADHD. P value < 0.05 was considered statistically significant.

RESULT

The prevalence rate of ADHD among medical students was 33.3%. Female gender, third-year academic year student, and 21-26-year-old age group were the high-risk groups of ADHD. Inattention (r = -0.263, P value -0.000) and hyperactivity (r = -0.260, P value 0.000) were significantly correlated with life satisfaction level, with 92% of the variability in life satisfaction determined by inattention and hyperactivity.

CONCLUSION

The burden of ADHD is high among medical students, and it negatively correlates with life satisfaction level. Students' academic and social functioning was affected due to ADHD. There is a need to address this issue with early diagnosis and management of this disorder.

Students' mental health during the pandemic: results of the observational cross-sectional COVID-19 MEntal health inTernational for university Students (COMET-S) study

Introduction

The aim of the study was to search rates of depression and mental health in university students, during the COVID-19 pandemic.

Materials and methods

This is an observational cross-sectional study. A protocol gathering sociodemographic variables as well as depression, anxiety and suicidality and conspiracism was assembled, and data were collected anonymously and online from April 2020 through March 2021. The sample included 12,488 subjects from 11 countries, of whom 9,026 were females (72.2%; aged 21.11 ± 2.53), 3,329 males (26.65%; aged 21.61 ± 2.81) and 133 "non-binary gender" (1.06%; aged 21.02 ± 2.98). The analysis included chi-square tests, correlation analysis, ANCOVA, multiple forward stepwise linear regression analysis and Relative Risk ratios.

Results

Dysphoria was present in 15.66% and probable depression in 25.81% of the total study sample. More than half reported increase in anxiety and depression and 6.34% in suicidality, while lifestyle changes were significant. The model developed explained 18.4% of the development of depression. Believing in conspiracy theories manifested a complex effect. Close to 25% was believing that the vaccines include a chip and almost 40% suggested that facemask wearing could be a method of socio-political control. Conspiracism was related to current depression but not to history of mental disorders.

Discussion

The current study reports that students are at high risk for depression during the COVID-19 pandemic and identified specific risk factors. It also suggested a role of believing in conspiracy theories. Further research is important, as it is targeted intervention in students' groups that are vulnerable both concerning mental health and conspiracism.

Behavioral and psychosocial factors related to mental distress among medical students

Introduction

Physicians die by suicide at rates higher than the general population, with the increased risk beginning in medical school. To better understand why, this study examined the prevalence of mental distress (e.g., depressive symptoms and suicide risk) and behavioral and psychosocial risk factors for distress, as well as the associations between mental distress and risk factors among a sample of medical students in a pre-COVID-19-era.

Methods

Students enrolled in a large California medical school in 2018-2019 (N = 134; 52% female) completed questionnaires assessing sociodemographic characteristics, depression and suicide family history, health behaviors, and psychosocial wellbeing. Assessment scores indexing mental distress (e.g., depressive symptoms, thoughts of suicide in the past 12 months, suicide risk, and history of suicidality) and risk factors (e.g., stress, subjective sleep quality, alcohol use, impostor feelings, and bill payment difficulty) were compared across biological sex using chi-squared tests, and associations between mental distress and risk factors were determined through logistic regression.

Results

Elevated mental distress indicators were observed relative to the general public (e.g., 16% positive depression screen, 17% thought about suicide in previous 12 months, 10% positive suicide risk screen, and 34% history of suicidality), as well as elevated risk factors [e.g., 55% moderate or high stress, 95% at least moderate impostor feelings, 59% poor sleep quality, 50% screened positive for hazardous drinking (more likely in females), and 25% difficulty paying bills]. A positive depression screen was associated with higher stress, higher impostor feelings, poorer sleep quality, and difficulty paying bills. Suicidal ideation in the previous 12 months, suicide risk, and a history of suicidality were independently associated with higher levels of impostor feelings.

Discussion

Higher scores on assessments of depressive symptoms and suicidal thoughts and behaviors were related to several individual-level and potentially modifiable risk factors (e.g., stress, impostor feelings, sleep quality, and bill payment difficulties). Future research is needed to inform customized screening and resources for the wellbeing of the medical community. However, it is likely that the modification of individual-level risk factors is limited by the larger medical culture and systems, suggesting that successful interventions mitigate suicide risk for medical providers need to address multiple socio-ecological levels.

Association between healthy sleep patterns and depressive trajectories among college students: a prospective cohort study

BACKGROUND

The purpose of this study was to identify different develpment trajectories of depression symptoms during college period, and prospectively investigate the associations healthy sleep patterns with trajectories of depression symptoms among college students from freshman through junior year.

METHODS

A total of 999 participants from the College Student Behavior and Health Cohort Study were included between April 2019 and June 2021. Healthy sleep patterns were defined by chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. Latent growth curve model was used to identify trajectories of depression symptoms. Then binary logistic regression was used to examine association of the healthy sleep patterns with these trajectories.

RESULTS

In baseline survey, we found that a total of 100 (10.0%) participants had healthy sleep patterns' score equal to 5. Then, we used 5 surveys' data to identify 2 distinct trajectories of depression symptoms during college (decreasing: 82.5%; increasing: 17.5%). The healthy sleep patterns were associated with these trajectories, the better healthy sleep patterns significantly decrease the risk of increasing trajectories of depression symptoms in males (OR: 0.72, 95%CI: 0.54 ~ 0.97, P = 0.031). Moreover, we found out that the healthy sleep patterns of college students can predict the future depressive symptoms in this study (all P < 0.001).

CONCLUSION

Our findings indicate that the better healthy sleep patterns may significantly decrease the risk of increasing trajectory of depression symptoms only in male college students. The results speak to a need for college student with depression symptoms to identify and address sleep problems when present, which could prevent or reduce depression detriments in later life.

