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Qiu L, Wangzhou K, Liu Y, Ding J, Li H, Ma J. Status of professional mental health help-seeking intention associated factors among medical students: a cross-sectional study in China. Front Psychiatry 2024; 15:1376170. [PMID: 38895034 PMCID: PMC11184052 DOI: 10.3389/fpsyt.2024.1376170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/22/2024] [Indexed: 06/21/2024] Open
Abstract
Aim Low professional help-seeking intention (PHSI) hinders effective treatment of mental illness. PHSI among Chinese students is still understudied and under-recognized. This study aimed to evaluate the status of PHSI and its associated risk factors among Chinese medical students. Methods A cross-sectional survey was conducted in Hainan province, South China, between January 1, 2021, and May 31, 2021. A total of 2182 medical students were recruited and surveyed via an anonymous structured questionnaire. Logistic regression analyses were performed to identify the factors associated with PHSI. Results Among the 2182 medical students (mean age 21.0 years (SD = 3.70), 61.5% females), those with and without PHSI were 72.0% and 28.0%, and 16.4% with moderate to severe depression. Male students, those with a high level of depression stigma, serious family dysfunction, and heavy dependence on mobile phones were significantly less likely to seek professional mental health help, with odds ratios (ORs) of 1.5, 2.0, 2.1, and 1.7, respectively. Conclusion A significant proportion of Chinese medical students demonstrate low PHSI, influenced by factors such as gender, depression stigma, family dysfunction, and mobile phone dependence. Future interventions aimed at increasing medical students' PHSI should prioritize reducing depression stigma, mitigating reliance on mobile phone use, and enhancing family function to address these key barriers to seeking professional mental health support.
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Affiliation(s)
- Lei Qiu
- International School of Public Health, Hainan Medical University, Hainan, China
| | - Kaixin Wangzhou
- School of Management, Hainan Medical University, Hainan, China
| | - Yudan Liu
- School of Public Health, North Sichuan Medical College, Sichuan, China
| | - Jindong Ding
- International School of Public Health, Hainan Medical University, Hainan, China
- Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hui Li
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Jinhui Ma
- School of Management, Hainan Medical University, Hainan, China
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Kupcewicz E, Rachubińska K, Cybulska AM, Jastrzębski P, Bentkowska A, Grochans E. Positive Orientation and Feelings of Loneliness among Polish Students during the COVID-19 Pandemic. J Clin Med 2024; 13:3192. [PMID: 38892903 PMCID: PMC11172793 DOI: 10.3390/jcm13113192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: The COVID-19 pandemic was a time of limited direct contact with other people. The aim of this study was to determine the role of positive orientation and sociodemographic variables in the feelings of global, social and emotional loneliness and to seek predictors for loneliness among students during the COVID-19 pandemic. Methods: The study was conducted on a group of 798 students at the University of Warmia and Mazury in Olsztyn (Poland) between January and March 2022. The empirical data were gathered with the following research tools: the Positive Orientation Scale and the De Jong Gierveld Loneliness Scale-DJGLS. Results: The study found a correlation (r = -0.370; p < 0.001) between positive orientation and emotional loneliness. The level of loneliness was significantly higher in students who greatly reduced their social contact, compared to those who reduced them moderately (p < 0.001). The intensity of social loneliness among women was lower (p < 0.001) than among men. Those who lived with their families or with a close companion felt less intense emotional loneliness (p < 0.001) than those who lived alone. Conclusions: A positive orientation, which manifests itself in a favourable opinion about oneself and in attaching weight to positive aspects of life, was found to be the main determinant of the feelings of global and emotional loneliness. However, it did not prove to be a predictor of social loneliness in the group of students under study.
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Affiliation(s)
- Ewa Kupcewicz
- Department of Nursing, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 14 C Zolnierska Street, 10-719 Olsztyn, Poland;
| | - Kamila Rachubińska
- Department of Nursing, Pomeranian Medical University in Szczecin, 48 Zolnierska Street, 71-210 Szczecin, Poland; (A.M.C.); (E.G.)
| | - Anna Maria Cybulska
- Department of Nursing, Pomeranian Medical University in Szczecin, 48 Zolnierska Street, 71-210 Szczecin, Poland; (A.M.C.); (E.G.)
| | - Paweł Jastrzębski
- Department of Emergency Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 14 C Zolnierska Street, 10-719 Olsztyn, Poland;
| | - Aleksandra Bentkowska
- Hospital Emergency Department, Provincial Specialist Hospital in Olsztyn, 18 Zolnierska Street, 10-719 Olsztyn, Poland;
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, 48 Zolnierska Street, 71-210 Szczecin, Poland; (A.M.C.); (E.G.)
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Winter ML, Olivia SG. A Scoping Review of Mental Health Needs and Challenges among Medical Students within South African Universities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:593. [PMID: 38791806 PMCID: PMC11120686 DOI: 10.3390/ijerph21050593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/22/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024]
Abstract
The mental health of medical students is a growing concern worldwide, with studies indicating high levels of stress, anxiety, and depression among this population. In a South African context, this review aims to review the existing literature on mental health needs and challenges among medical students in South Africa. The rationale for this review is crucial to identify gaps, understand unique contextual factors, and inform the development of targeted interventions and support tailored to the specific needs of South African medical students. This review followed a scoping review framework by Arksey and O'Malley which consists of five stages. The review was initiated in December 2023. The search process was conducted on the following electronic databases: PubMed, Psych-info, Scopus, Google Scholar, and Science Direct. The search terms of this review were "Medical students" OR "Mental health", OR "Challenges", OR "South Africa", OR "Universities" OR "Needs", OR "Support systems", OR "Mental health interventions". This study included articles published in English between 2010 and 2023. After a thorough review of the literature, only eight articles met the inclusion criteria. This study excluded articles that were not published in English, articles published before 2010, full-text articles that could not be retrieved, and studies that did not address the mental health needs and challenges faced by medical students and risk factors contributing to mental issues among South African medical students. The review yielded only three themes utilizing Creswell's Tesch method of data analysis. (1) Prevalence of mental health disorders, (2) risk factors contributing to poor mental health, and (3) available university support systems and interventions. Therefore, the unique aspect of our review lies in shedding light on the underexplored intersections between mental health and the unique context of medical education in South Africa. This includes examining the impact of historical, cultural, and institutional factors on the mental health and well-being of medical students, which has not been comprehensively addressed in previous literature in terms of the South African context. The findings of this review highlight the importance of implementing comprehensive mental health support programs within medical education institutions to address the needs of students and promote their well-being.
