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Suliman S, Allen M, Chivese T, de Rijk AE, Koopmans R, Könings KD. Is medical training solely to blame? Generational influences on the mental health of our medical trainees. MEDICAL EDUCATION ONLINE 2024; 29:2329404. [PMID: 38488138 PMCID: PMC10946265 DOI: 10.1080/10872981.2024.2329404] [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: 10/28/2023] [Accepted: 03/07/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION The negative impact of medical training on trainee mental health continues to be a concern. Situated within a sociocultural milieu, Generation Z and Generation Y, defined by their highly involved parents and the widespread use of technology, currently dominate undergraduate and graduate medical education respectively. It is necessary to explore medical trainees' generational characteristics and job-related factors related to stress, burnout, depression, and resilience. This might provide different perspectives and potential solutions to medical trainees' mental health. METHODS A cross-sectional study was conducted among medical trainees (students and residents) from two institutions in Qatar. A self-administered online survey included measures for trainees' social media overuse, their parent's parenting style, the educational support by the clinical teacher, job (demands, control, and support), and work-life balance and their relation with their stress, burnout, depression, and resilience. Relationships were tested with multiple linear regression analyses. RESULTS Of the 326 medical trainees who responded, 142 (44%) trainees - 93 students and 49 residents - completed all items and were included in the analysis. Social media overuse and inability to maintain a work-life balance were associated with higher levels of stress, depression, and student burnout. Higher levels of job support were associated with lower levels of stress, depression, and resident burnout, and a higher level of resilience. Job control was associated with lower burnout levels. Parenting style was unrelated to trainees' mental health. DISCUSSION The two generations 'Y' and 'Z' dominating current medical training showed more stress-related complaints when there is evidence of social media overuse and failure to maintain a work-life balance, while job support counterbalances this, whereas parenting style showed no effect. Measures to enhance medical trainees' mental health may include education about the wise use of social media, encouraging spending more quality social time, and enhancing job support and job control.
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Affiliation(s)
- Shireen Suliman
- Medical Education, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, QU Health, Qatar University, Doha, Qatar
- Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - Margaret Allen
- Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Tawanda Chivese
- Department of Population Medicine, Qatar University, Doha, Qatar
| | - Angelique E. de Rijk
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Richard Koopmans
- Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Karen D. Könings
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
- School of Health Sciences, University of East Anglia, Norwich, UK
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Polujanski S, Nett U, Rotthoff T, Oezsoy M, Schindler AK. Uncovering heterogeneity in mental health changes among first-year medical students. MEDICAL EDUCATION ONLINE 2024; 29:2317493. [PMID: 38394063 PMCID: PMC10896144 DOI: 10.1080/10872981.2024.2317493] [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: 12/01/2023] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION The initial year of medical school is linked to a decline in mental health. To assess mental health comprehensively, the dual-factor model posits the consideration of both psychopathology (e.g., depression) and positive mental health (e.g., well-being). Previous mental health research among medical students has primarily examined these two factors independently. This study uses the dual-factor approach for a deeper understanding of mental health changes during the first year of medical school. METHODS Students from eight German medical schools (N = 450) were surveyed three times (T0 = entering medical school, T1 = end of the first semester, T2 = end of the second semester) regarding depression (PHQ-9), well-being (subscale of FAHW-12), and general life satisfaction (German Single-Item Scale L1). Latent profile analysis was used to identify distinct mental health groups based on their combinations of psychopathology and positive mental health. We then analysed trajectories descriptively by examining the longitudinal stability and dynamics of mental health group membership during the first year of medical school. RESULTS We identified five mental health groups: (1) complete mental health, (2) moderately mentally healthy, (3) symptomatic but content, (4) vulnerable, and (5) troubled. The examination of change trajectories unveiled diverse paths pointing towards both recovery and deterioration. In comparison to the other groups, students belonging to the complete mental health group exhibited greater stability and a higher potential to recover after initial deteriorations in the first semester. CONCLUSIONS Our study uncovers distinct mental health trajectories in the first year of medical school, emphasizing the crucial role of initial mental health status. Our findings stress the diverse nature of mental health changes in medical students, underscoring the need for tailored prevention strategies. The implications for research and practice are discussed.
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Affiliation(s)
- Sabine Polujanski
- Medical Didactics and Education Research, DEMEDA (Department of Medical Education), Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Ulrike Nett
- Department of Empirical Educational Research, Faculty of Philosophy and Social Sciences, University of Augsburg, Augsburg, Germany
| | - Thomas Rotthoff
- Medical Didactics and Education Research, DEMEDA (Department of Medical Education), Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Melissa Oezsoy
- Medical Didactics and Education Research, DEMEDA (Department of Medical Education), Medical Faculty, University of Augsburg, Augsburg, Germany
- Department of Education and Educational Psychology, Faculty of Psychology and Education, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Ann-Kathrin Schindler
- Medical Didactics and Education Research, DEMEDA (Department of Medical Education), Medical Faculty, University of Augsburg, Augsburg, Germany
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Rich A, Viney R, Silkens M, Griffin A, Medisauskaite A. The experiences of students with mental health difficulties at medical school: a qualitative interview study. MEDICAL EDUCATION ONLINE 2024; 29:2366557. [PMID: 38870397 DOI: 10.1080/10872981.2024.2366557] [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: 06/01/2023] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND High rates of burnout, anxiety, and depression in medical students are widespread, yet we have limited knowledge of the medical school experiences of students with mental health issues. The aim of the study is to understand the impact of mental health issues on students' experience and training at medical school by adopting a qualitative approach. METHODS Qualitative study using in-depth semi-structured interviews with 20 students with mental health issues from eight UK medical schools of varying size and location. Students were purposefully sampled to gain variety in the type of mental health issue experienced and demographic characteristics. Reflexive thematic analysis was employed using NVivo software. RESULTS Three themes were identified. 1) Culture of medicine: medical culture contributed to causing mental ill-health through study demands, competitiveness with peers, a 'suck it up' mentality where the expectation is that medical school is tough and medical students must push through, and stigma towards mental ill-health. 2) Help-seeking: students feared others discovering their difficulties and thus initially tried to cope alone, hiding symptoms until they were severe. There were multiple barriers to help-seeking including stigma and fear of damage to their career. 3) Impact on academic life: mental health issues had a detrimental impact on academic commitments, with students' unable to keep up with their studies and some needing to take time out from medical school. CONCLUSION This study provides insight into how medical culture contributes both to the cause of mental health difficulties and the reluctance of medical students to seek help. Mental health issues had a considerable negative impact on medical students' ability to learn and progress through their degree. Addressing the medical culture factors that contribute to the cause of mental health issues and the barriers to help-seeking must be a priority to ensure a healthier medical workforce.
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Affiliation(s)
- Antonia Rich
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Rowena Viney
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Milou Silkens
- Centre for Healthcare Innovation Research, Department of Health Services Research and Management, School of Health and Psychological Sciences, City University of London, London, UK
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Ann Griffin
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Asta Medisauskaite
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
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Bao D, Mydin F, Surat S, Lyu Y, Pan D, Cheng Y. The relationship between challenge-hindrance stressors and innovative behavior among medical postgraduates in China: the mediation role of academic engagement and the moderating effect of relaxation. MEDICAL EDUCATION ONLINE 2024; 29:2379110. [PMID: 39016967 PMCID: PMC11257006 DOI: 10.1080/10872981.2024.2379110] [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: 01/10/2024] [Accepted: 07/08/2024] [Indexed: 07/18/2024]
Abstract
This study investigated the relationship between challenge-hindrance stressors and innovative behavior of medical postgraduates in China, examining the mediating role of academic engagement and the moderating effect of relaxation. Drawing from a sample of 437 medical postgraduates from three Chinese universities, our findings revealed that challenge stressors positively correlated with innovative behavior, while the direct relationship between hindrance stressors and innovative behavior was not statistically significant. Furthermore, academic engagement mediated the relationship between two types of stressors and innovative behavior. Challenge stressors enhanced academic engagement, which in turn fostered innovative behavior. Conversely, hindrance stressors were found to diminish academic engagement, which in turn indirectly limited innovative behavior. Additionally, relaxation was identified as a moderating factor that helped mitigate the negative effects of hindrance stressors on academic engagement and indirectly on innovative behavior. These results suggested that academic engagement as a mechanism played a pivotal role in determining how different stressors influenced innovative behavior, underscoring the need for stress management, particularly through relaxation techniques, to maintain high levels of academic engagement and innovative behavior. This study offers practical insights for medical education policymakers and educators in China, emphasizing the importance of balancing stressors and incorporating relaxation practices to enhance the innovative capabilities of medical postgraduates in demanding academic environments.
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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, 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, China
| | - Dongsheng Pan
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Yahua Cheng
- School of Government, Shanghai University of Political Science and Law, Shanghai, China
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Yang J, Ma S, Cheng A, Zhang L, Li B, Cui W, Li K, Zhang Y, Liu X. Analysis of functional network asymmetry in major depressive disorder under four fNIRS tasks. J Affect Disord 2024; 365:303-312. [PMID: 39137836 DOI: 10.1016/j.jad.2024.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/10/2024] [Accepted: 08/09/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Research in functional asymmetry of Major Depressive Disorder (MDD) under different tasks is crucial for clinical diagnose. METHODS Fifty individuals with MDD and twenty healthy controls (HCS) were recruited for hemodynamic data collection under four fNIRS tasks (Emotional picture, Verbal fluency, Fingering and Negative emotional picture description task). Integral values and functional connectivity strength were employed to probe neural activation and functional connectivity in frontal and temporal lobes in MDD. Following, asymmetry characteristic of the frontal cortex between MDD and HCS under four tasks were carefully analyzed and compared. RESULTS Individuals with MDD demonstrated heightened connectivity between the frontal and right temporal lobes and reduced connectivity between the frontal and left temporal lobes compared to HCS in all tasks. Additionally, MDD exhibited attenuated activation in the left frontal lobes and exaggerated activation in the right frontal lobes, diverging from HCS. Furthermore, the disparities in left-right asymmetry characteristic of frontal cortex activation between MDD and HCS were more pronounced during the combined task. LIMITATIONS Further research is required to grasp the neurophysiological mechanisms governing left-right asymmetry across various tasks and the influence of task-induced brain fatigue on cerebral cortex hemodynamics in MDD. CONCLUSION The left-right asymmetry feature provides valuable neurophysiological insights for diagnosing MDD clinically. Variations in activation patterns and functional connectivity features between MDD and HCS are closely tied to the task chosen. Thus, in clinical practice, carefully selecting appropriate fNIRS tasks and relevant features can significantly improve the diagnostic accuracy of MDD.
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Affiliation(s)
- Jianli Yang
- College of Electronic and Information Engineering, Hebei University, Baoding 071002, China; Key Laboratory of Digital Medical Engineering of Heibei Province, Baoding 071002, China
| | - Shuwei Ma
- College of Electronic and Information Engineering, Hebei University, Baoding 071002, China
| | - Aobo Cheng
- Hebei Provincial Mental Health Center, Baoding 071000, China; Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding 071000, China; The Sixth Clinical Medical College of Hebei University, Baoding 071000, China
| | - Lili Zhang
- Hebei Provincial Mental Health Center, Baoding 071000, China; Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding 071000, China; The Sixth Clinical Medical College of Hebei University, Baoding 071000, China
| | - Bing Li
- Hebei Provincial Mental Health Center, Baoding 071000, China; Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding 071000, China; The Sixth Clinical Medical College of Hebei University, Baoding 071000, China
| | - Wei Cui
- Hebei Provincial Mental Health Center, Baoding 071000, China
| | - Keqing Li
- Hebei Provincial Mental Health Center, Baoding 071000, China; Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding 071000, China; The Sixth Clinical Medical College of Hebei University, Baoding 071000, China
| | - Yunshu Zhang
- Hebei Provincial Mental Health Center, Baoding 071000, China; Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding 071000, China; The Sixth Clinical Medical College of Hebei University, Baoding 071000, China.
| | - Xiuling Liu
- College of Electronic and Information Engineering, Hebei University, Baoding 071002, China; Key Laboratory of Digital Medical Engineering of Heibei Province, Baoding 071002, China.
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Orsolini L, Longo G, Volgare R, Piergentili S, Servasi M, Perugi G, Volpe U. Cyclothymic affective temperament and low positive attitude coping strategies as predictors of comorbid depressive symptomatology in adult ADHD patients. J Affect Disord 2024; 365:417-426. [PMID: 39154981 DOI: 10.1016/j.jad.2024.08.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 08/20/2024]
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) in adults could be frequently underdiagnosed due to concomitant psychiatric disorders, including depressive symptomatology, which could determine inappropriate treatments. Our study aims at clinically characterizing adult ADHD with or without depressive symptomatology in order to identify the relationship with specific affective temperamental profiles and coping strategies. METHODS A total of 225 outpatients consecutively afferent to our outpatient adult ADHD service since September 2019 were retrospectively screened for eligibility and administered Beck Depression Inventory-II (BDI-II), Coping Orientation to Problems Experienced Inventory (COPE-NV) and Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (TEMPS-M). RESULTS 64.7 % of patients displayed a significant comorbid depressive symptomatology. According to the multivariate linear regression model, depressive levels were positively predicted by TEMPS-M cyclothymic subscale (B = 0.567, p = 0.004) and negatively predicted by COPE-NVI "positive attitude" subscale (B = -0.438, p = 0.024) (R = 0.496, R2 = 0.246, F(2,66) = 10.747, p < 0.001). LIMITATION While considering the results, it should be taken in consideration that: the assessment was carried out only at baseline, our sample is constituted only by adult ADHD patients and mostly without a previous ADHD diagnosis, the presence of a discrepancy between the rates of ADHD subtypes, the absence of a healthy control group and emotional dysregulation was not directly assessed. CONCLUSION Affective temperamental profiles and coping strategies could help in clinically characterizing and personalizing treatment in adult comorbid ADHD-depressive symptomatology patients. Further research is warranted to explore the efficacy of targeted psychotherapeutic and pharmacological interventions within this ADHD sub-sample.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Giulio Longo
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy.
| | - Rosa Volgare
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Simone Piergentili
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Michele Servasi
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
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Duan H, Qin K, Hu L, Liu B, Su G, Zhang H, Xu J, Tu H. Association between sleep duration, suicidal ideation, suicidal attempt and suicidal behavior among Chinese adolescents. J Affect Disord 2024; 363:348-357. [PMID: 39029697 DOI: 10.1016/j.jad.2024.07.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/08/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND A relatively small number of studies have researched the relationship between sleep duration and suicidal ideation, attempts, and behavior. This research aims to investigate the link between sleep duration and suicide in Chinese adolescents, and to examine the role of depression as a mediating factor. METHOD Data were collected from 3315 students using a multi-stage random cluster sampling method and self-administered questionnaires. The study applied logistic regression to investigate the relationship between sleep duration and various forms of suicidal behavior, and mediation analysis to understand how depression might influence this relationship. RESULTS The average sleep duration among the adolescents was 7.25 h (±0.20), with 59.67 % reporting insufficient sleep. The logistic regression analysis showed that longer sleep duration is linked with lower risks of suicidal ideation (OR: 0.753, 95%CI: 0.696 to 0.814), suicidal attempts (OR: 0.830, 95%CI: 0.748 to 0.922), and suicidal behavior (OR: 0.841, 95%CI: 0.713 to 0.992). Analysis using restricted cubic spline plots indicated the connection between sleep duration and these suicidal factors was not linear. The study found that depression plays a partial mediating role between sleep duration and suicidal ideation, with an effect of 52.29 %. LIMITATIONS The cross-sectional study design could not prove causation. CONCLUSIONS There is a clear non-linear association between sleep duration and suicidal tendencies in adolescents, with depression acting as a mediator. This suggests that future research could focus on sleep and mood management as ways to address suicide risk in this age group.
