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Allen MT, Shields MM, Myers CE. Distressed (Type D) personality is predicted by avoidance: evidence from a computer-based avatar task. PeerJ 2022; 10:e14302. [PMID: 36320564 PMCID: PMC9618263 DOI: 10.7717/peerj.14302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/05/2022] [Indexed: 01/24/2023] Open
Abstract
Background One personality type associated with poor health outcomes is distressed (Type D) personality which involves high levels of both social inhibition (SI) and negative affectivity (NA). Type D is also linked to psychopathologies such as post-traumatic stress disorder (PTSD), anxiety disorders, and depression. One mechanism through which personality temperament may result in these psychopathologies is avoidance. Recently, a computer-based measure designed to assess avoidant behaviors, in which the participant guides the behavior of an avatar interacting with strangers in social situations, has been found to be related to various forms of avoidance. In the current study, we extended this work with the avatar avoidance task to determine its relationship to distressed (Type D) personality. We hypothesized that Type D personality, along with SI, but not NA, would be positively related to avatar avoidance scores. We also hypothesized that avatar avoidance scores would be higher in Type D individuals than non-Type D individuals. Methods A total of 302 undergraduates completed the Distressed Type D Personality Scale (DS-14), and a computer-based avatar avoidance task. Results Type D and SI, and NA to a lesser degree, were positively correlated with avoidance scores on the avatar task. Furthermore, regression analyses revealed that Type D and SI scores were best predicted by a model including avoidance scores and education level while NA scores were best predicted by a model including avoidance scores. Standard cut-off scores on the DS-14 scale resulted in four groups (i.e., low SI and NA, high SI, high NA, and Type D) which significantly differed in avoidance scores. Specifically, Type D individuals had higher avoidance scores than the other three groups. Taken together these findings support a role for avoidance in Type D personality. The computer-based avatar avoidance task may be particularly relevant as an ecologically valid measure to identify avoidance in a virtual setting for use with individuals expressing Type D personality who may be unwilling or unable to accurately self-report or describe their own avoidant tendencies.
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Affiliation(s)
- M. Todd Allen
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Michelle M. Shields
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Catherine E. Myers
- Department of Pharmacology, Physiology & Neuroscience, Rutgers University—New Jersey Medical School, Newark, NJ, USA,Department of Veterans Affairs, VA Medical Center, East Orange, NJ, USA
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A Controlled Community Study of Distress and Resilience in Women Diagnosed with Fibromyalgia and Systemic Lupus Erythematosus. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09903-7. [PMID: 35995960 DOI: 10.1007/s10880-022-09903-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 10/15/2022]
Abstract
This study examines psychological and physical influences on the distress and well-being of patients with chronic rheumatic diseases. The study aims were to (1) evaluate the relative contribution of objective disease activity and psychological factors on the wellbeing of patients with systemic lupus erythematosus (SLE); (2) to compare the psychological distress of SLE patients to fibromyalgia (FM) patients and healthy controls, and to (3) characterize subgroups of patients by performing cluster analysis using psychological variables. Participants were ascertained from closed forums and social media channels resulting in 41 women with a diagnosis of SLE, 47 with a diagnosis of FM, and 77 healthy controls (HC). Hierarchical linear regression for well-being of SLE patients found that most of the variance was accounted for by social support. Cluster analysis performed on the entire sample identified two clusters, a distressed group tending to Type D personality, anxiety and depression, low in well-being and social support, and a resilient group; the proportion of resilient individuals was highest in the HC intermediate in the SLE group and lowest in the FM group. The importance of psychological variables vs disease severity in these two rheumatic diseases for wellbeing is demonstrated by these results. The results suggest that psychological interventions that enhance the experience of social support in medical settings, might benefit patients with both diseases, and be of particular importance to the well-being of patients who are more distressed.
