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Colonnello V, Leonardi G, Farinelli M, Russo PM. The relationship of psychological health and primary emotional traits in medical students. MEDICAL TEACHER 2023; 45:717-723. [PMID: 36488198 DOI: 10.1080/0142159x.2022.2152662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Several studies have called for attention to medical students' well-being. Building on the neuroevolutionary affective neuroscience perspective that views primary emotional systems as central to well-being and the foundation of personality, this study investigated the facets of medical students' psychological well-being that are challenged and the relationships between emotional traits, psychological well-being, and depression. METHODS In a single-center cross-sectional study, medical students' primary emotional traits (SEEKING, FEAR, ANGER, SADNESS, CARE, PLAY and Spirituality), psychological well-being dimensions (autonomy, environmental mastery, positive relations, self-acceptance, purpose in life, and personal growth), and depressive symptoms were assessed using the Affective Neuroscience Personality Scale; the Psychological Well-being Scale, which provides normative data; and the Beck Depression Inventory. RESULTS Compared with the normative data, the medical students perceived lower psychological autonomy, positive relations, and self-acceptance but higher purpose in life. The medical students' emotional traits were related to specific psychological well-being facets and depression. SEEKING and, inversely, FEAR were related to well-being across dimensions and depressive symptoms. CONCLUSION Our findings are the first to show a link between emotional traits and specific facets of psychological health in medical students. Thus, this study encourages medical teachers to set learning environments that target multiple facets of well-being that harness primary emotional traits.
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Affiliation(s)
- Valentina Colonnello
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | - Marina Farinelli
- Clinical Psychology Service, Villa Bellombra Rehabilitation Hospital, Colibrì Consortium, Bologna, Italy
| | - Paolo M Russo
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Young C, Juliani M. Universal Brief Mental Health Screenings for First-Year Medical Students: A 6-Year Retrospective of the Keck Checks Program. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:782-787. [PMID: 36780668 DOI: 10.1097/acm.0000000000005169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Medical students are at elevated risk for mental health difficulties and may struggle to ask for help. Innovative outreach programs are warranted to reduce barriers and ensure that students receive the professional care they need and deserve. This article provides a 6-year retrospective of the Keck Checks program, a well-established initiative that offered universal 15-minute mental health screenings to every first-year medical student at the Keck School of Medicine of the University of Southern California from fall 2016 to fall 2022. This early detection program was designed to combat barriers to seeking mental health care by normalizing the concept of all students meeting with a psychologist early in their academic careers. The Keck Checks program showed promising feasibility, with a single full-time clinician successfully hosting appointments for entire classes of first-year medical students (mean of 189 students per class) during approximately 4 months, in addition to other work duties. Participation rates were high, with 715 eligible students (76.3%) choosing to attend their Keck Check. Students were frequently referred to follow-up services during the Keck Check, including mental health care (n = 360 [50.4%] referred), occupational therapy (n = 72 [10.1%] referred), and academic support services (n = 60 [8.4%] referred). Next steps include possible expansion of similar programs to medical students in years 2 to 4, residents, and physicians, as well as understanding the effect of brief mental health screenings on long-term help-seeking, adherence to mental health treatment plans, and general educational or professional success. Brief, universal mental health screenings are a relatively low-cost, high-impact approach for medical schools to consider in supporting the mental health of their student body.