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Affiliation(s)
- Hanmin Duan
- Center of Clinical Big Data and Analytics, The Second Affiliated Hospital, Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., Hangzhou 310058, China
| | - Kang Qin
- HangZhou Center for Disease Control and Prevention, 568 Mingshi Road, Shangcheng District, Hangzhou, Zhejiang 310021, China
| | - Lingling Hu
- Center of Clinical Big Data and Analytics, The Second Affiliated Hospital, Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., Hangzhou 310058, China
| | - Bing Liu
- HangZhou Center for Disease Control and Prevention, 568 Mingshi Road, Shangcheng District, Hangzhou, Zhejiang 310021, China
| | - Guowei Su
- Center of Clinical Big Data and Analytics, The Second Affiliated Hospital, Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., Hangzhou 310058, China
| | - Han Zhang
- Center of Clinical Big Data and Analytics, The Second Affiliated Hospital, Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., Hangzhou 310058, China
| | - Jue Xu
- HangZhou Center for Disease Control and Prevention, 568 Mingshi Road, Shangcheng District, Hangzhou, Zhejiang 310021, China.
| | - Huakang Tu
- Center of Clinical Big Data and Analytics, The Second Affiliated Hospital, Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd., Hangzhou 310058, China.
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Hua H, Fu X, Wang W, Wang S, Wang D, Wu Z, Zhang Q, He T, Yang C. A bibliometric analysis of research on psychedelics for depression treatment. Heliyon 2024; 10:e36886. [PMID: 39281459 PMCID: PMC11401032 DOI: 10.1016/j.heliyon.2024.e36886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 08/13/2024] [Accepted: 08/23/2024] [Indexed: 09/18/2024] Open
Abstract
Psychedelics, as a class of potent psychoactive substances, significantly alter sensory perception and mood, thereby profoundly impacting cognition. Increasing evidence indicates that psychedelics can facilitate individual social function and rapidly and sustainably improve symptoms of moderate and severe depression. The growing interest in psychedelics as potential treatments for depression has led to a substantial increase in related publications; however, the overall quantity and quality of these works remain unclear. To address this issue, we conducted a bibliometric analysis of literature on psychedelic drugs for depression published between 2004 and October 2023. Our study meticulously collected 710 publications, allowing for a comprehensive analysis of bibliographic elements such as annual publication trends, authorship, country of origin, institutional affiliations, journals, and keywords. By visualizing trends, emerging frontiers, popular topics, author collaborations, and influential factors in the field of psychedelics for depression, we have enhanced our understanding of advancements in this area. On this basis, we assert that the regulation of psychedelic drugs is necessary, but it should not hinder the scientific research progress.
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Affiliation(s)
- Hao Hua
- Department of Anesthesiology, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi, 214062, China
| | - Xinghuo Fu
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
- Department of Anesthesiology, Taizhou Fourth People's Hospital, Taizhou, 225300, China
| | - Wenli Wang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Sen Wang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Di Wang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zifeng Wu
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Qi Zhang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Teng He
- Department of Anesthesiology and Perioperative Medicine, Huaian Hospital of Huaian City, Huaian Cancer Hospital, Huaian, 223200, China
| | - Chun Yang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
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Shiraly R, Roshanfekr A, Asadollahi A, Griffiths MD. Psychological distress, social media use, and academic performance of medical students: the mediating role of coping style. BMC MEDICAL EDUCATION 2024; 24:999. [PMID: 39272179 PMCID: PMC11401414 DOI: 10.1186/s12909-024-05988-w] [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: 02/12/2023] [Accepted: 09/03/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Given that social media use (SMU) is an increasingly widespread activity among university students, more information is needed to evaluate its relationship with students' mental health, particularly medical students. OBJECTIVE The present study assessed the relationships between SMU and coping style with psychological distress and academic performance of medical students. METHODS An offline cross-sectional survey conducted with 398 undergraduate medical students. The survey collected data on demographics, psychological distress (DASS-21), coping strategies (Brief COPE Scale), academic performance (grade point average) and estimated average time spent on social media per day. Structural equation modeling was used to clarify relationships between the main study variables. The study also examined the mediating effect of maladaptive coping between SMU and psychological distress. RESULTS Students with higher levels of psychological distress were more likely to be engaged in frequent social media use. Spending more than two hours a day on social media use had a positive association with maladaptive coping (p < 0.001), particularly with substance use and behavioral disengagement both of which could negatively affect academic performance. Maladaptive coping mediated the relationship between students' SMU and psychological distress. CONCLUSION The findings suggest that medical students commonly use social media as a maladaptive coping tool to deal with psychological distress. Empowering students to adopt and foster appropriate coping strategies could help them to enhance resilience against life stresses and ameliorate potential long-term mental health consequences associated with maladaptive behaviors.
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Affiliation(s)
- Ramin Shiraly
- Department of Preventive and Community Medicine, School of Medicine, Health Behavior Science Research Unit, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Preventive and Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Abdolrahim Asadollahi
- Department of Gerontology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mark D Griffiths
- Distinguished Professor of Behavioural Addiction. International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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Alzahrani A, Keyworth C, Alshahrani KM, Alkhelaifi R, Johnson J. Prevalence of anxiety, depression, and post-traumatic stress disorder among paramedic students: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02755-6. [PMID: 39264380 DOI: 10.1007/s00127-024-02755-6] [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: 10/12/2023] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
PURPOSE There are elevated mental health concerns in paramedic students, but estimates vary between studies and countries, and no review has established the overall prevalence. This systematic review addressed this by estimating the global prevalence of common mental health disorders, namely anxiety, depression, and post-traumatic stress disorder (PTSD), in paramedic students internationally. METHODS A systematic search of six databases, including MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, and medRxiv, was conducted to identify studies relating to mental health among paramedicine students. The search encompassed studies from inception until February 2023. To be considered for inclusion in the review, the studies had to report prevalence data on at least one symptom of anxiety, depression, or PTSD in paramedicine students, using quantitative validated scales. The quality of the studies was assessed using Joanna Briggs Institute (JBI) Checklist, which is a specific methodological tool for assessing prevalence studies. Subgroup analyses were not conducted due to insufficient data. RESULTS 1638 articles were identified from the searches, and 193 full texts were screened, resulting in 13 papers for the systematic review and meta-analysis. The total number of participants was 1064 from 10 countries. The pooled prevalence of moderate PTSD was 17.9% (95% CI 14.8-21.6%), anxiety was 56.4% (95% CI 35,9-75%), and depression was at 34.7% (95% CI 23.4-48.1%). CONCLUSION This systematic review and meta-analysis has found that paramedicine students globally exhibit a high prevalence of moderate PTSD, anxiety, and depression. The prevalence of these mental health conditions surpasses those among paramedic providers and the general population, as indicated by previous reviews. Further research is therefore warranted to determine appropriate support and interventions for this group.
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Affiliation(s)
- Adnan Alzahrani
- School of Psychology, University of Leeds, Leeds, LS29JT, UK.
- Department of Basic Science, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, 11466, Riyadh, Saudi Arabia.
| | - Chris Keyworth
- School of Psychology, University of Leeds, Leeds, LS29JT, UK
| | - Khalid Mufleh Alshahrani
- School of Psychology, University of Leeds, Leeds, LS29JT, UK
- Faculty of Arts and Humanity, Psychology Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rayan Alkhelaifi
- Department of Aviation and Marines, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, 11466, Riyadh, Saudi Arabia
| | - Judith Johnson
- School of Psychology, University of Leeds, Leeds, LS29JT, UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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11
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Wu J, Li J, Guo J, Yan R. Vitamin C and suicidal ideation: A cross-sectional and Mendelian randomization study. J Affect Disord 2024:S0165-0327(24)01546-5. [PMID: 39271073 DOI: 10.1016/j.jad.2024.09.062] [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: 06/15/2024] [Revised: 08/12/2024] [Accepted: 09/10/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Studies have shown that a history of suicide attempts is associated with low levels of antioxidant vitamins. However, the specific relationship between vitamin C and suicidal ideation remains poorly understood. The purpose of this study is to investigate the effect of vitamin C on the development of suicidal ideation and to explore further the causal relationship using Mendelian randomization (MR). METHODS Using the 2005-2018 National Health and Nutrition Examination Survey (NHANES) dataset, a comprehensive, cross-sectional, stratified survey of 28,623 participants aged 20 years and older was conducted. Suicidal ideation was assessed using item 9 of the Patient Health Questionnaire-9 (PHQ-9) item. The relationship between vitamin C and suicidal ideation was revealed by weighted multiple linear regression, smooth curve fitting, hierarchical analysis, and interaction test. To determine causality, MR was performed on vitamin C and suicidal ideation. RESULTS In cross-sectional studies, all models showed a negative association between vitamin C and suicidal ideation, with a 37 % reduction in the risk of suicidal ideation for each unit increase in vitamin C in the highest quartile in the fully adjusted model. The results of the subgroup analysis showed that the association between vitamin C and suicidal ideation was stable across gender, age, education, smoking status, and marital status. In the MR study, our bivariate model showed no significant causal relationship between vitamin C and the development of suicidal ideation. CONCLUSIONS Dietary vitamin C intake was negatively associated with the development of suicidal ideation. However, genetic evidence does not support causation of these associations.
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Affiliation(s)
- Jiabei Wu
- Shanxi Medical University, Taiyuan, China
| | | | - Jinli Guo
- The Second Hospital of Shanxi Medical University, Taiyuan, China.
| | - Rui Yan
- Shanxi Medical University, Taiyuan, China.
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12
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Gutkin PM, Botros M, Kasper L, Solovieva I, Gomes I, Dream S. In the Era of pass/fail: Medical student perceptions on optimizing their surgical residency applications. Am J Surg 2024:115951. [PMID: 39271428 DOI: 10.1016/j.amjsurg.2024.115951] [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: 06/28/2024] [Revised: 08/18/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND It is unclear how changes to the 2023-2024 Electronic Residency Application Service (ERAS) application will impact future applicants. We investigate students' perceptions about applying to residency during this transition period. METHODS An anonymous electronic survey was sent to medical students through social media of a women's surgical society. Questions reflected aspects of the ERAS application. RESULTS There were 415 responses, with 68 % planning to apply into surgical specialties (SS) and 17 % into non-surgical specialties (NSS). Compared with the NSS group, SS students reported decreased confidence in successfully matching, less attainable applicant expectations, and increased personal sacrifices to pursue their residency of interest. Students interested in Plastic and Reconstructive Surgery (PRS) placed 3-times more importance on the number of publications than General Surgery students. Away rotations were rated significantly more important for Otolaryngology, Orthopaedic, and PRS students. CONCLUSION Students applying into surgical residencies experience unique stressors. Values among SS students differed across surgical subspecialties in preparation for the match. Further investigation characterizing the relationship between these values and characteristics of successful resident applicants is warranted.
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Affiliation(s)
| | - Margaret Botros
- Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | | | | | - Isabella Gomes
- Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Sophie Dream
- Medical College of Wisconsin, Milwaukee, WI, USA.
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13
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Oh H, Landré B, Yon DK, Frajerman A, Gyasi RM, Jacob L. Physical activity and suicidal behavior in medical students from the United States. J Affect Disord 2024; 367:658-667. [PMID: 39243821 DOI: 10.1016/j.jad.2024.08.234] [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: 05/29/2024] [Revised: 08/24/2024] [Accepted: 08/31/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND There are little data on the relationship between physical activity and suicidal behavior in medical students. Therefore, this cross-sectional study aimed to investigate the association between physical activity and suicidal behavior and identify mediating factors involved in the association among medical students from the United States. METHODS Data from the Healthy Minds Study (2007-2023) were used. Physical activity and suicidal behavior (i.e., suicidal ideation, suicide plans, and suicide attempts) were self-reported. Control variables included age, gender, ethnicity/race, relationship status, citizenship, current financial stress, and academic year. Mediating factors were flourishing, generalized anxiety disorder symptoms, depressive symptoms, eating disorder symptoms, binge drinking, smoking, and drug use. RESULTS There were 6452 medical students included in the study (median [IQR] age 25.0 [3.0] years; 4032 [62.5 %] women). After adjusting for control variables, compared with <1 hour of physical activity per week, the odds of any suicidal behavior were significantly lower for 3-4 hours (OR = 0.57, 95 % CI = 0.41-0.79) and ≥5 hours of physical activity per week (OR = 0.52, 95 % CI = 0.39-0.70). The physical activity-any suicidal behavior relationship was partially explained by decreased depressive symptoms (39.4 %), increased flourishing (27.6 %), and decreased generalized anxiety disorder symptoms (18.7 %). LIMITATIONS Data are of a cross-sectional nature. CONCLUSIONS There was an inverse association between physical activity and suicidal behavior in medical students from the United States, while several variables were identified as mediating factors (i.e., depressive symptoms, flourishing, and general anxiety disorder symptoms). Further research is needed to corroborate these findings in other settings, while longitudinal data are urgently warranted.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Benjamin Landré
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Ariel Frajerman
- Université Paris-Saclay, AP-HP, Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, France; Équipe MOODS, Inserm U1178, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Le Kremlin-Bicêtre, France
| | - Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| | - Louis Jacob
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France; AP-HP, Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, Paris, France; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain.