Formative objective structured clinical examination with immediate feedback improves surgical clerks' self-confidence and clinical competence

OBJECTIVE

Clerkship is crucial for fourth-year medical students before entering the clinical environment. However, lack of confidence impairs clerks' performance during the clinical rotation. We assess the impact of formative Objective Structured Clinical Examination (OSCE) with immediate feedback on surgical clerks' self-confidence and clinical competence.

METHODS

This is a prospective randomized controlled study. Thirty-eight fourth-year medical students starting their surgical clerkship were randomly divided into the control group (n = 19) and the OSCE group (n = 19), where an extra 6-station formative OSCE was given prior to the surgical rotation with immediate feedback on the participant's performance. Self-confidence assessment (SCA) was collected from each participant before, right after the formative OSCE and one month later. Clinical competence was assessed using a mini-clinical evaluation exercise (mini-CEX) with a case of acute abdominal pain and direct observation of procedural skills (DOPS) with incision and suture one month later.

RESULTS

The SCAs were significantly improved in the OSCE group right after the training, and a month later, compared to the control group. The mini-CEX score was significantly higher in the OSCE group compared to the control group, but not the DOPS score of incision and suture.

CONCLUSION

The formative OSCE with immediate feedback could significantly enhance surgical clerks' self-confidence and their clinical competence when taking the history, performing the physical examination, and in clinical reasoning; however, the formative OSCE did not improve their dexterity in performing the procedural skills.

Anxiety and depression and their interdependent influencing factors among medical students in Inner Mongolia: the cross-sectional survey

BACKGROUND

Mental health has become a global problem, among which anxiety and depression disorder were ranked as the first and sixth leading causes of disability, respectively, according to the World Health Organization (WHO). Medical students experienced higher levels of anxiety and depression than the general population. But there was a lack of research on the emotional situation among medical students in Inner Mongolia. The main objectives of this study were to investigate the prevalence of anxiety and depression symptoms as well as the factors that influence them among medical students in Inner Mongolia.

METHODS

A cross-sectional study was conducted on 1282 students from a university in Inner Mongolia, China, ranging in age from 16 to 27 years. They were assessed demographic indicators, the disorder of anxiety and depression using Zung's Self-Rating Anxiety Scale and Self-Rating Depression Scale (SAS and SDS) by an anonymous, self-administered questionnaire. The internal reliability and validity of the questionnaire were determined using Cronbach's alpha coefficient, Kaiser-Meyer-Olkin (KMO), and Bartlett's sphericity. T-tests and one-way ANOVA were used to explore factors, including demographic and behavioral information influencing anxiety and depression disorder. According to the above results of exploring the influencing factors based on univariate analysis, significant factors (p < 0.05) were entered into multiple linear regressions that sequentially fitted to predictors associated with anxiety and depression. The collected data were entered into EpiData for windows and analyzed using SPSS 26.0. The p < 0.05 was considered to be significantly different.

RESULTS

The questionnaire was completed by 1187 students with a 92.59% response rate. The prevalence of anxiety and depression symptoms among medical students were 10.36% and 24.43%, and the mean ± standard deviation (M ± SD) anxiety and depression scores were 39.60 ± 7.81 and 48.23 ± 9.06, respectively, among the medical students. The specific contributions of the two scales with good reliability and validity were 60.58% and 63.59%, respectively. For univariate analysis, age, whether the daily meal was at a fixed time, grade, the birthplace of students, average daily eating habits, were the factors that influenced both the total score of SAS and SDS (p < 0.05). For further analysis, the results showed that "Birthplace of students" and "Whether daily meals at a fixed time" were significantly associated with anxiety and depression. Furthermore, "Age" and "Mode of delivery" were independent risk factors for depressive disorder.

CONCLUSION

Our findings revealed that high prevalence of mental health problems among medical students in Inner Mongolia. The Ministry of Medical Education should make a targeted intervention for specific risk factors of this study to improve psychological well-being and face uncertain future challenges among university students in Inner Mongolia.

Interventions in Chinese Undergraduate Students' Mental Health: Systematic Review

BACKGROUND

Over 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students' mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being.

OBJECTIVE

The aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students' affairs counselors, and mental health providers.

METHODS

We performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis.

RESULTS

We retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students' affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers.

CONCLUSIONS

This was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students' mental health is a research topic worth further investigation.

The impacts of coping style and perceived social support on the mental health of undergraduate students during the early phases of the COVID-19 pandemic in China: a multicenter survey

BACKGROUND

An increasing number of undergraduate students in China have been reported to have psychological problems. In response to the COVID-19 pandemic, a series of preventive and control measures were implemented, which undoubtedly worsened their psychological health. Coping style and social support were probably important factors that affected the psychological well-being of undergraduate students during the pandemic. This study aimed to explore the effects of coping style and perceived social support on the psychological well-being of college students and relevant risk factors.

METHODS

This cross-sectional study was performed in February and March of 2020 by distributing an online questionnaire among undergraduate students from seven geographical regions across China. The questionnaire included sociodemographic information; the 21-item Depression, Anxiety and Stress Scale (DASS-21); the Perceived Social Support Scale (PSSS); and the Simplified Coping Style Questionnaire (SCSQ). For the analyses, t-tests, one-way analysis of variance (ANOVA), the Kruskal-Wallis test and multiple linear regression were utilized. The level of significance was set at P < 0.05.

RESULTS

Among 3113 college students, the rates of anxiety, depression and stress symptoms were 13.3, 15.4 and 6.8%, respectively. Increased rates of current smoking and drinking (5.5 and 25.2%, respectively) among undergraduates were identified. The results indicated that the PSSS subscales and SCSQ subscales were significantly associated with DASS-21 scores (P < 0.001). Multiple linear regression analysis showed that active coping style and family support were protective factors while passive coping style could aggravate psychological problems among participants (P < 0.001).

