Burnout, depression and suicidal ideation in dental students

Depressive symptoms and their correlates among predoctoral dental students in the United States

OBJECTIVE

To investigate the prevalence of self-reported depressive symptoms among predoctoral dental students in the United States and examine potential correlates.

METHODS

A survey was emailed to all 66 dental schools in the United States, inviting them to distribute it to their predoctoral students. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Data collection occurred from February to April 2020. Multivariable ordinal logistic regression was used to assess associations between demographic variables and depressive symptom severity category, adjusting for potential confounding.

RESULTS

Of an estimated 25,000 predoctoral dental students at the 66 schools, 631 students from 21 schools completed the survey. A total of 24.1% were categorized as having minimal or no depressive symptoms, 33.6% as having mild depressive symptoms, and 42.3% as having moderate, moderately severe, or severe depressive symptoms. Gender (p = 0.015) and race/ethnicity (p = 0.002) were significant predictors of severity, adjusting for other variables. Students identifying as female had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as male. Students identifying as African American/Black (non-Hispanic) and Asian/Pacific Islander had higher odds of self-reporting greater depressive severity symptoms compared with students identifying as White.

CONCLUSION

There is evidence of a high prevalence of depressive symptoms among predoctoral dental students in the United States. Demographic variables may be risk indicators within this population. Approaches to reduce depressive symptoms among US predoctoral dental students are needed.

Emotional Intelligence, Perceived Stress and Life Quality Assessment Among Dental Students

Background

The capacity to grasp and recognize one's own and human feelings, use cognitive awareness to control actions and behavior, and modify moods in response to difficult situations is known as emotional intelligence (EI). Perceived stress has been linked to higher levels of depression among healthcare students. This study set out to assess EI, perceived stress (PS), and life quality assessment (LQA) among dental undergraduates and to ascertain how these factors are linked to one another.

Materials and Methods

The self-reported cross-sectional research was organized among preclinical and clinical years of dental students to examine their emotional intelligence and stress-coping capacity. About 146 students participated in the study, with ages ranging from 19 to 25, irrespective of gender. The students were given the Schutte Emotional Intelligence and Perceived Stress Scale tools (PSS10) by Cohen, and with World Health Organization Quality of Life (WHOQOL-BREF) tool examined the characteristics that contribute to life quality among students.

Results

The study included 146 individuals, 38 males (26.02%) and 108 females (73.97%), with an unresponsiveness rate of 2.66%. The correlation revealed statistically high significance among emotional intelligence and perceived stress (P = 0.000), perceived stress and life quality (P = 0.02), and emotional intelligence and life quality (P = 0.008). The statistical analysis of the influence of EI, PS, and LQA on academic year-wise analysis determined non-significant (P > 0.05).

Conclusion

Due to the time constraints of their job, dentistry training may be highly stressful, yet regular evaluations of student performance and the accompanying factors would help us to understand how students behave in challenging circumstances.

Examining the links between burnout and suicidal ideation in diverse occupations

Introduction

It is uncertain whether burnout is associated with suicidal ideation among workers not in health care services. The aim of this study was to identify how burnout and suicidal ideation are linked among employees in various occupations and whether depression affects this link.

Methods

This cross-sectional study collected data from 12,083 participants aged 19-65 years from 25 companies and public institutions who underwent workplace mental health screening. Burnout and depression were assessed using both the Oldenburg Burnout Inventory and the Center for Epidemiologic Studies Depression Scale. Suicidal ideation was assessed by a self-rated questionnaire from the Korea National Health and Nutrition Examination Survey.

Results

Exhaustion but not the cynicism dimension of burnout was associated with increased odds of suicidal ideation after adjustment for depression and other covariates (odds ratio [OR] = 1.47, 95% CI = 1.26-1.72). The association of exhaustion with suicidal ideation was significant in both depressed (OR = 1.36, 95% CI = 1.14-1.61) and not depressed (OR = 1.77, 95% CI = 1.13-2.76) participants. In exhausted participants, insufficient job control, an unfavorable occupational climate, low educational level, and depression were associated with increased odds of suicidal ideation.

Conclusion

Exhaustion is linked with risk of suicidal ideation in employees not in health care service, regardless of depression status. Exhausted employees, particularly those having poor job resources, should be recognized as an at-risk group.

Australian dental practitioners experience of burnout

BACKGROUND

The aim of this study was to investigate factors associated with burnout in Australian dental practitioners.

METHODS

A cross-sectional survey of 1483 Australian dental practitioners was conducted from Oct to Dec 2021. Participants reported burnout using the Sydney Burnout Measure, and aspects of mental health including psychological distress, depression, and anxiety disorders. Predictors of burnout were explored using a generalized linear model with a stepped approach including demographic, health and risk factor variables.

RESULTS

One in four participants were classified as likely to be experiencing burnout. Burnout was associated with working in a regional/rural location (β = 2.82, p < 0.001), an academic/non-clinical role (β = 5.01, p = 0.037), more years of experience as a dental practitioner (β = 0.08, p = 0.022), a current diagnosis of depression (β = 2.38, p = 0.049), moderate/severe psychological distress (β = 7.16, p < 0.001), poor self-rated physical health (β = 5.84, p < 0.001) and increasing alcohol consumption (β = 0.17, p = 0.020). Participants who scored high on resilience (β = -0.23, p = 0.002) or perfectionism (β = -0.24, p < 0.001) had lower burnout scores.

CONCLUSION

Australian dental practitioners appear to be at high risk of burnout which may impact on their health and wellbeing and ability to deliver patient care. There is a need for support services to manage burnout and education to address workplace and environmental factors that may contribute to burnout.

Burnout in oral health students: A scoping review

BACKGROUND

Student burnout can be defined as the negative reactions that occur because of prolonged academic stress, which can result in emotional exhaustion/exhaustion (EE/EX), depersonalization/cynicism, and diminished personal accomplishment/reduced academic efficacy (DPA/RAE).