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14
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Frajerman A, Colle R, Jollant F, Corruble E. Mental health in midwifery students: A French nationwide survey. Midwifery 2024; 139:104165. [PMID: 39260125 DOI: 10.1016/j.midw.2024.104165] [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: 03/30/2024] [Revised: 08/16/2024] [Accepted: 08/27/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Poor mental health in health students is a major public health issue, impacting personal quality of life and functioning, curriculum and care quality to patients. PROBLEM Few studies to date have examined mental health in midwifery students. AIM To evaluate the midwifery students'mental health. METHODS An online cross-sectional survey was performed between 02/11/2023 and 11/12/2023. Anonymous questionnaires were sent to midwife students via academic emails by all midwife faculties in France. We assessed the prevalence of current depressive symptoms, current generalised anxiety symptoms, burnout for students in internship, 12-month major depressive disorder and 12-month suicidal ideation, humiliation, sexual harassment, and sexual aggression during their curriculum with specific questions. Multivariate logistic regression was performed to identify the main factors associated with major depressive disorder and suicidal ideation. FINDINGS Among midwifery students, 1920 (response rate: 51.9 %) were included. The prevalences of current depressive symptoms, anxiety symptoms, burnout, 12-month major depressive disorder, and 12-month suicidal ideation were 62 %, 47 %, 44 %, 13 % and 14 %, respectively. Humiliation, sexual harassment and sexual aggression were reported by 19 %, 1.8 % and 0.7 %, respectively. In multivariable analyses, having important financial difficulties and sexual violence were associated with higher rates of major depressive episodes and suicidal ideation. DISCUSSION >1 in 10 students suffered from 12-month depression and/or suicidal ideation, and almost half of them expressed various distressing symptoms. CONCLUSION These alarming results highlighted the need for interventions to improve mental health in midwifery students, including safer conditions of education and living.
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Affiliation(s)
- Ariel Frajerman
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Medicine Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre F-94275, France.
| | - Romain Colle
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Medicine Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre F-94275, France
| | - Fabrice Jollant
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Medicine Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre F-94275, France; Service de psychiatrie, CHU Nîmes, France; Department of psychiatry, McGill University, Montreal Québec, Canada
| | - Emmanuelle Corruble
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Medicine Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre F-94275, France
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15
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Williams-York B, Guenther GA, Patterson DG, Mohammed SA, Kett PM, Dahal A, Frogner BK. Burnout, Exhaustion, Experiences of Discrimination, and Stress Among Underrepresented and First-Generation College Students in Graduate Health Profession Education. Phys Ther 2024; 104:pzae095. [PMID: 39018222 DOI: 10.1093/ptj/pzae095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 05/08/2024] [Accepted: 07/16/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVES Mental health disorders are increasing among health profession students. Compounding this, students from underrepresented backgrounds may face additional stressors and challenges. The aims of this study were to: (1) assess the extent to which burnout, exhaustion, experiences of discrimination, and stress exist among students in dentistry, nursing, occupational therapy, pharmacy, and physical therapist professional education programs; (2) determine if there are significant differences by key demographic characteristics (those who are first-generation college students [FGCSs], a member of an underrepresented minority [URM] group, or both); and (3) highlight strategies and solutions to alleviate these challenges identified by students. METHODS Cross-sectional survey using a mix of question types of a sample of graduate students from dentistry, nursing, occupational therapy, pharmacy, and physical therapy programs from February to June 2020. Utilizing the Maslach Burnout Inventory Student Survey and campus climate and stress survey, mean subscale scores were calculated for the following outcomes of interest: MBI-SS burnout, dimensions of stress, and observed racism. Logistic regressions examined student factors that may help explain these outcomes. Content analysis examined participants' responses to open-ended questions. RESULTS There were 611 individuals who completed all survey questions. FGCSs were significantly more likely than non-FGCSs to report exhaustion (adjusted odds ratio [aOR]: 1.50; 95% CI = 1.04-2.16), family stress (aOR: 3.11; 95% CI = 2.13-4.55), and financial stress (aOR: 1.74; 95% CI = 1.21-2.50). URM students reported not feeling supported in their program and mentioned needing additional support, particularly for well-being, from staff and faculty. CONCLUSION Findings from this study are consistent with literature that FGCSs experience additional stressors that may lead to burnout and exhaustion. URM students reported not feeling supported in their programs. This study's findings point to the need for leadership and faculty of health professional schools to implement or strengthen current policies, practices, and strategies that support URM students and FGCSs. IMPACT Research demonstrates that a diverse student body and faculty enhances the educational experience for health professional students, and that diversity strengthens the learning environment and improves learning outcomes, preparing students to care for an increasingly diverse population. However, this study finds that students from underrepresented backgrounds may still experience more burnout, exhaustion, discrimination, and stress than their peers. Programs and policies to support URM students and FGCSs throughout their academic careers can help improve graduation and retention rates, leading to improved workforce diversity.
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Affiliation(s)
- Bernadette Williams-York
- Division of Physical Therapy, Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
- Center for Health Workforce Studies, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
| | - Grace A Guenther
- Center for Health Workforce Studies, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
| | - Davis G Patterson
- Center for Health Workforce Studies, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
| | - Selina A Mohammed
- Center for Health Workforce Studies, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, Washington, United States
| | - Paula M Kett
- Center for Health Workforce Studies, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
| | - Arati Dahal
- Center for Health Workforce Studies, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
| | - Bianca K Frogner
- Center for Health Workforce Studies, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
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Bull S, Terry R, Rice N, Carrieri D, Tarrant M, Curnow G. Social connections and social identity as a basis for learning and support: Experiences of medical students with minoritised and non-minoritised ethnic identities. MEDICAL EDUCATION 2024; 58:1126-1135. [PMID: 38414290 DOI: 10.1111/medu.15367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 01/25/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Social connections between medical students provide a key basis for learning and support. These connections, and associated social identity, may be patterned by ethnicity, and students often perform similarly academically to those they connect with. The mechanisms that underpin the formation of these connections and the role that they play are not fully understood. This study explored how medical students connect with each other, and the potential impact of this on their academic attainment and well-being, with a focus on students with minoritised ethnic identities. METHODS A mixed methods study combining (1) a survey to establish the number and strength of connections formed by Years 1 and 2 medical students with both minoritised and non-minoritised ethnicities and (2) semi-structured interviews to understand how connections were formed, whether this was shaped by ethnicity and the role of connections in supporting students with their learning and well-being. RESULTS One hundred fifty-one students (15.5% response rate) completed the survey. Students connected regularly with three to four peers with the goal of supporting learning and 71.9% of students reported a sense of social identification with this group. There was no statistical difference between ethnically minoritised and White students on either of these measures (t = 0.1, p = 0.92, χ2 = 2.9, p = 0.56). Interviews with 19 students found that social connections were shaped by perceptions of their self-identity and the need to find 'equilibrium' by forming relationships with compatible others. The education environment, including its ethnic diversity, impacted on the opportunities to make connections. Students who were ethnically minoritised reported encountering challenges, especially in the clinical environment, and described the burden of these for them. DISCUSSION Curriculum designers should consider the time and space that is afforded to student interaction during course development, as finding compatible others with whom students can socially connect is important to balancing well-being with academic performance.
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Affiliation(s)
- Stephanie Bull
- Medical Education Innovation and Research Centre, Imperial College London, London, UK
- University of Exeter, Exeter, UK
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17
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Vergeron L, Morvan Y, Hadouiri N, Haas-Jordache A, Gouy E, Mathieu L, Goulard A, Rolland F, Frajerman A. Use of service and treatment adequacy in medical students and residents suffering from depression in France: A nationwide study. Psychiatry Res 2024; 339:115975. [PMID: 38875916 DOI: 10.1016/j.psychres.2024.115975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/16/2024]
Abstract
Depression was already a public health issue before the Covid-19 pandemic. Use of service and treatment adequacy in medical students was poorly known. A 2021 French national study found the prevalence of 12-month major depressive disorder (MDD) was 25 % in medical school students and residents (MSSR). The main objective of our study was to measure the prevalence of service use and adequate treatment (therapy and/or recommended pharmacotherapy) and their associated factors. A national online survey was conducted in 2021. The Composite International Diagnostic Interview Short-Form questionnaire was used to assess MDD; 12-months service use and pharmacotherapy were assessed. Univariate and multivariate logistic regressions were performed between students' demographic characteristics, use of services, and treatment adequacy. Among included MSSR who experienced MDD in the last 12 months, only 32 % received adequate treatment, including 20 % with recommended pharmacotherapy. Being more advanced in medical studies and being treated both by a general practitioner and a psychiatrist were associated with receiving recommended pharmacotherapy. To our knowledge, our study is the largest to assess use of service and treatment adequacy in MSSR. Given the low percentage of depressed students receiving recommended treatment, it seems important to develop new interventions to better detect and treat MDD in MSSR.
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Affiliation(s)
- Laure Vergeron
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin-Bicêtre F-94275, France
| | - Yannick Morvan
- Center for research in epidemiology and population health (CESP), National Institute of Health and Medical Research (INSERM) U1018, Paris-Saclay University, Villejuif, France; Université Paris Nanterre - UFR SPSE - laboratoire CLIPSYD, EA4430, Nanterre, France
| | - Nawale Hadouiri
- Pôle rééducation-réadaptation, CHU de Dijon, 23 rue Gaffarel, 21078 Dijon, France
| | - Adrien Haas-Jordache
- ISNAR-IMG (InterSyndicale Nationale Autonome Représentative des Internes de Médecine Générale), 286 Rue Vendôme, 69003 Lyon, France
| | - Evan Gouy
- Service de génétique médicale, Hospices Civils de Lyon, 59 boulevard Pinel, 69500 Bron, France
| | - Loona Mathieu
- ANEMF (Association Nationale des Étudiants en Médecine de France), 79 rue Périer, 92120 Montrouge, France
| | - Anne Goulard
- ISNAR-IMG (InterSyndicale Nationale Autonome Représentative des Internes de Médecine Générale), 286 Rue Vendôme, 69003 Lyon, France
| | - Franck Rolland
- Center for research in epidemiology and population health (CESP), National Institute of Health and Medical Research (INSERM) U1018, Paris-Saclay University, Villejuif, France; MGEN Action sanitaire et sociale - groupe VYV, Établissement de Santé Mentale de Rueil-Malmaison, 2 rue du Lac, 92500 Rueil-Malmaison, France
| | - Ariel Frajerman
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin-Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre F-94275, France.
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Lawrence EC, Sheridan C, Hurtado A, Lee WW, Lizotte-Waniewski M, Rea M, Zehle C. A Guiding Model for Undergraduate Medical Education Well-Being Programs. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:946-952. [PMID: 38722282 DOI: 10.1097/acm.0000000000005755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
ABSTRACT Most medical schools have instituted undergraduate medical education (UME) well-being programs in recent years in response to high rates of medical student distress, but there is currently significant variability in the structure of UME well-being programs and limited guidance on how to best structure such programs to achieve success. In this article, the authors, all leaders of medical student well-being programs at their home institutions and members of the Association of American Medical Colleges Group on Student Affairs Committee on Student Affairs Working Group on Medical Student Well-Being between 2019 and 2023 offer guidance to the national community on how best to structure a UME well-being program. They use the current literature and their professional experiences leading well-being efforts at 7 different institutions to review the case for addressing medical student well-being, propose a guiding model, and make recommendations for strategies to implement this model.The proposed guiding model emphasizes the importance of the learning environment and efficiency of learning to medical student well-being, as well as personal resilience. Based on this model, the authors recommend specific and tangible well-being strategies to implement systemic interventions to improve the learning environment, efficiency of learning, and personal resilience, including formalizing the well-being program; hiring qualified, dedicated, and empowered well-being leadership with clear responsibilities; acting as a central hub for resources and as a liaison with mental health care; and establishing robust program evaluation methods.
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Yang YJ, Granlund M, Tao FB, Tao SM, Zou LW, Enskar K, Wu XY, Hong JF. Exploring the relationship between depressive symptoms, problematic smartphone use, and cumulative risk factors in nursing students: A cross sectional study. Acta Psychol (Amst) 2024; 249:104430. [PMID: 39178496 DOI: 10.1016/j.actpsy.2024.104430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND No single risk factor is decisive in shaping an individual's healthy development. This study aimed to analyze the relationship between depressive symptoms and a cumulative risk index comprising individual, family, and social variables among nursing students. METHODS We enrolled 1716 Chinese nursing students from three universities in a paperless survey that assessed a range of individual, family, and social risk factors associated with depressive symptoms. Multiple risk analysis was conducted to create a composite risk score for each individual. A test for trend was employed to assess the relationship between the multiple risk classification and depressive symptoms individually. Additionally, a 2-step cluster analysis and χ2 tests were used to examine the relationship between the different clusters and the level of depressive symptoms. RESULTS The mean scores of depressive symptoms increased significantly as the number of risk factors increased, regardless of their combination. As the number of risk factors increased, the proportion of nursing students in the normal group decreased, while the proportion in the group with depressive symptoms of varying severity tended to increase (P < 0.001). A high-risk cluster characterized by poor sleep quality combined with problematic smartphone use was associated with higher levels of depressive symptoms (P < 0.001). CONCLUSION Based on these findings that cumulative exposure to multiple risk factors is more harmful than cumulative exposure to fewer risk factors, then interventions that isolate only one risk factor are less likely to be effective than those that are multifaceted.