CONCLUSIONS

A remarkable number of college students adopted passive coping strategies to cope with negative feelings, such as smoking and drinking, which were detrimental to their mental health. In contrast, active coping strategies helped improve their psychological well-being. Moreover, family support was particularly important for maintaining their mental health and ameliorating mental health challenges in this major health crisis. Consequently, suitable psychointervention, routine screening for risk behaviors, and provision of further social support are needed for undergraduate students in the COVID-19 pandemic or other emergency public health events.

Prevalence of depression among Chinese medical students: A systematic review and meta-analysis

The prevalence of depression continues to increase among medical students in China, and higher than that of other majors, which is a potential risk for medical students and their patients. This study aimed to observe the prevalence of depression in Chinese medical students and also the correlation between them. All cross-sectional studies on the prevalence of depression in Chinese medical students were retrieved from PubMed, Embase, the Cochrane Database of Systematic Reviews, CNKI, and Wanfang. An 11-item checklist recommended by the Agency for Healthcare Research and Quality was adopted to evaluate the methodological quality of the included studies. Software Stata 12.0 was used to analyze the data. Registration: PROSPERO, CRD42020169681. The prevalence of depression among medical students in China was 27%. The subgroup analysis showed significant differences in the prevalence of depression in different regions. The sleep quality was a significant heterogeneous source of depression. Medical students with sleep disorders were more than three times as likely to report depression. The prevalence of depression in Chinese medical students is relatively high, and medical students with sleep disorders are more likely to have depression problems. Regular screening and appropriate intervention are recommended for these mental health problems.

Depression and its correlation with social support and health-promoting lifestyles among Chinese university students: a cross-sectional study

OBJECTIVES

To investigate the prevalence of depression in college students and determine how social support and healthy lifestyle factors are associated with depression in this population.

DESIGN

A cross-sectional design.

SETTING

A comprehensive university in Changsha, Hunan, South China. The study was conducted from May to June 2019.

PARTICIPANTS

A total of 541 students at the comprehensive university.

PRIMARY AND SECONDARY OUTCOME MEASURES

The Zung Self-Rating Depression Scale, Social Support Rating Scale and Health-Promoting Lifestyle Profile-II (HPLP-II) were used to evaluate depression, social support and lifestyles, respectively, and analyse the mutual relationships among them.

RESULTS

Among the 541 participants, 161 (29.8%) experienced depressive symptoms, and there were significant gender-related and academic discipline-related differences in self-rated depression. The average social support score was 38.06 (38.06±7.52). The average HPLP-II score was 71.09 (71.09±11.47). A monofactor analysis showed that depression was correlated with social support and a healthy lifestyle. As demonstrated by logistic regression analysis, being a woman (OR=2.613, 95% CI: 1.541 to 4.43), inadequate social support (OR=0.912, 95% CI: 0.877 to 0.948), poor nutrition (OR=0.87, 95% CI: 0.775 to 0.977) and lack of self-actualisation (OR=0.644, 95% CI: 0.572 to 0.724) were significantly correlated with depression.

CONCLUSIONS

Owing to the high prevalence of depression among Chinese university students, educational institutions must take measures such as providing compulsory mental health education courses and improving the psychological counselling services available to students.

Impact of COVID-19 on medical students' mental wellbeing in Jordan

COVID-19 has spread throughout the world and has resulted in significant morbidity, mortality, and negative psychological impact. This prospective cross-sectional study is exploring the effect of the pandemic on mental health of medical students. The study was conducted at six Jordanian medical schools using an online survey to collect students’ socio-demographic and academic data. Assessment of mental wellbeing status was done using Kessler’s psychological stress scale (K10); the impact of COVID-19 on life activities and strategies followed to manage the situation were also examined. A total of 553 medical students were recruited for the study. Men constituted 40.1%, and women were 59.9%. Students reported that COVID-19 has affected the aspects of physical fitness (73.1%), study (68.4%), and social relationships (65.6%) the most. Sixty-six percent of the students were concerned about family members’ affection, and more than half (58.4%) explained their concerns about the inability to get clinical sessions and labs. Cooking, baking, and hobby practicing were the most popular methods to improve their mental wellbeing. About half of the participants had a severe mental disorder, and only 13.2% were likely to be well. The study indicates that half of our medical students suffer severe mental disorders, with physical fitness, exercise, and studying being among the most affected aspects during the COVID 19 pandemic. It is recommended that measures need be taken to alleviate students’ stress, which might have deleterious effects in many aspects.

The mediating effect of self-efficacy on the relationship between family functioning and quality of life among elders with chronic diseases

Aim

To explore whether self‐efficacy has any positive or negative mediating effects between family functioning and quality of life among elders with chronic diseases.

Design

A cross‐sectional study.

Methods

Questionnaires were collected from 516 community‐dwelling elderly individuals with chronic diseases using a convenience sampling method. The questionnaires included the Self‐efficacy for Managing Chronic Disease Six‐Item Scale, the Family Adaptation Partnership Growth Affection Resolve Index and the MOS 36‐Item Short Form Health Survey.

Results

Family functioning and self‐efficacy impacted the quality of life of community‐dwelling elderly individuals with chronic diseases. Family functioning was mediated by self‐efficacy and had an indirect impact on quality of life. The mediating effect accounted for 62.50% of the total effect.