OBJECTIVE

The purpose of this scoping review is to determine if burnout is prevalent in oral health students (OHS); identify the factors that are shown to be predicators of burnout in OHS; determine the preventive and coping strategies OHS used to mitigate the effects of burnout; and identify gaps in the literature on burnout in OHS.

METHODS

A systematic search was completed using the following databases: PubMed, CINAHL, EBSCO, and ERIC. The returns were screened by all members of the team using inclusion and exclusion criteria, and the studies that met the criteria were appraised.

RESULTS AND DISCUSSION

Eighteen studies assessed burnout in OHS, 15 studied dental students, 2 studied dental hygiene students, and 1 studied both. Findings concerning the prevalence of burnout varied greatly across the literature with anywhere between 7% and 70.4% of OHS reporting suffering from burnout syndrome. The most prevalent scale of burnout in OHS was EE/EX with 10%-66.2% of OHS reporting high levels. Stressors for OHS were years of study, clinical components, and demanding academic courses. Early identification and interventions are keys to prevent the negative consequences of burnout.

CONCLUSION

Burnout in OHS can affect their mental health, empathy toward patients, and professional conduct. Therefore, educating students and faculty on the signs and symptoms of burnout is key in preventing detrimental effects that may inhibit their academic success.

Should suicide risk assessment be embedded in undergraduate dental curricula?

Aims and objectives The aim of this Plan-Do-Study-Act cycle was to establish if undergraduate students believe they have a role to play in suicide risk assessment, and to discuss the implementation of suicide risk prevention into the undergraduate dental curriculum. Data gathered informed development of a subsequent suicide risk assessment educational workshop.Methodology An online questionnaire was disseminated to undergraduate students as part of a quality improvement service evaluation within a UK dental hospital and school. This sought to gain information on attitudes to suicide prevention, previous suicide awareness training, and the appetite and potential barriers to future training.Results A response rate of 23% (n = 30) was achieved. In total, 87% of undergraduate students responding reported having no experience or training in the identification of suicidal patients, 97% of respondents expressed a desire for training, and 80% stated not knowing what to do if a patient disclosed suicidal thoughts during an appointment.Conclusion The dental team have a role to play in suicide risk assessment and the signposting of at-risk patients to appropriate services. To embed this within daily practice, awareness and training must be introduced to undergraduate curricula.

Association Of Burnout And Depression Symptoms And Their Prevalence Among Medical Students In Karachi, Pakistan

Background — The mental health of medical students has long been a concern. Symptoms of depression and burnout are common among medical students, but the overlap of symptoms of both diseases with risk factors remains unclear. The goal of this study was to determine the prevalence of burnout and depression symptoms’ overlap in medical students. Methods — This cross-sectional study was conducted among students of the clinical course (3rd, 4th and 5th years). A multistage stratified random sampling design was used to select 284students that were offered a validated and structured questionnaire that included a modified Oldenburg Burnout Inventory and Patient Health Questionnaire-9 to assess their emotional burnout and depression, respectively. Chi-square and multinomial regression analyses were done to identify overlapping symptoms of burnout and depression with association of risk factors with dependent variable. Results — Out of 284 students, 13% had symptoms of severe depression, 24% had high burnout symptoms, and 32% had overlapping symptoms of burnout and depression. In regression analysis, higher academic year more than 2 times (5th year, OR 2.03, 95% CI 1.42-7.96, p-value 0.004) and living at dormitory more than 3 times (OR 3.97, 95% CI 1.97-5.01, p-value 0.003) were more likely associated with more extensive overlap of burnout and depression symptoms. Conclusion — There is a high prevalence of burnout and depression symptoms among medical students, with a strong association between the two disorders. Early burnout detection and psychiatric therapies given to affected students and these disorders management training at medical school, may help reduce negative consequences of these conditions.

Burnout, Surface Acting, and Suicidal Ideation Among Military Personnel: Results of a Longitudinal Cohort Study

Introduction: Chronic life stressors are positively correlated with suicidal ideation and suicidal behaviors among military personnel. Surface acting, a strategy that involves hiding or faking one's emotional state to match organizational expectations dictating when and how to express emotions, contributes to burnout and increased emotional distress. Because surface acting involves a form of emotional suppression, frequent use of surface acting may also contribute to suicidal ideation. Methods: One thousand seven-hundred fifty-four military personnel stationed at a U.S. military installation completed a self-report survey repeatedly administered 6 times from January 2020 to December 2021. Survey items assessed suicidal ideation, surface acting, burnout, and depression. Results: Burnout and surface acting were significantly correlated with severity of suicidal ideation. When depression was added as a covariate, surface acting but not burnout remained a statistically significant correlate of suicidal ideation. Discussion: Surface acting, a job-specific form of emotional suppression, may increase suicide risk among military personnel. Creating opportunities for military personnel to appropriately express their emotional states could mitigate suicide risk in this population.

Relationship between Job Burnout, Depressive Symptoms, and Career Choice Regret among Chinese Postgraduates of Stomatology

A qualified Chinese dental postgraduate requires at least eight years of training. The huge academic burden, strict clinical requirements, and high workload increases the risk of job burnout, depression symptoms, and career choice regret of dental postgraduates, which may cause one to waver in their choice of a career as a doctor. Therefore, we aimed at assessing the relationship between job burnout, depressive symptoms, and career choice regret among Chinese dental postgraduates. The Chongqing Stomatological Association conducted an online cross-sectional study among 558 dental postgraduates in China, with an average age of 22.54 ± 2.44. Demographic information, the Maslach Burnout Inventory, the 2-item Primary Care Evaluation of Mental Disorders scale, and career choice regret scale were included in the questionnaire. About 41.0% of dental postgraduates experienced job burnout, 44.1% had depressive symptoms, and 41.6% reported career choice regret. Logistic regression analysis indicated the risk factors for job burnout were time worked/studied per week, depressive symptoms, and career choice regret. Job burnout and career choice regret was significantly related to depressive symptoms (p < 0.001). Risk factors for career choice regret were gender, postgraduate entrance examination score, daily hours of sleep, job burnout, and depressive symptoms. Such results suggest that job burnout, depressive symptoms, and career choice regrets are prevalent among dental postgraduates. Accurate measures should be taken to change this situation.