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Affiliation(s)
- Mokhwelepa Leshata Winter
- School of Medicine, Faculty of Health Science, University of Limpopo, Private Bag X 1106, Sovenga 0727, South Africa;
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Bao D, Mydin F, Surat S, Lyu Y, Pan D, Cheng Y. Challenge-Hindrance Stressors and Academic Engagement Among Medical Postgraduates in China: A Moderated Mediation Model. Psychol Res Behav Manag 2024; 17:1115-1128. [PMID: 38505350 PMCID: PMC10949402 DOI: 10.2147/prbm.s448844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/29/2024] [Indexed: 03/21/2024] Open
Abstract
Background Improving academic engagement of medical postgraduates is crucial for enhancing the quality of learning and the development of medical education. Due to medical postgraduates face high levels of stress and rigorous demands, yet the mechanisms linking challenge-hindrance stressors to academic engagement in this context remain largely unexplored. This study aims to explore the comprehensive relationship between challenge-hindrance stressors and academic engagement among medical postgraduates in China. Methods Data were collected from 437 medical postgraduates in China, to investigate their challenge-hindrance stressors, emotional exhaustion, learning, relaxation and academic engagement. Among these postgraduates, 40.3% were male and 59.7% were female, with the mean age of the participants being 25.71 years. Statistical procedures were conducted using Mplus 8.3, ensuring a robust analysis of the data collected. Results Our study showed that both challenge and hindrance stressors are significantly positively correlated with emotional exhaustion among Chinese medical postgraduates, and emotional exhaustion is negatively associated with academic engagement. Emotional exhaustion mediates the relationship between challenge-hindrance stressors and academic engagement. Learning plays a protective role, moderating the challenge stressors and emotional exhaustion relationship and its indirect effect on academic engagement. However, relaxation was not identified as a significant moderating factor in this context. Conclusion Our findings not only revealed emotional exhaustion as a potential mechanism underlying the relationship between challenge-hindrance stressors and academic engagement but also validated the moderating role of learning in mitigating the adverse effects of challenge stressors on emotional exhaustion and academic engagement among Chinese medical postgraduates. This comprehensive insight into the complex dynamics between different stressors and academic engagement provides both theoretical and empirical evidence for medical universities. It underscores the importance of interventions to enhance academic engagement in stressful environments and serves as a valuable reference for the development of reasonable assessment systems. These contributions are crucial for fostering a supportive educational atmosphere and promoting the well-being of medical postgraduates.
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Affiliation(s)
- Dan Bao
- Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
- Department of Humanities and Social Sciences, Hubei University of Medicine, Shiyan, Hubei, People’s Republic of China
| | - Faridah Mydin
- Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Shahlan Surat
- Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Yanhong Lyu
- Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Dongsheng Pan
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Yahua Cheng
- School of Government, Shanghai University of Political Science and Law, Shanghai, People’s Republic of China
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Fountoulakis KN, Alias NA, Bjedov S, Fountoulakis NK, Gonda X, Hilbig J, Jakovljević M, Kulig B, Mahale G, Manafis A, Mohammed M, Nadareishvili I, Navickas A, Patsali ME, Pavlichenko A, Pilaga SM, Razali S, Romanov D, Rossitza I, Salihu AS, Sinauridze A, Stoyanova M, Thosar K, Vorobjova J, Vrublevska J, Rancans E, Javed A, Theodorakis PN, Breda J, Smirnova D. Students' mental health during the pandemic: results of the observational cross-sectional COVID-19 MEntal health inTernational for university Students (COMET-S) study. Front Psychiatry 2024; 14:1320156. [PMID: 38293595 PMCID: PMC10825874 DOI: 10.3389/fpsyt.2023.1320156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
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.
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Affiliation(s)
- Konstantinos N. Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
- WHO Collaboration Center for Quality in Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nor Aziah Alias
- Academic Affairs Division, Faculty of Education, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Sarah Bjedov
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Jan Hilbig
- Clinic of Psychiatry, Medical Faculty, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Barbara Kulig
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
- Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
| | - Girija Mahale
- Symbiosis Centre for Emotional Wellbeing, Symbiosis International (Deemed) University, Pune, India
| | - Alexandros Manafis
- Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Muftau Mohammed
- Department of Mental Health, University of Abuja Teaching Hospital, Abuja, Nigeria
| | | | - Alvydas Navickas
- Clinic of Psychiatry, Medical Faculty, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Mikaella E. Patsali
- School of Social Sciences, Hellenic Open University, Patras, Greece
- Department of Internal Medicine, Nicosia General Hospital, Nicosia, Cyprus
| | - Alexey Pavlichenko
- Education Center, Mental-Health Clinic No. 1 n.a. N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | | | - Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Dmitry Romanov
- Department of Psychiatry, Samara State Medical University, Samara, Russia
| | - Iakimova Rossitza
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry “Saint Naum”, Sofia, Bulgaria
| | - Auwal Sani Salihu
- Department of Psychiatry, Bayero University, Kano, Nigeria
- Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Ana Sinauridze
- Georgian Medical Students' Association, Tbilisi, Georgia
| | - Maria Stoyanova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry “Saint Naum”, Sofia, Bulgaria
| | - Ketaki Thosar
- Symbiosis Centre for Emotional Wellbeing, Symbiosis International (Deemed) University, Pune, India
| | | | - Jelena Vrublevska
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
- Institute of Public Health, Riga Stradins University, Riga, Latvia
- Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
- Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | - Afzal Javed
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | | | - Joao Breda
- WHO Athens Quality of Care Office, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, Samara, Russia
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Carlos KM, Ahmadi H, Uban KA, Riis JL. Behavioral and psychosocial factors related to mental distress among medical students. Front Public Health 2023; 11:1225254. [PMID: 37575125 PMCID: PMC10413116 DOI: 10.3389/fpubh.2023.1225254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/26/2023] [Indexed: 08/15/2023] Open
Abstract
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.
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Affiliation(s)
- Kathleen M. Carlos
- Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
| | - Hedyeh Ahmadi
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
| | - Kristina A. Uban
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
- Developing Brains Laboratory, Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Jenna L. Riis
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
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Park CH, Kwon J, Lee JT, Ahn S. Impact of Criterion Versus Norm-Referenced Assessment on the Quality of Life in Korean Medical Students. J Korean Med Sci 2023; 38:e133. [PMID: 37128877 PMCID: PMC10151616 DOI: 10.3346/jkms.2023.38.e133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/11/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Medical students are known to be subjected to immense stress under competitive curricula and have a high risk of depression, burnout, anxiety and sleep disorders. There is a global trend of switching from norm-referenced assessment (NRA) to criterion-referenced assessment (CRA), and these changes may have influenced the quality of life (QOL), sleep phase, sleep quality, stress, burnout, and depression of the medical students. We hypothesized that there is a significant difference of QOL between CRA and NRA and that sleep, stress, burnout, and depression are the main contributors. METHODS By administering an online survey regarding QOL and its contributors to Korean medical students, 365 responses from 10 medical schools were recorded. To clarify the complex relationship between the multiple factors in play, we applied nonlinear machine learning algorithms and utilized causal structure learning techniques on the survey data. RESULTS Students with CRA had lower scores in stress (68.16 ± 11.29, 76.03 ± 12.38, P < 0.001), burnout (48.09 ± 11.23, 55.93 ± 13.07, P < 0.001), depression (12.77 ± 9.82, 16.44 ± 11.27, P = 0.003) and higher scores in QOL (95.79 ± 16.20, 89.65 ± 16.28, P < 0.001) compared with students with NRA. Multiple linear regression, permutation importance of the random forest model and the causal structure model showed that depression, stress and burnout are the most influential factors of QOL of medical students. CONCLUSION Medical students from schools that use CRA showed higher QOL scores, as well as lower burnout, stress and depression when compared with students from schools that use NRA. These results may be used as a basis for granting justification for the transition to CRA.
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Affiliation(s)
- Ce Hwan Park
- Inje University College of Medicine, Busan, Korea
| | - Jihyeon Kwon
- Inje University College of Medicine, Busan, Korea
| | - Jong Tae Lee
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
| | - Sangzin Ahn
- Department of Pharmacology and Pharmacogenomics Research Center, Inje University College of Medicine, Busan, Korea.