Prevalence of anxiety and depression symptom, and the demands for psychological knowledge and interventions in college students during COVID-19 epidemic: A large cross-sectional study

BACKGROUND

Although studies have suggested experiencing the epidemic of severe infectious diseases increased the prevalence of mental health problems, the association between COVID-19 epidemic and risk of anxiety and depression symptom in college students in China was unclear.

METHODS

A large cross-sectional online survey with 44,447 college students was conducted in Guangzhou, China. The Zung's Self-rating Anxiety Scale (SAS) and the Center for Epidemiologic Studies Depression Scale (CES-D Scale) were used to define the anxiety and depression symptom, respectively. Multivariable logistic regression models were used to analyze the association between COVID-19 epidemic and risk of anxiety and depression symptom.

RESULTS

The prevalence of anxiety and depression symptom was 7.7% (95% confidence interval [CI]: 7.5%, 8.0%) and 12.2% (95%CI: 11.9%, 12.5%), respectively. Compared with students who reported have not infected or suspected cases in family members and relatives, students who reported having confirmed (OR=4.06; 95%CI: 1.62, 10.19; P = 0.003), and suspected (OR=2.11; 95%CI: 1.11, 4.00; P = 0.023) cases in family members and relatives had higher risk of depression symptom. Additionally, the proportions of students with anxiety and depression symptom reported more demand of psychological knowledge and interventions than those without (P<0.001).

LIMITATIONS

All the data in this study was collected through online questionnaire, and we did not evaluate the reliability and validity.

CONCLUSIONS

The prevalence of anxiety and depression symptom was relatively low in college students, but the COVID-19 epidemic-related factors might be associated with higher depression symptom risk.

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.

Prevalence of depression among university students in low and middle income countries (LMICs): a systematic review and meta-analysis

INTRODUCTION

Though university years are peak time for the onset of many mental health problems including depression, knowledge on the prevalence of depressive symptoms among university students in low and middle-income countries (LMICs) is limited. This study examined the prevalence of depressive symptoms among university students in LMICs.

METHODS

We systematically searched PubMed, Web of Science, and WHO Global Health Library for studies published between January 1, 2009 and December 31, 2018. Cross-sectional and longitudinal studies conducted in LMICs (as defined by World Bank), having a sample size≥500 and published in English were identified. Data on study characteristics and prevalence of depressive symptoms was extracted by two investigators. Estimate of prevalence was pooled in meta-analysis using random-effects meta-analysis. Sub-group differences were estimated using mixed-effects meta-analysis and meta-regression.

RESULTS

Depressive symptoms prevalence data were extracted from 37 studies involving 76,608 individuals in 20 countries. Studies on depression among university students in LMICs were limited, and most were based on non-representative and small study samples. The overall prevalence of depressive symptoms was 24.4% (95% CI, 19.2% -30.5%). Subgroup analysis revealed that the prevalence did not vary by study design, sampling technique, sample size, study major, educational level, economic regions, and screening instrument.

LIMITATIONS

Only English language studies were included. Included studies were diverse in design, screening tool, and sample size that introduced substantial heterogeneity.

CONCLUSION

Overall prevalence of depressive symptoms among university students in LMICs was 24.4%, however, finding should be interpreted with caution. Further research is needed to address the issue.

Association between Family Functionality and Depression: A Systematic Review and Meta-Analysis

Background

Different scales have attempted to assess various aspects of family dynamics and structures. Good family function seems to allow for better prognoses for basic diseases and appears to be a predictor of depression. The aim of this study was to determine the association between family functionality and depression.

Methods

This is a systematic review and meta-analysis including cross-sectional, cohort, and case-control studies using validated instruments such as the Family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve) and Family Adaptability and Cohesion Evaluation Scale III. A search strategy was designed for the MEDLINE, Embase, Central, and LILACS databases along with data saturation through a search of unpublished literature from the onset of the databases to the present. The categorical variables are expressed in terms of odds ratios (OR), and the statistical analysis was carried out using Review Manager ver. 5.31 (The Cochrane Collaboration, Oxford, UK) using forest plots with corresponding 95% confidence intervals (CI). A fixed-effect model was used according to the expected heterogeneity, expressed in terms of I². The risk of bias was evaluated using the MINORS (methodological index for non-randomized studies) tool.

Results

A total of 1,519 studies were found, of which 10 were selected for the qualitative synthesis and four were chosen for the meta-analysis. The result for the association between family dysfunction and depression yielded an OR (95% CI) of 3.72 (2.70 to 5.12) and I² of 24%.

Conclusion

Family dysfunction and depression are strongly associated.

Associations of Suicidality with Adverse Life Events, Psychological Distress and Somatic Complaints in a Chinese Medical Student Sample

The present study aimed to examine the associations of suicidality with psychological distress, somatic symptoms, and stressors in medical school students. We conducted a cross-sectional survey of medical students at a large, top-ranked medical school. A total sample of 662 medical students (269 men) completed a battery of self-reported questionnaire. Of the respondents, 136 (20.5%) reported having suicidal ideation, 40 (6.0%) reported having planned suicide, and 10 (1.5%) reported having attempted suicide during the previous year. Students from rural areas and the 3rd year of study reported higher levels of suicidal ideation than their counterparts. General pain/fatigue was associated with suicidal ideation and planning, while interpersonal difficulties were associated only with suicidal ideation. This study provides evidence linking severe psychological distress, general pain/fatigue, interpersonal stress and psychosocial factors with suicide risk among Chinese medical students which provides targets for future psychological interventions.

Association of ADHD symptoms, depression and suicidal behaviors with anxiety in Chinese medical college students

BACKGROUND

Anxiety is one of the most common psychiatric disorder and imposes a great burden on both the individual and the society. Previous studies indicate a high comorbidity of anxiety disorders and Attention Deficit Hyperactivity Disorder (ADHD). However, few studies have examined the comorbidity of anxiety and ADHD among medical college students in mainland China. This study aimed to examine the prevalence of anxiety and the associated risk factor of anxiety disorder as well as to explore the association between ADHD symptoms, depression, suicidal behaviors and anxiety.