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Affiliation(s)
- Chantal Young
- C. Young is director of medical student well-being, director, Office of Well-being, and assistant professor of clinical medical education and psychiatry, Keck School of Medicine of the University of Southern California, Los Angeles, California; ORCID: http://orcid.org/0000-0001-7271-5417
| | - Maria Juliani
- M. Juliani is associate director of medical student well-being and associate professor of clinical medical education and psychiatry, Keck School of Medicine of the University of Southern California, Los Angeles, California; ORCID: https://orcid.org/0000-0001-6660-1149
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Zaidi TH, Zafar M, Ilyas A, khan M, Ghani R, Naz R, Mubbashir A. Association Of Burnout And Depression Symptoms And Their Prevalence Among Medical Students In Karachi, Pakistan. RUSSIAN OPEN MEDICAL JOURNAL 2023. [DOI: 10.15275/rusomj.2023.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Background — The mental health of medical students has long been a concern. Symptoms of depression and burnout are common among medical students, but the overlap of symptoms of both diseases with risk factors remains unclear. The goal of this study was to determine the prevalence of burnout and depression symptoms’ overlap in medical students. Methods — This cross-sectional study was conducted among students of the clinical course (3rd, 4th and 5th years). A multistage stratified random sampling design was used to select 284students that were offered a validated and structured questionnaire that included a modified Oldenburg Burnout Inventory and Patient Health Questionnaire-9 to assess their emotional burnout and depression, respectively. Chi-square and multinomial regression analyses were done to identify overlapping symptoms of burnout and depression with association of risk factors with dependent variable. Results — Out of 284 students, 13% had symptoms of severe depression, 24% had high burnout symptoms, and 32% had overlapping symptoms of burnout and depression. In regression analysis, higher academic year more than 2 times (5th year, OR 2.03, 95% CI 1.42-7.96, p-value 0.004) and living at dormitory more than 3 times (OR 3.97, 95% CI 1.97-5.01, p-value 0.003) were more likely associated with more extensive overlap of burnout and depression symptoms. Conclusion — There is a high prevalence of burnout and depression symptoms among medical students, with a strong association between the two disorders. Early burnout detection and psychiatric therapies given to affected students and these disorders management training at medical school, may help reduce negative consequences of these conditions.
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Mostafa HES, Alahmadi D, Jorob S, Murtada L, Aloufi R, Almeshaly S, Aloufi R. Psychological Impact of Online Education on University Students. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.10917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND: Stressful events like the COVID-19 pandemic can significantly impact education. Online learning has become crucial in educational institutions such as schools, institutes, and universities.
AIM: This study’s purpose is to evaluate the psychological impact of online education on university students in Al-Madinah Al-Munawara.
METHODS: A cross-sectional study using a self-administered survey is designed based on previous studies and frameworks to assess the psychological impact of online education.
RESULTS: The present study showed that 21.8% of students always had trouble concentrating through the online learning process. About 23.4% had thoughts that their ability to study is impaired. About 19.8% found it difficult to work up. There is a negative impact on psychological health because 13.9% feel agitated, 20.8% become nervous, 20.6% become watchful and on guard, and 21.8% are usually distressed and find it difficult to relax. The sleep mode was also affected in 19.0% of participants, besides lack of interest which was noted in 17.7%. Hence, students experienced harmful and unwanted psychological impacts during the COVID-19 pandemic and lockdown period.
CONCLUSION: Results of the present study suggest a relation between online education and the negative psychological status of students. Students experienced increased depression, anxiety, and stress that had a negative effect on their daily schedule and social well-being during the COVID-19 pandemic.
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Hasan S, Pozdol SL, Nichelson BK, Cunningham SJ, Lasek DG, Dankoski ME. The Development of a Comprehensive Mental Health Service for Medical Trainees. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1610-1615. [PMID: 35731599 PMCID: PMC9592167 DOI: 10.1097/acm.0000000000004789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Mental distress in medical learners and its consequent harmful effects on personal and professional functioning, a well-documented concern, draws attention to the need for solutions. The authors review the development of a comprehensive mental health service within a large and complex academic medical education system, created with special attention to offering equitable, accessible, and responsive care to all trainees. From the inception of the service in January 2017, the authors placed particular emphasis on eliminating obstacles to learners' willingness and ability to access care, including concerns related to cost, session limits, privacy, and flexibility with modality of service delivery. Development of outreach initiatives included psychoeducational programming, consultation services, and cultivation of liaison relationships with faculty and staff. Significant utilization of clinical services occurred in the first year of the program and increased further over the course of 4 academic years (2017-2021); with a 2.2 times increase in trainees served and a 2.4 times increase in visits annually. In the 2020-2021 academic year, 821 medical learners received services (for a total 5,656 visits); 30% of all medical students and 25% of house staff and fellows sought treatment in that year. In 2021, 38% of graduating medical school students and 27% of graduating residents and fellows had used mental health services at some point in their training. Extensive use of services combined with very high patient satisfaction ratings by medical learners within this system demonstrate the perceived value of these services and willingness to pursue mental health care when offered a resource that is cognizant of, and responsive to, their unique needs. The authors reflect on potential factors promoting utilization of services-institutional financial support, outreach efforts, and design of services to increase accessibility and reduce barriers to seeking treatment-and propose future areas for investigation.