University students' profiles of burnout symptoms amid the COVID-19 pandemic in Germany and their relation to concurrent study behavior and experiences

Burnout symptoms are prevalent among university students. This study examined students' understudied profiles of burnout symptoms and their relation to procrastination, dropout intentions, and study- and life satisfaction. We used cross-sectional data from two online-studies conducted in Germany in April 2020 amid the COVID-19 pandemic (N _study1 = 597, N _study2 = 857). Latent profile analyses indicated three profiles in both studies: (1) well-functioning, (2) moderately exhausted-inefficacious, and (3) burned-out. Most students belonged to Profiles 1 and 2 with low to moderate burnout symptoms. Students in Profile 3 reported the highest symptoms, most procrastination, strongest dropout intentions, and lowest study- and life satisfaction. The distinct profiles broaden knowledge about intra-individual differences in students' burnout experiences and underpin the need for tailored interventions.

Gender Differences in Job Burnout, Career Choice Regret, and Depressive Symptoms Among Chinese Dental Postgraduates: A Cross-Sectional Study

Background

Job burnout, career choice regret, and depressive symptoms among medical students have received widespread attention. However, little is known about the role of gender in these areas for dental postgraduates. This study aimed to explore gender differences in job burnout, career choice regret, and depressive symptoms among Chinese dental postgraduates.

Methods

The data were collected from an epidemiological survey conducted by our group from February 2021 to March 2021. We used a self-administered questionnaire covering demographic characteristics, the Maslach Burnout Inventory, the Primary Care Evaluation of Mental Disorders scale, and the Career Choice Regret scale. Univariate and multivariable analyses were performed to explore influencing factors.

Results

A total of 558 valid dental postgraduate questionnaires were included in this study. The prevalence of job burnout, career choice regret, and depressive symptoms exceeded 30% in males and females. The prevalence of job burnout was 4.7% higher in females than in males; career choice regret was 12.2% higher in females than in males (P < 0.05), and depressive symptoms were 4.9% higher in females than in males. The multivariable analysis showed that factors associated with job burnout for males were sleep time and career choice regret for females. The influencing factors on career choice regret for females were postgraduate entrance examination score, sleep time, and job burnout. Depressive symptoms were a common influencing factor for job burnout and career choice regret in male and female dental postgraduates. Also, job burnout and depressive symptoms had the highest odds ratio for influencing factors on each other.

Conclusion

Over 30% of dental postgraduates suffered from job burnout, career choice regret, and depressive symptoms, and incidences were higher in females. A discrepancy of influencing factors existed between male and female dental postgraduates. Targeted measures should be taken to change this situation.

The Relationship Between Anatomical Self-efficacy and Feelings of Burnout in First-year Medical Students

Feelings of burnout in professional students have been associated with additional psychological morbidities and decreased academic achievement. Due to the large volume of content that medical students need to learn during gross anatomy courses, it is possible that anatomical self-efficacy may be a contributing factor to feelings of burnout. Anatomical self-efficacy is defined as a student's judgment of their ability to execute tasks related to learning anatomy and perform course activities (e.g., dissection). First-year medical students were invited to provide basic demographic information at the beginning of the semester and to complete the Oldenburg Burnout Inventory-student version (OLBI-SS) and the Anatomical Self-Efficacy Instrument (ASEI); at the beginning, middle, and end of the semester, they were enrolled in gross anatomy. Typical descriptive statistics for the demographic information were conducted, as well as, correlational analyses assessing if the information had a relationship with either anatomical self-efficacy or burnout. Female students were more burnt out than male students. Repeated measures ANOVA revealed that students' feelings of burnout significantly increased from the beginning of the semester to the midpoint and the end of the semester (p < 0.05). Linear regression demonstrated a predictive relationship between anatomical self-efficacy and burnout (p < 0.05) at all three measurement points in which lower self-efficacy was predictive of increased feelings of burnout.

Psychological Distress, Burnout, and Academic Performance in First Year College Students

Background: The first years of university can be very challenging for students. Previous research has focused on the study of the prevalence of burnout and of psychological distress in medical students. The aim of this study was to investigate the prevalence of psychological symptoms and burnout reported by first-year students, the relationship between these variables and their academic performance, and the differences between health and non-health sciences students. Methods: An observational study with a cross-sectional design was performed. Students of health sciences (medicine, nursing, physiotherapy, psychology), and non-health sciences (biology, social sciences, business management, and engineering) undergraduate programs completed the Brief Symptom Inventory (BSI-18) and the Maslach Burnout Inventory-Student Survey (MBI-SS). Students’ grades for the first semester were collected. Results: A sample of 506 students participated. Prevalence of psychological distress was 27.1% and burnout was 7.3%. Academic performance was unaffected in relation to either psychological distress or burnout. Non-health sciences students showed a greater risk of depression. Conclusions: This study provides evidence of the high prevalence of psychological distress in the first year of college. Even when burnout prevalence was low, the results suggest the need to introduce prevention programs to improve the psychological wellbeing of these students.

Depression, suicidal ideation, and suicidal behaviors among dental students of Neo-state capital region in India

BACKGROUND

The challenges of dental education place students at high risk of stress. Because dental education is a highly demanding and challenging course, placing heavy demands on the mental resources of the students, making them vulnerable to high levels of stress, this study aimed to determine the prevalence of depression, suicidal ideation, and suicidal behaviors in dental students.

MATERIALS AND METHODS

A descriptive cross-sectional study was done on a convenience sample of 388 dental students in a teaching dental institution. Data were collected using standard, prevalidated, self-administered questionnaires (Patient Health Questionnaire-9 and Suicidal Behaviours Questionnaire-Revised [SBQ-R]). Analysis was done using SPSS version 20. Descriptive statistics, Chi-square test, and logistic regression were performed.