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Gębska M, Dalewski B, Pałka Ł, Kołodziej Ł, Sobolewska E. The Importance of Type D Personality in the Development of Temporomandibular Disorders (TMDs) and Depression in Students during the COVID-19 Pandemic. Brain Sci 2021; 12:brainsci12010028. [PMID: 35053772 PMCID: PMC8773638 DOI: 10.3390/brainsci12010028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 11/22/2022] Open
Abstract
Background: a type D personality is a factor in a person’s susceptibility to general mental stress, especially during the COVID-19 pandemic. Although many studies were conducted on the relationships among stressful situations, an individual’s personality, depression, and the occurrence of various diseases, e.g., cardiovascular disease or cancer, there are no analogous data on people with temporomandibular disorders (TMDs). Aim: the assessment of TMDs and depression symptoms in students with type D personality. Material and Methods: the research was carried out with the participation of 240 physiotherapy students. The study group (G1) consisted of 120 participants with type D personalities, the control group (G2) consisted of the same number of participants, without “stress” personalities. All subjects were assessed for the occurrence of TMD symptoms, as well as for depression and anxiety symptoms, using the Beck Depression Inventory (BDI), based on the proprietary questionnaire. Results: in students with type D personality symptoms, TMDs occurred significantly more often and in greater number (p = 0.00) than in those without stress personalities. The exception was the symptom of increased muscle tension, which showed no statistical difference (p = 0.22). Among the 240 respondents, depression was found in 128 people (53.3%). In the group of students with type D personalities, depression was significantly more frequent than in the group without type D personalities (p = 0.00). In participants with depression, TMD symptoms were more common, i.e., headaches, neck, and shoulder girdle pain, TMJ acoustic symptoms, increased masticatory muscle tension, teeth clenching, and teeth grinding. There was no significant difference between the incidence of depression and TMJ pain and jaw locking. There was a significant interaction between the occurrence of headaches and acoustic symptoms and the occurrence of depression. For headache and depression interactions, the OR was >1; based on the results, we may assume that a headache depends more on the occurrence of depression rather than it being a symptom of a TMJ disorder in people with type D personalities. Conclusion: type D personality and depression may contribute to the development of TMD symptoms.
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Affiliation(s)
- Magdalena Gębska
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, 70-204 Szczecin, Poland; (M.G.); (Ł.K.)
| | - Bartosz Dalewski
- Department of Dental Prosthetics, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.D.); (E.S.)
| | - Łukasz Pałka
- Private Dental Practice, 68-200 Zary, Poland
- Correspondence:
| | - Łukasz Kołodziej
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, 70-204 Szczecin, Poland; (M.G.); (Ł.K.)
| | - Ewa Sobolewska
- Department of Dental Prosthetics, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.D.); (E.S.)
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Domagalska J, Rusin M, Razzaghi M, Nowak P. Personality Type D, Level of Perceived Stress, Insomnia, and Depression Among High School Teachers in Poland. Front Psychol 2021; 12:626945. [PMID: 34621203 PMCID: PMC8490815 DOI: 10.3389/fpsyg.2021.626945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 08/17/2021] [Indexed: 12/22/2022] Open
Abstract
Teaching is inherently connected with specific burdens that may imply stressful situations. The goal of this study was to explore the prevalence of type D (distressed) personality in teachers. This is known to cause depressive episodes and sleep disorders, which not only have direct physical health effects, but can also impact the wellbeing of individuals and hence adversely affect their job performance. The participants consisted of 412 high school teachers from the Silesian Province, located in the south of Poland. Using the following research tools: Type D Scale (DS14), Perceived Stress Scale, Athens Insomnia Scale, and Beck Depression Inventory, it was found that type D personality was observed in a large percentage of teachers (30.1%). It was reported that teachers with distressed personality suffered from insomnia and depression significantly more often. Findings from the current study indicate the need to implement preventive activities focused on reducing psychosocial risk factors in the work environment in order to reduce the frequency of depressive disorders among teachers.