METHODS

A cross-sectional design was employed among 4882 medical college students who were recruited and enrolled with convenience sampling. Self-reported demographic information and clinical characteristics were collected online on a computer or through a social media app named Wechat.

RESULTS

The prevalence of anxiety in this study was 19.9%. Students with anxiety were more likely to have a poor relationship with parents, be of Han nationality, have smoking or drinking habits, have an extensive physical disorder history and have engaged in suicidal behaviors. The independent risk factors for anxiety were: smoking, physical disorder history, suicidal ideations, suicide attempts, inattention and hyperactivity. Significant associations were observed between anxiety and depression, inattention, hyperactivity, suicide plans and suicide attempts.

CONCLUSIONS

Nearly one in five medical students suffered from anxiety. The findings of this study indicate the importance of addressing both anxiety and ADHD symptoms in order to better promote mental health and the well-being of medical students as well as reduce suicidal behaviors.

Social Violence Increases the Risk of Suicidal Ideation Among Undergraduate Medical Students

BACKGROUND

Depression is highly prevalent worldwide, and may have fatal consequences. Violence is associated to psychopathology and has exponentially increased in some areas of Mexico. Healthcare professionals are vulnerable to increased anxiety, depression, suicide and lately, to violence by organized crime. The aim of the study was to determine the prevalence of anxiety/depression/suicidal ideation and the weight of social violence as a risk factor.

METHODS

Cross sectional study in three generations of undergraduate medical students at entry to internship year in our institution. All students voluntarily agreed to participate. All of them answered Beck and HAM-A. Two generations also responded Plutchik suicidal risk inventory. Sex, type of university and degree of violence in their geographic areas were also recorded. Prevalence rates were calculated for each outcome. χ² tests and odds ratio (OR) for bivariate analysis, and Mantel-Hanezel to adjust according to level of violence.

RESULTS

All of the eligible students responded the anxiety and inventories (n = 8,858), and 6,451 also responded the suicide risk test. Overall, 37.2% displayed severe anxiety, 14.9% moderate/severe depression and 8.5% suicidal ideation. Female sex and private university increased the risk for anxiety and depression. High violence, severe anxiety or depression increased the risk for suicidal ideation. Adjusted by violence zone, female sex, being single and the coexistence of depression were associated with a higher risk for suicidal ideation.

CONCLUSIONS

Anxiety, depression and suicidal ideation are highly prevalent among premedical interns in Mexico. Living in highly violent areas significantly increases the risk for anxiety/depression/suicidal ideation.

A systematic review of depression and anxiety in medical students in China

BACKGROUND

Medical students in China face severe depression and anxiety because of their difficult circumstances, such as the long length of schooling, academic pressure, and the stress of clinical practice. Although there have been many empirical studies about depression or anxiety in medical students in China, no previous studies have conducted a related systematic review about this topic in English. This analysis can convey the general findings from China to other areas of the world.

METHODS

A systematic review and meta-analysis of depression or anxiety in medical students and related determinants were conducted. Three Chinese and three English databases were searched for the review, with no restrictions on language. Articles published between January 1, 2000 and April 1, 2018 were included.

RESULTS

Twenty-one articles investigating a total of 35,160 individual Chinese medical students were included in this review. The prevalence of depression ranged from 13.10 to 76.21% with a mean of 32.74%, and the prevalence of anxiety ranged from 8.54 to 88.30% with a mean of 27.22%. Based on the meta-analysis, gender, grade level, residence, satisfaction with current major and monthly household income per capita were significantly associated with depression. Grade level and satisfaction with current major were significantly associated with anxiety. Other risk factors were identified and described using a narrative approach.

CONCLUSION

The mean prevalence of depression was 32.74% amongst medical students in China, whereas the mean prevalence of anxiety was 27.22%. The determinants of depression and anxiety included individual factors, social and economic factors, and environmental factors. More measures should be taken towards at-risk medical students based on the identified risk factors.

The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis

Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2–38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety—a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.

Prevalence of mental health problems among medical students in China: A meta-analysis

BACKGROUND

The prevalence of mental health problems in medical students has continuously increased and is higher than the prevalence of mental health problems in students with other majors, which could lead to undesirable consequences for the students and their future patients. In China, the current states of medical education and healthcare workplaces differ in certain areas from those in Western or other Asian countries. However, the mental health status of Chinese medical students has not been systematically analyzed.

OBJECTIVES

The purpose of this meta-analysis was to summarize the prevalence of mental health problems in Chinese medical students.

METHODS

All cross-sectional studies that investigated the prevalence of any mental health problem among Chinese medical students were retrieved from the following databases: EMBASE, PubMed, PsycINFO, OVID, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. We accepted each individual trial's inclusion and exclusion criteria for participants. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was adopted to appraise the methodological quality of each study. RevMan (version 5.3) was used to analyze the data.

RESULTS

Ten cross-sectional studies involving a total of 30,817 Chinese medical students were included. The prevalence of depression, anxiety, suicidal ideation, and eating disorders were 29%, 21%, 11%, and 2%, respectively. Subgroup analysis revealed no significant differences in the prevalence of depression and suicidal ideation between genders and no significant difference in the prevalence of depression between individuals of different ages (20 years and older or younger than 20 years).

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

Chinese medical students have relatively high prevalence of depression, anxiety, and suicidal ideation but a low prevalence of eating disorders. Mental health problems in Chinese medical students should be taken seriously, and timely screening of and proper intervention in these mental health problems are highly recommended.