RESULTS

At least half of the students were in major depression with different levels of severity. When students from different years were analyzed, majority from each year fell under II and III categories (P < 0.001). Most of the students reported that they do not have any suicidal ideation or behavior (SBQ-R). Nearly 16% of the students either presented the threat of suicidal attempt or likelihood of suicidal behavior in future. Almost 13% of the dental students thought of killing themselves in the past year for at least two times. Around 16% of them expressed to someone about their thought of committing suicide.

CONCLUSION

Even though depression and suicidal tendencies were not prominent in dental students, there is a need to shed light on those who responded positively and take necessary reforms to relieve academic stress.

Meta-Analysis of Prevalence of Depression in Dental Students during COVID-19 Pandemic

Background and Objectives: The COVID-19 pandemic has a negative impact on the mental health of the population in general, and in college students in particular. Dental students have seen their teaching altered and their clinical practice reduced. This study was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among dental students during the COVID-19 and estimating the pooled prevalence of depression. Materials and Methods: Medline via PubMed and other databases were searched for studies on the prevalence of depression in dental undergraduates, published from 1 December 2019 to 1 September 2021. The pooled proportions of depression were calculated with random effects models. Results: We identified 13 studies from 9 countries. The pooled prevalence of depression in dental students was 37% (95% CI: 26-49%) with no variation due to gender, response rate or methodological quality. We only found a significantly higher prevalence of depression in studies from Asia compared to Europe and America. Conclusions: Our results suggest that dental students are suffering from higher levels of depression compared with the general population or other college students during the COVID-19 pandemic, with differences across regions. Measures to improve mental health and wellbeing of dental students during the pandemic are needed.

Depression and suicidal ideation among dental students of Southern Saudi Arabia: A cross sectional study

PURPOSE

To assess depression and suicidal ideation among dental students at King Khalid University College of Dentistry, Abha, Saudi Arabia.

METHODS

A cross-sectional questionnaire-based study was carried out among dental students between January and March 2020. The Arabic version of the Patient Health Questionnaire (PHQ-9) was used to assess depression, while suicidal ideation was assessed using three questions related to suicidal behaviors drawn from the literature.

RESULTS

A total of 218 participants completed the questionnaires. More than 40% of the participants experienced depression while the prevalence of suicidal ideation was 48.2%; around a third of the sample had suicidal ideation, and half of which made a suicidal attempt in the preceding year (p < 0.05). There was a lack of association between depression severity and suicidal ideation.

CONCLUSION

A large proportion of dental students experienced depression and suicidal ideation. These findings invite in depth analysis of the causative and contributing factors for such high rates as well as ways for addressing them.

Impact of career choice motivation on academic burnout in senior dental students: A cross-sectional study

BACKGROUND

Motivation triggers all human activities including learning and lack of career motivation can lead to decreased efficiency. This study assessed the association between academic burnout and career choice motivation in senior dental students.

METHODS

This cross-sectional study was performed on senior dental students of all four dental schools in Tehran in 2017. Dental students voluntarily filled out a 33-item questionnaire that comprised three sections. The first section included the Burnout Clinical Subtype Questionnaire (BCSQ-SS) with 12 questions addressing academic burnout. The second section consisted of 8 questions about career choice motivation, and the third section concentrated on 13 questions dealing with demographics. The individual scores of each section and the total scores were reported. The factor analysis of 8 questions about dental career choice motivation yielded 3 factors of social status and security, altruism, and others' advice motivations. The data were analyzed using regression test.

RESULTS

Totally, 131 students filled out the questionnaire (response rate = 86%). The total score of academic burnout was 38.89% ± 1.13%. The highest and the lowest burnout scores belonged to the domains of "overload" (46.69%± 1.46%) and "neglect" (31.98%± 1.32%), respectively. The most and the least frequently mentioned source of motivation for choosing dentistry were high income and failing to enter other fields, respectively. The burnout score was higher in students with altruism motivations (P = 0.007) and lower in students with others' advice motivations (P = 0.004). The burnout score was higher in students with inadequate or moderate financial support from the family and lower in students whose mothers' educational level was high-school diploma or lower.

CONCLUSION

Senior dental students in Tehran encountered different levels of academic burnout. In the present study, low financial support and altruism as career choice motivations were associated with higher level of academic burnout.

The impact of stress, anxiety and depression on stomatognathic system of physiotherapy and dentistry first-year students

INTRODUCTION

It is well proven that psychoemotional factors play causative role in development of many civilization diseases. Psychosocial stress is effecting with development of certain oral parafunctions like teeth grinding, bruxism, or cheeks biting. Eventually, all of those parafunctional activities may cause increase of masticatory muscles tone and provoke its intensification. Literature indicates that students must cope with greater level of stressful situations than the average representative of the society.

METHODS

The research group comprised Ist-year physiotherapy and dentistry students from University School of Physical Education in Wroclaw and Wroclaw Medical University. The study consisted the following: psychological and health questionnaires, and stomatological examination with masseter muscles' electromyography.

RESULTS

In intraoral examination, symptoms of parafunctions were more frequently observed in physiotherapy students. The mean tone of masseters was higher also among physiotherapy students. The level of perceived stress was high in both groups, and the experienced borderline and incorrect results in Hospital Anxiety and Depression Scale were more frequently observed in dentistry students. The mean tone of masseter muscle was rising with the level of anxiety in physiotherapy group. Among dentistry, the tendency for rise of masseter muscle tone together with level of anxiety and depression was observed.

CONCLUSIONS

Physiotherapy and dentistry beginners differ between each other's by prevalence of temporomandibular disorders (TMD) and oral parafunction symptoms. The level of perceived stress is high in both groups. The level of experienced anxiety and depression is higher in dentistry group. In both study groups, there is significant growth and tendency for simultaneous rise of masseter muscle tone accordingly to stress, anxiety, and depression indicators.

Self-reported depressive symptoms in dental students: Systematic review with meta-analysis

OBJECTIVE

This study aimed to systematically review the literature about the prevalence of self-reported depressive symptoms in dental students.