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Affiliation(s)
- Joanna Domagalska
- Department of Environmental Health, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Monika Rusin
- Department of Environmental Health, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Mehdi Razzaghi
- Department of Mathematics, Bloomsburg University, Bloomsburg, PA, United States
| | - Przemysław Nowak
- Department of Pharmacology, Faculty of Medicine, University of Opole, Opole, Poland
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Structural relationship model of type D personality and depression with the mediating role of cognitive distortions and family functioning in irritable bowel syndrome patients and healthy people: A multi-group analysis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01755-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dehghani F. Type D personality and life satisfaction: The mediating role of social support. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Lahortiga-Ramos F, Unzueta CR, Zazpe I, Santiago S, Molero P, Sánchez-Villegas A, Martínez-González MÁ. Self-perceived level of competitiveness, tension and dependency and depression risk in the SUN cohort. BMC Psychiatry 2018; 18:241. [PMID: 30053851 PMCID: PMC6062999 DOI: 10.1186/s12888-018-1804-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 06/28/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Emerging evidence suggests a possible etiologic role of certain personality traits (not necessary dysfunctional) in the risk of depression, but the longitudinal long-term available evidence is currently scarce. We longitudinally assessed whether 3 common personality traits (competitiveness, tension and dependency) were associated with the risk of depression after a maximum follow-up of 15 years. METHODS We assessed 15,604 university graduates free of depression at baseline through a self-administered questionnaire including personality traits. Simple, Likert-type, questions with 11 possible answers ranging from 0 to 10 were used at baseline to assess the 3 personality traits. We compared participants with high scores (7-10) versus those with low scores (0-4). New medical diagnoses of depression during follow-up were used as the outcome. RESULTS During a median follow-up of 10.1 y, we prospectively identified 902 new medical diagnoses of depression. The multivariable-adjusted hazard ratios (95% confidence intervals) for depression were 1.85 (1.52-2.24) for participants with higher baseline tension (7-10 versus 0 to 4), P-trend < 0.001; and 1.23 (1.06-1.44) for high versus low baseline dependence levels, P-trend = 0.004. Higher levels of competitiveness were marginally associated with lower risk of depression, with hazard ratio = 0.78 (0.61-1.01), P-trend = 0.105. CONCLUSION A simple scoring system of personality traits shows an independent association with the future occurrence of depression. This finding underscores, with now prospective evidence, the importance of personality traits in the aetiology of depression and can provide a clinically useful tool for gathering valid information about depression-related personality traits.
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Affiliation(s)
- Francisca Lahortiga-Ramos
- Department of Psychiatry and Clinical Psychology, University Clinic of Navarra, Pamplona, Navarra, Spain. .,Navarra Institute for Health Research (IdisNA), Pamplona, Navarra, Spain.
| | - Cristian Raquel Unzueta
- 0000000419370271grid.5924.aDepartment of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Navarra Spain
| | - Itziar Zazpe
- 0000000419370271grid.5924.aDepartment of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Navarra Spain ,0000000419370271grid.5924.aDepartment of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarra Spain ,Navarra Institute for Health Research (IdisNA), Pamplona, Navarra Spain ,0000 0000 9314 1427grid.413448.eBiomedical Research Center Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Susana Santiago
- 0000000419370271grid.5924.aDepartment of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Navarra Spain ,Navarra Institute for Health Research (IdisNA), Pamplona, Navarra Spain
| | - Patricio Molero
- 0000 0001 2191 685Xgrid.411730.0Department of Psychiatry and Clinical Psychology, University Clinic of Navarra, Pamplona, Navarra Spain ,Navarra Institute for Health Research (IdisNA), Pamplona, Navarra Spain
| | - Almudena Sánchez-Villegas
- 0000 0004 1769 9380grid.4521.2Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain ,0000 0000 9314 1427grid.413448.eBiomedical Research Center Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Miguel Ángel Martínez-González
- 0000000419370271grid.5924.aDepartment of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarra Spain ,Navarra Institute for Health Research (IdisNA), Pamplona, Navarra Spain ,0000 0000 9314 1427grid.413448.eBiomedical Research Center Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain ,000000041936754Xgrid.38142.3cDepartment of Nutrition, Harvard School of Public Health, Boston, USA
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Arivan R, Deepanjali S. Prevalence and risk factors of gastro-esophageal reflux disease among undergraduate medical students from a southern Indian medical school: a cross-sectional study. BMC Res Notes 2018; 11:448. [PMID: 29986748 PMCID: PMC6038284 DOI: 10.1186/s13104-018-3569-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/05/2018] [Indexed: 12/18/2022] Open
Abstract
Objective Gastro-esophageal reflux disease (GERD) affects all age groups, and various lifestyle as well as psychological factors are recognized as risk factors for GERD. Undergraduate medical students are exposed to lifestyle changes and psychological stressors. We aimed to study the prevalence of GERD among undergraduate students of a medical school in southern India in a cross-sectional survey using a validated symptom score. Results A total of 358 undergraduate medical students participated in the study. There were 188 (52.5%) males and 170 (47.4%) females; the mean (SD) age of the participants was 20.3 (1.5) years. A total of 115 (31.2%) participants had at least one episode of heartburn per week, while 108 (30.1%) participants had at least one episode of regurgitation per week. Heartburn or regurgitation of at least mild severity was present in 115 (32.1%) and 108 (30.16%) of participants respectively. Based on the symptom score, a diagnosis of GERD was made in 18 (5.02%) students. Frequent consumption of carbonated drinks (OR = 3.63 [95% CI 1.39–9.5]; P = 0.008) and frequent consumption of tea or coffee (OR = 4.65 [95% CI 1.2–17.96]; P = 0.026) were significantly associated with a diagnosis of GERD. Electronic supplementary material The online version of this article (10.1186/s13104-018-3569-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ramachandran Arivan
- Jawaharlal Institute of Postgraduate Medical Education and Research, 605006, Puducherry, India
| | - Surendran Deepanjali
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, 605006, Puducherry, India.