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Affiliation(s)
- Samia Hasan
- S. Hasan is assistant professor, Department of Psychiatry, and director, Mental Health Services, Indiana University School of Medicine, Indianapolis, Indiana; ORCID: https://orcid.org/0000-0002-6546-5007
| | - Stacie L. Pozdol
- S.L. Pozdol is program manager and staff therapist, Mental Health Services, Indiana University School of Medicine, Indianapolis, Indiana
| | - Brian K. Nichelson
- B.K. Nichelson is staff psychologist, Mental Health Services, Indiana University School of Medicine, Indianapolis, Indiana
| | - Stephanie J. Cunningham
- S.J. Cunningham is staff psychologist, Mental Health Services, Indiana University School of Medicine, Indianapolis, Indiana
| | - Dana G. Lasek
- D.G. Lasek is regional campus staff psychologist, Mental Health Services, Indiana University School of Medicine, Indianapolis, Indiana
| | - Mary E. Dankoski
- M.E. Dankoski is the Lester D. Bibler Professor of Family Medicine and executive associate dean, Faculty Affairs, Professional Development, and Diversity, Indiana University School of Medicine, Indianapolis, Indiana
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Kihumuro RB, Kaggwa MM, Nakandi RM, Kintu TM, Muwanga DR, Muganzi DJ, Atwau P, Ayesiga I, Acai A, Najjuka SM, Najjuma JN, Frazier-Koussai S, Ashaba S, Harms S. Perspectives on mental health services for medical students at a Ugandan medical school. BMC MEDICAL EDUCATION 2022; 22:734. [PMID: 36284284 PMCID: PMC9592876 DOI: 10.1186/s12909-022-03815-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/19/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND University-based mental health services for medical students remain a challenge, particularly in low-income countries, due to poor service availability. Prior studies have explored the availability of mental health services in high-income countries but little is known about mental health services in countries in sub-Saharan Africa, such as Uganda. Medical students are at a higher risk of developing mental health challenges during their course of study as compared with other students. Thus, there is a need for well-structured mental health services for this group of students. The aim of this study was to explore perspectives on mental health services for medical students at a public University in Uganda. METHODS This was a qualitative study where key informant interviews were conducted among purposively selected university administrators (n = 4), student leaders (n = 4), and mental health employees of the university (n = 3), three groups responsible for the mental well-being of medical students at a public university in Uganda. Interviews were audio-recorded, transcribed, and thematically analyzed to identify relevant themes. RESULTS The working experience of university administrators and mental health providers was between eight months to 20 years, while student leaders had studied at the university for over four years. We identified five broad themes: (1) Burden of medical school: A curriculum of trauma, (2) Negative coping mechanisms and the problem of blame, (3) The promise of services: Mixed Messages, (4) A broken mental health system for students, and (5) Barriers to mental health services. CONCLUSION Distinguishing between psychological distress that is anticipated because of the subject matter in learning medicine and identifying those students that are suffering from untreated psychiatric disorders is an important conceptual task for universities. This can be done through offering education about mental health and well-being for administrators, giving arm's length support for students, and a proactive, not reactive, approach to mental health. There is also a need to redesign the medical curriculum to change the medical education culture through pedagogical considerations of how trauma informs the learning and the mental health of students.