METHODS

PUBMED, SCOPUS, and EMBASE databases were search up to January 2020 with the following focused questions: "What is the prevalence of self-reported depression symptom in dental students?" and "Are sex and years of educational training associated with self-reported depressive symptom in dental students?". Observational studies that applied a questionnaire assessing depression were eligible. Standard mean differences (SMD) and pooled odds ratios (OR) were calculated for the questionnaires' scores and self-reported depressive symptom, respectively.

RESULTS

Fifty-eight studies were included, and 15 different questionnaires were used. The prevalence of self-reported depressive symptoms/at least mild depression ranged from 2.75% to 89.84%, and the pooled overall prevalence was 29% (95% confidence interval [CI]: 26-34). Meta-analysis showed significantly lower scores in the questionnaires for self-reported depressive symptoms of male students (SMD: -0.22; 95% CI: -0.42 - -0.03). Conversely, no significant difference was detected for the OR of self-reported depressive symptom in the comparison between sex (OR: 1.11 - 95% CI: 0.77-1.62). Similarly, no significant difference was observed for the different school years regardless of the analytical strategy used.

CONCLUSION

It was concluded that female dental students presented more self-reported depressive symptoms, but no difference is demonstrated during the years of dental education.

Distinguishing burnout from depression: An exploratory qualitative study

Whether depression and burnout are synonymous or not has been a longstanding debate. Many studies have examined for similarities and differences, but findings have overall been inconclusive, with most studies being quantitative in design. We therefore undertook a qualitative study in which participants who self-identified as having experienced both burnout and depression were asked how they distinguished between the two conditions. Thematic qualitative analysis was undertaken and while a fifth of the sample stated that their burnout and depression experiences were indistinguishable or were very similar, we also identified 11 key themes of difference. The most prevalent themes captured differences in the perceived cause of each condition, in experiencing hopelessness as against helplessness, and impacts on levels of functioning, sadness, anger, anxiety and emotional lability. We also identified differences in suicidal ideation between the two conditions. While some differences identified could be dimensional and suggest that burnout is simply synonymous with or a developmental phase of depression, the several categorical symptom differences nominated by participants suggest that most sufferers who have experienced both conditions perceive them as distinct. Such 'lived experience' reports are therefore intrinsically informative and should shape further quantitative analyses.

High levels of burnout and depression in a population of senior dental students in a school of dentistry in Korea

Background/purpose

Dental students are exposed to highly stressful environments, making them high-risk for burnout and depression. This study intended to investigate the burnout and depression level in senior dental students in Korea.

Materials and methods

We conducted a cross-sectional questionnaire study among third- and fourth-year dental students enrolled at Seoul National University. Demographic data, Maslach Burnout Inventory (MBI), Patient Health Questionnaire (PHQ-9), dental education satisfaction, and counseling needs were measured. Statistical analyses included intergroup comparison of MBI subscales (emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA)) to identify the risk factors for burnout. Correlation analyses between MBI subscales and PHQ-9 were also conducted.

Results

Among 112 students included in the study, 44.6% had high EE, 36.6% showed high DP, and 51.8% had low PA. There were 20 (17.9%) students who satisfied burnout criteria on all three subscales. There were 19 (17.0%) students with PHQ-9 scores of 10 or greater. There were no significant differences in MBI subscales or PHQ-9 scores according to sex, study year, marital status, funding for studies, or academic grade, but there was a difference according to academic workload. All MBI subscales had significant correlation with PHQ-9 score. Burnout students reported significantly lower satisfaction scores and greater need for counseling compared to non-burnout students.

Conclusion

Burnout and depression levels among dental students in Korea were relatively high and intercorrelated. Burnout level was significantly associated with high academic workload. Students experiencing burnout were likely to be dissatisfied with their education programs and likely to need counseling.

Assessing the Quality of Life of Dental Students by using the WHOQOL-BREF Scale

Background/Aim: The study aimed to evaluate the quality of life (QOL) of dental students in a private dental school with the use of the WHOQOLBREF scale.

Material and Methods: The Turkish version of the WHOQOLBREF questionnaire was used to assess the QOL of dental students in their first (n=73), second (n=58), third (n=55), fourth (n=47) and fifth (n=48) years with a mean age of 22,15 ± 1,89 between January and February 2019. The items were organized in four domains (physical and psychological health, social relations and the environment) with most response options on a five-point Likert-type scale. Descriptive statistics were computed and the P-value of <0,05 was set as statistically significant.

Results: The sample was composed of 281 students, corresponding to an overall response rate of 90,6%. The overall QOL was rated good by the responding students. The difference between male and female respondents’ answers was not statistically significant. Mean scores were lowest for the psychological domain and were highest for the physical health domain. The psychological domain of the first-year participants was significantly better than that of fourth-year participants. Furthermore, the overall quality of life was highest for first-year students’ compared to all years.

Conclusions: Although the overall QOL for students in the present study was generally acceptable, the psychological domain was the lowest in dental students. A positive relationship was observed between students’ satisfaction with health and their QOL. Dental schools should focus on reorganizing the curriculum and provide support for dental students, especially for those in their fourth-year.

Does Emotional Labor Increase the Risk of Suicidal Ideation among Firefighters?

PURPOSE

To investigate whether emotional labor is associated with suicidal ideation in Korean firefighters.

MATERIALS AND METHODS

Data were obtained from the Firefighter Research: Enhancement of Safety & Health (FRESH) Study, which was designed to investigate the effects of job characteristics on mental and physical health among Korean firefighters. A total of 18101 firefighters were chosen from a nationwide sample. The Korean Emotional Labor Scale (K-ELS) was used to evaluate exposure to emotional labor, which consisted of five sub-factors: emotional demand and regulation, overload and conflict in customer service, emotional disharmony and hurt, organizational surveillance and monitoring, and lack of a supportive and protective system in the organization.

