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Naillon PL, Flaudias V, Brousse G, Laporte C, Baker JS, Brusseau V, Comptour A, Zak M, Bouillon-Minois JB, Dutheil F. Cannabis Use in Physicians: A Systematic Review and Meta-Analysis. MEDICINES (BASEL, SWITZERLAND) 2023; 10:medicines10050029. [PMID: 37233605 DOI: 10.3390/medicines10050029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023]
Abstract
Background: Cannabis use by physicians can be detrimental for them and their patients. We conducted a systematic review and meta-analysis on the prevalence of cannabis use by medical doctors (MDs)/students. Method: PubMed, Cochrane, Embase, PsycInfo and ScienceDirect were searched for studies reporting cannabis use in MDs/students. For each frequency of use (lifetime/past year/past month/daily), we stratified a random effect meta-analysis depending on specialties, education level, continents, and periods of time, which were further compared using meta-regressions. Results: We included 54 studies with a total of 42,936 MDs/students: 20,267 MDs, 20,063 medical students, and 1976 residents. Overall, 37% had used cannabis at least once over their lifetime, 14% over the past year, 8% over the past month and 1.1 per thousand (‱) had a daily use. Medical students had a greater cannabis use than MDs over their lifetime (38% vs. 35%, p < 0.001), the past year (24% vs. 5%, p < 0.001), and the past month (10% vs. 2%, p < 0.05), without significance for daily use (0.5% vs. 0.05%, NS). Insufficient data precluded comparisons among medical specialties. MDs/students from Asian countries seemed to have the lowest cannabis use: 16% over their lifetime, 10% in the past year, 1% in the past month, and 0.4% daily. Regarding periods of time, cannabis use seems to follow a U-shape, with a high use before 1990, followed by a decrease between 1990 and 2005, and a rebound after 2005. Younger and male MDs/students had the highest cannabis use. Conclusions: If more than a third of MDs tried cannabis at least once in their lifetime, this means its daily use is low but not uncommon (1.1‱). Medical students are the biggest cannabis users. Despite being common worldwide, cannabis use is predominant in the West, with a rebound since 2005 making salient those public health interventions during the early stage of medical studies.
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Affiliation(s)
- Pierre-Louis Naillon
- Université Clermont Auvergne, CNRS, LaPSCo, CHU Clermont-Ferrand, WittyFit, F-63000 Clermont-Ferrand, France
| | - Valentin Flaudias
- Université de Nantes, Laboratoire de Psychologie des Pays de la Loire, LPPL, F-44000 Nantes, France
| | - Georges Brousse
- Université Clermont Auvergne, NPsy-Sydo, CHU Clermont-Ferrand, Addiction, F-63000 Clermont-Ferrand, France
| | - Catherine Laporte
- Université Clermont Auvergne, Clermont Auvergne INP, CNRS, Institut Pascal, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Julien S Baker
- Sport and Physical Education, Hong Kong Baptist University, Kowloon CN-99230, Hong Kong
| | - Valentin Brusseau
- Université Clermont Auvergne, CHU Clermont-Ferrand, Endocrinology Diabetology and Metabolic Diseases, F-63000 Clermont-Ferrand, France
| | - Aurélie Comptour
- INSERM, CIC 1405 CRECHE Unit, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France
| | - Marek Zak
- Institute of Health Sciences, The Jan Kochanowski University of Kielce, P-25-002 Kielce, Poland
| | | | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, CHU Clermont-Ferrand, WittyFit, F-63000 Clermont-Ferrand, France
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Wadi MM, Yusoff MSB, Taha MH, Shorbagi S, Nik Lah NAZ, Abdul Rahim AF. The framework of Systematic Assessment for Resilience (SAR): development and validation. BMC MEDICAL EDUCATION 2023; 23:213. [PMID: 37016407 PMCID: PMC10073620 DOI: 10.1186/s12909-023-04177-5] [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: 07/24/2022] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Burnout and depression among health professions education (HPE) students continue to rise, leading to unwanted effects that ultimately jeopardise optimal medical care and patient health. Promoting the resilience of medical students is one solution to this issue. Several interventions have been implemented to foster resilience, but they focus on aspects other than the primary cause: the assessment system. The purpose of this study is to develop a framework to promote resilience in assessment planning and practice. METHODS We followed the guidelines suggested by Whetten for constructing a theoretical model for framework development. There were four phases in the model development. In the first phase, different literature review methods were used, and additional students' perspectives were collected through focus group discussions. Then, using the data, we constructed the theoretical model in the second phase. In the third phase, we validated the newly developed model and its related guidelines. Finally, we performed response process validation of the model with a group of medical teachers. RESULTS The developed systematic assessment resilience framework (SAR) promotes four constructs: self-control, management, engagement, and growth, through five phases of assessment: assessment experience, assessment direction, assessment preparation, examiner focus, and student reflection. Each phase contains a number of practical guidelines to promote resilience. We rigorously triangulated each approach with its theoretical foundations and evaluated it on the basis of its content and process. The model showed high levels of content and face validity. CONCLUSIONS The SAR model offers a novel guideline for fostering resilience through assessment planning and practice. It includes a number of attainable and practical guidelines for enhancing resilience. In addition, it opens a new horizon for HPE students' future use of this framework in the new normal condition (post COVID 19).
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Affiliation(s)
- Majed Mohammed Wadi
- Medical Education Department, College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Muhamad Saiful Bahri Yusoff
- Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Mohamed Hassan Taha
- College of Medicine and Center of Medical Education, University of Sharjah, Sharjah, United Arab Emirates
| | - Sarra Shorbagi
- Department of Family and Community Medicine and Behavioral Science, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Nik Ahmad Zuky Nik Lah
- Obstetrics and Gynecology Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Ahmad Fuad Abdul Rahim
- Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
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Rudrakumar S, Varshney N, Taylor RD. Medical student perspectives on substance misuse education in the medical undergraduate programme: a grounded theory approach. BMC MEDICAL EDUCATION 2023; 23:205. [PMID: 37009901 PMCID: PMC10068233 DOI: 10.1186/s12909-023-04145-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Substance misuse teaching within the undergraduate medical curriculum has been underrepresented compared to more traditional medical topics. In response several national curriculum reviews such as the most recent UK department of health initiative (DOH) have identified deficiencies in substance misuse education and have suggested curriculum interventions for local faculties to implement. The student perspective however has largely been muted during this process and this study aims to explore this using a constructivist grounded theory approach. METHODS Eleven final year and intercalating medical students across three separate focus groups participated in this study over a three-month period commencing from March 2018. Time between the audio recorded focus groups allowed for a parallel process of data collection and analysis into more focussed codes and categories to occur, consistent with the grounded theory approach. The qualitative study took place in a single medical school in the UK. RESULTS Medical students had a common consensus that substance misuse education was an underperforming subject in their curriculum, from limited teaching hours to curriculum design and organisational problems. Students identified an alternative curriculum is required to not only prepare students for their future clinical duties but also their own personal lives. Students highlighted this proximity to a 'dangerous world' where exposure to substance misuse risks were faced daily. This exposure also provided a source of informal learning experiences which students deemed as being potentially unbalanced and even dangerous. Students also identified unique barriers to curriculum change with reference to a lack of openness due to the impacts of disclosure in substance misuse. CONCLUSION Large scale curriculum initiatives appear to correspond to the student voice obtained in this study, providing backing for the implementation of a co-ordinated substance misuse curriculum within medical schools. The student voice however provides an alternative lens by outlining how substance misuse pervades into students' lives and how informal learning is a largely underestimated hidden source of learning with more dangers than benefits. This together with the identification of further barriers to curriculum change, provide space for medical faculties to incorporate and work with students to facilitate local level curriculum changes relating to substance misuse education.
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Boden M, Day E. Illicit drug use in university students in the UK and Ireland: a PRISMA-guided scoping review. Subst Abuse Treat Prev Policy 2023; 18:18. [PMID: 36915093 PMCID: PMC10012457 DOI: 10.1186/s13011-023-00526-1] [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: 01/10/2023] [Accepted: 03/05/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Interest in the health and well-being of university students has increased in the UK and Ireland in the past two decades as their numbers have grown. Recent high-profile deaths of students after using illicit drugs have highlighted the importance of the topic for policy makers. This scoping review maps the state of the existing literature evaluating use of illicit drugs in university students in the UK and Ireland. It aims to highlight research gaps and inform policy. METHOD We conducted a systematic search of papers related to psychoactive drug use in university students in the UK and Ireland published before August 2021. The 18 extracted study characteristics included author(s); year of publication; journal; location of data collection; study design; delivery method (e.g., online survey, in-person, postal survey); number of participants; response rate; participant course of study, year of study, degree level (i.e., undergraduate, postgraduate), gender and age; time-period assessed (e.g., lifetime, current use, past 12 months); primary aim; primary outcome; ethical approval; and funding source. RESULTS The PRISMA-guided search strategy identified 1583 papers for abstract review; of 110 papers retained for full-text review, 54 studies met criteria for inclusion for this paper. Primary outcomes were coded into five groups: prevalence and patterns of drug use; factors associated with drug use; attitudes and knowledge about, and motivation for, drug use; supply of drugs; consequences of drug use. The results show that there is no coherent body of research in this area. The prevalence of reported drug use has crept up and the range of substances reported has broadened over time, and attitudes to drugs on average have normalised. However, there are significant methodological limitations that limit the utility of these findings. There was little evidence of published work on prevention of, or intervention to reduce, drug-related harms. CONCLUSION The domains identified offer a framework for university administrators, researchers and policy makers to understand the potential response to drug use in university students in the UK and Ireland. Recommendations are made to fill the gaps in the research evidence base.
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Affiliation(s)
- Maeve Boden
- University of Birmingham, Institute for Mental Health, School of Psychology, 52 Pritchatts Road, Edgbaston, Birmingham, B152TT, UK
| | - Ed Day
- University of Birmingham, Institute for Mental Health, School of Psychology, 52 Pritchatts Road, Edgbaston, Birmingham, B152TT, UK.
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Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM. Effective coping strategies utilised by medical students for mental health disorders during undergraduate medical education-a scoping review. BMC MEDICAL EDUCATION 2022; 22:121. [PMID: 35193564 PMCID: PMC8863569 DOI: 10.1186/s12909-022-03185-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/16/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Coping denotes cognitive, emotional and behavioural struggles to tackle a troubled person-environment association. Therefore, coping strategies (CSs) are vital for mental well-being. Widespread research studies have explored this domain, targeting caregivers, nurses, physicians and medical teachers, but limited research has been done to explore the common CSs utilised by medical students at the undergraduate medical education level. Therefore, we aimed to identify the frequently occurring CSs and their effects on mental health disorders (MHDs) through the evidence available in the existing literature. METHODS For this scoping review, we searched the available literature (articles published from January 1, 1986, to March 31, 2021) on CSs at Google Scholar, PubMed and Scopus using the terms coping, medical students and undergraduate medical education. We included in our search all peer-reviewed journal articles whose central topics were the CSs employed by undergraduate medical students of any age, nationality, race and gender. RESULTS From among the 2,134 articles that were found, 24 were ultimately included in the study. The articles were authored in 14 countries, allowing us to gather broader data to answer our research question. The first identified theme (MHDs) had four subthemes: stress (55% of the articles), depression (30%), anxiety (25%) and burnout (15%). The second theme (CSs), on the other hand, had eight subthemes: support seeking (60%), active coping (40%), acceptance (40%), avoidance/denial (40%), substance abuse (35%), faith/religion (25%), sports (25%) and miscellaneous (40%). CONCLUSIONS Themes and subthemes were identified about the most common CSs utilised by undergraduate medical students to tackle common MHDs in the context of medical education. Among the most used CSs was support (social and emotional) seeking. Teaching medical students how to cope with challenging times is essential.