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Dutta G, Rajendran N, Kumar T, Varthya SB, Rajendran V. Prevalence of Depression Among Undergraduate Medical Students in India: A Systemic Review and Meta-Analysis. Cureus 2023; 15:e33590. [PMID: 36779123 PMCID: PMC9910033 DOI: 10.7759/cureus.33590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Systematic reviews have proved that there is a high rate of depression among medical students when compared with their age-matched peers. Very few studies have evaluated the pooled prevalence of depression among medical students in India. OBJECTIVES To determine the pooled prevalence of depression among medical students in India. MATERIALS AND METHODS This review was done by searching databases like PubMed, Google Scholar, and Scopus for available original articles published between 2019 and 2022 on depression among Indian medical (MBBS) undergraduate students using PRISMA guidelines. RESULTS A total of 19 original research articles were included in this review, involving students at different medical colleges from various regions of India. The pooled prevalence of depression among 5944 medical students was 50.0% (95% CI: (31%-70%)) based on the random effect model. This meta-analysis also found that the pooled prevalence of depression among females (pooled prevalence: 38.0%, 95% CI: 20.0 to 58.0) was slightly higher than among males (pooled prevalence: 34.0%, 95% CI: 15.0 to 55.0). CONCLUSION The high prevalence of depression among medical students demands regular screening for depression along with counselling services. It shows that there is a need to raise awareness among students and other stakeholders, such as parents and medical educators, concerning symptoms and signs of depression among medical students.
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Affiliation(s)
- Gitashree Dutta
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, IND
| | - Navin Rajendran
- Paediatrics, Dr. Sampurnanand (SN) Medical College, Jodhpur, IND
| | - Tarun Kumar
- Pharmacology, All India Institute of Medical Sciences, Jodhpur, IND
| | - Shoban B Varthya
- Pharmacology, All India Institute of Medical Sciences, Jodhpur, IND
| | - Vinoth Rajendran
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, IND
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Broks VMA, Stegers-Jager KM, van der Waal J, van den Broek WW, Woltman AM. Medical students' crisis-induced stress and the association with social support. PLoS One 2022; 17:e0278577. [PMID: 36454995 PMCID: PMC9714810 DOI: 10.1371/journal.pone.0278577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 11/20/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Medical schools are challenged to guard student wellbeing given the potential negative impact of the COVID-19 outbreak combined with an already high prevalence of mental distress. Although social support is generally associated with less crisis-induced stress, it is unknown whether this applies to medical students during the COVID-19 outbreak. OBJECTIVES The impact of the COVID-19 outbreak on perceived stress of medical students was assessed by comparing their perceived stress levels during the outbreak to both their own baseline and the previous cohort's pre-COVID-19 stress levels. Then, the association between social support and stress during the COVID-19 outbreak was assessed. METHODS Dutch Year-1 medical students of cohort 2019 (n = 99) completed the 14-item Perceived Stress Scale (PSS-14) at two time points: baseline (pre-COVID-19) and final measurement (COVID-19). Social support-emotional-informational support and club membership-was assessed during the final measurement. PSS and social support scores were compared to similar measurements of cohort 2018 (n = 196). Students' baseline stress levels, gender, and study performance were controlled for when comparing final stress levels. RESULTS In cohort 2018 (pre-COVID-19), students' perceived stress levels did not differ significantly between the baseline and final measurements. Additionally, baseline stress levels of the two cohorts (2018 and 2019) were not found to be significantly different. Cohort 2019's final stress levels (COVID-19) were significantly higher compared to their baseline stress levels (paired t-test: t = 6.07, p < .001) and cohort 2018's final stress levels (linear regression: B = 4.186, p < .001). Only during the COVID-19 outbreak higher social support levels-i.e., emotional-informational support (B = -0.75, p < .001) and club membership (B = -3.68, p < .01)-were associated with lower stress levels. CONCLUSIONS During the COVID-19 outbreak, medical students' perceived stress levels were higher-especially for students with lower social support levels. Our results suggest that medical schools should optimize social support to minimize crisis-induced stress.
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Affiliation(s)
- Vera M. A. Broks
- Institute of Medical Education Research Rotterdam, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Karen M. Stegers-Jager
- Institute of Medical Education Research Rotterdam, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Jeroen van der Waal
- Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Walter W. van den Broek
- Institute of Medical Education Research Rotterdam, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Andrea M. Woltman
- Institute of Medical Education Research Rotterdam, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
- * E-mail:
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Dhanoa S, Oluwasina F, Shalaby R, Kim E, Agyapong B, Hrabok M, Eboreime E, Kravtsenyuk M, Yang A, Nwachukwu I, Moreau C, Abba-Aji A, Li D, Agyapong VIO. Prevalence and Correlates of Likely Major Depressive Disorder among Medical Students in Alberta, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811496. [PMID: 36141768 PMCID: PMC9517002 DOI: 10.3390/ijerph191811496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Medical students are exposed to multiple factors during their academic and clinical studies that contribute to depression. AIMS This study aims to examine the prevalence and correlates of likely major depressive disorder (MDD) among medical students. METHODS This study utilized a descriptive cross-sectional design. Data were collected through a self-administered online survey, which included questions on sociodemographic characteristics and likely MDD using the PHQ-9. Data were analyzed using a descriptive, Chi-square test and logistic regression model. RESULTS There were 246 medical students who participated in the survey. The majority were females, 155 (65.1%); Caucasian, 158 (66.4%); and in a relationship, 168 (70.5%). The prevalence of likely MDD was 29.1%. Respondents who did not feel supported and respondents who were neutral about their social support, friends, and family, were 11 and 4 times more likely to experience MDD than those who felt well supported (OR = 11.14; 95% CI: 1.14-108.80) and (OR = 4.65; 95% CI: 1.10-19.56), respectively. CONCLUSIONS This study suggests a high prevalence of likely MDD among medical students who do not feel they have sufficient social support from friends and family. Social adjustments, including talking to friends and family and participating in leisure activities, could reduce the level of depression among medical students.
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Affiliation(s)
- Sumeet Dhanoa
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Esther Kim
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Marianne Hrabok
- Department of Psychiatry, University of British Columbia, Vancouver Island, BC V6T 1Z4, Canada
| | | | - Maryana Kravtsenyuk
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Alicia Yang
- Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Izu Nwachukwu
- Department of Psychiatry, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Chantal Moreau
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Adam Abba-Aji
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Daniel Li
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
- QEII Health Sciences Centre, Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, Halifax, NS B3H 2E2, Canada
- Correspondence: ; Tel.: +1-780-215-7771; Fax: +1-902-473-4887
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Kappner N, Lang J, Berthold A, Gaum PM. The moderating effect of social resources on the link between study-related stressors and depressive symptoms among medical students in North Rhine-Westphalia, Germany - a cross-sectional study. BMC Psychiatry 2022; 22:524. [PMID: 35918711 PMCID: PMC9345665 DOI: 10.1186/s12888-022-04170-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 07/18/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Previous research has demonstrated the negative effects of study-related stressors on the mental health of medical students. It has been found that social resources such as social identity, dual identity and social support help buffer negative mental health outcomes. Notably, social status has been found to weaken the connection between stress and depressive symptoms. Based on these findings, the present study investigates how social resources (i.e., social identity, social support, dual identity and status) mitigate the impact of study-related stressors on the mental health of medical students who carry an inordinate stress burden. METHODS The data collection was based on a questionnaire (online and paper-pencil) which was distributed to medical students in North Rhine-Westphalia, Germany. The sample (224 participants) consisted of 77.2% female and 22.8% male medical students (36.2% human medicine students (HMS) and 63.8% dental medicine students (DMS)). The questionnaire included graphical scales and standardized questionnaires. We investigated demographic data, study-related stressors (i.e. academic performance, clinical practice, faculty relations) and depressive symptoms as outcomes, and social identity, social support, dual identity and status as moderators. The analyses were performed using SPSS 25 for Windows. RESULTS We found significant positive associations between study-related stressors and depressive symptoms. While dual identity as well as social support by fellow students emerged as buffers in these associations, the other social resources did not. As regards status, it was found to work as a buffer only in HMS, who typically enjoy a significantly higher status than dental medical students. CONCLUSION It is only social resources such as support from fellow students and dual identity, but not other resource types, that can be effective buffers against depressive symptoms associated with study-related stressors. These findings can be used to promote students' identities in relation to both fellow students and the faculty, or the university as a whole, enabling students to better cope with stress and, thus, suffer less from depressive symptoms. Furthermore, the HMS, who ascribe a relatively high status to themselves, can use their status as a buffering factor in stressful situations, in which little can be done from the outside.