RESULTS

Firefighters who were in the risk group were more likely to experience suicidal ideation than those in the normal group for each of the five sub-scales of emotional labor. The estimated mean values for suicidal ideation in the risk group were significantly higher than those in the normal group: 1.667 (95% CI: 1.344-2.069) for emotional demand and regulation, 1.590 (95% CI: 1.243-2.033) for overload and conflict in customer service, 2.409 (95% CI: 1.954-2.969) for emotional disharmony and hurt, 2.214 (95% CI: 1.832-2.676) for organizational surveillance and monitoring, and 1.665 (95% CI: 1.387-1.999) for lack of a supportive and protective system in the organization.

CONCLUSION

These results suggest that experience and exposure to chronic and excessive emotional labor might play a crucial role in the development of suicidal ideation among firefighters.

The Burnout Phenomenon: A Résumé After More Than 15,000 Scientific Publications

The "burnout" phenomenon, supposedly caused by work related stress, is a challenge for academic psychiatry both conceptually and professionally. Since the first description of burnout in 1974 until today, more than 140 definitions have been suggested. Burnout-symptomatology's main characteristic, the experience of exhaustion, is unspecific. Different development-models of burnout were proposed, assumed to depict a quasi-natural process. These could not be confirmed empirically. An expert consensus on the diagnostic criteria and the conceptual location, whether as an independent disorder or as a risk, could not be agreed on. Nevertheless, the phenomenon of burnout in the ICD-11 is considered to be categorized as a work-related disorder. Psychiatric research on the burnout-phenomenon ignores problems of definition resulting from different perspectives: It may meet societal expectations, but does not fulfill scientific criteria, and therefore is not suitable to establish an objective diagnosis and treatment. Parallel detection of ICD/DSM diagnoses from an expert perspective and subjective perturbation models are considered appropriate.

Burn out among Iranian dental students: psychometric properties of burnout clinical subtype questionnaire (BCSQ-12-SS) and its correlates

BACKGROUND

Burnout Clinical Subtype Questionnaire (BCSQ-12-SS) is a short valid questionnaire for assessment of burnout in students. The aim of the present study was to evaluate the psychometric properties of Persian-translated version of the BCSQ-12-SS and assess the burn out clinical subtypes and their correlates in dental students.

METHODS

In this psychometry study, the BCSQ-12-SS questionnaire in domains of overload (4 questions), lack of development (4 questions), and neglect (4 questions) was translated to Persian and back-translated. Six experts determined the content and face validity of the Persian version. The questionnaire was then piloted on 167 dental students of Tehran University of Medical Sciences in 2016. Data were analyzed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) for construct validity and Linear Regression modeling in IBM SPSS and AMOS SPSS. To assess reliability, the questionnaire was filled out by 15 students twice and Kappa coefficient and Composite Reliability (CR) were calculated.

RESULTS

Content validity Ratio (CVR) and Content Validity Index (CVI) values and Cronbach's alphas were all over 0.8. Kappa coefficient ranged from 65 to 82.5%. The average burnout score was 29.6 out of maximum score of 60. There were no significant differences in burnout scores across the different semesters (8,10 and 12). Financial support by the family significantly affected the total score of burnout and lack of development. In addition, gender, mother's education, residential status of student, preparing for post graduate exam and financial support by the family affected the overload.

CONCLUSION

The BCSQ-12-SS has good psychometric properties and therefore can be used to assess burnout in IRANIAN dental students. The BCSQ-12-SS may provide an opportunity to identify individuals at risk for burn out and provide counseling to assist in dental student development.

Emotional exhaustion, burnout, and perceived stress in dental students

Objective

As in other health sciences, a career in dentistry is associated with numerous stressors in practitioners. The main objective of this research was to examine the prevalence of emotional exhaustion, burnout, and perceived stress among dental students in Mexico.

Methods

A cross-sectional study was conducted among 73 dental students attending a private university in Northern Mexico. Three scales were administered to students to identify emotional exhaustion, burnout, and perceived stress, and parametric data analysis was performed.

Results

Among participants (mean age 19.7 years), the proportion with emotional exhaustion, perceived high stress, and burnout was 52.0%, 42.3%, and 17.8%, respectively. All students with perceived stress also had burnout.

Conclusions

We found that emotional exhaustion and perceived stress are experienced by a large proportion of dentistry students enrolled in the third semester at this private university in Northern Mexico. The proportions were independent of age and sex.

The Roles of Empathy, Attachment Style, and Burnout in Pharmacy Students' Academic Satisfaction

Objective. To investigate empathy, burnout, and attachment style, and explore the relationships between these variables and academic satisfaction in a group of pharmacy students. Methods. Students enrolled in the first two years (n=200) and last two years (n=210) of a five-year master's degree program in pharmaceutical sciences were invited to participate. The data collected included sociodemographic characteristics; responses on the Portuguese version of the Interpersonal Reactivity Index (IRI) to assess empathy levels; responses on the Maslach Burnout Inventory (MBI) to measure emotional exhaustion, depersonalization, and personal accomplishment; responses on the Adult Attachment Scale (AAS) to evaluate students' attachment style; and responses on an original academic satisfaction scale. Results. Although students in both groups had similar levels of empathy, female students had significantly higher scores in the IRI subscales and in emotional exhaustion. Students in the last two years of the program had significantly higher depersonalization scores. The majority of students reported that they were satisfied with the quality of their academic experience, however, the satisfaction scores of students enrolled in their first two years were significantly higher. Attachment styles explained 14% of all students' depersonalization and academic satisfaction scores (11%). Burnout explained 39% of all students' academic dissatisfaction. Conclusion. Although a majority of pharmacy students were satisfied with their academic life, burnout negatively influenced the academic satisfaction of some students completing the final years of their education. The type of interpersonal relationship students have influences their ability to understand patients and the quality of their learning experience. A large percentage of students indicated they had a significant level of burnout, which underscores the need to provide preventive and restorative interventions for these students.

Burnout and depressive symptoms in intensive care nurses: relationship analysis

OBJECTIVE

To analyze the existence of a relationship between burnout and depressive symptoms among intensive care unit nursing staff.