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Affiliation(s)
- Kamran Sattar
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Wan Nor Arifin
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Mohd Zarawi Mat Nor
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Wadi M, Yusoff MSB, Abdul Rahim AF, Lah NAZN. Factors affecting test anxiety: a qualitative analysis of medical students' views. BMC Psychol 2022; 10:8. [PMID: 34991718 PMCID: PMC8739979 DOI: 10.1186/s40359-021-00715-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/29/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Medical students are vulnerable to test anxiety (TA), which impacts their professional lives and jeopardizes the optimal health care of their patients. The qualitative exploration of TA among medical students is crucial to understanding the problem. Hence, this study examined medical students' insights into TA and their suggestions on how to reduce it. METHODS We conducted a phenomenological study on medical students at a public university. We utilized focus group discussions (FGDs) to investigate their experiences of TA. The FGDs were transcribed verbatim, and these transcripts were analyzed using Atlas.ti software. The thematic analysis followed the recommended guidelines. RESULTS Seven FGD sessions were conducted with 45 students. Three major themes emerged: the students, their academic resources, and the examiner. Each theme comprised mutually exclusive subthemes. The "students" theme was divided into negative vs. positive thoughts and self-negligence vs. self-care, "academic recources" into heavy curriculum vs. facilitative curricular aids, and "examiner" into criticism vs. feedback and strict vs. kind approaches. CONCLUSION This study provides a solid foundation for policymakers and decision makers in medical education to improve current assessment practices and student well-being. Medical students will be able to significantly alter and reduce TA if they are provided with additional psychological support and their examiners are trained on how to deal with examinees.
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Affiliation(s)
- Majed Wadi
- Medical Education Department, College of Medicine, Qassim University, Buraidah, Saudi Arabia
- Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Muhamad Saiful Bahri Yusoff
- Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Ahmad Fuad Abdul Rahim
- Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
| | - Nik Ahmad Zuky Nik Lah
- Obstetrics and Gynecology Department, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia
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Alcohol-Related Behaviour in Freshmen University Students in Sardinia, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137203. [PMID: 34281140 PMCID: PMC8297276 DOI: 10.3390/ijerph18137203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 12/04/2022]
Abstract
This study aims to provide a picture of University of Cagliari students’ alcohol-related behaviour and to explore factors associated with it. Data were collected by administering a questionnaire to 992 freshmen university students from different programs consisting of twelve closed questions, including three questions from the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C short form). Three subgroups of alcohol-related behaviour were distinguished (risky drinkers, social drinkers and abstainers). In order to explore factors associated with patterns of alcohol consumption, a multivariate logistic regression was performed. The prevalence of risky drinkers was 35%. A binge-drinking behaviour at least once in the last twelve months was declared by 65% (more widespread in men and in students living away from their parents). Risky consumption is significantly associated with age of onset of alcohol use, living away from parents’ home, drinking outside meals and attending health courses. Regarding the levels of daily alcohol consumption perceived as a health risk, 66% of men and 88% of women indicate values higher than those recommended. The results underline the need for tailored prevention measures. University could be a promising setting to implement actions according to a health promotion perspective, to empower students to control their alcohol consumption.
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Wang Q, Du T. Implementation of the college student mental health education course (CSMHEC) in undergraduate medical curriculum: effects and insights. BMC MEDICAL EDUCATION 2020; 20:505. [PMID: 33308205 PMCID: PMC7731140 DOI: 10.1186/s12909-020-02438-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 12/08/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Extant literature reveals that medical students suffer from various mental health problems in the process of learning medicine. However, there are few studies evaluating the implementation of a mental health education course in medical curriculum. The current study aimed to test the effectiveness of an 8-week intensive mental health education course, the College Student Mental Health Education Course (CSMHEC), and to gain further insights on how the course could be improved from students' feedback. METHODS This is a quasi-experimental study with both quantitative and qualitative analyses. We recruited 374 first year medical students as our subjects with 188 (age = 17.97 ± 0.65 years, 37.2% male) for the experiment group and 186 (age = 18.02 ± 0.63 years, 40.3% male) for the control group. For quantitative analysis, Depression Anxiety Stress Scales-21 (DASS-21), Chinese College Student Academic Burnout Inventory (CCSABI) and Satisfaction With Life Scale (SWLS) were used and a 5-point Likert scale was used to indicate students' overall satisfaction with CSMHEC. For qualitative analysis, a thematic analysis method was adopted to gain insights from the feedback of medical students. RESULTS Medical students in the experiment group saw a significant decline in psychological distress (p < 0.001, d = 0.31) and academic burnout (p < 0.001, d = 1.46), while they experienced a significant increase in life satisfaction levels after the intervention (p < 0.001, d = 0.48). Compared with students in the control group, students in the experiment group had statistically significant lower levels of psychological distress (p < 0.05, d = 0.23) and academic burnout (p < 0.001, d = 0.70), but statistically significant higher levels of life satisfaction in the post-test (p < 0.01, d = 0.31). Most students in the experiment group were satisfied with CSMHEC and themes extracted in the thematic analysis shed light on how the course could be improved. CONCLUSIONS Implementing a mental health education course like CSMHEC in medical curriculum can be effective in helping medical students improve psychological health. More research needs to be conducted on further refinement and better design of such a course to implement in medical education.
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Affiliation(s)
- Qinghua Wang
- English Department, School of Fundamental Sciences, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Tianjiao Du
- Department of Psychology, School of Humanities and Social Sciences, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
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Steiner-Hofbauer V, Holzinger A. How to Cope with the Challenges of Medical Education? Stress, Depression, and Coping in Undergraduate Medical Students. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:380-387. [PMID: 32080825 PMCID: PMC7359127 DOI: 10.1007/s40596-020-01193-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/31/2020] [Indexed: 05/06/2023]
Abstract
OBJECTIVES Up to 90% of medical students experience stress. Studies have observed a relationship between stress and depression. Coping strategies to deal with stress and depression are of great interest. This study aimed to evaluate the prevalence of stress and depression and the efficacy of coping strategies in undergraduate medical students. METHODS This survey was conducted with 589 second-year and sixth-year students in 2017 at the Medical University of Vienna. The questionnaire included a stress and coping questionnaire, depression screening, substance use questionnaire, and questionnaire concerning leisure time activities. RESULTS The coping strategies were included in a regression model to assess their predictive value for stress and depression screening scores. The most common stressor was performance pressure overload (92.1%). Overall, 52.4% of the participating students reached critical scores in the depression screening. Positive thinking and active coping were associated with lower stress scores. Positive thinking also was a protective factor against depressive symptoms. Less than 2% of all students reached high-risk values for substance use. CONCLUSION Accessible counseling for students in need of psychological care should be provided. Different interventions of positive psychology showed a positive impact on depression screening scores.
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Affiliation(s)
| | - Anita Holzinger
- Medical University Vienna/Medizinische Universität Wien, Vienna, Austria
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Prevalence and Socio-Demographic, Academic, Health and Lifestyle Predictors of Illicit Drug/s Use among University Undergraduate Students in Finland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145094. [PMID: 32679701 PMCID: PMC7400316 DOI: 10.3390/ijerph17145094] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 12/13/2022]
Abstract
Illicit drug/s use (IDU) among university students is a public health concern. We assessed the associations between socio-demographic, academic, and health and lifestyle characteristics (independent variables) and regular, occasional or never IDU (dependent variables). Data were collected across seven faculties (1177 students) at the University of Turku (Finland) via an online questionnaire. About 1.5% of the sample had regular IDU, 19% occasional IDU, and 79% never IDU. Independent predictors of ever (lifetime) IDU included males [adjusted odds ratio (AOR) 1.82, P = 0.001], not living with parents (AOR 2.59, P < 0.001), singles (AOR 0.51, P < 0.001), lower religiosity (AOR 1.49, P = 0.022), better self-rated general health (AOR 0.41, P = 0.003), higher health awareness (AOR 1.93, P = 0.014), more depressive symptoms (AOR 1.82, P = 0.004), daily smokers (AOR 3.69, P < 0.001), heavy episodic drinking (AOR 2.38, P < 0.001) and possible alcohol dependency (AOR 2.55, P < 0.001). We observed no independent associations between ever IDU with age, study discipline, perceived stress or academic performance. The 20.5% ever IDU is concerning. The compelling independent predictors of ever IDU included not living with parents, lower religiosity, daily smokers, heavy episodic drinking and possible alcohol dependency (AOR range 2.38-3.69). Education and prevention need to emphasize the negative consequences to reinforce abstinence from IDU. Health promotion could focus on beliefs and expectations about IDU and target students at risk for successful efforts.
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Thiemann P, Brimicombe J, Benson J, Quince T. When investigating depression and anxiety in undergraduate medical students timing of assessment is an important factor - a multicentre cross-sectional study. BMC MEDICAL EDUCATION 2020; 20:125. [PMID: 32326926 PMCID: PMC7181528 DOI: 10.1186/s12909-020-02029-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/01/2020] [Indexed: 05/30/2023]
Abstract
BACKGROUND Symptoms of depression and anxiety experienced by undergraduate medical students have become a prominent concern. Evidence about students' depression and anxiety including prevalence, trajectory during medical education, gender differences and comparisons with age-matched peers is conflicting. However few studies of medical students' mental health specify the precise time of assessment. Proximity to examinations may be relevant. Precise identification of the time of data collection might help explain contradictory findings and facilitate provision of more timely support. METHODS This study addressed whether: 1)Proximity of final examinations affected students' depression and anxiety symptoms2)Males and females differed in this respect. We analysed data provided by 446 final year students from 6 UK medical schools. These students were a subset of data provided by 14 UK medical schools which participated in an online survey comparing first and final year students and in which final year response rates exceeded 30%. We used the Hospital Anxiety and Depression Scale to assess symptoms of depression and anxiety and the norms to indicate potentially clinically relevant cases. We grouped students into those for whom final exams were imminent i.e. within 2 months of completing the survey (n = 164) and those for whom exams were more distant or had been taken (n = 282). We used parametric and non-parametric tests to compare both groups and gender differences in respect of depression and anxiety sum scores and cases rates. RESULTS For both depression and anxiety male and female students facing imminent final exams recorded greater prevalence and significantly higher mean scores. The effect size of differences for anxiety were large. No substantial gender differences were found for depression. Regardless of the timing of final exams female students recorded both significantly higher mean scores and clinically relevant rates for anxiety. CONCLUSIONS Proximity to final exams negatively affected the mental health of both male and female final year students. The study suggests that there may be times in the undergraduate medical curriculum when additional or targeted support is needed. It also highlights the need for research to provide a greater specificity of context when investigating medical students' mental health.