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Affiliation(s)
- Nora Kappner
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany.
| | - Jessica Lang
- grid.1957.a0000 0001 0728 696XInstitute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - Anne Berthold
- grid.5801.c0000 0001 2156 2780Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Petra Maria Gaum
- grid.1957.a0000 0001 0728 696XInstitute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
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12
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Ego-resiliency moderates the risk of depression and social anxiety symptoms on suicidal ideation in medical students. Ann Gen Psychiatry 2022; 21:19. [PMID: 35717375 PMCID: PMC9206746 DOI: 10.1186/s12991-022-00399-x] [Citation(s) in RCA: 4] [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: 12/09/2021] [Accepted: 06/03/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Little is known about the role of protective factors in suicidal ideation among medical students. This study aimed to examine the association between suicidal ideation and protective (self-esteem/ego-resiliency/social support) and risk (depression/social anxiety) factors. METHODS Data on sociodemographic factors, depression, social anxiety, self-esteem, ego-resiliency, social support, and current suicidal ideation were collected from 408 medical students. A logistic regression model was constructed to identify the independent impact of potential influencing factors on suicidal ideation. Potential moderating effects were also explored. RESULTS Thirty-eight participants (9.3%) reported experiencing suicidal ideation. Younger age, higher levels of depression, social anxiety, and lower levels of self-esteem, ego-resiliency, and social support were found to be significantly correlated with suicidal ideation. In the final model, higher levels of depression and social anxiety were associated with an increased risk of suicidal ideation, while higher levels of self-esteem and social support were associated with a decreased risk of suicidal ideation. Although the independent effect was not significant, the interactions of ego-resiliency with both depression and social anxiety on suicidal ideation were significant. Higher levels of ego-resiliency acted as a buffer against suicidal ideation among those with higher levels of depression or social anxiety. CONCLUSIONS In addition to risk factors, this study revealed the underlying protective and moderating factors of suicidal ideation among medical students. Mental health programs focusing on enhancing ego-resiliency, self-esteem, and social support may contribute to suicide prevention in medical students.
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Kupcewicz E, Mikla M, Kadučáková H, Grochans E, Valcarcel MDR, Cybulska AM. Correlation between Positive Orientation and Control of Anger, Anxiety and Depression in Nursing Students in Poland, Spain and Slovakia during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2482. [PMID: 35206674 PMCID: PMC8876154 DOI: 10.3390/ijerph19042482] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 12/21/2022]
Abstract
(1) This study analysed the relationship between positive orientation and subjective control of anger, anxiety and depression in nursing students in Poland, Spain and Slovakia during the pandemic. (2) The survey was carried out by the diagnostic survey method in a group of 756 nursing students in Poland, Spain and Slovakia. The empirical data were gathered using an original survey questionnaire, the Positive Orientation Scale and the Courtauld Emotional Control Scale. (3) It was shown that the positive orientation level in Polish students was significantly lower than in students in Spain (p < 0.0001) and Slovakia (p < 0.0001). Low results for positive orientation were obtained in nearly half (47.18%) of the respondents in the Polish sample, whereas it was 34.18% and 31.18% in the Spanish and Slovak samples, respectively (p < 0.0001). A positive orientation was the most important predictor of emotional control among the nursing students at all the sites (p < 0.0001). (4) Positive orientation has been shown to have a significant impact on emotional control in nursing students during the pandemic. Therefore, it is important to carefully monitor students' mental health during the pandemic to determine the demand for psychological and emotional support.
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Affiliation(s)
- Ewa Kupcewicz
- Department of Nursing, Collegium Medicum University of Warmia and Mazury, 10-719 Olsztyn, Poland;
| | - Marzena Mikla
- Department of Nursing, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain; (M.M.); (M.D.R.V.)
| | - Helena Kadučáková
- Department of Nursing, Faculty of Health, Catholic University in Ruzomberok, 034-01 Ruzomberok, Slovakia;
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland;
| | | | - Anna Maria Cybulska
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland;
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Watari T, Nagai N, Kono K, Onigata K. Background factors associated with academic motivation for attending medical school immediately after admission in Japan: A single‐center study. J Gen Fam Med 2022; 23:164-171. [PMID: 35509336 PMCID: PMC9062539 DOI: 10.1002/jgf2.528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Takashi Watari
- General Medicine Center Shimane University Hospital Shimane Japan
| | | | - Kaori Kono
- Shimane University Faculty of Medicine Shimane Japan
| | - Kazumichi Onigata
- Shimane University Faculty of Medicine Shimane Japan
- Postgraduate Clinical Training Center Shimane University Hospital Shimane Japan
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15
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Ruan H, Shen K, Chen F. Negative Life Events, Social Ties, and Depressive Symptoms for Older Adults in China. Front Public Health 2022; 9:774434. [PMID: 35127620 PMCID: PMC8810507 DOI: 10.3389/fpubh.2021.774434] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022] Open
Abstract
Although it is widely acknowledged that older adults who have gone through negative life events are more likely to develop depression, there is limited evidence on whether and which type of social ties moderate this perceived relationship. Based on 2016 and 2018 waves of Chinese Longitudinal Aging Social Survey (4,466 individuals, 8,932 observations), we apply linear fixed effects models and confirm that negative life events are associated with depressive symptoms for older adults (Coef. = 0.35; 95% CIs 0.11–0.61), and social ties are negatively associated with depression (Coef. = −0.08; 95% CIs −0.10 to −0.07). Our study further suggests that the association between negative life events and depressive symptoms is significantly moderated by friendship ties (Coef. = −0.18, 95% CIs −0.30 to −0.07), rather than family ties (Coef. = −0.03, 95% CIs −0.09 to 0.15). Moreover, the buffering effects of friendship ties are more prominent for the less resilient and less privileged groups, namely male, rural, and less educated older adults. Our findings point to the importance of expanding and strengthening social networks for Chinese older adults in promoting their psychological health.