METHOD

A quantitative, descriptive, cross-sectional study with 91 intensive care nurses. Data collection used a sociodemographic questionnaire, the Maslach Burnout Inventory - Human Services Survey, and the Beck Depression Inventory - I. The Pearson test verified the correlation between the burnout dimension score and the total score from the Beck Depression Inventory. Fisher's exact test was used to analyze whether there is an association between the diseases.

RESULTS

Burnout was presented by 14.29% of the nurses and 10.98% had symptoms of depression. The higher the level of emotional exhaustion and depersonalization, and the lower professional accomplishment, the greater the depressive symptoms. The association was significant between burnout and depressive symptoms.

CONCLUSION

Nurses with burnout have a greater possibility of triggering depressive symptoms.

Association between different blood groups, depression and oral health status of dental students

Introduction

Knowledge of blood groups and their association with oral diseases and depression is very important, as it may help in early diagnosis and treatment strategies.

Method

A cross sectional descriptive study was conducted among dental students of a private dental college. The study was conducted in two phases, in the first phase the blood samples of each student were collected and sent for blood group examination in laboratory. Data for oral health status was collected by recording oral hygiene, dental caries and questions regarding oral hygiene habits and adverse oral habits. Depression level was recorded using a pre-validated, 21 item close ended questionnaire. Data thus collected was subjected to statistical analysis using chi-square and frequency distribution test using SPSS software.

Results

The total study subjects were 315, 95 males and 220 females. On applying chi-square test between blood group and Decayed, Missing and Filled Teeth (DMFT) score, a highly significant association (p=0.00) was observed. A non-significant association p=0.217 and p=0.668 was observed between gender and DMFT and Oral hygiene index-simplified and Blood group respectively. When comparing blood group and Depression score, a non-significant association (p=0.74) was observed.

Conclusion

DMFT score varies in different blood groups and this might suggest a positive association between blood groups and DMFT score, while depression, oral hygiene and gender might not be affected by the different blood groups.

Burnout, depression and suicidal ideation in dental and dental hygiene students

INTRODUCTION

The aim of this study was to assess the relationship between burnout, depressive symptoms and suicidal ideation in dental and dental hygiene students and to evaluate the influence of gender, programme type and year of study.

SUBJECTS AND METHODS

Third- and fourth-year dental (DS) and first- and second-year hygiene students (DHS) completed the Patient Health Questionnaire (PHQ-9) and an abbreviated Maslach Burnout Inventory online as measures of depressive symptoms/suicidality and burnout, respectively. The statistical analyses included summary statistics and tests for intergroup comparisons (chi-square) to evaluate the influence of gender, programme type (DHS or DS) and year of study. Correlations between depression, suicidality and burnout were also conducted.

RESULTS

A total of 32 dental hygiene and 119 dental students participated. 40% of the dental and 38% of the hygiene students met criteria for burnout. No differences were found between years or between programmes. Nine per cent of both dental and hygiene students were above the cut-off for moderate depressive symptoms, but there were no statistical differences between the third- and fourth-year dental and the first- and second-year hygiene students. Six per cent of the dental and 9% of the dental hygiene students were above the cut-off for clinically significant suicidal ideation, but there were no statistical differences between dental and hygiene students. There were no differences noted in the dental students based on gender for any of the measures. Depression was significantly associated with all three subscales of burnout. Suicidal ideation was only significantly related to the lack of personal accomplishment subscale of burnout.

DISCUSSION

These findings suggest the need for introducing preventive measures for such affective states in dental and dental hygiene training programmes.

A longitudinal study on stress sources perceived by Chilean dental students

Introducción. La percepción de los estudiantes universitarios sobre el estrés académico es fundamental, ya que proporciona información valiosa sobre la eficiencia y aceptabilidad de los métodos educativos.Objetivo. Evaluar las diferencias en los factores de estrés percibidos por los estudiantes de primer año de odontología durante el primer y segundo semestre según género.Materiales y método. Estudio descriptivo exploratorio, longitudinal y no experimental. En mayo y octubre de 2016 se aplicó la versión en español del Dental Environment Stressors (DES), adaptado y validado para estudiantes de odontología en la Universidad San Sebastián (Concepción, Chile). La muestra consistió en 83 estudiantes de primer año. La comparación de las variables en estudio (stress y sus dimensiones) entre los dos períodos comparados, en general y considerando los géneros, se realizaron mediante la prueba t-Student, previa estimación de existencia o no de igualdad de varianzas entre los grupos mediante la prueba F de Fisher.Resultados. En la segunda medición, la dimensión “Formación clínica” en mujeres fue el único componente que mostró diferencias significativas con valores superiores de la media.Conclusión. Existe una percepción de estrés para todos los ítems del cuestionario DES; las mujeres tuvieron una mayor puntuación en la dimensión “Formación clínica”.

Burnout in medical students: a systematic review of experiences in Chinese medical schools

BACKGROUND

To identify the: extent to which medical students in China experience burnout; factors contributing to this; potential solutions to reduce and prevent burnout in this group; and the extent to which the experiences of Chinese students reflect the international literature.

METHODS

Systematic review and narrative synthesis. Key words, synonyms and subject headings were used to search five electronic databases in addition to manual searching of relevant journals. Titles and abstracts of publications between 1st January 1989-31st July 2016 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesised.

RESULTS

Thirty-three studies were eligible and included in the review. Greater levels of burnout were generally identified in males, more senior medical students, and those who already experienced poorer psychological functioning. Few studies explored social or contextual factors influencing burnout, but those that did suggest that factors such as the degree of social support or the living environment surrounding a student may be a determinant of burnout.

CONCLUSIONS

Greater understanding of the social and contextual determinants of burnout amongst medical students in China is essential towards identifying solutions to reduce and prevent burnout in this group.

Association between burnout and depressive symptoms among Turkish dentists

Background/purpose

Health care professionals including dentists can experience increased professional burnout. The aim of the study was to evaluate the association between depressive symptoms and burnout among Turkish dentists.