Factors associated with mental health among high school students in Iran: Does mobile phone overuse associate with poor mental health?

PROBLEM

Mobile phone (MP) overuse is extensively rising among high school students in developing countries. Our aim in this study is to investigate the association between MP overuse and mental health, in the presence of other determinant factors, among high school students in Iran.

METHODS

We recruited a clustered random sample of 1,034 high school students in Saqqez County, Iran, to complete a self-administered questionnaire with three sections: a sociodemographic questionnaire, Mobile Phone Addiction Index, and General Health Questionnaire.

FINDINGS

A majority of the students (n = 654, 63.2%) were found to be with poor mental health. Applying multiple logistic regression, gender (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.15-1.97), education degree (OR = 1.47; 95% CI = 1.30-1.67), frequency of daily messages (OR = 1.18; 95% CI = 1.07-1.31), being awakened at night for MP use (OR = 1.83; 95% CI = 1.54-2.18), and MP overuse (OR = 3.21; 95% CI = 1.20-8.58) were found in significant associations with poor mental health.

CONCLUSIONS

Planning gender-based health education programs on proper use of MP for students and their parents is suggested to school healthcare providers. The parents should be educated on the proper ways of dealing with their adolescents while using MP at home.

Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis

IMPORTANCE

Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies.

OBJECTIVE

To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students.

DATA SOURCES AND STUDY SELECTION

Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included.

DATA EXTRACTION AND SYNTHESIS

Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression.

MAIN OUTCOMES AND MEASURES

Point or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview.

RESULTS

Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n = 116 628) and 16 longitudinal studies (n = 5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37 933/122 356 individuals; 95% CI, 24.7% to 29.9%, I2 = 98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982-2015; slope, 0.2% increase per year [95% CI, -0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during medical school (n = 2432), the median absolute increase in symptoms was 13.5% (range, 0.6% to 35.3%). Prevalence estimates did not significantly differ between studies of only preclinical students and studies of only clinical students (23.7% [95% CI, 19.5% to 28.5%] vs 22.4% [95% CI, 17.6% to 28.2%]; P = .72). The percentage of medical students screening positive for depression who sought psychiatric treatment was 15.7% (110/954 individuals; 95% CI, 10.2% to 23.4%, I2 = 70.1%). Suicidal ideation prevalence data were extracted from 24 cross-sectional studies (n = 21 002) from 15 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of suicidal ideation was 11.1% (2043/21 002 individuals; 95% CI, 9.0% to 13.7%, I2 = 95.8%). Summary prevalence estimates ranged across assessment modalities from 7.4% to 24.2%.

CONCLUSIONS AND RELEVANCE

In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%. Further research is needed to identify strategies for preventing and treating these disorders in this population.

Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis

Importance

Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies.

Objective

To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students.

Data Sources and Study Selection

Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included.

Data Extraction and Synthesis

Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression.

Main Outcomes and Measures

Point or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview.

Results

Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n = 116 628) and 16 longitudinal studies (n = 5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37 933/122 356 individuals; 95% CI, 24.7% to 29.9%, I2 = 98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982-2015; slope, 0.2% increase per year [95% CI, -0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during medical school (n = 2432), the median absolute increase in symptoms was 13.5% (range, 0.6% to 35.3%). Prevalence estimates did not significantly differ between studies of only preclinical students and studies of only clinical students (23.7% [95% CI, 19.5% to 28.5%] vs 22.4% [95% CI, 17.6% to 28.2%]; P = .72). The percentage of medical students screening positive for depression who sought psychiatric treatment was 15.7% (110/954 individuals; 95% CI, 10.2% to 23.4%, I2 = 70.1%). Suicidal ideation prevalence data were extracted from 24 cross-sectional studies (n = 21 002) from 15 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of suicidal ideation was 11.1% (2043/21 002 individuals; 95% CI, 9.0% to 13.7%, I2 = 95.8%). Summary prevalence estimates ranged across assessment modalities from 7.4% to 24.2%.

Conclusions and Relevance

In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%. Further research is needed to identify strategies for preventing and treating these disorders in this population.

Assessment of depression and suicidal behaviour among medical students in Portugal

OBJECTIVES

To examine depression and suicidal behaviour and associated factors in a sample of medical students in Portugal.

METHODS

We conducted a cross-sectional study design of 456 native Portuguese medical students from the 4^th and 5^th year at the University of Lisbon. Participants answered a self-report survey including questions on demographic and clinical variables. Statistical analyses were conducted using the chi-square test, with a Monte Carlo simulation when appropriate.

RESULTS

Depression among medical students was 6.1% (n=28) and suicidal behaviour 3.9% (n=18). Higher depression scores were noted in female medical students (χ²=4.870,df=2,p=0.027), students who lived alone (χ²=8.491,df=3,p=0.037), those with poor physical health (χ²=48.269,df=2,p<0.001), with poor economic status (χ²=8.579,df=2,p=0.014), students with a psychiatric diagnosis (χ²=44.846,df=1,p=0.009), students with a family history of psychiatric disorders (χ²=5.284,df=1,p=0.022) and students with high levels of anxiety (χ²=104.8, df=3, p<0.001).  Depression scores were also higher in students with suicidal ideation (χ²=85.0,df=1,p<0.001), suicidal plan (χ²=47.9,df=1,p<0.001) and suicidal attempt (χ²=19.2,df=1,p<0.001). Suicidal behaviour was higher in medical students who lived alone (χ²=16.936,df=3,p=0.001), who had poor physical health (χ²=18,929,df=2,p=0.001), poor economic status (χ²=9.181,df=2,p=0.01), who are/were in psychopharmacology treatment (χ²=30.108,df =1,p<0.001), and who had high alcohol use (χ²=7.547,df=2,p=0.023), severe depression (χ²=88.875,df=3,p<0.001) and high anxiety levels (χ²=50.343,df=3,p<0.001). The results also revealed that there were no differences between students in the 4^th and 5^th years of medical school regarding rate of depression and suicidal behaviour.