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Kumar SG, Kattimani S, Sarkar S, Kar SS. Prevalence of depression and its relation to stress level among medical students in Puducherry, India. Ind Psychiatry J 2017; 26:86-90. [PMID: 29456328 PMCID: PMC5810174 DOI: 10.4103/ipj.ipj_45_15] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Currently, depression among medical students is an important health issue at the global level. There is also a paucity of information on its relation to the stress level. OBJECTIVE The aim of this study is to assess the prevalence of depression and its relation to stress level and other factors among medical students. MATERIALS AND METHODS A cross-sectional study was conducted among medical students at a tertiary care medical institution in Puducherry, coastal south India. Beck Depression Inventory Scale was used for screening of depression and Cohen's Perceived Stress scale to assess perceived stress level. Data on associated factors were collected by self-administered questionnaire. RESULTS The overall prevalence of depression was found to be 48.4% (215/444). According to the cutoff scores, 229 (51.6%) students scored as normal (0-9), 149 (33.6%) as mild (10-18), 60 (13.5%) as moderate (19-29), 3 (0.7%) as severe (30-40), and 3 (0.7%) students scored as very severe (>40) depression. Depression was significantly less among those with mild stress (adjusted odds ratio [OR] = 0.010) and moderate stress level (adjusted OR = 0.099) compared to severe stress level and those without interpersonal problems (adjusted OR = 0.448). CONCLUSION Depression is more common among medical students. Stress coping mechanisms and improvement of interpersonal relationship may help to reduce depressive symptoms among medical students.
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Affiliation(s)
- S Ganesh Kumar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shivanand Kattimani
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sonali Sarkar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA 2016; 316:2214-2236. [PMID: 27923088 PMCID: PMC5613659 DOI: 10.1001/jama.2016.17324] [Citation(s) in RCA: 1202] [Impact Index Per Article: 150.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
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.
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Affiliation(s)
- Lisa S Rotenstein
- Harvard Medical School, Boston, Massachusetts2Harvard Business School, Boston, Massachusetts
| | - Marco A Ramos
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Matthew Torre
- Harvard Medical School, Boston, Massachusetts4Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Michael J Peluso
- Harvard Medical School, Boston, Massachusetts5Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Srijan Sen
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor8Department of Psychiatry, University of Michigan, Ann Arbor
| | - Douglas A Mata
- Harvard Medical School, Boston, Massachusetts9Division of MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts10Brigham Education Institute, Boston, Massachusetts
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Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA 2016. [PMID: 27923088 DOI: 10.1001/jama.2016.17324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
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.