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Affiliation(s)
| | - Mark Mohan Kaggwa
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
- African Centre for Suicide Prevention and Research, Mbarara, Uganda.
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.
| | | | - Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - David Jolly Muganzi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Pius Atwau
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Innocent Ayesiga
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Anita Acai
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | | | | | - Susan Frazier-Koussai
- Texas Juvenile Crime Prevention Center at Prairie View, A and M University (PVAMU), Texas, USA
| | - Scholastic Ashaba
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Sheila Harms
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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Volpe RL, de Boer C, Wasserman E, Van Scoy LJ. Can an Arts Course Help Mitigate Medical Student Burnout? MEDICAL SCIENCE EDUCATOR 2022; 32:1023-1032. [PMID: 35966164 PMCID: PMC9361955 DOI: 10.1007/s40670-022-01604-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Burnout in healthcare providers begins early, with about half of medical students experiencing symptoms of burnout, and as many as one-quarter experiencing depression. While organizational, systemic-level changes certainly contribute to mitigation, organizationally sponsored individual-level changes may also play a significant role. Although the nature of the burnout epidemic and its impact on trainee wellness is fairly well understood, and interventions have been studied, there remains a gap in the empirical research examining the impact of the arts on medical student well-being. METHODS We designed a convergent mixed methods study to evaluate whether a 9-month course for fourth-year medical students called Art as Self Care (AASC) would help trainees develop habits that supported their well-being. An online survey was used to collect data at the beginning and end of each academic year on two consecutive cohorts of students. A focus group explored students' experience with and perceptions about the course. RESULTS Qualitative results indicated that the AASC course provided positive distraction that is calming and allowed students to shift focus from the stresses of daily medical school life. Our quantitative results suggest that art might provide a slight protective effect in medical students: whereas 22% of the non-AASC students saw a worsening of their psychological distress across the fourth year of medical school, this was observed in only 13% of the AASC students. DISCUSSION Our study presents pilot and feasibility data to better inform future research and practice around the use of art to support medical student well-being. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-022-01604-y.
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Affiliation(s)
- Rebecca L. Volpe
- Department of Humanities, H134, Penn State College of Medicine, 500 University Drive, Hershey, PA 17011 USA
| | - Claire de Boer
- Doctors Kienle Center for Humanistic Medicine and Center Stage Arts in Health, Penn State Health Hershey Medical Center and College of Medicine, Hershey, USA
| | - Emily Wasserman
- Public Health Sciences, Penn State College of Medicine, Hershey, USA
| | - Lauren Jodi Van Scoy
- Pulmonary and Critical Care Medicine, and Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, USA
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Training of Faculty and Staff in Recognising Undergraduate Medical Students’ Psychological Symptoms and Providing Support: A Narrative Literature Review. Behav Sci (Basel) 2022; 12:bs12090305. [PMID: 36135109 PMCID: PMC9495451 DOI: 10.3390/bs12090305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/19/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Mental illness among medical students in particular, and higher education students in general, is very high. Many measures have been suggested in order to improve the situation, including training members of faculty and staff. However, to the best of our knowledge there seem to be no studies proposing training programmes for medical schools’ faculty and staff in response to recognising students’ psychological difficulties and symptoms in order to provide the relevant support. Also, in cases where such training for supporting medical students with psychological symptomatology exist, the efficacy of the approach employed is not known. By employing a careful literature search according to published guidelines for narrative literature reviews, this study aimed to fill in this identified gap in the literature. From the literature search, 14 articles were included in this review and the results show that no training tailored for faculty and staff in medical schools was identified. However, articles that related to higher education were included because they were useful in providing insights for medicine, and show the following: (a) faculty and staff acknowledged the importance of mental illness among students, (b) many of them discussed with their students psychological symptoms and provided support, (c) they tended to feel unprepared for recognising students’ psychological symptoms successfully and providing support, (d) they embraced the idea of being trained, and (e) any training seemed to be helpful for members of faculty and staff. From the results of this narrative review, we propose the CReATE circular pathway to ensure a sustainable process of training and support for students’ development.