CONCLUSIONS

Since depression and suicidal behaviour are mental health problems affecting a significant proportion of medical students, medical schools should implement programs that promote mental health wellness, physical health and economic status between other factors.

Prevalence of depression amongst medical students: a meta-analysis

CONTEXT

Medical schools are known to be stressful environments for students and hence medical students have been believed to experience greater incidences of depression than others. We evaluated the global prevalence of depression amongst medical students, as well as epidemiological, psychological, educational and social factors in order to identify high-risk groups that may require targeted interventions.

METHODS

A systematic search was conducted in online databases for cross-sectional studies examining prevalences of depression among medical students. Studies were included only if they had used standardised and validated questionnaires to evaluate the prevalence of depression in a group of medical students. Random-effects models were used to calculate the aggregate prevalence and pooled odds ratios (ORs). Meta-regression was carried out when heterogeneity was high.

RESULTS

Findings for a total of 62 728 medical students and 1845 non-medical students were pooled across 77 studies and examined. Our analyses demonstrated a global prevalence of depression amongst medical students of 28.0% (95% confidence interval [CI] 24.2-32.1%). Female, Year 1, postgraduate and Middle Eastern medical students were more likely to be depressed, but the differences were not statistically significant. By year of study, Year 1 students had the highest rates of depression at 33.5% (95% CI 25.2-43.1%); rates of depression then gradually decreased to reach 20.5% (95% CI 13.2-30.5%) at Year 5. This trend represented a significant decline (B = - 0.324, p = 0.005). There was no significant difference in prevalences of depression between medical and non-medical students. The overall mean frequency of suicide ideation was 5.8% (95% CI 4.0-8.3%), but the mean proportion of depressed medical students who sought treatment was only 12.9% (95% CI 8.1-19.8%).

CONCLUSIONS

Depression affects almost one-third of medical students globally but treatment rates are relatively low. The current findings suggest that medical schools and health authorities should offer early detection and prevention programmes, and interventions for depression amongst medical students before graduation.

Interactions of problematic mobile phone use and psychopathological symptoms with unintentional injuries: a school-based sample of Chinese adolescents

Background

Unintentional injuries are a major contributor to morbidity and mortality in adolescents. Mobile phone use in certain circumstances (e.g., driving, cycling, walking) and mental health conditions are risk factors for unintentional injury. However, research on the interactions between problematic mobile phone use (PMPU) and psychopathological symptoms in unintentional injuries is limited. The present study aimed to determine the prevalence of unintentional injuries (road traffic injuries, pedestrian collisions, and falls) and examined interactions of PMPU and psychopathological symptoms with unintentional injuries in a school-based sample of Chinese adolescents.

Methods

A total of 14,221 students (6915 middle school students and 7306 high school students) were randomly selected from 32 schools in four cities in China in 2012. The sample comprised 6712 boys and 7509 girls with a mean age of 15.12 years (standard deviation 1.89 years). PMPU, psychopathological symptoms, and unintentional injuries were measured with validated instruments. Chi-square tests and multivariable logistic regression were used to analyze the rates of unintentional injuries, the relationship with PMPU and psychopathological symptoms, and the interactions of PMPU and psychopathological symptoms with unintentional injuries.

Results

The prevalence of road traffic injuries, pedestrian collisions, and falls were 4.9, 16.2, and 10.1 %, respectively. The rates of unintentional injuries were higher among students with PMPU and psychopathological symptoms. Interaction analysis indicated that psychopathological symptoms were associated with a greater increase in the likelihood of unintentional injuries for adolescents with PMPU than for those without PMPU.

Conclusions

The findings indicate that unintentional injuries in adolescents are an important public health issue in China that merit further research. Intervention programs must consider the adolescents’ behavioral and psychological health.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-2776-8) contains supplementary material, which is available to authorized users.

Prevalence of depressive symptoms and its correlates among medical students in China: a national survey in 33 universities

We conducted a national survey among medical students in China to estimate the prevalence of depressive symptoms and explore associated risk factors based on an established questionnaire composed of demographic information, life events in the past four weeks before survey, and the validated Chinese version of the 21-item Beck's Depression Inventory (BDI). The mean age of enrolled 9010 students was 20.7 (standard deviation: 1.6) years. BDI scores indicated that 19.9% had depressive symptoms based on the cut-off score of 14. Socioeconomic factors and student characteristics such as male sex, low monthly income per capita, father's poor education background, and higher year of study were associated with higher prevalence of depressive symptoms among medical students. Students who studied in comprehensive universities were more likely to have depressive symptoms compared with those from medical universities. Habitual smoking and alcohol drinking, sleep deprivation, and hospitalization or medication for one week or more in the last four weeks also predisposed students to higher risk of depressive symptoms. Our results indicate that depressive symptoms are becoming a highly prevalent health problem among Chinese medical students. Primary and secondary prevention should be prioritized to tackle this issue based on potential risk factors.

Prevalence and correlates of depression among college nursing students in China

This study aims to assess the prevalence of depression and examine potential risk factors correlated to depression among nursing college students in China. Between September and November 2012, a total of 763 college nursing students were randomly selected to participate in a survey, which included the Center for Epidemiologic Studies Depression Scale (CES-D). The result showed that 22.9% (95% CI: 20.0%-25.9%) of participants reported high score on the CES-D (16 or above). Risk factors significantly associated with depression in the univariate analysis were academic performance, academic stress, interest in majors, occupational future, interpersonal relationship, frequency of exercise, self-reported health status, social support, educational level of father, relationship with parents and making decisions without interference by parents. Backward multivariate logistic regression analysis revealed that lower academic stress, and better occupational future were strongly related to lower risk of depression, followed by active use of social support, full making decision power, better relationship with father and higher self-reported health status. The findings suggested that in order to prevent depression among college nursing students, school- and family-based strategies should be developed and implemented.