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Affiliation(s)
- Pia Thiemann
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - James Brimicombe
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - John Benson
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thelma Quince
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Tangiisuran B, Kalaithasan A, Cin Tye S, Abd. Aziz F. Prevalence, factors associated and coping strategies of stress among pharmacy students in a public university in Malaysia. ACTA ACUST UNITED AC 2020. [DOI: 10.15406/ppij.2020.08.00281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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13
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Heradstveit O, Skogen JC, Edland-Gryt M, Hesse M, Vallentin-Holbech L, Lønning KJ, Sivertsen B. Self-Reported Illicit Drug Use Among Norwegian University and College Students. Associations With Age, Gender, and Geography. Front Psychiatry 2020; 11:543507. [PMID: 33362594 PMCID: PMC7758438 DOI: 10.3389/fpsyt.2020.543507] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 11/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: Several studies have pointed to relatively high levels of illicit drug use among students in higher education compared to the general population. The aim of the present study was to provide an updated examination of self-reported illicit drug use among Norwegian University and college students. Methods: Data stem from the SHoT study (Students' Health and Well-being Study), a nationwide cross-sectional survey for higher education in Norway including Norwegian full-time students aged 18-35. Self-reported illicit drug use across a range of specified drugs comprised the outcome variables. Information on gender, age, and study location (geographical area) was also collected and used as stratification variables. The SHoT-survey from 2018 (N = 50,054) was used for the analyses of associations between demographical variables and illicit drug use, while trends in illicit drug use were estimated by comparing the 2018-results with data from the SHoT-surveys conducted in 2010 and 2014. Results: The proportion of students reporting having ever tried illicit drugs increased from 2014 to 2018, for both males (30.8 vs. 36.7%) and females (17.5 vs. 24.0%, both p < 0.001), while only minimal changes occurred between 2010 and 2014. The most commonly used illicit drugs during the past 12 months in 2018 were cannabis (15.2%), followed by MDMA (4.0%), cocaine (3.0%), and LSD/psilocybin (2.1%). Illicit drug use showed both linear increase with age, and inverted U-shaped relationships that peaked in the age span from 23 to 28 years of age. Males reported higher illicit drug use compared with females for all drugs. Proportions of illicit drug use varied across geographical areas within the country, with the highest use being reported in the Oslo area (the largest city and capital of Norway). Conclusions: The present study reports an increase from 2010 to 2018 among Norwegian University and college students in the proportion of those reporting to have tried illicit drugs. Despite varying proportions of use across type of drug, age, gender, and geographical location, the overall high levels of illicit drug use past 12 months confirm the need to address illicit drug use in this population.
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Affiliation(s)
- Ove Heradstveit
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway.,Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Jens Christoffer Skogen
- Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Marit Edland-Gryt
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Morten Hesse
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Lotte Vallentin-Holbech
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Kari-Jussie Lønning
- Norwegian Medical Association, Oslo, Norway.,The Student Welfare Association of Oslo and Akershus (SiO), Oslo, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152735. [PMID: 31370266 PMCID: PMC6696211 DOI: 10.3390/ijerph16152735] [Citation(s) in RCA: 304] [Impact Index Per Article: 60.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 12/11/2022]
Abstract
Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2–38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety—a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.
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Gibson TM, Loza-Herrero MA, Yepes JF, Kim-Berman H, Dilbone DA, Perez H. Mandatory Drug Testing of Dental Students: To Test or Not to Test: Viewpoint 1: Drug Testing of Dental Students Should Be Mandatory for the Benefit of Students, Institutions, Patients, and the Profession and Viewpoint 2: Mandatory Drug Testing of Dental Students Carries Costs and Risks for Institutions and Students and Has Unproven Benefits. J Dent Educ 2019; 83:924-934. [PMID: 31010888 DOI: 10.21815/jde.019.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 12/07/2018] [Indexed: 11/20/2022]
Abstract
An educational institution's decision to test or not test its students for drug use is controversial and complex. Although negative consequences of substance use disorder are well known, the consumption of prohibited substances continues to increase in young adults. Given the awareness of increasing drug use on college campuses and the potential impact on future health care professionals, issues associated with mandatory drug testing of dental students warrant investigation. The purpose of this Point/Counterpoint article is to present opposing viewpoints on whether mandatory student drug testing (MSDT) should be implemented for dental students. Viewpoint 1 affirms that MSDT is legal, ensures public safety, is recognized as a need in health care education, promotes professional and ethical responsibility, and is cost-effective. Viewpoint 2 asserts that MSDT has not been proven to be an effective deterrent for student drug use and it poses risks and costs for both institutions and students, ranging from potential violation of students' civil liberties to the consequences of false positive tests. This article's presentation of the recent literature on both sides of this issue provides dental educators with pertinent information for considering implementation of MSDT in their institutions.
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Affiliation(s)
- Tanya Marie Gibson
- Tanya Marie Gibson, DDS, is Assistant Professor, Department of Oral Pathology, Radiology, and Medicine, University of Missouri-Kansas City School of Dentistry; Maria A. Loza-Herrero, DMD, MS, is Professor, Department of Restorative Sciences, Prosthodontics Section, University of Puerto Rico School of Dental Medicine; Juan F. Yepes, DDS, MD, MPH, MS, DrPH, is Associate Professor, Department of Pediatric Dentistry, Indiana University School of Dentistry; Hera Kim-Berman, DDS, MMSc, is Clinical Assistant Professor and Program Director, Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry; Deborah A. Dilbone, DMD, is Clinical Associate Professor and Chair, Department of Restorative Dental Sciences, University of Florida College of Dentistry; and Herminio Perez, DMD, MBA, is Clinical Assistant Professor, Department of Restorative Dentistry, and Director of Student Affairs, Diversity, and Inclusion, Rutgers School of Dental Medicine.
| | - Maria A Loza-Herrero
- Tanya Marie Gibson, DDS, is Assistant Professor, Department of Oral Pathology, Radiology, and Medicine, University of Missouri-Kansas City School of Dentistry; Maria A. Loza-Herrero, DMD, MS, is Professor, Department of Restorative Sciences, Prosthodontics Section, University of Puerto Rico School of Dental Medicine; Juan F. Yepes, DDS, MD, MPH, MS, DrPH, is Associate Professor, Department of Pediatric Dentistry, Indiana University School of Dentistry; Hera Kim-Berman, DDS, MMSc, is Clinical Assistant Professor and Program Director, Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry; Deborah A. Dilbone, DMD, is Clinical Associate Professor and Chair, Department of Restorative Dental Sciences, University of Florida College of Dentistry; and Herminio Perez, DMD, MBA, is Clinical Assistant Professor, Department of Restorative Dentistry, and Director of Student Affairs, Diversity, and Inclusion, Rutgers School of Dental Medicine
| | - Juan F Yepes
- Tanya Marie Gibson, DDS, is Assistant Professor, Department of Oral Pathology, Radiology, and Medicine, University of Missouri-Kansas City School of Dentistry; Maria A. Loza-Herrero, DMD, MS, is Professor, Department of Restorative Sciences, Prosthodontics Section, University of Puerto Rico School of Dental Medicine; Juan F. Yepes, DDS, MD, MPH, MS, DrPH, is Associate Professor, Department of Pediatric Dentistry, Indiana University School of Dentistry; Hera Kim-Berman, DDS, MMSc, is Clinical Assistant Professor and Program Director, Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry; Deborah A. Dilbone, DMD, is Clinical Associate Professor and Chair, Department of Restorative Dental Sciences, University of Florida College of Dentistry; and Herminio Perez, DMD, MBA, is Clinical Assistant Professor, Department of Restorative Dentistry, and Director of Student Affairs, Diversity, and Inclusion, Rutgers School of Dental Medicine
| | - Hera Kim-Berman
- Tanya Marie Gibson, DDS, is Assistant Professor, Department of Oral Pathology, Radiology, and Medicine, University of Missouri-Kansas City School of Dentistry; Maria A. Loza-Herrero, DMD, MS, is Professor, Department of Restorative Sciences, Prosthodontics Section, University of Puerto Rico School of Dental Medicine; Juan F. Yepes, DDS, MD, MPH, MS, DrPH, is Associate Professor, Department of Pediatric Dentistry, Indiana University School of Dentistry; Hera Kim-Berman, DDS, MMSc, is Clinical Assistant Professor and Program Director, Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry; Deborah A. Dilbone, DMD, is Clinical Associate Professor and Chair, Department of Restorative Dental Sciences, University of Florida College of Dentistry; and Herminio Perez, DMD, MBA, is Clinical Assistant Professor, Department of Restorative Dentistry, and Director of Student Affairs, Diversity, and Inclusion, Rutgers School of Dental Medicine
| | - Deborah A Dilbone
- Tanya Marie Gibson, DDS, is Assistant Professor, Department of Oral Pathology, Radiology, and Medicine, University of Missouri-Kansas City School of Dentistry; Maria A. Loza-Herrero, DMD, MS, is Professor, Department of Restorative Sciences, Prosthodontics Section, University of Puerto Rico School of Dental Medicine; Juan F. Yepes, DDS, MD, MPH, MS, DrPH, is Associate Professor, Department of Pediatric Dentistry, Indiana University School of Dentistry; Hera Kim-Berman, DDS, MMSc, is Clinical Assistant Professor and Program Director, Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry; Deborah A. Dilbone, DMD, is Clinical Associate Professor and Chair, Department of Restorative Dental Sciences, University of Florida College of Dentistry; and Herminio Perez, DMD, MBA, is Clinical Assistant Professor, Department of Restorative Dentistry, and Director of Student Affairs, Diversity, and Inclusion, Rutgers School of Dental Medicine
| | - Herminio Perez
- Tanya Marie Gibson, DDS, is Assistant Professor, Department of Oral Pathology, Radiology, and Medicine, University of Missouri-Kansas City School of Dentistry; Maria A. Loza-Herrero, DMD, MS, is Professor, Department of Restorative Sciences, Prosthodontics Section, University of Puerto Rico School of Dental Medicine; Juan F. Yepes, DDS, MD, MPH, MS, DrPH, is Associate Professor, Department of Pediatric Dentistry, Indiana University School of Dentistry; Hera Kim-Berman, DDS, MMSc, is Clinical Assistant Professor and Program Director, Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry; Deborah A. Dilbone, DMD, is Clinical Associate Professor and Chair, Department of Restorative Dental Sciences, University of Florida College of Dentistry; and Herminio Perez, DMD, MBA, is Clinical Assistant Professor, Department of Restorative Dentistry, and Director of Student Affairs, Diversity, and Inclusion, Rutgers School of Dental Medicine
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Olano RFP, Wright MDGM. DRUG CONSUMPTION, KNOWLEDGE ON THE CONSEQUENCES OF CONSUMPTION AND ACADEMIC PERFORMANCE AMONG COLLEGE STUDENTS IN SAN SALVADOR, EL SALVADOR. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-cicad-10-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: determine the relationship among drug consumption, knowledge on the consequences of consumption and academic performance, for alcohol cocaine and marijuana, among undergraduate students of social sciences and health of San Salvador, El Salvador. Method: the used method was a cross-sectional survey, with a convenience sample of 250 university students. A modified version of the combination of two instruments was applied evaluating the variables for the knowledge on the consequences, pursuing the knowledge of a student about the adverse effects of the biological, psychological and social categories related to consumption of the drugs under study. Drug consumption was evaluated by consulting the student whether or not they used drugs at any time or in the last 3 months. Academic performance was evaluated by consulting students on the average in which they are applied on a scale of 1 to 10. Results: the results showed that 88.1% of the survey participants have a broad knowledge on the consequences of consuming alcoholic beverages; 45.5% on the consequences of marijuana use and 55.7% know the consequences of cocaine consumption. While 28.4% have consumed alcohol in the last year, 6.5% have consumed marijuana and 1.7% cocaine. The relationship of alcohol consumption with the knowledge on each of the consequences reflected a very low influence, while the larger is the knowledge obtained from these consequences caused by the use of the drugs under study, the lower is the consumption. Conclusion: the use of alcohol, cocaine and marijuana is not related to academic performance, indicating very low positive and negative correlations according to each case.