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Affiliation(s)
- Ya-Juan Yang
- School of Nursing, Anhui Medical University, No. 81 Meishan Rd, Shushan District, Hefei, Anhui Province 230032, PR China.
| | - Mats Granlund
- CHILD, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, He Fei City 230032, Anhui Province, PR China.
| | - Shu-Man Tao
- The Second Affiliated Hospital of Anhui Medical University, No. 678 Fu Rong Road, Economic and Technological Development District, He Fei City 230601, Anhui Province, PR China.
| | - Li-Wei Zou
- The Second Affiliated Hospital of Anhui Medical University, No. 678 Fu Rong Road, Economic and Technological Development District, He Fei City 230601, Anhui Province, PR China.
| | - Karin Enskar
- Department of Women's and Children's Health, Uppsala University, Sweden.
| | - Xiao-Yan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, He Fei City 230032, Anhui Province, PR China.
| | - Jing-Fang Hong
- School of Nursing, Anhui Medical University, No. 81 Meishan Rd, Shushan District, Hefei, Anhui Province 230032, PR China.
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Zu S, Wang D, Fang J, Xiao L, Zhu X, Wu W, Lin X, Wang G, Hu Y. Acute treatment residual depression symptoms and functional impairment among depressive patients of different age groups and education levels in China: A prospective, multicenter, randomized study. Brain Behav 2024; 14:e70024. [PMID: 39262174 PMCID: PMC11391025 DOI: 10.1002/brb3.70024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 05/13/2024] [Accepted: 07/24/2024] [Indexed: 09/13/2024] Open
Abstract
OBJECTIVE A prospective, multicenter, randomized study evaluated the efficacy of major depressive disorder (MDD) patients after 2-3 months of acute treatment based on the dual factors of education and age. METHODS This study classified the included patients into four groups using two classification parameters: age (≤45 years, vs. >45 years) and education years (≤12 vs. >12). We analyzed age, gender, marital status, personal income, depression onset history, medication use, and follow-up across various groups. We evaluated residual somatic symptoms and social functioning in depression patients was conducted using the 16-item Quick Inventory of Depressive Symptomatology Self-report (QIDS-SR16), the Patient Health Questionnaire-15 (PHQ15), and the Sheehan Disability Scale (SDS). RESULTS In China, 16 hospitals, 553 depression patients, and 428 fulfilled the inclusion criteria. Baseline patient data revealed significant differences among the different age groups in gender, marital status, income, first onset age, physical illness, combination of antipsychotics, and benzodiazepines use (all p < .05). Statistically significant differences were observed in overall comparisons among the four groups, encompassing the QIDS-SR16 score, PHQ15 score, and various SDS parameters (all p < .05). However, no statistically significant differences (all p > .05) were found in residual somatic symptoms and social functioning parameters between different education levels (≤12 years vs. >12 years) at baseline, 3 months, and 6 months, based on total scores on the scale. Repeated measures mixed model indicates that the QIDS-SR16 assessment indicates statistical differences among various marital statuses, income levels, medical histories, and antipsychotic medication use (p < .05). Furthermore, PHQ-15 and SDS assessments reveal statistical differences between single and married/cohabiting statuses, physical comorbidities, 3 and 6 months follow-ups compared to baseline (p < .05). CONCLUSION This study indicates that compared to depressive patients >45 years old, those ≤45 years old often exhibit more residual depression, somatic symptoms, and severe social functional impairment; patients' education levels less influence this trend.
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Affiliation(s)
- Si Zu
- Department of Psychiatry, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Dong Wang
- Department of Psychiatry, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jiexin Fang
- Department of Psychiatry, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Le Xiao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xuequan Zhu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Wenyuan Wu
- Department of Psychiatry, Tongji Hospital of Tongji University, Shanghai, China
| | - Xiufeng Lin
- School of Information, Renmin University Beijing, China Research Institute, Kunlun Digital Technology, Co, Ltd. Beijing, China, Beijing, China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yongdong Hu
- Department of Psychiatry, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Wang X, Li C. Knowledge, attitude, and practice of depression among university students. Brain Behav 2024; 14:e70030. [PMID: 39295097 DOI: 10.1002/brb3.70030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 08/06/2024] [Accepted: 08/20/2024] [Indexed: 09/21/2024] Open
Abstract
INTRODUCTION This study aimed to investigate the knowledge, attitude, and practice (KAP) of depression among university students. METHODS A cross-sectional survey was carried out across randomly selected universities in Shandong Province from October 25, 2023, to November 8, 2023. Demographic information and KAP scores were assessed through the administration of questionnaires. The reliability of the questionnaire was confirmed with a Cronbach's alpha coefficient of 0.816 and the Kaiser-Meyer-Olkin measure of 0.894. RESULTS This study included 2448 university students, with 1489 (60.8%) females. The median scores for KAP were 20 (Interquartile Range (IQR): 17-21), 26 (IQR: 23-28), and 35 (IQR: 32-38), respectively. Multivariate regression analysis indicated that being a junior (odds ratio [OR] = 0.720, 95% Confidence Interval (CI): 0.538-0.965, p = .028), senior or above (OR = 0.474, 95% CI: 0.325-0.691, p < .001), having divorced parents (OR = 0.618, 95% CI: 0.409-0.933, p = .022), having direct relatives with depression (OR = 0.710, 95% CI: 0.589-0.856, p < .001), and lacking intimate friends (OR = 0.344, 95% CI: 0.245-0.484, p < .001) were negatively associated with practice. Only having an attitude score of ≥26 (OR = 5.076, 95% CI: 4.230-6.091, p < .001) was significantly and positively associated with practice. CONCLUSION University students had insufficient knowledge, positive attitude, and passive practice toward depression. Clinical interventions should focus on enhancing the understanding and management of depression among university students, particularly through targeted educational programs and support groups, to bridge the gap between knowledge and practice and foster a proactive approach to mental health care.
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Affiliation(s)
- Xuechao Wang
- Department of Human Resources and Organizational Behavior, Shandong University of Finance and Economics, Jinan, China
| | - Cuiluan Li
- Shandong Mental Health Center, Jinan, China
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Frajerman A, Rolland F, Hadouiri N, Haas-Jordache A, Gouy E, Mathieu L, Goulard A, Léon C, Morvan Y. Depression and suicidal thoughts in medical students and the general population: A comparison from 2 national studies. Gen Hosp Psychiatry 2024; 90:204-205. [PMID: 38997936 DOI: 10.1016/j.genhosppsych.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024]
Affiliation(s)
- Ariel Frajerman
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Médecine Paris- Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, F-94275, France.
| | - Franck Rolland
- Center for Research in Epidemiology and Population Health (CESP), National Institute of Health and Medical Research (INSERM), U1018, Paris-Saclay University, Villejuif, France; MGEN Action Sanitaire et Sociale - Groupe VYV, Etablissement de Santé Mentale de Rueil-.Malmaison, 2 rue du Lac, Rueil-Malmaison 92063, France
| | - Nawale Hadouiri
- Pôle Rééducation-Réadaptation, CHU de Dijon, 23 rue Gaffarel, 21078 Dijon, France
| | - Adrien Haas-Jordache
- Faculté de Médecine, Maïeutique et Sciences de la santé de Strasbourg 4, rue Kirschleger, F-67085 Strasbourg, France; Sciences Po Strasbourg, Université de Strasbourg Bâtiment le Cardo, 7 rue de l'Ecarlate - CS 20024, 67082 Strasbourg, France
| | - Evan Gouy
- Service de génétique médicale, Hospices Civils de Lyon, 59 boulevard Pinel, 69500 Bron, France; Université Claude Bernard Lyon 1, INSERM, CNRS, Institut Neuro Myogene, MéLis (CNRS UMR 5284 -INSERM U1314), Génétique et Neurobiologie de C. Elegans, F-69008 Lyon, France
| | - Loona Mathieu
- ANEMF (Association Nationale des Etudiants en Médecine de France), 79 rue Périer, 92120 Montrouge, France
| | - Anne Goulard
- ISNAR-IMG (InterSyndicale Nationale Autonome Représentative des Internes de Médecine Générale), 286 Rue Vendôme, 69003 Lyon, France
| | | | - Yannick Morvan
- Université Paris Nanterre, UFR SPSE, Laboratoire CLIPSYD, UR4430, 200 avenue de la République, 92001 Nanterre, France; Inserm U1018, CESP, Equipe Psychiatrie du Développement et Trajectoires, 16 av PV Couturier - 94807 Villejuif Cedex, France
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da Cunha GH, Fontenele MSM, Galvão MTG, Dantas MB, Gomes MEC, Fechine FV, de Sousa Paiva S. Factors Associated With Symptoms of Anxiety and Depression in People Living With HIV in Northeast Brazil. J Acquir Immune Defic Syndr 2024; 97:87-98. [PMID: 39116335 DOI: 10.1097/qai.0000000000003468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/21/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND The diagnosis of HIV infection can cause mental disorders or exacerbate existing symptoms because of the stigma, psychological stress, and need for the self-management of the illness. The aim of this study was to determine the prevalence of anxiety and depression symptoms in people with HIV and to identify the associated factors. METHODS This is a cross-sectional study. A sample of 385 people living with HIV (PLWH) was interviewed using the Sociodemographic, Epidemiological, and Clinical Form; the Beck Anxiety Inventory; the Beck Depression Inventory; and Pittsburgh Sleep Quality Index. Univariate and multivariate logistic regression analysis were performed. The odds ratio and 95% confidence interval were calculated. RESULTS The prevalence of anxiety was 27.1% and depression was 39.8%. Being female (P = 0.0227), antiretroviral therapy (ART) for 8 years or less (P = 0.0042), and having depression (P < 0.0001) were associated with the occurrence of anxiety. Having a detectable viral load (P = 0.0476), not exercising regularly (P = 0.0070), and having sleep disorders (P = 0.0001) and anxiety (P < 0.0001) were associated with depression. Retired and on leave or sick pay were, respectively, 2.67 and 3.90 times more likely to have depression than those who were employed. CONCLUSIONS A considerable percentage of PLWH have anxiety and depression symptoms. Being female, less than 8 years of ART, and depression are associated with anxiety, while detectable viral load, not practicing physical exercise, having sleep disorders, anxiety, and being retired or on leave or sick pay are associated with depression. The study showed important data for health interventions by members of the multidisciplinary team for PLWH.
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Yan D, Wu Y, Luo R, Yang J. Bedtime music therapy for college students with insomnia: A randomized assessor-blinded controlled trial. Sleep Med 2024; 121:326-335. [PMID: 39053128 DOI: 10.1016/j.sleep.2024.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 07/03/2024] [Accepted: 07/14/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Insomnia, a prevalent sleep disorder in contemporary society, frequently coexists with other mental health conditions such as depression, schizophrenia, and obsessive-compulsive disorder. Sleep disorders can compromise daytime functioning and overall quality of life. While music has been explored as an adjunct therapy for insomnia, its efficacy in improving insomnia among students remains unclear. METHODS Seventy-five students, aged between 18 and 30 years with an average age of 20.97 years (SD: 1.92), presenting sleep issues were randomly allocated to one of three groups: the classical music group, the jazz music group, and the control group, each with 25 participants. Participants in the classical and jazz music group were instructed to listen to classical or jazz music for a minimum of 30 min preceding bedtime. This was paired with deep breathing and relaxation techniques, practiced two consecutive nights per week from 23:00 to 01:00 over a five-week intervention period. Conversely, participants in the control group were only directed to follow the deep breathing and relaxation techniques before sleep on two consecutive nights weekly. Insomnia severity with the Insomnia Severity Index (ISI), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), depressive symptoms with the Beck Depression Inventory-II (BDI- II), and anxiety symptoms with the Self-rating Anxiety Scale (SAS). Measurements were taken at baseline, after the second week of intervention, at the intervention's conclusion (five weeks), and two months post-intervention (follow-up). RESULTS 1. The music groups showed a significant difference in insomnia severity compared with the control group after five weeks of intervention(p < .05). 2. music groups exhibited significant enhancements in sleep quality relative to the control group after a five-week intervention (p < .05). 3. Regarding mood enhancement, music groups showed significant improvements in depression and anxiety symptoms compared to the baseline after the five-week intervention. Notably, the control group also displayed improvements in these symptoms post-intervention. CONCLUSION 1. Integrating music into a consistent bedtime routine ameliorates sleep quality and insomnia severity. However, no specific genre of music emerged as the superior choice for pre-sleep listening. 2. While music can considerably enhance mood indicators like depression and anxiety, techniques such as deep breathing and mindfulness also contribute positively. 3. Incorporating music before sleep tangibly elevates overall quality of life and daytime functioning. TRIAL REGISTRATION ChiCTR2300073953.
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Affiliation(s)
- Danni Yan
- Department of Psychology, Tianjin Medical University General Hospital, Tianjin, China.
| | - Yufei Wu
- Department of Psychology, Tianjin Medical University General Hospital, Tianjin, China.
| | - Ruihan Luo
- Department of Psychology, Tianjin Medical University General Hospital, Tianjin, China.
| | - Jianli Yang
- Department of Psychology, Tianjin Medical University General Hospital, Tianjin, China.