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Affiliation(s)
- Lisa S Rotenstein
- Harvard Medical School, Boston, Massachusetts2Harvard Business School, Boston, Massachusetts
| | - Marco A Ramos
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Matthew Torre
- Harvard Medical School, Boston, Massachusetts4Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Michael J Peluso
- Harvard Medical School, Boston, Massachusetts5Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Srijan Sen
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor8Department of Psychiatry, University of Michigan, Ann Arbor
| | - Douglas A Mata
- Harvard Medical School, Boston, Massachusetts9Division of MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts10Brigham Education Institute, Boston, Massachusetts
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Demirci K, Yıldız M, Selvi C, Akpınar A. The relationship between childhood trauma and type D personality in university students. Int J Soc Psychiatry 2016; 62:542-8. [PMID: 27288419 DOI: 10.1177/0020764016653774] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIM There has been increasing evidence that childhood traumas are related to reduced health-related quality of life, neurobiological changes and long-term adverse effects, such as an increase in the likelihood of psychiatric disorders in adulthoods. The aim of this study was to investigate the relationships between childhood traumas and type D personality. SUBJECTS AND METHODS In total, 187 university students (64 males and 123 females; mean age = 21.69 ± 2.00) were included in the study. All participants were evaluated using the Type D Personality Scale (DS-14), Childhood Trauma Questionnaire (CTQ-28) and Beck Depression Inventory (BDI). The participants were divided into the two groups according to the presence of type D personality. Then, statistical analyses were performed. RESULTS The frequency of type D personality in participants was 43.3% (n = 81). The emotional neglect, physical neglect, emotional abuse component of the CTQ-28, total CTQ-28 scores and BDI scores were higher in the group with type D personality than in the group without type D personality (p < .001, p = .003, p = .001, p < .001 and p < .001, respectively). There were significantly positive correlations between the type D personality scores and BDI scores, emotional neglect, physical neglect, emotional abuse and childhood trauma total scores (p < .05, for all). Linear regression analyses showed that the significant and independent predictors of the score of DS-14 were total score of CTQ-28 and BDI score. CONCLUSION Childhood trauma may be associated with type D personality, and there is predictive value of the childhood trauma on the scores of type D personality.
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Affiliation(s)
- Kadir Demirci
- Department of Psychiatry, School of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Mesut Yıldız
- Department of Psychiatry, School of Medicine, Gaziosmanpaşa University, Tokat, Turkey
| | - Cansu Selvi
- School of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Abdullah Akpınar
- Department of Psychiatry, School of Medicine, Süleyman Demirel University, Isparta, Turkey
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Naja WJ, Kansoun AH, Haddad RS. Prevalence of Depression in Medical Students at the Lebanese University and Exploring its Correlation With Facebook Relevance: A Questionnaire Study. JMIR Res Protoc 2016; 5:e96. [PMID: 27246394 PMCID: PMC4908302 DOI: 10.2196/resprot.4551] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 12/29/2015] [Accepted: 03/21/2016] [Indexed: 01/25/2023] Open
Abstract
Background The prevalence of major depression is particularly high in medical students, affecting around one-third of this population. Moreover, online social media, in particular Facebook, is becoming an intrinsic part in the life of a growing proportion of individuals worldwide. Objective Our primary objective is to identify the prevalence of depression in medical students at the Lebanese University Faculty of Medicine, a unique state university in Lebanon, its correlation with the utilization of the interactive features of Facebook, and the way students may resort to these features. Methods Students of the Lebanese University Faculty of Medicine were assessed for (1) depression and (2) Facebook activity. To screen for major depression, we used the Patient Health Questionnaire-9 (PHQ-9) scale. To test for Facebook activity, we developed the Facebook Resorting Questionnaire (FbRQ), which measures the degree to which students resort to Facebook. Results A total of 365 out of 480 students (76.0%) participated in the survey. A total of 25 students were excluded, hence 340 students were included in the final analysis. Current depression was reported in 117 students out of 340 (34.4%) and t tests showed female predominance. Moreover, PHQ-9 score multiple regression analysis showed that feeling depressed is explained 63.5% of the time by specific independent variables studied from the PHQ-9 and the FbRQ. Depression varied significantly among the different academic years (P<.001) and it peaked in the third-year students. One-way analysis of variance (ANOVA) showed that depression and resorting to Facebook had a positive and significant relationship (P=.003) and the different FbRQ categories had significant differences in resorting-to-Facebook power. The like, add friend, and check-in features students used when resorting to Facebook were significantly associated with depression. Conclusions This study showed that depression was highly prevalent among students of the Faculty of Medicine at the Lebanese University. Moreover, Facebook may be a promising, helpful, psychological tool for optimizing the management of depression. Our study brought to bear further questions that now prompt further observation and scrutiny to know more about the high rates of depression in this student population, more so in the part of the world studied, and to the growing role of social media.