Materials and methods

This study was conducted among a Turkish dentist sample in Ankara (Turkey) between February 2015 and August 2015. From a total of 500 dentists, 337 were included. A self-structured questionnaire, Maslach Burnout Inventory (MBI), and Beck Depression Inventory (BDI) were completed by the participants. The Student t test or analysis of variance was used to compare the variables.

Results

A total of 337 dentists (162 female dentists; mean age of participants 36 ± 4.45 years) participated in this study. Age, sex, professional status, years in profession, sector, and number of patients seen/d were factors affecting level of burnout (P < 0.05); 29% of the participants showed burnout and 22.2% showed depressive symptoms. Participants showed increase in emotional exhaustion (38%), increase in depersonalization (22%), and decrease in personal accomplishment (12%). The mean score of BDI significantly correlated with those of the MBI subscales (P < 0.05). All items of BDI except weight loss, irritability, and loss of appetite significantly correlated with MBI subscores (P < 0.05).

Conclusion

Dentists may face burnout and depressive symptoms during their professional life. Increased burnout level can give an idea on depressive symptoms, and may provide an opportunity to identify depression earlier. Creating and raising awareness about burnout are important to avoid and prevent depression among dentists. Further longitudinal studies analyzing the effects of interdisciplinary client-centered self-management programs for dentists on depressive symptoms and burnout must be planned.

Burnout prevalence and correlates amongst Colombian dental students: the STRESSCODE study

INTRODUCTION

Accumulating evidence amongst dental students indicates an alarming prevalence of stress, which can precipitate the development of burnout--a state of mental or physical exhaustion and disengagement. Understanding individual and educational correlates of burnout is necessary for its prevention. The aims of this study were to determine the prevalence of burnout amongst a large sample of Colombian dental undergraduates and investigate its psychosocial and educational correlates.

MATERIALS AND METHODS

Survey data collected from 5647 students participating in the Stress in Colombian Dental Education study were used for this analysis. Burnout was measured using the Maslach Burnout Inventory-Student Survey (MBI-SS). Covariates included participants' socio-demographic characteristics and perceived stress, as well as educational environment factors. Descriptive, bivariate and multivariate methods based on multilevel mixed-effects logistic regression modelling were used for data analysis.

RESULTS

Seven per cent of the students surveyed met the criteria for burnout. The prevalence of burnout was higher amongst upper classes, older and married students, those who reported not having passed all required courses and not having dentistry as their first career choice, as well as students in public institutions and those with large class sizes. Moreover, students' perceived stress in the domains of workload and self-efficacy was significantly and positively associated with burnout.

CONCLUSIONS

Both personal and educational environment characteristics were found to be associated with burnout. Irrespective of these factors, students' perceived stress with regard to workload and self-efficacy was a strong influence on burnout and its alleviation may be a promising avenue to prevent psychological morbidity.

Evaluation of anxiety, depression and suicidal intent in undergraduate dental students: A cross-sectional study

BACKGROUND

There is an increasing amount of stress in undergraduate dental students leading to anxiety, depression, and suicidal attempts/suicide.

AIMS

This study aims to evaluate anxiety, depression and suicidal intent in undergraduate dental students and to find out the various areas of stress.

MATERIALS AND METHODS

A cross-sectional study was conducted using a semi-structured questionnaire (to assess academic and nonacademic areas of stress) and three scales-Hamilton scale for anxiety (HAM-A); Hamilton depression rating scale (HDRS) and Beck's Suicide Intent Scale (BSI). Descriptive statistics; Pearson's Chi-square test; Multiple ANOVA; Kruskal-Wallis test and Mann-Whitney test were used to analyze the data at the significant level of P ≤ 0.05.

RESULTS

In a total of 258 dental undergraduate students, academic areas of stress that were found to be statistically significant were long teaching hours (P = 0.002); high workload (P ≤ 0.001); frequency of tests (P ≤ 0.001) and competition/fear of failure (P = 0.009). Lack of interest in the profession was a statistically significant nonacademic area for stress (P ≤ 0.001). The students of first and final year reported higher anxiety (HAM-A 13.93 ± 6.908 and 16.44 ± 7.637 respectively) and depression (HDRS 14.29 ± 6.302 and 14.22 ± 5.422); whereas suicidal intent was reported almost the same throughout the study sample (BSI 5.65 ± 5.465).

CONCLUSION

An increasing level of anxiety, depression and suicidal intent due to various stressors in undergraduate dental students indicate a need to modify current education system and timely help to have psychological healthy dental professionals in future.

Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: a cross-sectional study

OBJECTIVES

Medical and dental students experience poor psychological well-being relative to their peers. This study aimed to assess the psychological well-being among medical and dental students in Saudi Arabia, identify the high-risk groups and assess the association between the psychological well-being and the academic performance.

METHODS

In this cross-sectional study, 422 preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia, were recruited to assess their depression, anxiety, stress, self-efficacy and satisfaction with life levels using 21-items Depression Anxiety Stress Scale (DASS-21), General Self-Efficacy (GSE) scale and Satisfaction With Life Scale (SWLS). Students' academic weighted grades were obtained later. Descriptive statistics and univariate general linear model were used to analyse data.

RESULTS

High levels of depression (69.9%), anxiety (66.4%) and stress (70.9%) were indicated, whereas self-efficacy (mean = 27.22, sd = 4.85) and life satisfaction (mean = 23.60, sd = 6.37) were within the normal range. Female medical students had higher psychological distress in contrast to dental students. In general, third-year students were more depressed and stressed in comparison with second-year students, except for stress among dental students. Moreover, all females had higher self-efficacy than males. Life satisfaction was higher within the second-year and high family income students. Depression was the only psychological variable correlated with the academic performance.

CONCLUSION

High levels of psychological distress were found. Female medical students had higher psychological distress than males, whereas male dental students had higher distress than female. Medical students at third year were more depressed and stressed. Dental students were more depressed in the third year, but more stressed in the second year. Attention should be directed towards reducing the alarming levels of depression, anxiety and stress among medical and dental students.