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Selič-Zupančič P, Petek D, Jerala N. Exploring Personality Traits, Values, and Attitudes toward Professionalism: Implications for the Promotion of Mental Health and Functioning in Medical Students. Healthcare (Basel) 2024; 12:1732. [PMID: 39273756 PMCID: PMC11394833 DOI: 10.3390/healthcare12171732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/24/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
Healthcare workers face significant mental health challenges, including stress, burnout, and psychological distress, leading to high rates of mental health symptoms and even suicide attempts, as well as an increase in medication errors and unprofessional behavior. Targeted interventions are needed to address these issues. However, promoting healthier traits in medical students or refining selection could also prove beneficial, as research shows that mental health is significantly influenced by personality traits and personal values. This study examines the relationship between personality traits, values, and attitudes toward professionalism among medical students in Slovenia. A total of 996 participants were examined in three data collections from the academic years 2015-2016 to 2019-2020 using the Big Five Questionnaire, the Personal Values Scale, and the Attitude Toward Professionalism Scale. Hierarchical linear regression analysis was conducted to examine the factors associated with professionalism. The results showed that attitudes toward professionalism were stable over the years, with higher scores consistently associated with the female gender, agreeableness, and conscientiousness. Conversely, material value orientation had a negative impact on professionalism. In addition, we examine the associations between mental health and personality traits, personal values, and attitudes toward professionalism to illustrate the importance of selecting and nurturing medical students, based on traits that promote mental health and professional behavior. These findings may lead to improvements in medical education and selection processes to improve the well-being and functioning of future medical professionals.
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Affiliation(s)
- Polona Selič-Zupančič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski Nasip 58, 1000 Ljubljana, Slovenia
- Department of Psychology, Faculty of Medicine, University of Maribor, Taborska 8, 2000 Maribor, Slovenia
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski Nasip 58, 1000 Ljubljana, Slovenia
| | - Nina Jerala
- University Psychiatric Clinic Ljubljana, Studenec 48, 1260 Ljubljana, Slovenia
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26
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Tabaie SA, Dance S, Samora JB. Bridging the Gap: Advocating for Medical Students Without Home Orthopaedic Surgery Programs. J Am Acad Orthop Surg 2024:00124635-990000000-01080. [PMID: 39231297 DOI: 10.5435/jaaos-d-24-00495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/22/2024] [Indexed: 09/06/2024] Open
Abstract
Medical students without a home orthopaedic surgery program face unique challenges due to the absence of institutional connections and mentorship opportunities. This review explores the hurdles faced by these students, including financial constraints, emotional strains, mentorship gaps, and networking hurdles. Drawing from empirical evidence and scholarly research, tailored advocacy strategies to empower these medical students pursuing orthopaedic surgery residency are proposed, including mentorship programs, financial assistance, psychosocial support, and community-building initiatives.
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Affiliation(s)
- Sean A Tabaie
- From the Department of Orthopaedic Surgery (Tabaie, Dance), Children's National Hospital, 111 Michigan Ave NW, Washington DC 20010, and the Department of Orthopaedic Surgery (Samora), Nationwide Children's Hospital, 479 Parsons Ave, Columbus, OH 43215
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27
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Gellisch M, Olk B, Schäfer T, Brand-Saberi B. Unraveling psychological burden: the interplay of socio-economic status, anxiety sensitivity, intolerance of uncertainty, and stress in first-year medical students. BMC MEDICAL EDUCATION 2024; 24:945. [PMID: 39210353 PMCID: PMC11363420 DOI: 10.1186/s12909-024-05924-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND The escalating prevalence of mental health issues among young adults, set against the backdrop of a global healthcare system under pressure, underscores the necessity for cultivating a resilient medical workforce. This study investigates the influence of socio-economic status (SES) on psychological well-being, with a particular focus on Anxiety Sensitivity (AS) and Intolerance of Uncertainty (IU) among first-year medical students. Understanding the psychological dimensions affecting medical students is crucial for fostering a future medical workforce that is both capable and mentally healthy. METHODS This research involved 321 first-year medical students, evaluated using the Perceived Stress Questionnaire (PSQ), Anxiety Sensitivity Index (ASI), the Intolerance of Uncertainty Scale (UI-18), and the Student Self-Efficacy Scale (SSE), alongside socio-economic categorization. Employing descriptive statistics, ANOVA, and correlation analyses, the study aimed at elucidating the SES impact on AS and IU, among other psychological constructs. RESULTS The analysis revealed significant SES-related differences, especially in the realms of Anxiety Sensitivity and Intolerance of Uncertainty. Notably, ASI_C (cognitive concerns) exhibited strong positive correlations with both UI_A (reduced ability to act due to IU) (Pearson's r = 0.562, p < 0.001) and UI_B (burden due to IU) (Pearson's r = 0.605, p < 0.001), highlighting the link between cognitive aspects of anxiety and uncertainty intolerance. Furthermore, UI_C (vigilance due to IU) was significantly associated with SES (F(4, 316) = 2.719, p = 0.030, η² = 0.033), pointing to the complex ways in which socio-economic factors modulate responses to uncertainty. Self-efficacy emerged as a significant counterbalance, showing protective associations against the adverse effects of heightened Anxiety Sensitivity and Intolerance of Uncertainty. CONCLUSION Our findings indicate that lower socio-economic status is associated with higher levels of Anxiety Sensitivity and Intolerance of Uncertainty, which contribute to increased stress among first-year medical students. Additionally, Self-Efficacy emerged as a significant protective factor, mitigating the expressions of AS and IU. Although medical faculties cannot change SES characteristics within their student body, recognizing its impact allows for the development of tailored support systems to address the unique challenges faced by students from diverse socio-economic backgrounds. This study underscores the necessity of considering social diversity, particularly regarding AS and IU characteristics, to foster a supportive and effective medical education environment with an outlook on sustainable mental health in a demanding work context.
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Affiliation(s)
- Morris Gellisch
- Center for Medical Education, Ruhr-University Bochum, 44801, Bochum, Germany.
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany.
- Faculty of Health, Department of Operative Dentistry and Preventive Dentistry, Witten/Herdecke University, Witten, Germany.
| | - Bettina Olk
- HSD Hochschule Döpfer, University of Applied Sciences, Waidmarkt 3 and 9, 50676, Cologne, Germany
| | - Thorsten Schäfer
- Center for Medical Education, Ruhr-University Bochum, 44801, Bochum, Germany
| | - Beate Brand-Saberi
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, 44801, Bochum, Germany
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Akbayram HT, Demir M, Keten HS. Barriers to Seeking Psychological Help among First-Year Medical Students: A Cross- Sectional Study from Turkey. Psychiatr Q 2024:10.1007/s11126-024-10086-7. [PMID: 39183222 DOI: 10.1007/s11126-024-10086-7] [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] [Accepted: 08/08/2024] [Indexed: 08/27/2024]
Abstract
Despite high rates of psychological symptoms, many medical students often avoid psychological help. Determining the mental status of medical students at an early stage is very important for developing necessary interventions. The aim of this study was to evaluate the barriers to seeking psychological help among first-year medical students. This cross-sectional study was conducted between January 2-20, 2023. Data were collected using an anonymous online questionnaire comprising students' self-reported psychological problems and treatment status, help-seeking barriers, and a validated mental health tool (Patient Health Survey 4). The response rate was 58.8% (n = 250). Of them, 34.4% had anxiety symptoms and 25.2% had depressive symptoms. The prevalence of self-reported psychological problems and serious psychological problems were 61.2% and 10.4%, respectively. Only 7.6% of students reported receiving psychological treatment. It was found that 5.6% of the students used psychiatric drugs (2% officially prescribed and 3.6% not officially prescribed). The most common barriers to help-seeking were not were not serious problems, lack of time, difficulty explaining psychological problems, fear of being recorded, and fear of stigmatization. The results indicated that a significant number of students had psychological problems, and some did not seek psychological help.
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Affiliation(s)
- Hatice Tuba Akbayram
- Faculty of Medicine, Department of Family Medicine, Gaziantep University, Gaziantep, 27600, Turkey.
| | - Mustafa Demir
- Faculty of Medicine, Department of Family Medicine, Gaziantep University, Gaziantep, 27600, Turkey
| | - Hamit Sirri Keten
- Faculty of Medicine, Department of Family Medicine, Gaziantep University, Gaziantep, 27600, Turkey
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Shafiee A, Teymouri Athar MM, Seighali N, Amini MJ, Hajishah H, Arabazadeh Bahri R, Akhoundi A, Beiky M, Sarvipour N, Maleki S, Zandifar A, Bakhtiyari M. The prevalence of depression, anxiety, and sleep disturbances among medical students and resident physicians in Iran: A systematic review and meta-analysis. PLoS One 2024; 19:e0307117. [PMID: 39178292 PMCID: PMC11343466 DOI: 10.1371/journal.pone.0307117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 06/29/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND We sought to conduct this comprehensive systematic review and meta-analysis to assess the prevalence of depression, anxiety, and sleep disturbance in Iranian medical students and resident physicians. METHODS A systematic search was conducted on 23 December 2023 in PubMed/MEDLINE, Web of Science, Scopus, and Iranian national databases. We pooled the prevalence of individual studies using the random effect model. RESULTS Our systematic search showed 36 articles that meet the eligibility criteria. Most included studies were cross-sectional. The most used questionnaire to assess depression, anxiety, and sleep disturbance were Beck Depression Inventory (BDI), The Depression, Anxiety and Stress Scale-21 Items (DASS-21), and The Pittsburgh Sleep Quality Index (PSQI), respectively. The overall prevalence of depression, anxiety, and sleep disturbance among Iranian medical students were 43% (95%CI: 33%-53%%, I2 = 98%), 44% (95%CI: 31%-58%%, I2 = 99%), 48% (95%CI: 39%-56%%, I2 = 97%), respectively. The results of subgroup and meta-regression analyses showed questionnaires used and the place of the medical school were significantly associated with the prevalence of aforementioned outcomes. Funnel plot and Begg's regression test did not show a significant source of funnel plot asymmetry for depression, anxiety, and sleep disturbance. CONCLUSION In conclusion, our study showed that nearly half of the medical students had some type of depression, anxiety, and sleep disturbance problems. To address this serious national public health issue, efficient preventive measures, routine screenings, and prompt interventions are required.
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Affiliation(s)
- Arman Shafiee
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Niloofar Seighali
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Javad Amini
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamed Hajishah
- Student Research Committee, School of Medicine, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | - Amirhossein Akhoundi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Maryam Beiky
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Nastaran Sarvipour
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Saba Maleki
- School of Medicine, Guilan University of Medical Sciences (GUMS), Rasht, Guilan Province, Iran
| | - Atefeh Zandifar
- Department of Psychiatry, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahmood Bakhtiyari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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30
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Cappetto KD, Ehrlich B, Anderson EA, Huynh AT, Tran J, Hudon K. The benefits of undergraduate medical students delivering free preparticipation physical evaluations in collaboration with a K-12 school district. BMC MEDICAL EDUCATION 2024; 24:901. [PMID: 39169346 PMCID: PMC11340188 DOI: 10.1186/s12909-024-05806-3] [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: 05/09/2024] [Accepted: 07/22/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND Student-run free clinics are present at many medical schools throughout the United States. While many work with adult homeless or uninsured populations, few work with pediatric populations. We investigated the impact of volunteering at a free preparticipation sports physical clinic on medical students' educational motivation, school engagement, confidence in their clinical skills, connectedness to community, and self-efficacy. METHODS First and second year undergraduate medical students who volunteered at a preparticipation sports physical clinic were eligible for the study. 30 students participated in the study, some volunteering multiple times, for a total of 55 post-volunteering surveys. Pre- and post-volunteering surveys were administered via REDCap. The surveys were designed using Likert scales and the General Self-Efficacy scale. Paired two tailed t-tests were used to analyze pre- and post-volunteering data. RESULTS Students had statistically significant increases in their confidence in working with pediatric populations, performing a standard physical exam, working in an interdisciplinary setting, and communicating with patients. They also demonstrated statistically significant increases in their feelings of connectedness to their reason for practicing medicine and to the greater local community. CONCLUSIONS This research demonstrated measurable increases in motivation and confidence in clinical skills for medical students that participated. This is a valuable experience for medical students and is a model that other medical schools can adopt to help diversify and strengthen their curriculum. In the future, we would like to collect more data to further evaluate the impact of this volunteering on medical students, patients, families, and other community stakeholders.
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Affiliation(s)
- Kaitlin D Cappetto
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, 200 University Pkwy, Yakima, WA, 98901, USA.
| | - Benjamin Ehrlich
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, 200 University Pkwy, Yakima, WA, 98901, USA
| | - Elise A Anderson
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, 200 University Pkwy, Yakima, WA, 98901, USA
| | - Amelia T Huynh
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, 200 University Pkwy, Yakima, WA, 98901, USA
| | - Joanne Tran
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, 200 University Pkwy, Yakima, WA, 98901, USA
| | - Katheryn Hudon
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, 200 University Pkwy, Yakima, WA, 98901, USA
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Zila-Velasque JP, Grados-Espinoza P, Chuquineyra BSC, Diaz-Vargas M, Sierra Calderón GS, Choquegonza S, Temoche-Rivas MS, Siguas Peixoto K, Valladares-Garrido MJ, Failoc-Rojas VE. Resilience, sleep quality and sleepiness in Peruvian medical students: a multicenter study. Front Psychiatry 2024; 15:1284716. [PMID: 39211539 PMCID: PMC11358107 DOI: 10.3389/fpsyt.2024.1284716] [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: 08/29/2023] [Accepted: 07/08/2024] [Indexed: 09/04/2024] Open
Abstract
Background Resilience can mitigate the negative impact produced by the COVID-19 pandemic. Medical students endure significant academic stress, so adjusting to sudden changes can present greater mental health challenges. The aim is to identify the level and prevalence of resilience and to know what are the educational variables and is sleep quality associated with resilience. Methods A cross-sectional study was conducted using an online questionnaire. The survey was elaborated in Google Forms and shared through social networks. The outcome was resilience, measured with the Connor Davidson Resilience Scale. Its association was assessed with sleep quality (measured with the Pittsburgh Sleep Quality Index), daytime sleepiness (measured with the Epworth Sleepiness Scale), and selected academic/sociodemographic variables. Generalized linear models were used to identify the association between the variables. Results Of 1277 participants, 35.7% experienced high resilience. Poor sleep quality and sleepiness were present in 88.4% and 36.0% of students, respectively. High resilience was associated with good sleep quality (PR:1.56; 95%CI: 1.34 - 1.83; p-value<0.001), absent sleepiness (PR:1.59; 95%CI: 1.32-1.91; p-value<0.001), male sex (PR: 1.21; 95%CI: 1.05-1.39; p-value 0.006), working (PR:1.14), having family responsibilities (PR: 1.36; 95%CI: 1.09-1.70; p-value 0.005) and spending more than 6 hours studying (PR: 1.35; 95%CI: 1.17-1.54; p-value<0.001). Conclusion 4 out of 10 students presented high levels of resilience. The development of resilience depended on multiple individual and sociodemographic factors. These findings are important to support universities in developing resilience-building measures and strategies that can be implemented to mitigate the adverse pandemic event.