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Erschens R, Loda T, Herrmann-Werner A, Keifenheim KE, Stuber F, Nikendei C, Zipfel S, Junne F. Behaviour-based functional and dysfunctional strategies of medical students to cope with burnout. MEDICAL EDUCATION ONLINE 2018; 23:1535738. [PMID: 30371222 PMCID: PMC6211255 DOI: 10.1080/10872981.2018.1535738] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND High levels of burnout rates amongst medical students have been confirmed by numerous studies from diverse contexts. This study aims to explore the functional and dysfunctional coping strategies of medical students with regard to their respective burnout factors. METHODS About 845 medical students in the 3rd, 6th, and 9th semesters and students in their final year were invited to take part in the survey. The self-administered questionnaire included items on potential functional and dysfunctional behavioural-based coping strategies as well as the Maslach Burnout Inventory-Student Version (MBI-SS). In addition, a comparison of the local results with a German reference sample involving other students was calculated. RESULTS A total of 597 medical students (70.7%) participated in the cross-sectional study. The results showed high burnout rates, averaging 35%. Students in earlier stages of university education showed lower values for cynicism (a subdimension of burnout), but higher values for emotional exhaustion than students in higher stages. Concerning academic efficacy, there was a trend towards less efficient perception among students in higher education. The identified functional coping strategies were 'seeking support from friends', 'seeking support from family', 'doing relaxing exercise', 'doing sports' and 'seeking support from fellow students'. The identified dysfunctional coping strategies were 'taking tranquilizers', 'taking stimulants', 'drinking alcohol', 'withdrawal and ruminating', and 'playing games on the PC or mobile phone'. The medical students surveyed are more affected by burnout symptoms like emotional exhaustion than the reference populations, but the overall result was difficult to interpret. CONCLUSIONS The identified behavioural-based functional coping strategies suggest that social support and active relaxing exercises seem to be very important possibilities for medical students to reduce stress and exhaustion. The use of drugs and alcohol for stress reduction raises concerns. Programs are recommended to improve resilient behaviour and to impart the identified functional coping strategies to medical students.
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Affiliation(s)
- Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tübingen, Germany
- CONTACT Rebecca Erschens Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Osianderstraße 5, D-72076Tübingen, Germany
| | - Teresa Loda
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tübingen, Germany
| | - Anne Herrmann-Werner
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tübingen, Germany
| | - Katharina Eva Keifenheim
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tübingen, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tübingen, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Medical Hospital Heidelberg, Heidelberg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tübingen, Germany
- Deanery of Students’ Affairs, University’s Faculty of Medicine, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tübingen, Germany
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Papazisis G, Siafis S, Tsakiridis I, Koulas I, Dagklis T, Kouvelas D. Prevalence of Cannabis Use Among Medical Students: A Systematic Review and Meta-analysis. Subst Abuse 2018; 12:1178221818805977. [PMID: 30349282 PMCID: PMC6194916 DOI: 10.1177/1178221818805977] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 09/14/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Cannabis is reported to be the most common illicit substance used among medical students; however, the number of related studies is limited and their results are not systematically reviewed. The aim of our study was to analyze the prevalence of lifetime and current use of cannabis among medical students worldwide. METHODS A systematic review and meta-analysis was performed with adherence to the PRISMA guidelines. The electronic databases PubMed, Scopus, and Cochrane library were searched for studies on the prevalence of cannabis use among medical students. Prevalence of lifetime, past-year, and past-month cannabis use was extracted. Pooled prevalence and relative risk for sex were calculated using the random effects model and subgroup analyses were conducted. RESULTS A total of 38 observational (cross-sectional and cohort) studies were included (total number of participants 19 932), and most of them were conducted in Europe, Central and Southern America, and the United States. Overall pooled prevalence of lifetime cannabis use was 31.4% (95% confidence interval [CI]: 23.7%-39.6%), past-year use was 17.2% (95% CI: 10.8%-24.6%), and past-month use was 8.8% (95% CI: 5.6%-12.5%). Men displayed higher rates of cannabis use with a pooled relative risk of 1.55 (95% CI: 1.32-1.81). Heterogeneity was high (I 2 > 75%) and there were differences among continents in all outcomes (P < .001). CONCLUSIONS In conclusion, 1 in 3 medical students has used cannabis, whereas 8.8% were current users. Significant differences among continents were observed, but common finding was that male students tend to consume cannabis more often than female students.
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Affiliation(s)
- Georgios Papazisis
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Spyridon Siafis
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Tsakiridis
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Koulas
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Themistoklis Dagklis
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Kouvelas
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Balayssac D, Pereira B, Darfeuille M, Cuq P, Vernhet L, Collin A, Vennat B, Authier N. Use of Psychotropic Medications and Illegal Drugs, and Related Consequences Among French Pharmacy Students - SCEP Study: A Nationwide Cross-Sectional Study. Front Pharmacol 2018; 9:725. [PMID: 30065649 PMCID: PMC6056660 DOI: 10.3389/fphar.2018.00725] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/15/2018] [Indexed: 12/18/2022] Open
Abstract
Background: The use of psychotropic medications and illegal drugs is a worldwide public health issue, leading to addiction, psychiatric and somatic disorders, and death. Pharmacy students are more exposed to psychotropic medications than other students (non-medical), which could lead to an overuse. The main objective of this study was to assess the prevalence of psychotropic drug use (medications and illegal drugs) by French pharmacy students, by carrying out a nationwide cross-sectional study. The relation of these medications and illegal drug use with several comorbidities and academic achievement was also assessed. Methods: This online survey was performed by emails sent to all French pharmacy faculties over a period of 66 days (March 16, 2016 to May 20, 2016). The survey assessed the prevalence of uses of psychotropic medications and illegal drugs during the last 3 months. These uses were compared to student characteristics (personal and university) and comorbidities (anxiety, depression, stress, and fatigue). Results: Of the 2,609 questionnaires received, 2,575 were completed and useable for the analysis. Among French pharmacy students and during the 3 last months, 9.4% have used psychotropic medications, 21.5% illegal drugs and 3.3% both psychotropic medications and illegal drugs. Psychotropic medications were used in the cases of a medical prescription (49.0%), a self-medication (42.4%) or a non-medical intent (26.3%). Stress scores of the last 7 days were higher for psychotropic medication users compared to non-users and illegal drug users. Proportions of anxiety and depression at the time of answer were higher for psychotropic medication users than for non-users and illegal drug users. Fatigue scores of the last 7 days were lower for illegal drug users compared to non-users and self-medicated students. Annual average marks of the last year, attendance and perception of study difficulty were lower for illegal drug users than for non-users. Conclusion: French pharmacy students were less exposed to psychotropic medications and illegal drugs than the general French population. However, in comparison to other students in other countries, the use of psychotropic medications seemed to be lower, but with a proportionally higher use of anxiety/sedative medications and a lower use of opioid medications.
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Affiliation(s)
- David Balayssac
- Inserm U1107, NEURO-DOL, Faculté de Pharmacie, Laboratoire de Toxicologie, Université Clermont Auvergne, CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, Clermont-Ferrand, France
| | - Maxime Darfeuille
- Faculté de Pharmacie, Laboratoire de Toxicologie, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Pierre Cuq
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, ENSCM, Faculté de Pharmacie, Université de Montpellier, Montpellier, France
| | - Laurent Vernhet
- UMR Inserm 1085, Institut de Recherche sur la Santé, l'Environnement et le Travail (IRSET), Université de Rennes 1, Rennes, France
| | - Aurore Collin
- Inserm U1107, NEURO-DOL, Faculté de Pharmacie, Laboratoire de Toxicologie, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Brigitte Vennat
- ACCePPT, Faculté de Pharmacie, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Nicolas Authier
- Inserm U1107, NEURO-DOL, Université Clermont Auvergne, Faculté de Médecine, CHU Clermont-Ferrand, Pharmacologie Médicale, Clermont-Ferrand, France
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Sharp J, Theiler S. A Review of Psychological Distress Among University Students: Pervasiveness, Implications and Potential Points of Intervention. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2018. [DOI: 10.1007/s10447-018-9321-7] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bogowicz P, Ferguson J, Gilvarry E, Kamali F, Kaner E, Newbury-Birch D. Alcohol and other substance use among medical and law students at a UK university: a cross-sectional questionnaire survey. Postgrad Med J 2017; 94:131-136. [PMID: 29103016 DOI: 10.1136/postgradmedj-2017-135136] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/04/2017] [Accepted: 10/21/2017] [Indexed: 11/04/2022]
Abstract
PURPOSE OF THE STUDY To examine the use of alcohol and other substances among medical and law students at a UK university. STUDY DESIGN Anonymous cross-sectional questionnaire survey of first, second and final year medical and law students at a single UK university. RESULTS 1242 of 1577 (78.8%) eligible students completed the questionnaire. Over half of first and second year medical students (first year 53.1%, second year 59.7%, final year 35.9%) had an Alcohol Use Disorders Identification Test (AUDIT) score suggestive of an alcohol use disorder (AUDIT≥8), compared with over two-thirds of first and second year law students (first year 67.2%, second year 69.5%, final year 47.3%). Approximately one-quarter of medical students (first year 26.4%, second year 28.4%, final year 23.7%) and over one-third of first and second year law students (first year 39.1%, second year 42.4%, final year 18.9%) reported other substance use within the past year. Over one-third of medical students (first year 34.4%, second year 35.6%, final year 46.3%) and approximately half or more of law students (first year 47.2%, second year 52.7%, final year 59.5%) had a Hospital Anxiety and Depression Scale anxiety score suggestive of a possible anxiety disorder. CONCLUSIONS Study participants had high levels of substance misuse and anxiety. Some students' fitness to practice may be impaired as a result of their substance misuse or symptoms of psychological distress. Further efforts are needed to reduce substance misuse and to improve the mental well-being of students.