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Affiliation(s)
- Wadih J Naja
- Department of Psychiatry, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Menon V, Sarkar S, Kumar S. Barriers to healthcare seeking among medical students: a cross sectional study from South India. Postgrad Med J 2015; 91:477-82. [PMID: 26253923 DOI: 10.1136/postgradmedj-2015-133233] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 07/20/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the barriers to seeking help from healthcare services reported by medical students at an Indian medical school, and to compare the barriers for using physical health services with those for using mental health services. METHODS In 2014, we invited all medical students across the nine semesters of training at a government medical college in Puducherry, India, to complete a 28 item questionnaire about perceived barriers to seeking healthcare services. The questionnaire enquired about barriers to using physical and mental healthcare services separately. RESULTS Completed responses were available from 461 of 509 students (response rate 90.6%). Stigma, confidentiality issues, lack of awareness about where to seek help and fear of unwanted intervention were more commonly reported for mental healthcare seeking (OR 4.21, 4.01, 3.19 and 2.43, respectively), while issues relating to cost, lack of time and fear of side effects were observed less frequently (OR 0.45, 0.46 and 0.57, respectively) compared with physical healthcare seeking. In comparison with physical health, students were more indifferent to their mental health issues and preferred self-diagnosis and informal consultations over formal documented care. CONCLUSIONS Barriers to seeking healthcare services differ for mental and physical health issues. Many system based barriers such as stigma, confidentiality issues and poor awareness of service location were reported by students. Institutional programmes should use this information for improving the usage, satisfaction and effectiveness of healthcare delivery systems for medical students.
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Affiliation(s)
- Vikas Menon
- Department of Psychiatry, JIPMER, Puducherry, India
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Lussier A, Loas G. RELATIONSHIP BETWEEN TYPE D PERSONALITY AND ANHEDONIA: A DIMENSIONAL STUDY OF UNIVERSITY STUDENTS. Psychol Rep 2015; 116:855-60. [PMID: 25933043 DOI: 10.2466/09.02.pr0.116k27w2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Type D personality-characterized by negative affectivity and social inhibition-and anhedonia have independently been found to be significantly associated with depression or suicidal ideation in the general population or in psychiatric subjects. The aim of the study was to evaluate the association between Type D personality and anhedonia in a population of 204 university students (102 men, 102 women) after controlling for depression as a confounding variable. Type D personality was evaluated using the Type D scale, anhedonia with the Snaith-Hamilton Pleasure Scale, and depression with the Beck Depression Inventory-II. Significant correlations were found between social inhibition and anhedonia before and after adjustment for depression. In women, a Sobel test indicated significant mediation by social inhibition of the relationship between anhedonia and depression. Results suggested that the social inhibition component of Type D personality could constitute a poor prognosis factor.
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Affiliation(s)
- Axelle Lussier
- 1 Service de Psychiatrie, Hôpital Erasme, Université Libre de Bruxelles (ULB)
| | - Gwenolé Loas
- 1 Service de Psychiatrie, Hôpital Erasme, Université Libre de Bruxelles (ULB)
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Park YM, Ko YH, Lee MS, Lee HJ, Kim L. Type-d personality can predict suicidality in patients with major depressive disorder. Psychiatry Investig 2014; 11:232-6. [PMID: 25110494 PMCID: PMC4124180 DOI: 10.4306/pi.2014.11.3.232] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/01/2014] [Accepted: 01/11/2014] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE This study investigated the putative association between type-D personality and suicidality, including the history of suicide attempt and suicidal ideation in patients with major depressive disorder (MDD). METHODS Eighty-six outpatients aged between 18 and 65 years with MDD were recruited for this study from Ilsan Paik Hospital. The cohort was stratified into two subgroups according to the presence of type-D personality and history of suicide attempt (yes vs. no). Depression severity was evaluated using the Hamilton Depression Rating Scale. The type-D Personality Scale-14 (DS-14), the Beck Hopelessness Scale (BHS), the Barratt Impulsiveness Scale (BIS), the Hamilton Anxiety Scale, and the Beck Scale for Suicidal Ideation (BSS) were also applied. RESULTS The total BSS, BHS, and BIS scores were higher for the group with type-D personality than for the group without this personality (p=0.004, 0.01, and 0.003, respectively). In addition, the total scores for the BSS, BHS, and social inhibition (SI; subscale of DS-14) were higher for the group with a history of suicide attempt than for the group without this history (p=0.0000004, 0.003, and 0.033, respectively). There were positive correlations between the total DS-14 score and the total BSS, BHS, and BIS scores (r=0.413 and p=0.000077, r=0.404 and p=0.00012, and r=0.245 and p=0.024, respectively). CONCLUSION Depressed patients with type-D personality are more vulnerable to suicidality than those without type-D personality, even when the MDD severity is identical. In addition, the SI score was higher in patients with a history of suicide attempt than in those without this history.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Moon-Soo Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Leen Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
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