Depression and suicidal ideation in medical students in China: a call for wellness curricula

OBJECTIVE

To investigate rates of depression and suicidal ideation in medical students in mainland China and to explore wellness curricula and mental health services available to students.

METHODS

Second and third year medical students (N=348) at one medical school in mainland China completed the Patient Health Questionnaire-9 (PHQ-9). Based on responses to the PHQ-9, students were labeled as depressed, with suicidal ideation, and/or impaired. Additionally, students' feedback from a focus group (N=30) evaluating the current state of the school's wellness curricula and mental health services was thematically analyzed.

RESULTS

A total of 348 students responded (response rate = 99%) to the survey. Forty-seven of 348 (13.5%) students had moderate-severe depression. The mean PHQ-9 score was 6.02 (SD=3.44). Seven and a half percent of students reported suicidal ideation. The frequency of depression and suicidal ideation did not differ between second and third year medical students (p = 0.52). Nearly 30% of depressed students reported suicidal ideation. Depression and suicidal ideation were strongly correlated (r = 0.42, p=0.001). Students with depression (p =0.0001) or suicidal ideation (p = 0.004) were more likely to be impaired compared to students who were not. Focus group participants reported only off-campus student counseling services available to medical students in distress. No wellness curricula were established.

CONCLUSIONS

Rates of depression and suicidal ideation are high in medical students in mainland China. Mental health services are deficient and unlikely to address distress in students. Chinese medical schools should offer mental health support and treatment at an early stage, such as wellness curricula and proactive student counseling.

Rural/urban background, depression and suicidal ideation in Chinese college students: a cross-sectional study

Objectives

The objective of this study was to examine, first, the relationship of having a rural vs. urban background with suicidal ideation in Chinese college students, and second, whether a potential relationship was mediated by depression.

Methods

A survey was conducted among 1,145 undergraduate students at a university in China. Suicidal ideation and depressive symptoms were measured by the revised Hopkins’ Symptom checklist (SCL-90-R). Associations between rural vs. urban background, depression and suicidal ideation were estimated by multivariable linear regression-based β coefficients, logistic regression-based odds ratios (ORs), and corresponding 95% confidence intervals (CIs). The magnitude of indirect effect and bias-corrected 95% CIs were obtained through bootstrap techniques.

Results

Rural background was positively associated with depression, which was in turn associated with suicidal ideation. The OR for rural status and suicidal ideation equaled 2.15 (95% CI = 1.36–3.41). This OR was slightly, though significantly (p<0.05) attenuated by additional adjustment for depressive symptoms (OR = 1.99, 95% CI = 1.15–3.44).

Conclusion

Having a rural background is a determinant of suicidal ideation in Chinese college students. Depression may only marginally mediate this association.

Quality of life of medical students in China: a study using the WHOQOL-BREF

Objective

The aim of this study was to assess the quality of life (QOL) of medical students during their medical education and explore the influencing factors of the QOL of students.

Methods

A cross-sectional study was conducted in June 2011. The study population was composed of 1686 medical students in years 1 to 5 at China Medical University. The Chinese version of WHOQOL-BREF instrument was used to assess the QOL of medical students. The reliability and validity of the questionnaire were assessed by Cronbach’s α coefficient and factor analysis respectively. The relationships between QOL and the factors including gender, academic year level, and specialty were examined using t-test or one-way ANOVA followed by Student-Newman–Keuls test. Statistic analysis was performed by SPSS 13.0.

Results

The overall Cronbach’s α coefficient of the WHOQOL-BREF questionnaire was 0.731. The confirmatory factor analysis provided an acceptable fit to a four-factor model in the medical student sample. The scores of different academic years were significantly different in the psychological health and social relations domains (p<0.05). Third year students had the lowest scores in psychological health and social relations domains. The scores of different specialties had significant differences in psychological health and social relations domains (p<0.05). Students from clinical medicine had the highest scores. Gender, interest in the area of study, confidence in career development, hometown location, and physical exercise were significantly associated with the quality of life of students in some domains (p<0.05).

Conclusions

The WHOQOL-BREF was reliable and valid in the assessment of the QOL of Chinese medical students. In order to cope with the influencing factors of the QOL, medical schools should carry out curriculum innovation and give the necessary support for medical students, especially for 3^rd year students.

The 36-item short form health survey: reliability and validity in Chinese medical students

OBJECTIVE

The 36-Item Short Form Health Survey (SF-36) is widely validated and popularly used in assessing the subjective quality of life (QOL) of patients and the general public. The aim of the study is to assess the psychometric properties of the 36-Item Short Form Health Survey (SF-36) in medical students in mainland of China.

METHODS

The reliability and validity of the 36-Item Short Form Health Survey (SF-36) questionnaire were assessed by conducting a cross-sectional study of Chinese medical students in December 2011. All 1358 3(rd) year and 4(th) year medical students from 46 classes at China Medical University were investigated.

RESULTS

The overall Cronbach's α coefficient of the SF-36 questionnaire was 0.791, while the respective Cronbach's α coefficients for each of the seven dimensions were > 0.70, except where the social function dimension was 0.631. Results showed that the SF-36 questionnaire was reliable and valid.

CONCLUSION

In general, this study provides evidence that the SF-36 questionnaire is suitable measures for assess the QOL of medical students in China.