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Affiliation(s)
- Paul Bogowicz
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Ferguson
- School of Health & Social Care, Teesside University, Middlesbrough, UK
| | - Eilish Gilvarry
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Farhad Kamali
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
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Kiepek N, Baron JL. Use of substances among professionals and students of professional programs: a review of the literature. DRUGS: EDUCATION, PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1375080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Niki Kiepek
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Jonnie-Lyn Baron
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
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Harrison A, Robinson C, Williams G, Clough G, Owusu MW, Verma A. Utilizing community and voluntary sector partnerships to survey and compare the health outcomes of hard-to- reach groups to the wider community-the EURO- URHIS 2 Hard-to-Reach Project. Eur J Public Health 2017; 27:50-55. [PMID: 26420845 DOI: 10.1093/eurpub/ckv140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background This article describes the Hard-to-Reach (HtR) Project that was developed to capture health and lifestyle data from groups who are HtR by postal surveys within the larger EURO-URHIS 2 project. By collaborating with partner organizations, data were collected using standard survey tools, allowing for comparison with the wider population. Following a scoping exercise to determine which groups were HtR in Greater Manchester, black and minority ethnic (BME) groups and students were selected. BME groups were surveyed through partnership with Community and Voluntary Sector Organizations (CVSOs). Language barriers were addressed through the recruitment of volunteer interpreters. Students were surveyed by accessing university premises. Fifteen survey visits took place at nine CVSOs and five visits to University facilities. In total, 144 eligible surveys were collected. There were significant differences for both HtR groups, compared with Greater Manchester and the EURO-URHIS 2 mean. Both HtR groups had worse outcomes than both Greater Manchester and EURO-URHIS 2 for psychological problems. In addition, students had worse outcomes for passive smoking, binge drinking, use of cannabis, lack of access to green spaces, less sense of belonging and social cohesion and damp or mildewed homes, and better outcomes for self-perceived health and overweight and obesity. BME had in addition worse outcomes than both Greater Manchester and EURO-URHIS 2 for long-standing restrictive illness. Despite the limitations of this study, the development of this methodology allowed for the collection of comparable data, showing up statistically significant differences between the HtR populations and the wider population which merits further investigation.
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Lamberti M, Napolitano F, Napolitano P, Arnese A, Crispino V, Panariello G, Di Giuseppe G. Prevalence of alcohol use disorders among under- and post-graduate healthcare students in Italy. PLoS One 2017; 12:e0175719. [PMID: 28437428 PMCID: PMC5402935 DOI: 10.1371/journal.pone.0175719] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 03/30/2017] [Indexed: 11/19/2022] Open
Abstract
A cross-sectional study was carried out on 641 medical students, 359 students attending a degree course in the healthcare professions, and 500 resident physicians, all undergoing health surveillance at the ambulatory of the Division of Occupational Medicine, Second University of Naples, Italy. 76.1% of the participants drank alcohol, with 85.5% of medical students, 77.4% of resident physicians, and 63% of healthcare-professions students reporting regular alcohol use. In the whole sample, the mean Audit-C score was 1.6 for men and 1.1 for women; only 5.5% of men and 7.1% of women had a hazardous alcohol consumption with an Audit-C score of respectively ≥4 and ≥3. Multivariate regression modeling revealed that regular alcohol use was more likely in individuals who were men, were younger, had a lower body-mass index, were active smokers, were habitual coffee drinkers, and who were resident physicians or medical students rather than healthcare-professions students. This finding identifies a need to assess alcohol use in medical-profession workers in order to identify risky behavior early on and to carry out rapidly effective preventive and curative interventions.
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Affiliation(s)
- Monica Lamberti
- Department of Experimental Medicine, Section of Occupational Medicine, School of Medicine, Second University of Naples, Naples, Italy
- * E-mail:
| | - Francesco Napolitano
- Department of Experimental Medicine, Section of Hygiene, School of Medicine, Second University of Naples, Naples, Italy
| | - Paola Napolitano
- Department of Experimental Medicine, Section of Hygiene, School of Medicine, Second University of Naples, Naples, Italy
| | - Antonio Arnese
- Department of Experimental Medicine, Section of Hygiene, School of Medicine, Second University of Naples, Naples, Italy
| | - Vincenzo Crispino
- Department of Experimental Medicine, Section of Occupational Medicine, School of Medicine, Second University of Naples, Naples, Italy
| | - Gianclaudio Panariello
- Department of Experimental Medicine, Section of Occupational Medicine, School of Medicine, Second University of Naples, Naples, Italy
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, Section of Hygiene, School of Medicine, Second University of Naples, Naples, Italy
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Zvauya R, Oyebode F, Day EJ, Thomas CP, Jones LA. A comparison of stress levels, coping styles and psychological morbidity between graduate-entry and traditional undergraduate medical students during the first 2 years at a UK medical school. BMC Res Notes 2017; 10:93. [PMID: 28193287 PMCID: PMC5307866 DOI: 10.1186/s13104-017-2395-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 01/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stress levels and psychological morbidity are high among undergraduate medical students (UGs), but there is a lack of research into the psychological health of UK graduate-entry medical students (GEs). GEs are likely to experience different (perhaps more severe) stressors and to cope with stress differently. We compared stress levels, psychological morbidity and coping styles in GE versus UG medical students studying at the same UK medical school in the same academic year. A cross-sectional self-rated questionnaire study of all first- and second-year GE and UG medical students was conducted. Perceived stress, psychological morbidity, recent adverse life events, stress-related personality traits and coping styles were assessed using standard questionnaires. RESULTS 75% GEs and 46% UGs responded to the questionnaire. Both groups reported equally high levels, and similar profiles of, perceived stress and psychological morbidity. Levels of recent adverse life events and stress-related personality traits were similar in both groups. Compared to UGs, GEs were more likely to use active coping (p = 0.02) and positive reframing (p = 0.03), but were also more likely to use substances (alcohol and other drugs; p < 0.001) to help them cope. Unlike UGs, second-year GEs showed less perceived stress (p = 0.007) and psychological morbidity (p = 0.006) than first-year GEs although levels of both were still high. CONCLUSION Our results show that both GE students and their younger UG counterparts on a traditional medical course have similar profiles of stress symptoms. They do, however, cope with stress differently. GEs are more likely to use active problem-focused coping strategies, and they are also more likely to cope by using substances (alcohol or other drugs). GE students need interventions to prevent maladaptive coping styles and encourage adaptive coping that are tailored to their needs. Such interventions should be targeted at first-year students. It is vital that these students develop positive coping skills to benefit them during training and in a future career that is inherently stressful.
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Affiliation(s)
- R Zvauya
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. .,Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
| | - F Oyebode
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - E J Day
- National Addiction Centre, King's College London, London, UK
| | - C P Thomas
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - L A Jones
- Department of Psychological Medicine, University of Worcester, Worcester, UK
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The legal and moral perceptions of clinical and non-clinical undergraduates regarding substance use: a pilot project. Br Dent J 2017; 222:198-204. [PMID: 28184070 DOI: 10.1038/sj.bdj.2017.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 11/09/2022]
Abstract
Introduction Heavy alcohol and illicit drug use has been documented amongst medical and dental professionals and educational programs have been developed to attempt to reduce such behaviour in clinical undergraduates. This pilot study aims to investigate the legal and moral perceptions of substance use in clinical and non-clinical undergraduates.Method A cross-sectional self-report questionnaire was administered to 107 clinical and non-clinical undergraduates to investigate their moral and legal perceptions of alcohol and illicit substance use.Results More clinical (72.5%) than non-clinical students (66%) drink alcohol regularly. Both groups perceive ecstasy, cocaine and ketamine as 'high risk' drugs. A third of both clinical (34%) and non-clinical (36%) students support the legalisation of illicit drugs. Forty-seven percent of non-clinical students would consider changing their behaviour if illicit substances were legalised compared to 32% of clinical students. Clinical students believe the legal punishment for Class A drugs is appropriate, but disagree with that for Class C drug use. Personal values of clinical students differ regarding some immoral activities. Social perceptions of illicit substance users are similar for both clinical and non-clinical students with those who use heroin perceived most negatively by 86.5% of all undergraduates.Conclusion Individual substance use behaviours may be influenced by legal perceptions of illicit substance use. Personal values and social norms are also likely to be important. Further research is required to investigate how these perceptions affect a clinical student's decision to participate in excessive alcohol and illicit substance use behaviours.
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Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA 2016; 316:2214-2236. [PMID: 27923088 PMCID: PMC5613659 DOI: 10.1001/jama.2016.17324] [Citation(s) in RCA: 1144] [Impact Index Per Article: 143.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies. OBJECTIVE To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students. DATA SOURCES AND STUDY SELECTION Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included. DATA EXTRACTION AND SYNTHESIS Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. MAIN OUTCOMES AND MEASURES Point or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview. RESULTS Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n = 116 628) and 16 longitudinal studies (n = 5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37 933/122 356 individuals; 95% CI, 24.7% to 29.9%, I2 = 98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982-2015; slope, 0.2% increase per year [95% CI, -0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during medical school (n = 2432), the median absolute increase in symptoms was 13.5% (range, 0.6% to 35.3%). Prevalence estimates did not significantly differ between studies of only preclinical students and studies of only clinical students (23.7% [95% CI, 19.5% to 28.5%] vs 22.4% [95% CI, 17.6% to 28.2%]; P = .72). The percentage of medical students screening positive for depression who sought psychiatric treatment was 15.7% (110/954 individuals; 95% CI, 10.2% to 23.4%, I2 = 70.1%). Suicidal ideation prevalence data were extracted from 24 cross-sectional studies (n = 21 002) from 15 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of suicidal ideation was 11.1% (2043/21 002 individuals; 95% CI, 9.0% to 13.7%, I2 = 95.8%). Summary prevalence estimates ranged across assessment modalities from 7.4% to 24.2%. CONCLUSIONS AND RELEVANCE In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%. Further research is needed to identify strategies for preventing and treating these disorders in this population.