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Affiliation(s)
- Hangqing Ruan
- Department of Sociology, University of Maryland, College Park, MD, United States
| | - Ke Shen
- School of Social Development and Public Policy, Fudan University, Shanghai, China
- *Correspondence: Ke Shen
| | - Feinian Chen
- Department of Sociology, University of Maryland, College Park, MD, United States
- School of Social Development and Public Policy, Fudan University, Shanghai, China
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Ruzhenkova V, Khamskaya I, Gomelak Y. Depression in medical students: prevalence, dynamics and comorbidity. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:7-11. [DOI: 10.17116/jnevro20221220627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Luibl L, Traversari J, Paulsen F, Scholz M, Burger P. Resilience and sense of coherence in first year medical students - a cross-sectional study. BMC MEDICAL EDUCATION 2021; 21:142. [PMID: 33663468 PMCID: PMC7934430 DOI: 10.1186/s12909-021-02571-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 02/19/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND A broad range of studies show that medical students often have a significantly deteriorated mental health status. Although starting medical school with values comparable to the population average, only a few semesters later, medical undergraduates show increased rates of psychological risk states and some manifest mental illnesses, such as burnout and depression. In our survey we intentionally assessed mental health parameters from a salutogenetic, i.e. resource-oriented point of view. METHODS We examined first-year medical students in a cross-sectional study and assessed sense of coherence (SOC) and resilience as parameters from the salutogenesis model by Antonovsky in a structured way using validated, self-administered questionnaires. In total, we examined 236 students of human medicine, dentistry and molecular medicine at the Friedrich-Alexander-University Erlangen-Nürnberg (FAU). RESULTS Our analyses showed significantly higher values of resilience among male students compared to female students (p < 0.01). In contrast, even though a significant correlation between resilience and SOC was observed, only a non-significantly lower value of SOC was found in female students. Compared to the reference sample our medical students in their first year of study showed significantly lower values for resilience (p < 0.01) and SOC (p < 0.01). CONCLUSION Resilience and SOC are known to correlate with psychological stress (burnout parameters) and depression. In order to keep protective factors like SOC and resilience in medical students at a good and healthy level we see the necessity to address that problem proactively and educationally. Integrating training focused on the preservation of the students´ own mental health into the medical curriculum from the beginning of university courses, and throughout the whole medical study course, is essential and should be an obligatory training goal. Based on our study results, we also deem it necessary to think about ways to adapt the measures for the gender-specific needs of our students, e.g. dependent on their biological gender.
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Affiliation(s)
- Lena Luibl
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Universitätsstr. 19, 91054, Erlangen, Germany
| | - Julia Traversari
- Institute of Anatomy, University of Zurich, Winterthurerstrasse 190, 8057, Zürich, Switzerland
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Universitätsstr. 19, 91054, Erlangen, Germany
| | - Michael Scholz
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Universitätsstr. 19, 91054, Erlangen, Germany.
| | - Pascal Burger
- Department of Psychiatry, Psychiatric University Hospital, Lenggstrasse 31, 8008, Zurich, Switzerland
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Zhong Y, Schroeder E, Gao Y, Guo X, Gu Y. Social Support, Health Literacy and Depressive Symptoms among Medical Students: An Analysis of Mediating Effects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020633. [PMID: 33451118 PMCID: PMC7828636 DOI: 10.3390/ijerph18020633] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 11/16/2022]
Abstract
Depressive symptoms are prevalent in university students and may impair their social, educational, and economic transition into adulthood. Identifying the factors that determine depressive symptoms is crucial for the design of effective policy interventions. This study aims to examine the associations between health literacy and depressive symptoms among medical students, and to evaluate the effect of different types of social support as a potential mediator. A cross-sectional survey of medical students was conducted through convenience sampling in East China. Associations between variables were explored using OLS and the mediation effect was estimated using the Karlson, Holm and Breen method. A total of 746 valid questionnaires were collected. The prevalence of depressive symptoms among the sample was 32.4%. Higher health literacy levels and social supports were significantly associated with lower levels of depressive symptoms. Social support partially mediated the association between health literacy and depressive symptoms, accounting for a 54.03% of the total effect size. These findings suggest that interventions for medical student mental wellbeing could improve health literacy. Whilst family support reflects greatest impact, Universities can also lead and innovate novel interventions for this critical stage of life. Future research can extend this study by exploring the dynamic interactions between health literacy, depressive symptoms, and other sources of social support. Comparisons of these findings across the different regions of China and in other university subject disciplines are also warranted.
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Affiliation(s)
- Yaqin Zhong
- School of Public Health, Nantong University, Nantong 210029, China; (Y.Z.); (Y.G.)
| | - Elizabeth Schroeder
- Macquarie University Centre for the Health Economy, Macquarie Business School, Macquarie University, Macquarie Park, NSW 2109, Australia;
- Department of Health Systems and Populations, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Yuexia Gao
- School of Public Health, Nantong University, Nantong 210029, China; (Y.Z.); (Y.G.)
| | - Xiaojun Guo
- School of Sciences, Nantong University, Nantong 210029, China;
| | - Yuanyuan Gu
- Macquarie University Centre for the Health Economy, Macquarie Business School, Macquarie University, Macquarie Park, NSW 2109, Australia;
- Correspondence: ; Tel.: +61-298-504-619
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Chang Q, Xia Y, Bai S, Zhang X, Liu Y, Yao D, Xu X, Zhao Y. Association Between Pittsburgh Sleep Quality Index and Depressive Symptoms in Chinese Resident Physicians. Front Psychiatry 2021; 12:564815. [PMID: 34149465 PMCID: PMC8206480 DOI: 10.3389/fpsyt.2021.564815] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/11/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Previous studies have suggested that sleep quality is associated with depressive symptoms. However, associations between overall sleep quality and depressive symptoms in Chinese resident physicians remain unclear. Therefore, we aimed to determine whether overall sleep quality is associated with depressive symptoms in Chinese resident physicians. Methods: This cross-sectional study included 1,230 resident physicians. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was applied to estimate the associations between the PSQI and PHQ-9. Results: Among all participants, the prevalence of mild (PHQ-9 ≥ 5) and moderate or severe (PHQ-9 ≥ 10) depressive symptoms were 48.28 and 12.93%, respectively. PSQI score was positively associated with PHQ-9 score before and after adjustments of socio-demographic, behavioral, and psychologic confounding factors (all P < 0.0001). After adjustments, the regression coefficients (standard error) between PSQI scores and PHQ-9 scores were 0.95 (0.04), 0.88 (0.09), and 0.96 (0.05) in all participants, men, and women, respectively. Compared to physicians with good sleep quality (PSQI scores ≤ 5), the adjusted odds ratios (ORs) [95% confidence intervals (CIs)] for mild (PHQ-9 ≥ 5) and moderate or severe (PHQ-9 ≥ 10) depressive symptoms in physicians with poor sleep quality were 7.15 (5.44, 9.46) and 6.17 (4.03, 9.71) in all participants, respectively. Conclusions: Our findings suggest that poor sleep quality was associated with a higher prevalence of depressive symptoms in Chinese resident physicians.
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Affiliation(s)
- Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Bai
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xi Zhang
- Department of Graduate Medical Education, Health Service Center of Liaoning Province, Shenyang, China
| | - Yashu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Da Yao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xinrui Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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Guse J, Heinen I, Kurre J, Mohr S, Bergelt C. Perception of the study situation and mental burden during the COVID-19 pandemic among undergraduate medical students with and without mentoring. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc72. [PMID: 33364351 PMCID: PMC7740010 DOI: 10.3205/zma001365] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/06/2020] [Accepted: 10/23/2020] [Indexed: 05/12/2023]
Abstract
Objectives: The COVID-19 pandemic caused drastic changes in medical education and might affect students' mental health and perception of study conditions. Mentoring may have mediating effects by enhancing social support. The University Medical Center Hamburg-Eppendorf (UKE) offers a voluntary general mentoring program (g-mentoring) for all interested students and a mentoring program for students with excellent course results and scientific interest (e-mentoring) We aimed to investigate the mental burden and views of their study situation during COVID-19 among students who did or did not participate in one of the formal mentoring programs. Method: We conducted a cross-sectional online survey (May 2020) examining students' mental burden using the Patient Health Questionnaire (PHQ-4), and assessing their perception of study conditions and digital teaching using self-developed items. Results: Of 1193 invited students, 543 (45.5%) completed the survey. 35% of those participated in the g-mentoring and 7% in the e-mentoring. 59% did not participate in any program. More e-mentees than g-mentees and nonparticipants reported clinically unproblematic levels of anxiety and depression symptoms. The majority of students (55%) was somewhat worried about the impact of the pandemic on their study situation. Regarding digital teaching students did not feel overburdened by the lack of a fixed schedule and structure, e-mentees even less than g-mentees and nonparticipants. Both g-mentees and nonparticipants were significantly more appreciative of the possible repeated use of the digital teaching materials than e-mentees (both groups M=5.7 vs. M=5.4 in e-mentees, p=.045). Conclusion: The results indicate that while students feel substantially burdened by the situation and the majority worries about the impact of the pandemic on their studies, they also seem to cope well with the digital course format. Study motivation during COVID-19 decreased among the majority of students with and without mentoring. These aspects may be important to address by medical schools interested in developing effective interventions to support students during a pandemic and continuous online teaching.