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Affiliation(s)
| | | | | | - Mills Diaz-Vargas
- Facultad de Medicina Humana, Universidad Nacional del Centro del Peru, Huancayo, Peru
| | | | | | | | - Karina Siguas Peixoto
- Facultad de Medicina “Rafael Donayre Rojas”, Universidad Nacional de la Amazonía Peruana, Iquitos, Peru
| | - Mario J. Valladares-Garrido
- Facultad de Medicina, Universidad Continental, Lima, Peru
- Servicio de Epidemiología, Hospital Regional Lambayeque, Lambayeque, Peru
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Gómez Delgado G, Ponce Rojo A, Ramírez Mireles JE, Carmona-Moreno FDJ, Flores Salcedo CC, Hernández Romero AM. Suicide Risk Factors in High School Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1055. [PMID: 39200665 PMCID: PMC11354979 DOI: 10.3390/ijerph21081055] [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: 06/20/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 09/02/2024]
Abstract
In Mexico, suicide has become an important public health problem, representing the third leading cause of death in the adolescent population. Suicidal behavior in adolescents is associated with the interaction of complex relationships between personal, interpersonal, and sociocultural factors. Through a quantitative, descriptive, and correlational cross-sectional study, the present study aimed to analyze the prevalence and risk factors associated with suicidal ideation among adolescents from different high schools of the high school system (SEMS) of the University of Guadalajara, in response to the psychosocial impact of the COVID-19 pandemic. A descriptive statistical analysis was carried out on the data obtained from the 3583 students surveyed, followed by a principal component analysis (PCA) to identify closely related social, emotional, and behavioral variables. The PCA yielded eight principal components, which together represent 75.42% of the variance across psychometric tests. A multiple linear regression analysis was used, with a regression value (R2) of 0.4811, indicating that the explanatory model can predict 48.1% of the variability in suicidal ideation, with a statistical significance level of 0.05. According to the studies conducted, 19% (688 students) showed indicators of high suicide risk and 26.8% (960 students) showed moderate risk. Depression, mental health, health-related quality of life, physical and psychological well-being, and mood and emotions are the most influential factors in suicidal ideation.
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Affiliation(s)
- Guillermo Gómez Delgado
- High School Education System, University of Guadalajara, Tepatitlán de Morelos 47600, Jalisco, Mexico; (J.E.R.M.); (C.C.F.S.)
| | - Antonio Ponce Rojo
- Los Altos University Center Campus (CUALTOS), University of Guadalajara, Tepatitlán de Morelos 47600, Jalisco, Mexico; (A.P.R.); (A.M.H.R.)
| | - Jaime Eduardo Ramírez Mireles
- High School Education System, University of Guadalajara, Tepatitlán de Morelos 47600, Jalisco, Mexico; (J.E.R.M.); (C.C.F.S.)
| | - Felipe de Jesús Carmona-Moreno
- University Center for Exact Sciences and Engineering (CUCEI), University of Guadalajara, Guadalajara 44430, Jalisco, Mexico;
| | - Claudia Cecilia Flores Salcedo
- High School Education System, University of Guadalajara, Tepatitlán de Morelos 47600, Jalisco, Mexico; (J.E.R.M.); (C.C.F.S.)
| | - Aurea Mercedes Hernández Romero
- Los Altos University Center Campus (CUALTOS), University of Guadalajara, Tepatitlán de Morelos 47600, Jalisco, Mexico; (A.P.R.); (A.M.H.R.)
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Castro Pecci Maddalena ND, Lamas Granero Lucchetti A, da Silva Ezequiel O, Lucchetti G. Factors associated with mental health and quality of life among Brazilian medical students: a three-year longitudinal study. J Ment Health 2024:1-8. [PMID: 39126276 DOI: 10.1080/09638237.2024.2390374] [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: 11/07/2023] [Revised: 04/30/2024] [Accepted: 07/14/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Despite several studies on the mental health of medical students, there is insufficient research on long-term follow-ups. AIMS To investigate the associated factors and changes in the quality of life and mental health of a group of medical students followed-up for three years. METHODS An observational, prospective cohort study was conducted. Four classes were followed during the first three years of the medical course. The study included sociodemographic data, mental health data using the DASS-21 scale, and quality-of-life data using the WHOQOL-BREF scale. Linear regression models were used for analysis. RESULTS A total of 201 (66.1%) medical students responded to both data collection waves after a three-year follow-up. Depressive symptoms(p < 0.001), anxiety(p = 0.037), and stress(p < 0.001) increased. Additionally, physical(p < 0.001), psychological(p < 0.001), and social(p = 0.003) quality of life decreased. Worse mental health at baseline and being a woman were associated with worse mental health after three years, while higher income at baseline was associated with better quality of life after three years. CONCLUSIONS The mental health and quality of life of the medical students worsened after three years, being influenced by gender, income, and mental health at baseline. Educators and managers must be aware of these factors to minimize suffering in medical schools.
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Affiliation(s)
| | | | | | - Giancarlo Lucchetti
- School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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Liu M, Wang G, Jiang C. Independent and combined effect of serum copper and folate on depression: cross-sectional data from the NHANES 2011-2016. Front Nutr 2024; 11:1389480. [PMID: 39183983 PMCID: PMC11341402 DOI: 10.3389/fnut.2024.1389480] [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] [Received: 03/01/2024] [Accepted: 07/30/2024] [Indexed: 08/27/2024] Open
Abstract
Background and objective Depression is a widespread mental health condition that can impact both mental and physical well-being. Prior research has shown that high levels of copper in the blood and low levels of folate are linked to depression. This study aimed to explore whether serum folate levels, independently or in combination with serum copper levels, associated with the risk of depression. Methods Data from participants aged 18-80 years in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016 were analyzed to examine the role of trace elements. Depression was assessed using the nine-item Patient Health Questionnaire (PHQ-9). Logistic regression analyses were employed to evaluate the main effect of serum copper and folate levels on depression. Three indices, including the relative excess risk of interaction (RERI), attributable proportion of interaction (API), and synergy index (SI), were used to analyze the interaction effect. Results Among the 4,847 participants selected for this study, 429 (8.9%) had PHQ-9 scores above 10, which we defined as having depressive symptoms. After adjusting for all confounding factors, higher serum copper levels [≥15.5 vs. <15.5 μmol/L, odds ratio (OR): 1.54; 95% confidence intervals (CI): 1.18-2.11] and folate deficiency (folate ≥53.7 vs. <53.7 μmol/L, OR: 1.44; 95% CI: 1.21-2.10) were associated with an increased risk of depression. Patients with both higher serum copper levels and folate deficiency (OR: 2.11; 95% CI: 1.43-3.14) had the highest risk of depression than other levels. High copper levels and low folate levels are associated with the occurrence of depression symptoms, and there may be a synergistic effect between them (SI: 1.65; 95% CI: 1.49-4.76), with this interaction accounting for 19% of depression cases (API: 0.19; 95% CI: 0.01-0.54). Conclusion There may be a synergistic interaction between high copper levels and low folate levels associated with increasing risk of depression. Further population-based interventional studies are needed to confirm whether folic acid supplementation is effective in preventing depression in individuals with high blood copper levels.
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Affiliation(s)
- Mengqing Liu
- College of Humanities and Management, Guilin Medical College, Guilin, China
| | - Gang Wang
- Department of Nephrology, The University of HongKong-ShenZhen Hospital, ShenZhen, Guangdong, China
| | - Chongfei Jiang
- Department of Nephrology, The University of HongKong-ShenZhen Hospital, ShenZhen, Guangdong, China
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Bersia M, Charrier L, Zanaga G, Gaspar T, Moreno-Maldonado C, Grimaldi P, Koumantakis E, Dalmasso P, Comoretto RI. Well-being among university students in the post-COVID-19 era: a cross-country survey. Sci Rep 2024; 14:18296. [PMID: 39112645 PMCID: PMC11306340 DOI: 10.1038/s41598-024-69141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024] Open
Abstract
University students have to handle crucial challenges for their future lives, such as succeeding in academic studies and finding attachment figures. These processes could potentially involve their well-being and mental health, with possible sociocultural differences based on the country of study. In order to explore such potential differences, a cross-sectional, multi-center survey was performed involving students from the University of Torino (Italy), Sevilla (Spain), and Lusòfona (Portugal). The survey, conducted from May to November 2023, investigated students' demographic and educational details, socioeconomic status, social support, mental health, academic environment, perceived COVID-19 pandemic impact, and future plans. Demographic profiles showed a predominance of female participants and straight sexual orientation, followed by bisexuality. Italian students showed the lowest levels of mental well-being and the highest rates of mental problems (anxiety and depression) and suicidal risk across the three countries despite the relatively similar profiles of social support. The prevalence of the students' confidence in their professional future is higher in Spain than in Italy and Portugal. This study provides a comprehensive examination of university students' mental health and well-being in three Southern European countries, addressing the major mental health challenges among university students and offering valuable insights for public health purposes.
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Affiliation(s)
- M Bersia
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - L Charrier
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - G Zanaga
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
- Post Graduate School of Medical Statistics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - T Gaspar
- HEI-LAB, Digital Human-Environment Interaction Labs, Lusófona University, Campo Grande 376, 1749-024, Lisbon, Portugal
| | - C Moreno-Maldonado
- Department of Developmental and Educational Psychology, University of Sevilla, C/Camilo José Cela, s/n., 41018, Seville, Spain
| | - P Grimaldi
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
- Post Graduate School of Medical Statistics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - E Koumantakis
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy.
- Post Graduate School of Medical Statistics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy.
| | - P Dalmasso
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
| | - R I Comoretto
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Turin, Italy
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Dhachpramuk D, Sonjaipanich S, Theppiban S, In-Iw S. Exercise, mental well-being and burnout in Thai medical students in 2020-2021: an online cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:837. [PMID: 39095768 PMCID: PMC11297641 DOI: 10.1186/s12909-024-05843-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 07/30/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Within the Thai medical curriculum, its rigorous education framework, demanding schedules and high academic standards can contribute to psychological distress. Regular physical activity has consistently shown positive effects on mental health. The aim of the study was to investigate the association between exercise and psychological well-being, including depression, anxiety, and burnout, in Thai medical students, and factors related to insufficient exercise and depression. METHODS The cross-sectional study was conducted among medical students in the university hospital during 2020-2021. Participants completed self-administered questionnaires consisting of demographic data, Godin-Shephard Leisure-Time Physical Activity Questionnaire, depression screening (9Q), Thai General Health Question-28 (4 domains: somatic symptoms, anxiety and insomnia, social dysfunction, severe depression), and Maslach burnout inventory (Emotional exhaustion (EE), Depersonalization (DP), Reduced Personal Achievement (rPA). RESULTS Of the 404 participants, 50.5% were women, the mean age (SD) was 21.06 (1.8) years, and 52% were in clinical years. The prevalence of insufficient exercise was 59.6%, depression (30.2%), somatic symptoms (27.7%), anxiety (30.7%), insomnia (89.4%), social dysfunction (89.4%), high level of EE (32.4%), DP (21%), and rPA (56.7%). Insufficient exercise was associated with moderate to severe depression (OR 2.89, 95% CI 1.16-7.25), anxiety and insomnia (OR 1.56, 95% CI 1.01-2.43), social dysfunction (OR 2.51, 95% CI 1.31-4.78), burnout in part due to high rPA (OR 2.4, 95% CI 1.4-4.13), and study in clinical years (OR 1.91, 95% CI 1.28-2.87). After adjusted significant factors, only studying in the clinical year, social dysfunction, and burnout in part of rPA were related to insufficient exercise. CONCLUSIONS High rates of insufficient exercise, psychological challenges, and burnout were prevalent among medical students. To effectively address these issues, medical school should advise students to participate in regular exercise, promoting mental well-being and healthier lifestyles.
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Affiliation(s)
- Dhachdanai Dhachpramuk
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suprapath Sonjaipanich
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supparat Theppiban
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supinya In-Iw
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Manohar S. Commentary on "From Gloom to Bloom". ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:851. [PMID: 39092864 DOI: 10.1097/01.acm.0001027424.97020.5a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Affiliation(s)
- Sujal Manohar
- S. Manohar is a medical student, Baylor College of Medicine, Houston, Texas; ; ORCID: http://orcid.org/0000-0001-7128-7043
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Gbessemehlan A, Rafiou Taffa R, Galera C, Guerchet M, Adoukonou T. Prevalence and correlates of depressive symptoms among undergraduate health science students at the University of Parakou, Benin. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202525. [PMID: 38704931 DOI: 10.1016/j.jeph.2024.202525] [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: 09/20/2023] [Revised: 01/30/2024] [Accepted: 03/14/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES Research on psychological distress in African students is scarce. This study aimed at exploring the epidemiology (prevalence and correlates) of depressive symptoms among undergraduate health sciences students at the University of Parakou (Benin). METHODS We conducted a cross-sectional survey from June to July 2022 at the University of Parakou, the second-largest university in the Republic of Benin. Depressive symptoms were assessed using the Patient Health Questionnaire depression scale (PHQ-9). Information on several independent factors was collected and their associations with depressive symptoms were investigated using logistic regression models. RESULTS Data from 560 students were analyzed (mean age: 21.3± 2.3 years, 60 % were male, and 50.4 % were registered in the first year of study). The overall prevalence of depressive symptoms was 39.1 % [95 % CI: 35.2 %-43.1 %]. Moderate and severe depressive symptoms were observed in 15.3 % and 1.8 % of participants, respectively. In the multivariable model, being aged 21-23 (adjusted Odds Ratio=1.8, p-value: 0.007), a female (aOR=1.5, p-value: 0.050), a medical student (aOR=2.9, p-value: <0.001), a public health student (aOR=3.6, p-value: <0.001), belonging to households with higher incomes (aOR= 2.4, p<0.001), and experiencing stress (aOR=1.5, p-value: 0.048) independently increased the probability of having depressive symptoms. However, having support from close relatives (aOR= 0.5, p-value: 0.026) was associated with a lower probability of depressive symptoms. CONCLUSIONS Our findings revealed a high prevalence of depressive symptoms among undergraduate health science students. Given the correlates identified, actions to promote coping skills in stress and encourage more parental support may be real avenues likely to help reduce the frequency and consequences of depressive symptoms.