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Affiliation(s)
- Lisa S Rotenstein
- Harvard Medical School, Boston, Massachusetts2Harvard Business School, Boston, Massachusetts
| | - Marco A Ramos
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Matthew Torre
- Harvard Medical School, Boston, Massachusetts4Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Michael J Peluso
- Harvard Medical School, Boston, Massachusetts5Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Srijan Sen
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor8Department of Psychiatry, University of Michigan, Ann Arbor
| | - Douglas A Mata
- Harvard Medical School, Boston, Massachusetts9Division of MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts10Brigham Education Institute, Boston, Massachusetts
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Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA 2016. [PMID: 27923088 DOI: 10.1001/jama.2016.17324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Importance Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies. Objective To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students. Data Sources and Study Selection Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included. Data Extraction and Synthesis Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. Main Outcomes and Measures Point or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview. Results Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n = 116 628) and 16 longitudinal studies (n = 5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37 933/122 356 individuals; 95% CI, 24.7% to 29.9%, I2 = 98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982-2015; slope, 0.2% increase per year [95% CI, -0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during medical school (n = 2432), the median absolute increase in symptoms was 13.5% (range, 0.6% to 35.3%). Prevalence estimates did not significantly differ between studies of only preclinical students and studies of only clinical students (23.7% [95% CI, 19.5% to 28.5%] vs 22.4% [95% CI, 17.6% to 28.2%]; P = .72). The percentage of medical students screening positive for depression who sought psychiatric treatment was 15.7% (110/954 individuals; 95% CI, 10.2% to 23.4%, I2 = 70.1%). Suicidal ideation prevalence data were extracted from 24 cross-sectional studies (n = 21 002) from 15 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of suicidal ideation was 11.1% (2043/21 002 individuals; 95% CI, 9.0% to 13.7%, I2 = 95.8%). Summary prevalence estimates ranged across assessment modalities from 7.4% to 24.2%. Conclusions and Relevance In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%. Further research is needed to identify strategies for preventing and treating these disorders in this population.
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Affiliation(s)
- Lisa S Rotenstein
- Harvard Medical School, Boston, Massachusetts2Harvard Business School, Boston, Massachusetts
| | - Marco A Ramos
- Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Matthew Torre
- Harvard Medical School, Boston, Massachusetts4Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Michael J Peluso
- Harvard Medical School, Boston, Massachusetts5Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Srijan Sen
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor8Department of Psychiatry, University of Michigan, Ann Arbor
| | - Douglas A Mata
- Harvard Medical School, Boston, Massachusetts9Division of MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts10Brigham Education Institute, Boston, Massachusetts
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Baltieri DA, de Oliveira VH, de Souza Gatti AL, Junqueira Aguiar AS, de Souza Aranha E Silva RA. Factor Structure and Gender Stability of the Brazilian Version of the Pornography Consumption Inventory. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:589-601. [PMID: 26549730 DOI: 10.1080/0092623x.2015.1113581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
There are a few instruments available to measure pornograhy consumption-related constructs, and this lack of instruments can compromise the validity of research findings. The Pornography Consumption Inventory (PCI) assesses four motivations for pornography consumption, and it has been validated in hypersexual men and medical students. However, whether the psychometric properties of this instrument are comparable across genders remains unclear. Multigroup confirmatory factor analysis (MGCFA) was used to verify the invariance of the structure of the PCI across male (100) and female (105) university students. The confirmatory factor analysis (CFA) for each group showed a reasonably good fit of the data to the four-factor model. The MGCFA model included only factor loadings constrained to be equal between both genders (ΔCFI < 0.01 and p > 0.05). However, the ΔCFI did not support a strong and strict factorial invariance, ΔCFI > 0.01. Although both genders seemed to agree with the conceptualization of pornography and motivations for consuming it, the PCI was not gender-invariant, as men showed a stronger degree of motivation to consume pornographic material than women did. The implications of these findings regarding the measurement of motivations for pornography use are outlined.
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Affiliation(s)
- Danilo Antonio Baltieri
- a Sexual Disorders Outpatient Clinic (ABSex) , Department of Neurosciences, ABC Medical School , Santo André , São Paulo , Brazil
| | - Vitor Henrique de Oliveira
- a Sexual Disorders Outpatient Clinic (ABSex) , Department of Neurosciences, ABC Medical School , Santo André , São Paulo , Brazil
| | - Ana Luísa de Souza Gatti
- a Sexual Disorders Outpatient Clinic (ABSex) , Department of Neurosciences, ABC Medical School , Santo André , São Paulo , Brazil
| | - Ana Saito Junqueira Aguiar
- a Sexual Disorders Outpatient Clinic (ABSex) , Department of Neurosciences, ABC Medical School , Santo André , São Paulo , Brazil
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Lev-Ran S, Steinmetz Y, Weiser M. Attitudes towards substance use and substance use disorders among medical students in Israel. DRUGS: EDUCATION, PREVENTION AND POLICY 2016. [DOI: 10.3109/09687637.2016.1167167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gignon M, Havet E, Ammirati C, Traullé S, Manaouil C, Balcaen T, Loas G, Dubois G, Ganry O. Alcohol, cigarette, and illegal substance consumption among medical students: a cross-sectional survey. Workplace Health Saf 2015; 63:54-63. [PMID: 25881656 DOI: 10.1177/2165079915570917] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated addictive substance use by French medical students. A cross-sectional survey was distributed to 255 participants randomly selected from 1,021 second- to sixth-year medical students. Questionnaires were self-administered and included questions on sociodemographic characteristics, mental health, and alcohol (The Alcohol Use Disorders Identification Test [AUDIT test]), tobacco (Fagerstrom test), and illegal substance consumption (Cannabis Abuse Screening Test [CAST test]). The AUDIT scores indicated that 11% of the study participants were at risk for addiction and 21% were high-risk users. Tobacco dependence was strong or very strong for 12% of the participants. The CAST score showed that 5% of cannabis users needed health care services. Cannabis users were also more likely than non-users to fail their medical school examinations (89% vs. 39%, p<.01). One quarter of medical student participants (n=41) had used other illegal drugs, and 10% of study participants had considered committing suicide during the previous 12 months. Psychoactive substance consumption by French medical students requires preventive measures, screening, and health care services.
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Affiliation(s)
- M Gignon
- University Paris 13 Jules Verne University of Picardy Amiens University Hospital
| | - E Havet
- Jules Verne University of Picardy
| | - C Ammirati
- University Paris 13 Jules Verne University of Picardy
| | | | | | - T Balcaen
- Jules Verne University of Picardy Amiens University Hospital
| | - G Loas
- Jules Verne University of Picardy
| | - G Dubois
- Jules Verne University of Picardy Amiens University Hospital
| | - O Ganry
- Jules Verne University of Picardy Amiens University Hospital
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Roncero C, Rodríguez-Cintas L, Egido A, Barral C, Pérez-Pazos J, Collazos F, Grau-López L, Casas M. The influence of medical student gender and drug use on the detection of addiction in patients. J Addict Dis 2015; 33:277-88. [PMID: 25299484 DOI: 10.1080/10550887.2014.969600] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Little is known about medical students' interest in their training on drug addiction, their personal experience of consumption, and whether these aspects influence the detection of addiction in patients. Eighty-eight and one half percent considered that drug dependence issues are important to their professional future. The students report consuming alcohol (69%), cigarettes (19.5%), and illegal drugs (15.8%). Female students consumed fewer illegal drugs than the men (p =.022). Male students consumed more illegal drugs more frequently (p =.005), knew more consumers (p =.023), and those who drink alcohol consumed more illegal drugs than women who drink alcohol (p <.005). Drug and alcohol consumption among medical students may serve to normalize consumption and thus, may prevent the detection of addicts. It is important to educate and raise awareness about drugs and alcohol use, as this may influence detection. The focus should be particularly on the male group.
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Affiliation(s)
- Carlos Roncero
- a Outpatient Drug Clinic (CAS) Vall Hebron, Psychiatry Services Hospital , Universitario Vall Hebron-ASPB , Barcelona , Spain
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Drinking Outcome Expectancies and Normative Perceptions of Students Engaged in University Sport in England. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2015. [DOI: 10.1123/jcsp.2015-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examined whether students engaged in university sport have different drinking outcome expectancies and normative beliefs than students who are not engaged in university sport. A cross-sectional survey of university students in England in 2008–2009 was undertaken. A questionnaire battery, including the Drinking Expectancies Questionnaire (DEQ) and a measure of normative beliefs, was completed by 770 students from seven universities across England. Responses from 638 students who were not abstaining from alcohol were analyzed. Students engaged in university sport have significantly higher drinking expectancies of assertion compared with students not engaged in university sport. Moreover, students engaged in university sport consistently report higher personal alcohol consumption and higher perceptions of consumption in those around them than students not engaged in university sport. Both assertion and the perception that students around them drink heavily provide only a partial explanation for why students engaged in university sport drink more than those not engaged in university sport. Further research is required to identify the reasons for heavy drinking among students involved in university sport in England.
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Hankir AK, Northall A, Zaman R. Stigma and mental health challenges in medical students. BMJ Case Rep 2014; 2014:bcr2014205226. [PMID: 25183806 PMCID: PMC4158203 DOI: 10.1136/bcr-2014-205226] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2014] [Indexed: 11/03/2022] Open
Abstract
Despite the perception that medical students and doctors should be 'invincible', mental health challenges are common in this population. Medical students and doctors have low levels of help seeking for their own psychiatric problems often only presenting to mental health services once a crisis arises. Fear of exposure to stigmatisation is a crucial factor contributing to symptom concealment and is a barrier to accessing mental health services. Autobiographical narratives of the 'Wounded Healer' are gaining popularity among medical students and doctors with mental health challenges both as an effective form of adjunctive therapy and as a means to campaign against stigma. Indeed, the results of a randomised controlled trial to assess the efficacy of Coming Out Proud with mental illness revealed immediate positive effects on stigma stress-related variables. We provide an autobiographical narrative from a medical student who has first-hand experience with mental health challenges.
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Affiliation(s)
| | - Amy Northall
- School of Medicine, University of Sheffield, Sheffield, USA
| | - Rashid Zaman
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Kötter T, Tautphäus Y, Scherer M, Voltmer E. Health-promoting factors in medical students and students of science, technology, engineering, and mathematics: design and baseline results of a comparative longitudinal study. BMC MEDICAL EDUCATION 2014; 14:134. [PMID: 24996637 PMCID: PMC4096732 DOI: 10.1186/1472-6920-14-134] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 06/26/2014] [Indexed: 05/06/2023]
Abstract
BACKGROUND The negative impact of medical school on students' general and mental health has often been reported. Compared to students of other subjects, or employed peers, medical students face an increased risk of developing depression, anxiety and burnout. While pathogenetic factors have been studied extensively, less is known about health-promoting factors for medical students' health. This longitudinal study aims to identify predictors for maintaining good general and mental health during medical education. We report here the design of the study and its baseline results. METHODS We initiated a prospective longitudinal cohort study at the University of Lübeck, Germany. Two consecutive classes of students, entering the university in 2011 and 2012, were recruited. Participants will be assessed annually for the duration of their course. We use validated psychometric instruments covering health outcomes (general and mental health) and personality traits, as well as self-developed, pre-tested items covering leisure activities and sociodemographic data. RESULTS At baseline, compared to students of STEM (science, technology, engineering, and mathematics) subjects (n = 531; 60.8% response rate), a larger proportion of medical students (n = 350; 93.0% response rate) showed good general health (90.9% vs. 79.7%) and a similar proportion was in good mental health (88.3% vs. 86.3%). Medical students scored significantly higher in the personality traits of extraversion, conscientiousness, openness to experience and agreeableness. Neuroticism proved to be a statistically significant negative predictor for mental health in the logistic regression analyses. Satisfaction with life as a dimension of study-related behaviour and experience predicted general health at baseline. Physical activity was a statistically significant predictor for general health in medical students. CONCLUSIONS Baseline data revealed that medical students reported better general and similar mental health compared to STEM students. The annual follow-up questionnaires, combined with qualitative approaches, should clarify wether these differences reflect a higher resilience, a tendency to neglect personal health problems - as has been described for physicians - before entering medical school, or both. The final results may aid decision-makers in developing health-promotion programmes for medical students.