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Affiliation(s)
- Jennifer Guse
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Medical Psychology, Hamburg, Germany
- *To whom correspondence should be addressed: Jennifer Guse, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Medical Psychology, Martinistraße 52, W26, D-20246 Hamburg, Germany, E-mail:
| | - Ines Heinen
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Medical Psychology, Hamburg, Germany
| | - Jana Kurre
- FOM Hochschule für Oekonomie & Management, Berlin, Germany
| | - Sonja Mohr
- University Medical Center Hamburg-Eppendorf, Education and Students' Affairs, Hamburg, Germany
| | - Corinna Bergelt
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Medical Psychology, Hamburg, Germany
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Albajjar MA, Bakarman MA. Prevalence and correlates of depression among male medical students and interns in Albaha University, Saudi Arabia. J Family Med Prim Care 2019; 8:1889-1894. [PMID: 31334151 PMCID: PMC6618237 DOI: 10.4103/jfmpc.jfmpc_323_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Depression in medical students and interns appear higher than the general population, with evidence of mental health deterioration over a period of medical training. Objectives: To estimate the prevalence and evaluate the predictors of depression among male medical students and interns, Albaha University, Saudi Arabia. Subjects and Methods: A cross-sectional analytic study was conducted which includes a representative stratified random sample with the proportional allocation of male medical students and interns, College of Medicine, Albaha University (2017–2018). A questionnaire included sociodemographic characteristics of the participants as well as a medical and family history of depression, medical or psychiatric illness, abuse or violence, and the major traumatic event was utilized. In addition, the validated reliable Arabic version of Becks Depression Inventory (BDI) questionnaire was used to screen for depression. Results: The study included 161 medical students and 21 interns. Their age ranged between 19 and 26 years with a mean of 22.03 ± 1.94 years. Majority of the participants (98.9%) were Saudis and singles (84.6%). The prevalence of depression, based on the BDI scale, was 53.8%; it was mild in 25.8% and severe or extreme in 4.4% of the participants. No factor was significantly associated with depression. However, severe or extreme depression was more reported among students/interns with a history of domestic abuse or violence and those who had a history of major trauma or psychiatric event, P < 0.001. Conclusion: Depression is a common problem among male medical students and interns in AlBaha University, with no difference according to demographics, smoking history, family history of depression, history of chronic medical or psychiatric illness, history of domestic/violence abuse, and history of major trauma or psychiatric event.
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Affiliation(s)
| | - Marwan A Bakarman
- Department of Family and Community Medicine, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Nguyen TTT, Nguyen NTM, Pham MV, Pham HV, Nakamura H. The four-domain structure model of a depression scale for medical students: A cross-sectional study in Haiphong, Vietnam. PLoS One 2018; 13:e0194550. [PMID: 29566050 PMCID: PMC5864022 DOI: 10.1371/journal.pone.0194550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/06/2018] [Indexed: 11/19/2022] Open
Abstract
Depression is a common mental health problem with a higher prevalence in medical students than in the general population. This study aims to investigate the association between depressive symptoms, particularly those in each domain of the Center for Epidemiological Studies Depression (CES-D) Scale, and related factors. A cross-sectional study was conducted with a random sample of 1319 medical students at Haiphong University of Medicine and Pharmacy in 2016. The CES-D scale and a self-reported questionnaire were used to identify the prevalence of depressive symptoms and related risk factors. Univariate and multivariate logistic regression were performed to assess the risk factors associated with depressive symptoms and the score for each structure factor. Depressive symptoms were observed in 514 (39%) students, including more males than females (44.2% vs 36.9%, p = 0.015). Students whose mothers' highest education level was primary school had a higher prevalence of depressive symptoms than students whose mothers had higher education levels (p = 0.038). There was a significant relationship between depressive symptoms and stressful life events, especially a decline in personal health. A higher correlation was found between the somatic complaints and depressive affect domains. The impacts of risk factors differed for each domain of the depression scale. Only the factor of achieving excellence showed no statistically significant associations with depressive symptoms and the scores on the four domains considered in this study. The high prevalence of depressive symptoms among medical students with risk factors and the impact of these risk factors on each domain of depression scale need further clarification to alleviate depression in students during their medical training.
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Affiliation(s)
- Thao Thi Thu Nguyen
- Department of Environmental and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa City, Ishikawa Prefecture, Japan
- * E-mail:
| | - Ngoc Thi Minh Nguyen
- Department of Environmental Health, Public Health Faculty, Haiphong University of Medicine and Pharmacy, Haiphong City, Vietnam
| | - Manh Van Pham
- Department of Psychiatry, Haiphong University of Medicine and Pharmacy, Haiphong City, Vietnam
| | - Han Van Pham
- Department of Environmental Health, Public Health Faculty, Haiphong University of Medicine and Pharmacy, Haiphong City, Vietnam
| | - Hiroyuki Nakamura
- Department of Environmental and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa City, Ishikawa Prefecture, Japan
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Racic M, Todorovic R, Ivkovic N, Masic S, Joksimovic B, Kulic M. Self- Perceived Stress in Relation to Anxiety, Depression and Health-related Quality of Life among Health Professions Students: A Cross-sectional Study from Bosnia and Herzegovina. Zdr Varst 2017; 56:251-259. [PMID: 29062400 PMCID: PMC5639815 DOI: 10.1515/sjph-2017-0034] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/11/2017] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The purpose of the present study was to examine self-perceived stress of health professions students at the Faculty of Medicine Foča, and to explore its association with anxiety, depression and health-related quality of life. METHODS The cross-sectional study enrolled 451 students at the Faculty of Medicine (medicine, dentistry, nursing and speech therapy). Survey instruments were distributed at the conclusion of the spring semester during the last required lecture for each year and study programme class. Perceived stress was assessed using the 14-item Perceived Stress Scale. The students were evaluated for symptoms of depression and anxiety, using Zung's self-assessment inventory for depression and the Spielberger State-Trait Anxiety Inventory (STAI). European Quality of Life-5 dimensions were used for describing and evaluating health. Multivariate analyses were carried out using logistic regression to examine the relationship between the outcome variable and selected determinant factors. RESULTS A high degree of stress was reported by 1.6% of students, while the majority of students had either moderate (70.6%) or low degree (27.5%) of stress. The significant independent factors associated with perceived stress were anxiety score (OR, 0.339; CI 95%, 0.276-0.403) and EQ-5D score (OR, 0.044; CI 95%, 0.033-0.085). A high degree of perceived stress (OR, 0.624; CI 95%, 0.507-0.704), the presence of depression (OR, 0.800; CI 95%, 0.513-1.087), and low quality of life were associated with anxiety (OR, 0.073; CI 95%, 0.018-0.128). CONCLUSION Higher levels of perceived stress predispose health professions students for anxiety and lower quality of life. The study programme was not a significant determinant of perceived stress sore.