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Affiliation(s)
- Antoine Gbessemehlan
- University of Bordeaux, INSERM UMR 1219, Bordeaux Population Health Research Center, 33000 Bordeaux, France; University of Parakou, ENATSE - National School of Public Health and Epidemiology, Parakou, Benin.
| | - Rafath Rafiou Taffa
- University of Parakou, ENATSE - National School of Public Health and Epidemiology, Parakou, Benin
| | - Cédric Galera
- University of Bordeaux, INSERM UMR 1219, Bordeaux Population Health Research Center, 33000 Bordeaux, France; Department of Child and Adolescent Psychiatry, Charles Perrens Hospital, 33076, Bordeaux, France
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Thierry Adoukonou
- University of Parakou, ENATSE - National School of Public Health and Epidemiology, Parakou, Benin; University of Parakou, Department of Neurology, Parakou, Benin
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McKell D, Ely S, Ausel E, Bahner I, Belovich AN, Brenneman A, Brooks W, Garwood S, Habal S, Haight M, Hernandez M, Ikonne U, Porter R, Rowe R, Taylor TAH, Thesen T. Creating a Culture of Teaching and Learning. MEDICAL SCIENCE EDUCATOR 2024; 34:961-966. [PMID: 39099869 PMCID: PMC11296986 DOI: 10.1007/s40670-024-02103-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 08/06/2024]
Affiliation(s)
- Douglas McKell
- College of Population Health, Thomas Jefferson University, Philadelphia, PA USA
| | - Susan Ely
- Baylor College of Medicine, Temple, TX USA
| | - Erica Ausel
- Marian University College of Osteopathic Medicine, Indianapolis, IN USA
| | - Ingrid Bahner
- Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | | | | | - William Brooks
- University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL USA
| | - Steve Garwood
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ USA
| | - Shafik Habal
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA USA
| | - Michele Haight
- Sam Houston State University College of Medicine, Huntsville, TX USA
| | - Mark Hernandez
- Quillen College of Medicine, East Tennessee State University, Johnson City, TN USA
| | - Uzoma Ikonne
- Eastern Virginia Medical School, Norfolk, VA USA
| | - Rachel Porter
- Physician Assistant Program, Duke University, Durham, NC USA
| | - Rebecca Rowe
- College of Osteopathic Medicine, University of New England, Biddeford, ME USA
| | - Tracey A. H. Taylor
- Oakland University William Beaumont School of Medicine, Auburn Hills, MI USA
| | - Thomas Thesen
- Geisel School of Medicine, Dartmouth College, Hanover, NH USA
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Catalán L, Alvarado-Peña J, Torres-Soto G, Lorca-Sepúlveda B, Besoain-Cornejo AM, Kappes M. Second victim phenomenon among healthcare students: A scoping review. Nurse Educ Pract 2024; 79:104094. [PMID: 39146810 DOI: 10.1016/j.nepr.2024.104094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/16/2024] [Accepted: 07/31/2024] [Indexed: 08/17/2024]
Abstract
AIM This study aims to explore the "second victim" phenomenon in healthcare professions students following an adverse event. BACKGROUND In healthcare settings, adverse events affect not only patients but also the involved healthcare personnel, who experience a wide range of physical and psychological responses, a situation known as the second victim phenomenon. This phenomenon also extends to students in health-related professions during their clinical training, yet there needs to be more research specifically addressing this group. DESIGN A scoping review METHODS: This scoping review was guided by Arksey and O'Malley's methodological framework. In December 2023, we conducted a comprehensive database search in PubMed, the Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete, Web of Science (WoS), Scopus and the Virtual Health Library (VHL). The review included original research studies of any design that focused on the second victim phenomenon among students, published in English, Spanish, German or Portuguese, with no restrictions on the publication date. The review was reported according to PRISMA-ScR guidelines. RESULTS Seven studies were selected, primarily involving nursing and medical students. Common triggers of the second victim phenomenon in students were medication errors, patient falls and procedural errors. Described symptoms ranged from emotional distress, such as stress and hypervigilance, to physical symptoms, like sleep disturbances. Among the factors that influenced how this "second victim" phenomenon manifested in students were the reactions of their peers and the lack of support from supervisors. Contrary to the three possible outcomes described for professionals as second victims (surviving, thriving, or leaving), students are only described with two: giving up or moving on. CONCLUSION The studies highlighted the crucial role of peer and supervisor support in managing such difficult situations. The results suggest that additional research is necessary in other healthcare disciplines. Educational and healthcare institutions should improve their preventive and management strategies to address the phenomenon's impact on students.
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Affiliation(s)
- Lucía Catalán
- Faculty of Healthcare Sciences, Nursing School, Universidad San Sebastián, Santiago, Chile; Faculty of Nursing, Universidad Andres Bello, Santiago, Chile.
| | | | | | | | - Ana-María Besoain-Cornejo
- Faculty of Medicine & Science, Chemistry and Pharmacy School, Universidad San Sebastián, Chile; Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Institut de Recerca Sant Joan de Deu, Esplugues de Llobregat, Spain.
| | - María Kappes
- Faculty of Healthcare Sciences, Nursing School, Universidad San Sebastián, Puerto Montt, Chile.
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Calo M, Judd B, Peiris C. Grit, resilience and growth-mindset interventions in health professional students: A systematic review and meta-analysis. MEDICAL EDUCATION 2024; 58:902-919. [PMID: 38600797 DOI: 10.1111/medu.15391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Grit, resilience and a growth-mindset influence students' ability to positively adapt to the challenges of health professional training. However, it is unclear if interventions can improve these traits. This systematic review aimed to explore if interventions can improve these traits in health professional students (primary) and their impact on academic and/or wellbeing outcomes (secondary). METHODS A comprehensive search of CINAHL, MEDLINE, Eric and Embase was conducted from inception until 15 March 2023. Randomised or non-randomised controlled trials and single-group intervention studies that aimed to improve health professional students' resilience, grit and/or growth-mindset were eligible for inclusion. Two reviewers independently screened studies for inclusion and evaluated quality using the Mixed Methods Appraisal Tool. Post-intervention data from randomised and non-randomised control trials were pooled using a random-effects model to calculate standardised mean differences (SMD) and 95% confidence intervals (CIs). RESULTS Resilience interventions improved resilience by a moderate amount in 13 studies with 990 participants (pooled SMD 0.74, 95%CI 0.03 to 1.46) and a large amount when interventions were greater than one session duration in 10 trials with 740 participants (pooled SMD 0.97, 95%CI 0.08 to 1.85). Grit and growth-mindset interventions improved grit (pooled SMD 0.48, 95%CI -0.05 to 1.00, n = 2) and growth-mindset (pooled SMD 0.25, 95%CI -0.18 to 0.68, n = 2) by a small amount. Resilience interventions decreased perceived stress by a small amount (pooled SMD -0.38, 95%CI -0.62 to -0.14, n = 5). CONCLUSIONS Resilience interventions improve resilience and decrease perceived stress in health professional students. Preliminary evidence suggests grit and growth-mindset interventions may also benefit health professional students. Interventions may be most effective when they are longer than one session and targeted to students with low baseline levels of resilience and grit.
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Affiliation(s)
- Marlena Calo
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Belinda Judd
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Casey Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
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Huang F, Lu W, Zhao X, Li N, Zhao T, Guo S, Liu B, Ren R, Yang L, Wang L, Gao Y, Wang R, Song M, Lin Q, Xu Y, Jin N, Liu K, Bai M, Wang X. Suicidal ideation in medical students of Hebei province: prevalence and associated factors. Front Psychiatry 2024; 15:1398668. [PMID: 39140111 PMCID: PMC11319246 DOI: 10.3389/fpsyt.2024.1398668] [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: 03/10/2024] [Accepted: 07/08/2024] [Indexed: 08/15/2024] Open
Abstract
Objectives This study investigated the prevalence of suicidal ideation (SI) among Chinese medical students and its associated risk factors. Methods A total of 6643 medical students (2383 males/4260 females) were recruited from a medical college in Hebei Province, China. Demographic data were collected via a self-administered questionnaire. The Childhood Trauma Questionnaire Short Form (CTQ-SF) was used to evaluate childhood maltreatment (CM), and the Adolescent Self-Rating Life Events Checklist (ASLEC) was used to evaluate the stressful life events. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation (BSSI). Univariate and multivariate logistic regression models were used to analyze the factors affecting SI. Results The prevalence of SI in medical students was 11.5% (763/6643). Multivariate logistic regression analysis revealed that SI was significantly associated with younger age, a female sex, being lovelorn, being introverted, experiencing CM during childhood, and experiencing stressful life events within the past 12 months. Of the five subtypes of CM, emotional abuse may have the strongest effect on SI (OR=2.76, 95% CI: 1.72-4.42). The joint effects of CM and stressful life events were significantly associated with an increased risk of SI (OR=5.39, 95% CI: 4.15-6.98). Conclusion The prevalence of SI among medical students is high, and medical students who have experienced CM and stressful life events have a higher tendency towards SI. Screening for both CM and stressful life events may be an effective way of identifying individuals at high risk of SI.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xueyi Wang
- Mental Health Center, The First Hospital of Hebei Medical University, Hebei Clinical Medical Research Center for Mental Disorders, Shijiazhuang, China
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Regli J, Sadeghi-Bahmani D, Rigotti V, Stanga Z, Ülgür II, Fichter C, Lang UE, Brühl AB, Brand S. Psychiatric Characteristics, Symptoms of Insomnia and Depression, Emotion Regulation, and Social Activity among Swiss Medical Students. J Clin Med 2024; 13:4372. [PMID: 39124639 PMCID: PMC11313248 DOI: 10.3390/jcm13154372] [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: 06/19/2024] [Revised: 07/19/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Almost by default, young adult students are at increased risk of suffering from mental health issues, and this holds particularly true for medical students. Indeed, compared to the general population and non-medical students, medical students report higher scores for symptoms of depression. For Swiss medical students, research on the associations between psychiatric characteristics and symptoms of depression and insomnia, including cognitive-emotional processes and social activity, has been lacking so far. Given this, the aims of the present study were to relate self-declared psychiatric characteristics to symptoms of depression, insomnia, emotion regulation, and social activity. Methods: A total of 575 medical students (mean age: 22.4 years; 68.9% females) completed an online survey covering sociodemographic information (age and gender), study context (year of study), self-declared psychiatric characteristics and symptoms of depression, insomnia, emotion regulation (cognitive reappraisal vs. emotion suppression), and social activity. Data on insomnia sum scores and categories of historical samples (862 non-medical students and 533 police and emergency response service officers) were used for comparison. Results: Of the 575 participants, 190 participants (33%) self-declared psychiatric issues, such as major depressive disorder; anxiety disorders, including PTSD and adjustment disorders; eating disorders; ADHD; or a combination of such psychiatric issues. Self-reporting a psychiatric issue was related to higher symptoms of depression and insomnia and lower symptoms of social activity and cognitive reappraisal (always with significant p-values and medium effect sizes). Compared to historical data for non-medical students and police and emergency response service officers, medical students reported higher insomnia scores. In a regression model, current self-declared psychiatric issues, female gender, higher scores for insomnia, and lower scores for social activity were associated with higher scores for depression. Conclusions: Among a sample of Swiss medical students, the occurrence of self-declared psychiatric issues was associated with higher scores for depression and insomnia and lower cognitive reappraisal and social activity. Further, insomnia scores and insomnia categories were higher when compared to non-medical students and to police and emergency response service officers. The data suggest that medical schools might introduce specifically tailored intervention and support programs to mitigate medical students' mental health issues. This holds particularly true for insomnia, as standardized and online-delivered treatment programs for insomnia (eCBTi) are available.
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Affiliation(s)
- Jonas Regli
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
| | - Dena Sadeghi-Bahmani
- Department of Psychology, Stanford University, Stanford, CA 94305, USA;
- Department of Epidemiology & Population Health, Stanford University, Stanford, CA 94305, USA
| | - Viola Rigotti
- Outpatient Medical Clinic, University Hospital of Basel, 4031 Basel, Switzerland;
| | - Zeno Stanga
- Centre of Competence for Military and Disaster Medicine, Swiss Armed Forces, 3008 Bern, Switzerland; (Z.S.); (I.I.Ü.)