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Affiliation(s)
- Thomas Kötter
- Institute for Social Medicine and Epidemiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany
| | - Yannick Tautphäus
- Institute for Social Medicine and Epidemiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany
| | - Edgar Voltmer
- Department of Health and Behavioural Sciences, Friedensau Adventist University, An der Ihle 19, Friedensau 39291, Germany
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Babalola E, Akinhanmi A, Ogunwale A. Who guards the guards: drug use pattern among medical students in a nigerian university. Ann Med Health Sci Res 2014; 4:397-403. [PMID: 24971216 PMCID: PMC4071741 DOI: 10.4103/2141-9248.133467] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background: Several studies have examined the prevalence and pattern of substance use among medical students in Nigeria. Few of these studies have specifically examined the relationship between the psychological distress and psychoactive substance use among these students. Yet, evidence world-wide suggests that substance use among medical students might be on the rise and may be related to the level of stress among them. Aim: The present study is the first study aimed to determine the prevalence, pattern and factors associated with psychoactive substance use among medical students of Olabisi Onabanjo University, Ogun State, Nigeria. Subjects and Methods: The World Health Organization student drug use questionnaire was used to evaluate for substance use among 246 clinical medical students between September and October 2011. General health questionnaire (GHQ) 12 was used to assess for psychological distress among these students. Statistical analysis was performed using the SPSS version 16. (Chicago, USA). Proportions were compared using the Chi-square test while a value of P < 0.05 was considered statistically significant. Fisher exact test was used instead of Chi-square when the number in the cell is less than 5. Results: Lifetime prevalence of substance use among medical students was 65% (165/246). It was found that the most commonly used substances were alcohol 63.4% (156/246), mild stimulants 15.6% (38/246), tobacco 15% (37/246) and sedatives 6.1% (15/246). Substance use was associated with gender, frequency of participation in religious activities and GHQ scores. Conclusion: Psychoactive substance use is a major problem among medical students. Psychological well-being plays a significant role in substance use among these students. There is a need for adequate screening and assessment for substance use disorders among these students and incorporating stress management strategies in their curriculum.
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Affiliation(s)
- Eo Babalola
- Department of Clinical Services, Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, Nigeria
| | - A Akinhanmi
- Department of Clinical Services, Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, Nigeria
| | - A Ogunwale
- Department of Clinical Services, Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, Nigeria
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Yusoff MSB. Interventions on medical students’ psychological health: A meta-analysis. J Taibah Univ Med Sci 2014. [DOI: 10.1016/j.jtumed.2013.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Black LF, Monrouxe LV. 'Being sick a lot, often on each other': students' alcohol-related provocation. MEDICAL EDUCATION 2014; 48:268-279. [PMID: 24528462 DOI: 10.1111/medu.12300] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 03/15/2013] [Accepted: 07/02/2013] [Indexed: 06/03/2023]
Abstract
CONTEXT Many medical students consume alcohol in excess, which can compromise their professionalism and increase their risk of future alcohol dependency. Just one study in Japan has examined the social influences of alcohol consumption among medical students. Eighty-six per cent (n = 821) of their respondents reported experiencing some form of alcohol-related harassment since the beginning of medical school. No similar research has been conducted in the UK. METHODS A cross-sectional online questionnaire of medical students at three British medical schools. In total, 216 students answered questions regarding their experiences of alcohol-related provocation (as targets and instigators), the rate of occurrence of events and their distress following acts of provocation. An open-ended question enabled respondents to report personal experiences of alcohol-related provocation. RESULTS Seventy-five per cent (n = 162) of respondents reported experiencing alcohol-related provocation during the past year, with 49.1% (n = 106) reporting instigating acts of provocation. The most prevalent experience (both for targets and instigators) was coercion to drink an entire alcoholic beverage at once as part of a game. Most acts of alcohol-related provocation generated little or no distress. Males were significantly more likely to experience some events than females. Thirty-two personal narratives of alcohol-related provocation were reported (only three reported resisting provocation). Thematic analysis identified three themes with differing power relations: ongoing 'peer-peer provocation' as a commonplace social activity, hierarchical 'peer provocation' at initiation ceremonies and 'team-mate provocation' at sports socials as bonding exercises. The tone of the narratives depended on the context in which the events described occurred. CONCLUSIONS Alcohol-related provocation occurs among some UK medical students and may present professionalism issues to medical students. Medical schools may wish to integrate more teaching regarding behaviour around alcohol into their curricula by addressing students' explicit and implicit attitudes towards alcohol consumption.
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Affiliation(s)
- Lori F Black
- Institute of Medical Education, School of Medicine, Cardiff University, Cardiff, UK
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Vaysse B, Gignon M, Zerkly S, Ganry O. Alcool, tabac, cannabis, anxiété et dépression des étudiants en 2e année de médecine. Repérer pour agir. SANTE PUBLIQUE 2014. [DOI: 10.3917/spub.145.0613] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Quigg Z, Hughes K, Bellis MA. Student drinking patterns and blood alcohol concentration on commercially organised pub crawls in the UK. Addict Behav 2013; 38:2924-9. [PMID: 24064191 DOI: 10.1016/j.addbeh.2013.08.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/25/2013] [Accepted: 08/28/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Commercial student pub crawls are associated with high levels of alcohol consumption, and are of growing concern amongst public health and student bodies. However, little is currently known about drinking behaviours whilst participating in these events. METHODS A questionnaire was implemented amongst 227 students attending commercial pub crawls across three UK events. Questions established alcohol consumption patterns up to the point of interview and throughout the remaining night out, and pub crawl experience. Breathalyser tests were used to measure breath alcohol concentration (converted to blood alcohol concentration [BAC]) at interview. Analyses used chi squared, Mann-Whitney U, Kruskal-Wallis and logistic regression. RESULTS 94.3% of participants had consumed alcohol, 90.9% of whom reported preloading. Drinkers reported consuming a median of 10.0 alcohol units (80g of pure alcohol) up to the point of interview (range one-40.6), with estimated total consumption over the evening exceeding 16units (range three-70.6). Median BAC of drinkers at the time of interview was 0.10%BAC (range 0.00-0.27). High BAC (>0.08%; at interview) was associated with having not eaten food in the four hours prior (AOR 4.8, p<0.01), time spent drinking (AOR 1.4, p<0.01) and number of units drank per hour (AOR 1.2, p<0.01). CONCLUSIONS Measures to prevent high levels of alcohol consumption before and during commercial pub crawls should aim to alter drinking behaviours such as preloading and rapid and excessive drinking. Organisers, local authorities, universities and students should all be involved in ensuring the effective management of pub crawls, including implementation of harm prevention measures.
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Rau T, Plener P, Kliemann A, Fegert JM, Allroggen M. Suicidality among medical students - a practical guide for staff members in medical schools. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2013; 30:Doc48. [PMID: 24282451 PMCID: PMC3839076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 08/15/2013] [Accepted: 09/16/2013] [Indexed: 11/26/2022]
Abstract
Although suicidality in medical students is important, few studies dealt with this issue regarding German universities. Our aims were to describe the epidemiology as well as factors leading to suicidality in medical students. Furthermore we wanted to raise awareness for this topic among university employees and show options for handling suicidal crises in students. This manuscript especially aims to address university employees working in direct contact with students (such as student counselors or teachers).
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Affiliation(s)
- Thea Rau
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Ulm, Deutschland
| | - Paul Plener
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Ulm, Deutschland
| | - Andrea Kliemann
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Ulm, Deutschland
| | - Jörg M. Fegert
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Ulm, Deutschland
| | - Marc Allroggen
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Ulm, Deutschland
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Ketoja J, Svidkovski AS, Heinälä P, Seppä K. Risky drinking and its detection among medical students. Addict Behav 2013; 38:2115-8. [PMID: 23435272 DOI: 10.1016/j.addbeh.2013.01.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Revised: 12/07/2012] [Accepted: 01/24/2013] [Indexed: 10/27/2022]
Abstract
The drinking patterns of physicians may affect their own health and how they treat patients with substance use disorders. This is why we wanted to find out risky drinking among medical students. A questionnaire was delivered to all medical students at the University of Tampere and risky alcohol drinking was defined as a minimum score of five for women and six for men in the AUDIT-C alcohol screen (rating 0 to 12). The respondent rate was 94% (n=465). Of the whole sample 33% were risky drinkers, 24% of women and 49% of men. After the first study year the female risky drinkers significantly decreased and men increased their drinking. Significantly more men but not women with moderate alcohol use reduced drinking during the first year of studies compared with risky drinkers of the same gender. The AUDIT-C scored higher in the subgroups of risky drinkers willing to reduce drinking compared with those who did not want to cut down drinking (7.3. and 6.5., p<0.001). In the male sample the third AUDIT-C sub-question on binge drinking (=AUDIT-3, rating 0 to 4) at a cut-off point of ≥2 was nearly as effective as the whole AUDIT-C at a cut-off point of ≥6. This was not the case in the female sub-sample. Risky drinking is common among medical students and continues throughout the studies especially among men. AUDIT-3 is a short and reliable screening tool for male but not for female students.
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Prevalence and associated factors of stress, anxiety and depression among prospective medical students. Asian J Psychiatr 2013; 6:128-33. [PMID: 23466109 DOI: 10.1016/j.ajp.2012.09.012] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 09/11/2012] [Accepted: 09/15/2012] [Indexed: 11/21/2022]
Abstract
Many studies have reported that the prevalence of psychological distress among medical students during medical training was high. However, there are very few studies exploring on the psychological health of prospective medical students. This study aimed to determine the prevalence and associated factors for stress, anxiety and depression symptoms among the prospective medical students. A cross-sectional study was done on two cohorts of applicants to a public medical school. A total of 839 applicants were invited to participate in the study. The 21-item Depression Anxiety Stress Scale was administered to the applicants after they completed interviews. A total of 743 (92.2%) applicants took part in the study. The prevalence of moderate to extremely severe level of stress, anxiety and depression were 3.6%, 54.5% and 1.9%, respectively. Stress was significantly associated with extra-curricular activity (p<0.001) and race (p<0.001). Anxiety was associated with extra-curricular activity (p<0.001), race (p<0.001), mother education level (p=0.002) and CGPA group (p=0.034). Depression was associated with academic performance in class (p<0.001) and race (p=0.004). Prevalence of stress and depression among entering medical students was low; however prevalence of anxiety was high which could be due to worry about the interviews to enter medical course. The associated factors of psychological distress among prospective medical students were related to academic, non-academic, parent education and cultural backgrounds.