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Affiliation(s)
- Maja Racic
- University of East Sarajevo, Faculty of Medicine, Department for PC and Public Health, Studentska 5, 73300Foca, Bosnia and Herzegovina
| | | | - Nedeljka Ivkovic
- University of East Sarajevo, Faculty of Medicine, Department for PC and Public Health, Studentska 5, 73300Foca, Bosnia and Herzegovina
| | - Srdjan Masic
- University of East Sarajevo, Faculty of Medicine, Department for PC and Public Health, Studentska 5, 73300Foca, Bosnia and Herzegovina
| | - Bojan Joksimovic
- University of East Sarajevo, Faculty of Medicine, Department for PC and Public Health, Studentska 5, 73300Foca, Bosnia and Herzegovina
| | - Milan Kulic
- University of East Sarajevo, Faculty of Medicine, Department for PC and Public Health, Studentska 5, 73300Foca, Bosnia and Herzegovina
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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: 1193] [Impact Index Per Article: 149.1] [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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Shi M, Liu L, Wang ZY, Wang L. Prevalence of depressive symptoms and its correlations with positive psychological variables among Chinese medical students: an exploratory cross-sectional study. BMC Psychiatry 2016; 16:3. [PMID: 26754773 PMCID: PMC4707780 DOI: 10.1186/s12888-016-0710-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/08/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Knowledge about the prevalence of depressive symptoms among Chinese medical students and its related factors is rather limited. Understanding the correlates of depressive symptoms and the roles that positive psychological variables play in depressive symptoms is of vital importance for future interventions. The main objectives of this study were to investigate the prevalence of depressive symptoms and the integrated effects of resilience, hope and optimism on depressive symptoms among Chinese medical students. METHODS This multi-center cross-sectional study was conducted in June 2014. The questionnaires that consisted of the Center for Epidemiologic Studies Depression Scale (CES-D), Wagnild and Young Resilience Scale-14 (RS-14), Adult Dispositional Hope Scale (ADHS), Life Orientation Test-Revised (LOT-R), and socio-demographic characteristics, were distributed to students at four medical colleges or universities in Liaoning province, China. A total of 2925 medical students became the final subjects. Hierarchical linear regression analyses were used to explore the integrated effects of resilience, hope and optimism on depressive symptoms. RESULTS The prevalence of depressive symptoms among Chinese medical students was 66.8 % (CES-D ≥ 16). Resilience, hope and optimism were all negatively correlated with depressive symptoms and they accounted for 26.1 % of the variance in depressive symptoms. CONCLUSIONS The high prevalence of depressive symptoms among Chinese medical students calls for special attention from all stakeholders, especially university authorities. Intervention strategies that focus on enhancing the positive psychological variables of resilience, hope and optimism can be integrated into depression prevention and treatment programs.
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Affiliation(s)
- Meng Shi
- Department of English, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, PR China.
| | - Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, PR China.
| | - Zi Yue Wang
- Department of Social Medicine, School of Public Health, China Medical University, 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, PR China.
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, PR China.
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Park KH, Kim DH, Kim SK, Yi YH, Jeong JH, Chae J, Hwang J, Roh H. The relationships between empathy, stress and social support among medical students. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2015; 6:103-8. [PMID: 26342190 PMCID: PMC4561553 DOI: 10.5116/ijme.55e6.0d44] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 09/01/2015] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To examine the relationship between stress, social support, and empathy among medical students. METHODS We evaluated the relationships between stress and empathy, and social support and empathy among medical students. The respondents completed a questionnaire including demographic information, the Jefferson Scale of Empathy, the Perceived Stress Scale, and the Multidimensional Scale of Perceived Social Support. Correlation and linear regression analyses were conducted, along with sub-analyses according to gender, admission system, and study year. RESULTS In total, 2,692 questionnaires were analysed. Empathy and social support positively correlated, and empathy and stress negatively correlated. Similar correlation patterns were detected in the sub-analyses; the correlation between empathy and stress among female students was negligible. In the regression model, stress and social support predicted empathy among all the samples. In the sub-analysis, stress was not a significant predictor among female and first-year students. CONCLUSIONS Stress and social support were significant predictors of empathy among all the students. Medical educators should provide means to foster resilience against stress or stress alleviation, and to ameliorate social support, so as to increase or maintain empathy in the long term. Furthermore, stress management should be emphasised, particularly among female and first-year students.
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Affiliation(s)
- Kyung Hye Park
- Department of Emergency Medicine, Inje University College of Medicine, Busan, Republic of Korea
| | - Dong-hee Kim
- Inje University College of Medicine, Busan, Republic of Korea
| | - Seok Kyoung Kim
- Inje University College of Medicine, Busan, Republic of Korea
| | - Young Hoon Yi
- Inje University College of Medicine, Busan, Republic of Korea
| | - Jae Hoon Jeong
- Inje University College of Medicine, Busan, Republic of Korea
| | - Jiun Chae
- Inje University College of Medicine, Busan, Republic of Korea
| | - Jiyeon Hwang
- Inje University College of Medicine, Busan, Republic of Korea
| | - HyeRin Roh
- Department of Medical Education, Inje University College of Medicine, Busan, Republic of Korea
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Mojs EH, Warchoł-Biedermann K, Głowacka MD, Strzelecki W, Ziemska B, Samborski W. Are students prone to depression and suicidal thoughts? Arch Med Sci 2015; 11:605-11. [PMID: 26170855 PMCID: PMC4495140 DOI: 10.5114/aoms.2013.38179] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 07/05/2013] [Accepted: 07/16/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Depression may affect up to 9.8% of adolescents and young adults and is associated with significant life-long consequences. The aim of our study was to assess the association between symptoms of depression and demographic factors such as gender, having brothers or sisters, background (rural/small town or urban permanent place of residence), perceived financial status, current living arrangements, year and major area of study. MATERIAL AND METHODS One thousand one hundred eighty-three students of medical or similar faculties, 71% of whom were females, anonymously answered the Kutcher Adolescent Depression Scale (KADS) and completed a demographic questionnaire. RESULTS We found that 6.5% of all participants (n = 77) had depression according to Kutcher's criteria whereas 1.5% of them (n = 18) reported suicidal thoughts. We also observed the influence of such factors as gender (p < 0.009), year (p < 0.001), major area of study (p < 0.034), and financial status (p < 0.000-0.003), on depression scores. Moreover, depressive symptomatology was most frequent in subjects who were only children, in freshmen and in students of psychology (11.5%, 13.2% and 16.7% respectively). However, we did not observe an impact of such agents as students' permanent place of residence (p = 0.929) or current living arrangements on depressive symptoms (p = 0.940). CONCLUSIONS Susceptibility to depression fluctuates throughout the course of study and depends on factors associated with the study itself such as the student's major or year of study and other socio-demographic agents, i.e. gender or self-reported financial status.