- Division of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, University Hospital, University of Berne, 3012 Berne, Switzerland
| | - Ismail I. Ülgür
- Centre of Competence for Military and Disaster Medicine, Swiss Armed Forces, 3008 Bern, Switzerland; (Z.S.); (I.I.Ü.)
| | - Christian Fichter
- Department of Psychology, Kalaidos University of Applied Sciences, 8050 Zurich, Switzerland;
| | - Undine E. Lang
- Adult Psychiatric Hospital of the University of Basel, 4002 Basel, Switzerland;
| | - Annette B. Brühl
- Center for Affective, Stress and Sleep Disturbances, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
| | - Serge Brand
- Center for Affective, Stress and Sleep Disturbances, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, 4052 Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 1417653761, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
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Almadani AH, Alsubaihi AA, Alsqabi HA, Alkathiri MA, Alassaf MI, Alagel OA, Alshowihi SS, Alolayan MA. Comparison of depression and anxiety in first- versus non-first generation Saudi medical students: A cross-sectional study. Medicine (Baltimore) 2024; 103:e39115. [PMID: 39058812 PMCID: PMC11272298 DOI: 10.1097/md.0000000000039115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Depression and anxiety are prevalent psychiatric illnesses worldwide. This study aimed to estimate the prevalence of these illnesses and their associated sociodemographic factors among medical students at King Saud University, Riyadh, Saudi Arabia, by comparing first- and non-first-generation students. This cross-sectional study included 367 participants. The study tool, distributed in December 2023, consisted of a questionnaire developed by the research team to assess sociodemographic factors, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder 7-Item scale (GAD-7). Among the participants, 33.5% had a first-degree relative who attended medical school. The mean GAD-7 score was 8.30 for first-generation students and 7.48 for non-first-generation students, suggesting a trend toward higher anxiety in first-generation students, although the differences between the 2 groups were not statistically significant (P = .170). The mean PHQ-9 score was 9.54 for first-generation and 8.10 for non-first-generation students (P = .042). Women had significantly higher mean scores than men on both the GAD-7 and PHQ-9 (P=<.001). First- and third-year students had the highest mean scores on both the GAD-7 and PHQ-9 (P < .001). A statistically significant (P < .001) association was observed between anxiety and depression. Future research should focus on identifying, developing, and examining interventions that target at-risk groups of medical students. Multicenter studies with more rigorous research methodologies are warranted to validate these results.
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Affiliation(s)
- Ahmad H. Almadani
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- SABIC Psychological Health Research and Applications Chair (SPHRAC), Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | - Osama A. Alagel
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Mohammad A. Alolayan
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Psychiatry, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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45
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Cotobal Rodeles S, Martín Sánchez FJ, Martínez-Selles M. [Characteristics of the new internal resident physicians from Madrid Region, their opinions regarding family and community medicine]. Semergen 2024; 50:102295. [PMID: 39053337 DOI: 10.1016/j.semerg.2024.102295] [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: 02/13/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 07/27/2024]
Abstract
AIM To evaluate the opinions of the new internal resident physicians (IRP) on family and community medicine (FCM) and professional and personal issues. METHODS Anonymous survey of 837 new IRPs in the Madrid Region. RESULTS Mean age was 25.6±3.5 years, 525 (62.7%) had a specific subject of FCM during medical school, 799 (95.5%) did FCM practices during their medical degree, and 606 (72.4%) considered relevant to be some months in FCM during their medical residence. Only 103 (12.3%) consider becoming parents during residency, 416 (49.7%) have suffered from anxiety, 99 (11.8%) from depression, and 19 (2.3%) had previous suicidal thoughts. Although 638 (76.2%) have received training in ethical decisions, 345 (41.2%) did not know how to implement these decisions, 120 (14.3%) had studied artificial intelligence and 744 (88.9%) have a positive view of the College of Physicians. CONCLUSIóN: Most new medical residents of Madrid consider a Primary Care rotation relevant during their training, but only 63% have completed specific training in FCM as an undergraduate. A total of 12% reported previous depression and half anxiety.
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Affiliation(s)
- S Cotobal Rodeles
- Servicio de Geriatría, Hospital Universitario Severo Ochoa. Leganés, Madrid, España
| | - F J Martín Sánchez
- Hospital Universitario Clínico San Carlos. Madrid, España; Facultad de Medicina, Universidad Complutense, Madrid, España
| | - M Martínez-Selles
- Facultad de Medicina, Universidad Complutense, Madrid, España; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón. CIBERCV. Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea, Madrid, España.
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46
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Sempach L, Doll JPK, Limbach V, Marzetta F, Schaub AC, Schneider E, Kettelhack C, Mählmann L, Schweinfurth-Keck N, Ibberson M, Lang UE, Schmidt A. Examining immune-inflammatory mechanisms of probiotic supplementation in depression: secondary findings from a randomized clinical trial. Transl Psychiatry 2024; 14:305. [PMID: 39048549 PMCID: PMC11269721 DOI: 10.1038/s41398-024-03030-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024] Open
Abstract
We recently indicated that four-week probiotic supplementation significantly reduced depression along with microbial and neural changes in people with depression. Here we further elucidated the biological modes of action underlying the beneficial clinical effects of probiotics by focusing on immune-inflammatory processes. The analysis included a total of N = 43 participants with depression, from which N = 19 received the probiotic supplement and N = 24 received a placebo over four weeks, in addition to treatment as usual. Blood and saliva were collected at baseline, at post-intervention (week 4) and follow-up (week 8) to assess immune-inflammatory markers (IL-1β, IL-6, CRP, MIF), gut-related hormones (ghrelin, leptin), and a stress marker (cortisol). Furthermore, transcriptomic analyses were conducted to identify differentially expressed genes. Finally, we analyzed the associations between probiotic-induced clinical and immune-inflammatory changes. We observed a significant group x time interaction for the gut hormone ghrelin, indicative of an increase in the probiotics group. Additionally, the increase in ghrelin was correlated with the decrease in depressive symptoms in the probiotics group. Transcriptomic analyses identified 51 up- and 57 down-regulated genes, which were involved in functional pathways related to enhanced immune activity. We identified a probiotic-dependent upregulation of the genes ELANE, DEFA4 and OLFM4 associated to immune activation and ghrelin concentration. These results underscore the potential of probiotic supplementation to produce biological meaningful changes in immune activation in patients with depression. Further large-scale mechanistic trials are warranted to validate and extend our understanding of immune-inflammatory measures as potential biomarkers for stratification and treatment response in depression. Trial Registration: www.clinicaltrials.gov , identifier: NCT02957591.
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Affiliation(s)
- Lukas Sempach
- Translational Neuroscience, Department of Clinical Research (DKF), University of Basel, Basel, Switzerland.
- University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland.
| | - Jessica P K Doll
- Translational Neuroscience, Department of Clinical Research (DKF), University of Basel, Basel, Switzerland
- University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
| | - Verena Limbach
- Translational Neuroscience, Department of Clinical Research (DKF), University of Basel, Basel, Switzerland
- University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
| | - Flavia Marzetta
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Anna-Chiara Schaub
- University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
- Translational Psychiatry, Department of Clinical Research (DKF), University of Basel, Basel, Switzerland
| | - Else Schneider
- University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
- Experimental Cognitive and Clinical Affective Neuroscience (ECAN) Laboratory, Department of Clinical Research (DKF), University of Basel, Basel, Switzerland
| | - Cedric Kettelhack
- University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
| | - Laura Mählmann
- University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
| | | | - Mark Ibberson
- Vital-IT Group, SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Undine E Lang
- University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
| | - André Schmidt
- Translational Neuroscience, Department of Clinical Research (DKF), University of Basel, Basel, Switzerland
- University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
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Kristoffersson E, Boman J, Bitar A. Impostor phenomenon and its association with resilience in medical education - a questionnaire study among Swedish medical students. BMC MEDICAL EDUCATION 2024; 24:782. [PMID: 39030556 PMCID: PMC11264822 DOI: 10.1186/s12909-024-05788-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Concern over medical students' well-being is a global issue, with studies showing high psychological distress rates. Impostor Phenomenon (IP), i.e., underestimating one's abilities, attributing success to external factors, and feeling like a fraud, has been implicated as one reason behind these troubling findings. Meanwhile, resilience has been suggested to protect against psychological distress. This study aimed to investigate the prevalence of IP and its association with resilience among undergraduate medical students. METHODS The Clance Impostor Phenomenon Scale (CIPS), the Brief Resilience Scale (BRS), and sociodemographic questions were completed by 457 medical students registered in their 2-10th semester at a Swedish university. Of the respondents, 62.6% identified as women, 36.1% as men, and 1.3% as others. RESULTS The prevalence of IP was 58.4% (defined as CIPS score ≥ 62). According to the CIPS scoring guidelines, 10.3% of participants had low IP, 29.5% moderate, 41.6% frequent, and 18.6% intense IP. Of all participants, almost 90% experienced at least moderate and 60.2% frequent to intense IP. Women had significantly higher CIPS scores and lower BRS scores than men. In contrast, neither attending semester nor age group significantly impacted CIPS scores. Finally, there was a moderate inverse correlation between the level of resilience and the prevalence of IP. CONCLUSIONS Our findings suggest that the majority of Swedish medical students feels like an impostor, and of these students, most do so frequently. Furthermore, IP is more prevalent among female students - who also show lower levels of resilience. Moreover, our results indicated that IP could hinder achieving higher resilience. Future longitudinal studies should investigate how gender norms may contribute to IP feelings and explore the potential advantages of counteracting IP and strengthening resilience among medical students. However, targeted interventions addressing individual students' IP and resilience are insufficient. There is also a need to address structural aspects of the educational environment, such as gender stereotypes, that may contribute to IP.
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Affiliation(s)
- Emelie Kristoffersson
- Department of Clinical Science, Professional Development, Umeå University, Umeå, 901 87, Sweden
| | - Jens Boman
- Department of Clinical Science, Professional Development, Umeå University, Umeå, 901 87, Sweden
| | - Aziz Bitar
- Department of Clinical Science, Professional Development, Umeå University, Umeå, 901 87, Sweden.
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Li Y, Lin Y, Ou C, Xu R, Liu T, Zhong Z, Liu L, Zheng Y, Hou S, Lv Z, Huang S, Duan YG, Wang Q, Zhang X, Liu Y. Association between body mass index and semen quality: a systematic review and meta-analysis. Int J Obes (Lond) 2024:10.1038/s41366-024-01580-w. [PMID: 39003321 DOI: 10.1038/s41366-024-01580-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 06/23/2024] [Accepted: 07/02/2024] [Indexed: 07/15/2024]
Abstract
The continuous decline of human semen quality during the past decades has drawn much concern globally. Previous studies have suggested a link between abnormal BMI and semen quality decline, but the results remain inconsistent. This systematic review and meta-analysis aimed to evaluate the association between body mass index (BMI) and semen quality. We searched PubMed, Embase, and Web of Science for eligible studies from inception to April 17, 2022. We considered men with BMI < 25.0 kg/m2 as the reference and calculated the pooled weighted mean difference of men with overweight (BMI 25.0-29.9 kg/m2), obesity (BMI ≥ 30.0 kg/m2), class I obesity (BMI 30.0-34.9 kg/m2), and class II/III obesity (BMI ≥ 35.0 kg/m2). A total of 5070 articles were identified, of which 50 studies were included (71,337 subjects). Compared with men with BMI < 25.0 kg/m2, men with obesity had an average reduction of 0.24 ml in semen volume, 19.56 × 106 in total sperm number, 2.21% in total motility, 5.95% in progressive motility, and 1.08% in normal forms, respectively, while men with overweight had an average reduction of 0.08 ml in semen volume and 2.91% in progressive motility, respectively. The reduction of semen quality was more pronounced among men with obesity than that among men with overweight. Moreover, significant reductions in semen quality were identified in men with different classes of obesity, which were more pronounced in men with class II/III obesity than that in men with class I obesity. Across men from the general population, infertile or subfertile men, and suspiciously subfertile men, we identified significant semen quality reductions in men with obesity/overweight. In conclusion, obesity and overweight were significantly associated with semen quality reductions, suggesting that maintaining normal weight may help prevent semen quality decline.
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Affiliation(s)
- Yingxin Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yi Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Changkui Ou
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tingting Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zihua Zhong
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Likun Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yi Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Sihan Hou
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ziquan Lv
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Suli Huang
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Yong-Gang Duan
- Shenzhen Key Laboratory of Fertility Regulation, Centre of Assisted Reproduction and Embryology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Qiling Wang
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute, Guangdong Provincial Fertility Hospital, Guangzhou, Guangdong, China
| | - Xinzong Zhang
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute, Guangdong Provincial Fertility Hospital, Guangzhou, Guangdong, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Luo W, Fan W, Xia Y, Dou Y, Du J. Professional psychological qualities of Chinese medical students: theoretical models, questionnaire development, and relationship with mental health. Front Psychol 2024; 15:1411085. [PMID: 39035093 PMCID: PMC11258856 DOI: 10.3389/fpsyg.2024.1411085] [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] [Received: 04/02/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Professional psychological qualities are crucial for individuals' career development and overall well-being, especially in clinical medical professions. Medical students often face significant work, academic, and doctor-patient communication pressures, which can challenge their mental and emotional health. Measuring and understanding the relationship between medical students' professional psychological qualities and their mental health is of significant practical importance. Methods This study developed a comprehensive professional psychological qualities scale through a series of qualitative and quantitative studies, consisting of three main components and thirteen secondary dimensions. The scale's reliability was assessed using Cronbach's α coefficients. In Study 2, the scale was administered to 972 medical students to explore their anxiety and depression levels. A simple mediation analysis was conducted to investigate the relationship between professional psychological qualities, anxiety, and depression. Results The professional psychological qualities scale demonstrated satisfactory reliability, with a total scale α coefficient of 0.947 and subscale α coefficients ranging from 0.895 to 0.933. The mediation analysis revealed that medical students' professional psychological qualities directly negatively impact depression levels and indirectly positively influence them via their effects on anxiety levels, exhibiting an overall masking effect unrelated to depression levels. Discussion This study addresses the gap in research on the professional psychological qualities of medical students by providing a reliable measurement tool. The findings shed light on the complex mechanisms through which these qualities impact the mental health process. The scale can be used by other researchers to assess medical students' professional psychological qualities and further investigate their relationship with mental health outcomes.
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Affiliation(s)
- Wenping Luo
- School of Clinical Medicine/Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenshu Fan
- Mental Health Education Center for College Students, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yanglin Xia
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yanchun Dou
- Mianyang Maternal and Child Health Hospital, Mianyang, China
| | - Juan Du
- Mental Health Education Center for College Students, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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50
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Golafshani M, Buchman DZ, Husain MI. Disability rights and experiential use of psychedelics in clinical research and practice. NPJ MENTAL HEALTH RESEARCH 2024; 3:34. [PMID: 38956331 PMCID: PMC11219775 DOI: 10.1038/s44184-024-00065-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/01/2024] [Indexed: 07/04/2024]
Affiliation(s)
- Maryam Golafshani
- MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Daniel Z Buchman
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - M Ishrat Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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