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Yusoff MSB. Associations of pass-fail outcomes with psychological health of first-year medical students in a malaysian medical school. Sultan Qaboos Univ Med J 2013; 13:107-14. [PMID: 23573390 DOI: 10.12816/0003203] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 09/12/2012] [Accepted: 10/18/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms). METHODS A cross-sectional study was conducted on a cohort of first-year medical students in a Malaysian medical school. The depression anxiety stress scale 21-item assessment (DASS-21) was administered to them right after the final paper of the first-year final examination. Their final examination outcomes (i.e. pass or fail) were traced by using their student identity code (ID) through the Universiti Sains Malaysia academic office. RESULTS A total of 194 (98.0%) of medical students responded to the DASS-21. An independent t-test showed that students who passed had significantly lower stress, anxiety, and depression symptoms than those who failed the first-year final examination (P <0.05). Those who experienced moderate to high stress were at 2.43 times higher risk for failing the examination than those who experienced normal to mild stress. CONCLUSION Medical students who failed in the final examination had higher psychological distress than those who passed the examination. Those who experienced high stress levels were more likely to fail than those who did not. Reducing the psychological distress of medical students prior to examination may help them to perform better in the examination.
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Yusoff MSB, Yaacob MJ, Naing NN, Esa AR. Psychometric properties of the Medical Student Well-Being Index among medical students in a Malaysian medical school. Asian J Psychiatr 2013; 6:60-5. [PMID: 23380320 DOI: 10.1016/j.ajp.2012.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Revised: 08/08/2012] [Accepted: 09/02/2012] [Indexed: 11/16/2022]
Abstract
This study evaluated the convergent, discriminant, construct, concurrent and discriminative validity of the Medical Student Wellbeing Index (MSWBI) as well as to evaluate its internal consistency and optimal cut-off total scores to detect at least moderate levels of general psychological distress, stress, anxiety and depression symptoms. A cross sectional study was done on 171 medical students. The MSWBI and DASS-21 were administered and returned immediately upon completion. Confirmatory factor analysis, reliability analysis, ROC analysis and Pearson correlation test were applied to assess psychometric properties of the MSWBI. A total of 168 (98.2%) medical students responded. The goodness of fit indices showed the MSWBI had a good construct (χ(2)=6.14, p=0.803, RMSEA<0.001, RMR=0.004, GFI=0.99, AGFI=0.97, CFI=1.00, IFI=1.02, TLI=1.04). The Cronbach's alpha value was 0.69 indicating an acceptable level of internal consistency. Pearson correlation coefficients and ROC analysis suggested each MSWBI's item showed adequate convergent and discriminant validity. Its optimal cut-off scores to detect at least moderate levels of general psychological distress, stress, anxiety, and depression were 1.5, 2.5, 1.5 and 2.5 respectively with sensitivity and specificity ranged from 62 to 80% and the areas under ROC curve ranged from 0.71 to 0.83. This study showed that the MSWBI had good level of psychometric properties. The MSWBI score more than 2 can be considered as having significant psychological distress. The MSWBI is a valid and reliable screening instrument to assess psychological distress of medical students.
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Affiliation(s)
- Muhamad Saiful Bahri Yusoff
- Medical Education Department, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia.
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McKinney A, Coyle K, Penning R, Verster JC. Next day effects of naturalistic alcohol consumption on tasks of attention. Hum Psychopharmacol 2012; 27:587-94. [PMID: 24446537 DOI: 10.1002/hup.2268] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The aim of this study was to examine the next day effects of alcohol consumption on a range of attention tasks. METHODS The study followed a counterbalanced repeated measure design, with participants tested the morning following normal/usual alcohol consumption and again the morning after no alcohol consumption. Participants were 48 social drinkers (15 men and 33 women), who performed attention tests at 9 am, 11 am, or 1 pm. Performance was assessed by tasks measuring sustained attention, divided attention, selective attention, and spatial attention and by the Stroop test. RESULTS The morning after alcohol consumption, a significantly higher proportion of missed targets was observed (F(1, 40) = 6.43, p < 0.05) in the sustained attention task. In the Stroop test, participants responded significantly slower (F(1, 42) = 8.72, p < 0.005) in the interference condition (when naming the color of the ink of the words) the morning after alcohol consumption. In the selective attention task, the consumption of alcohol the night before eliminated the robust distance by compatibility interaction, which was observed the morning after no alcohol consumption (F(1, 43) = 10.41, p < 0.01). No influence of alcohol was observed in the divided attention test nor in the spatial attention task. CONCLUSION Alcohol consumption has a negative impact on some but not all facets of attentional processing the morning after a normal nights drinking.
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Affiliation(s)
- Adele McKinney
- School of Psychology, Magee Campus, University of Ulster, Derry, Northern Ireland, UK.
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Moreira MT, Oskrochi R, Foxcroft DR. Personalised normative feedback for preventing alcohol misuse in university students: Solomon three-group randomised controlled trial. PLoS One 2012; 7:e44120. [PMID: 22984466 PMCID: PMC3440433 DOI: 10.1371/journal.pone.0044120] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 07/30/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Young people tend to over-estimate peer group drinking levels. Personalised normative feedback (PNF) aims to correct this misperception by providing information about personal drinking levels and patterns compared with norms in similar aged peer groups. PNF is intended to raise motivation for behaviour change and has been highlighted for alcohol misuse prevention by the British Government Behavioural Insight Team. The objective of the trial was to assess the effectiveness of PNF with college students for the prevention of alcohol misuse. METHODOLOGY Solomon three-group randomised controlled trial. 1751 students, from 22 British Universities, allocated to a PNF group, a normal control group, or a delayed measurement control group to allow assessment of any measurement effects. PNF was provided by email. Participants completed online questionnaires at baseline, 6- and 12-months (only 12-months for the delayed measurement controls). Drinking behaviour measures were (i) alcohol disorders; (ii) frequency; (iii) typical quantity, (iv) weekly consumption; (v) alcohol-related problems; (vi) perceived drinking norms; and (vii) positive alcohol expectancies. Analyses focused on high-risk drinkers, as well as all students, because of research evidence for the prevention paradox in student drinkers. PRINCIPAL FINDINGS Follow-up rates were low, with only 50% and 40% responding at 6- and 12-months, respectively, though comparable to similar European studies. We found no evidence for any systematic attrition bias. Overall, statistical analyses with the high risk sub-sample, and for all students, showed no significant effects of the intervention, at either time-point, in a completed case analysis and a multiple imputation analysis. CONCLUSIONS We found no evidence for the effectiveness of PNF for the prevention of alcohol misuse and alcohol-related problems in a UK student population. REGISTRATION Controlled-Trials.com ISRCTN30784467.
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Affiliation(s)
- Maria T. Moreira
- Instituto Superior de Saúde do Alto Ave, Póvoa de Lanhoso, Braga, Portugal
| | - Reza Oskrochi
- Medical Statistics Programme, Oxford Brookes University, Oxford, Oxfordshire, United Kingdom
| | - David R. Foxcroft
- Department of Psychology, Social Work and Public Health, Oxford Brookes University, Oxford, Oxfordshire, United Kingdom
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Quince TA, Wood DF, Parker RA, Benson J. Prevalence and persistence of depression among undergraduate medical students: a longitudinal study at one UK medical school. BMJ Open 2012; 2:e001519. [PMID: 22893670 PMCID: PMC3425899 DOI: 10.1136/bmjopen-2012-001519] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 07/02/2012] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To determine the prevalence of depression among male and female medical students, its change over time and whether depression persists for affected students. DESIGN Longitudinal study comprising annual questionnaire surveys which included the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). PARTICIPANTS Between 2007 and 2010 all 1112 students entering the Core Science component (Year 1) and all 542 students entering the Clinical component (Year 4) of the Cambridge (UK) medical course were followed-up annually. METHODS We analysed, separately for men and women, mean HADS-D scores, the proportions whose scores indicated depression at different time-points and for students maintaining participation, the number of occasions on which their HADS-D scores indicated depression. RESULTS 725 Core Science and 364 Clinical students participated. Mean HADS-D scores ranged between 3.34 and 3.49 among all Core Science students and between 2.16 and 2.91 among all Clinical students. There was no difference between men and women in median HADS-D scores. Prevalence of depression ranged between 5.7% and 10.6% among all Core Science students and between 2.7% and 8.2% among all Clinical students. Over time Core Science students displayed no increase in mean HADS-D score. Among Clinical students only men displayed a small increase (time coefficient 0.33 (95% CI 0.11 to 0.55)). Prevalence did not increase over time. 220 Core Science and 150 Clinical students participated throughout the study. Of these, 18.2% and 10.6%, respectively, recorded HADS-D scores indicating depression on at least one occasion. Of 56 students recording depression at some point, 37 did so only once. CONCLUSIONS Prevalence of depression among participants was similar to that reported for comparable groups. Among men approaching the end of clinical studies depression scores increased. In all years a minority of students displayed depression; for some this persisted. Mechanisms are needed to identify and support students suffering from depression, particularly when persistent.
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Affiliation(s)
- Thelma A Quince
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Cambridge, UK
| | - Diana F Wood
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Richard A Parker
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Cambridge, UK
| | - John Benson
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Cambridge, UK
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Walkiewicz M, Tartas M, Majkowicz M, Budzinski W. Academic achievement, depression and anxiety during medical education predict the styles of success in a medical career: a 10-year longitudinal study. MEDICAL TEACHER 2012; 34:e611-9. [PMID: 22905663 DOI: 10.3109/0142159x.2012.687478] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
AIM Our study investigated the styles of success in the medical career in young physicians, in comparison with the same subjects examined 4-10 years earlier. METHODS The participants were first studied when they applied to the medical university (1999). Questionnaires were sent to all students each year (2000-2005). Fifty-four medical doctors participated in the first phase of the study completed a questionnaire four years after graduation. The current questionnaire included measures of burnout, satisfaction with medicine as a career, quality of life (QOL) and postgraduate examination results. Previous questionnaires had included measures of academic achievement, depression and anxiety. RESULTS We can describe three different styles of success, which can be predicted during medical education. Physicians with the best professional competence have the lowest income. However, physicians with the lowest professional competence gain the highest income. Those with the highest QOL (general well-being and life satisfaction) have the lowest professional stress and vulnerability to burnout. Anxiety and academic achievement (during the second and fourth year of study) are the significant predictors of specific style belonging. CONCLUSIONS Our results may be useful to medical school admissions and resident selection committees to identify candidates at risk for less satisfaction or less competence.
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