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Affiliation(s)
- Ewa H Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Maria D Głowacka
- Department of Health Sciences, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Strzelecki
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznan, Poland
| | - Beata Ziemska
- Department of Occupational Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Włodzimierz Samborski
- Department of Physiotherapy, Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poznan, Poland
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Shete A, Garkal KD. A study of stress, anxiety, and depression among postgraduate medical students. CHRISMED JOURNAL OF HEALTH AND RESEARCH 2015. [DOI: 10.4103/2348-3334.153255] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kim B, Roh H. Depressive symptoms in medical students: prevalence and related factors. KOREAN JOURNAL OF MEDICAL EDUCATION 2014; 26:53-58. [PMID: 25805080 PMCID: PMC8813393 DOI: 10.3946/kjme.2014.26.1.53] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 11/06/2013] [Accepted: 12/04/2013] [Indexed: 06/04/2023]
Abstract
PURPOSE This study was designed to estimate the prevalence of depression and the factors that influence it in Korean medical students. METHODS We evaluated depression in 122 first- and second-year medical students in December 2011 using the Korean Beck Depression Inventory (K-BDI). Sixteen potential factors were considered: gender, class year, grade point average, breakfast habits, residence type, leisure activity, sleep satisfaction, relationship status, a close friend or a significant other, finances, present health status, history of mood disorders, family history of mood disorders, religion, and self-esteem. RESULTS The average BDI score was 8.9. There were 80 (65.6%), 16 (13.1%), 15 (12.3%), and 11 (9.0%) students with minimal, mild, moderate, and severe depression, respectively. The group with depressive symptoms comprised males with a total BDI score > or =24 and females with total BDI > or =25 and constituted 9.0% of students. Students in the depressive symptom group had lower self-esteem and lower grade point averages and were more frequently ill, less likely to be in a relationship, and more likely to have a history of mood disorders (p<0.05 for all). In particular, low self-esteem score was an independent factor. CONCLUSION The BDI scores in our study were similar to those that have been reported in other countries but slightly higher than in other Korean medical and university students. Self-esteem, grade point average, health status, history of mood disorders, family history of mood disorders, and presence of a significant other correlated significantly with depression in medical students.
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Affiliation(s)
| | - HyeRin Roh
- Corresponding Author: HyeRin Roh (http://orcid.org/0000-0002-3879-709X) Department of Medical Education, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 614-735, Korea Tel: +82.51.890.8811 Fax: +82.51.893.9600
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Brouwers C, Kupper N, Pelle AJ, Szabó BM, Westerhuis BL, Denollet J. Depressive symptoms in outpatients with heart failure: Importance of inflammatory biomarkers, disease severity and personality. Psychol Health 2014; 29:564-82. [DOI: 10.1080/08870446.2013.869813] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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The association between stressful life events and depressive symptoms among Cypriot university students: a cross-sectional descriptive correlational study. BMC Public Health 2013; 13:1121. [PMID: 24304515 PMCID: PMC3866572 DOI: 10.1186/1471-2458-13-1121] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 11/27/2013] [Indexed: 11/13/2022] Open
Abstract
Background Previous findings suggest that stressful life events have a causal relationship with depressive symptoms. However, to date little is known concerning the contribution of the number and severity of recent stressful life events on the prevalence of depressive symptoms among university students. The aim of this study was to investigate the prevalence of depressive symptoms and its association with the number and the severity of self-reported stressful life events among university students in Cyprus. Methods A descriptive correlational design with cross sectional comparison was used. The CES-D scale was applied for the assessment of depressive symptoms and the LESS instrument for stressful life events. Both scales were completed anonymously and voluntarily by 1.500 students (response rate 85%). Results The prevalence of mild to moderate depressive symptoms [CES-D score between 16 and 21] and of clinically significant depressive symptoms [CES-D score ≥ 22] were 18.8% and 25.3% respectively. There were statistically significant differences in clinically significant depressive symptoms by gender, with higher rates among women (x2 = 8.53, df = 1, p = 0.003). Higher scores on the LESS scale were associated with more frequent reports of clinical depressive symptoms (x2 = 70.63, df = 4, p < 0.001). Similarly, an association was found between the number of life events and clinical depressive symptoms (x2 = 40.06, df = 4, p < 0.001). Logistic regression analysis after adjusting for socio-demographic characteristics confirmed that the responders who reported a high number (n = 12–21) of stressful life events during the previous year (OR = 2.64 95% CI: 1.02, 6.83) and a severe degree of stress due to these events (total LESS score > 351, OR = 3.03 95% CI: 1.66, 5.39) were more likely to manifest clinical depressive symptoms. Conclusions The high frequency of occurrence of depressive symptoms among Cypriot university students, as well as the strong association with stressful life events, highlights the need for psychological empowerment strategies towards students by institutional counseling services.
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Kim NE, Cho SM. Quality of Life of Medical Students during Clinical Clerkship. KOREAN JOURNAL OF MEDICAL EDUCATION 2012; 24:353-7. [PMID: 25813332 PMCID: PMC8813359 DOI: 10.3946/kjme.2012.24.4.353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 09/07/2012] [Accepted: 09/10/2012] [Indexed: 05/27/2023]
Abstract
PURPOSE This study examined the stress, resilience, social support, and quality of life (QOL) of medical students during a clinical clerkship and identified the factors that affected their QOL. METHODS The subjects were 53 medical college students and 43 postgraduate medical school students of D medical school in Korea. They completed a demographic questionnaire and self-rated questionnaires on stress, resilience, social support, and QOL. Frequency and descriptive analysis, correlation analysis, and regression analysis were performed. RESULTS The level of students' QOL was moderate. QOL correlated negatively with stress and positively with resilience and social support. Stress correlated negatively with resilience and social support. By regression analysis, stress and resilience affected the QOL of medical students. CONCLUSION The results of this study indicate that stress negatively affects the QOL of medical students during clinical clerkship, which can be mitigated by resilience. Therefore, it is advisable to develop measures to ease stress and enhance resilience.
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Affiliation(s)
- Nho-Eun Kim
- Corresponding Author: Nho-Eun Kim Department of Social Welfare, Graduate School of Buddhist Studies, 30 Pildong-ro 1-gil, Jung-gu, Seoul 100-715, Korea Tel: +82.2.2260.3096-7 Fax: +82.2.2260.8627
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Sun L, Sun LN, Sun YH, Yang LS, Wu HY, Zhang DD, Cao HY, Sun Y. Correlations between psychological symptoms and social relationships among medical undergraduates in Anhui Province of China. Int J Psychiatry Med 2012; 42:29-47. [PMID: 22372023 DOI: 10.2190/pm.42.1.c] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To assess the prevalence of psychological symptoms (depression, anxiety) among Chinese medical students and to find the possible relationships between psychological symptoms and social relationships. METHODS A sample of 10,140 medical students was investigated with a structured questionnaire, that included the Beck Depression Inventory, Beck Anxiety Inventory, Social Support Rating Scale, and Family APGAR Index (adaptability, partnership, growth, affection, resolve). RESULTS The present study revealed that 16.8% of the medical students suffered from depressive symptoms and 14.1% from anxiety symptoms. Female students were more likely to have anxiety, the second-year students had higher levels of psychological symptoms than the first-year students. Likewise, significant differences were found among college, satisfaction of specialty, and economic condition of the family in anxiety and depression symptoms. Social support, family function, and all dimensions were significantly negatively associated with depression and anxiety symptoms. Multivariable ordinal logistic regression showed that less social support, poor family function, the second-year students, and unsatisfactory specialty were associated with more psychological symptoms, after adjusting the effects of sex, age, and college. CONCLUSIONS Medical students have a relatively high level of depression and anxiety symptoms. These findings support the hypothesis that if medical students are better supported and cared for, negative psychosocial consequences might be prevented or at least reduced.
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Affiliation(s)
- Liang Sun
- Anhui Medical University, Hefei, China.
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Mojs E, Warchol-Biederman K, Samborski W. Prevalence of Depression and Suicidal Thoughts amongst University Students in Poznan, Poland, Preliminary Report. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/psych.2012.32020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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