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Colonnello V, Fino E, Russo PM. Attachment anxiety and depressive symptoms in undergraduate medical students : The mediating role of emotion regulation strategies. PERSPECTIVES ON MEDICAL EDUCATION 2022; 11:207-212. [PMID: 35587333 PMCID: PMC9391533 DOI: 10.1007/s40037-022-00713-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Several studies report that medical students are at high risk of depression. Despite the variability in students' vulnerability to depression, the role of individual differences in depression risk among medical students has hardly been investigated. Studies outside of medical student populations have shown that individual differences in attachment style and emotion regulation participate in vulnerability to depression. OBJECTIVES This study investigates to what extent medical students' depressive symptoms are related to differences in students' insecure attachment styles and their perception of reduced access to emotion regulation strategies. METHODS In a cross-sectional quantitative study, undergraduate medical students at the beginning of their second academic year completed online questionnaires measuring their attachment style, difficulties in emotion regulation, and depressive symptoms. RESULTS Out of the 390 medical students invited, 267 participated in the survey. Higher secure attachment was associated with fewer depressive symptoms. Medical students' insecure attachment style and emotion dysregulation were significantly related to depressive symptoms. Difficulties in employing strategies to disengage from one's own negative affect partly mediated the effects of two dimensions of insecure anxious attachment-need for approval and preoccupation with relationships-on depressive symptoms. DISCUSSION Anxious attachment style and limited access to emotion regulation strategies participate in medical students' depressive symptoms. These findings highlight the need for acknowledging medical students' attachment style and students' perceived access to emotion regulation strategies for the early identification of and intervention programs for the risk of depression.
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Affiliation(s)
- Valentina Colonnello
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
| | - Edita Fino
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Paolo Maria Russo
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Risk factors associated with student distress in medical school: Associations with faculty support and availability of wellbeing resources. PLoS One 2022; 17:e0265869. [PMID: 35395007 PMCID: PMC8992977 DOI: 10.1371/journal.pone.0265869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background
It is estimated that over half of medical students experience severe distress, a condition that correlates with low mental quality-of-life, suicidal ideation and serious thoughts of dropping out. While several risk factors for the development of severe distress have been identified, most focus on individual student characteristics. Currently, little is known about the impact medical schools have on student wellbeing.
Methods
Prospective, observational survey study from 2019–2020 from a national cohort of US medical students. Student wellbeing, school characteristics, and wellbeing resource availability was measured with a 30-question electronic survey. Medical student distress was defined as a Medical Student Wellbeing Index (MS-WBI) of ≥4. Risk factors for the development of severe distress were evaluated in a multivariate logistic regression model. The impact of the number of wellbeing resources available on student wellbeing was measured along multiple wellbeing domains. Independent reviewers categorized free text analysis of survey responses about desired wellbeing resources into themes.
Results
A total of 2,984 responses were included in the study, representing 45 unique medical schools. Medical school characteristics independently associated with severe distress included low faculty support (OR 4.24); the absence of mentorship resources (OR 1.63) and the absence of community building programs (OR 1.45) in a multivariate model. Increased availability of wellbeing resources was associated with lower average MS-WBI (4.58 vs. 3.19, p<0;05) and a smaller percentage of students who had taken or considered taking a leave of absence (40% vs. 16%, p<0.05). The resources most desired by students were mental health services and scheduling adjustments.
Conclusions
The majority of medical school characteristic that contribute to student distress are modifiable. Improving faculty support and offering more and varied wellbeing resources may help to mitigate medical student distress. Student feedback is insightful and should be routinely incorporated by schools to guide wellbeing strategies.
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Ekbäck E, von Knorring J, Burström A, Hunhammar D, Dennhag I, Molin J, Henje E. Training for Awareness, Resilience and Action (TARA) for medical students: a single-arm mixed methods feasibility study to evaluate TARA as an indicated intervention to prevent mental disorders and stress-related symptoms. BMC MEDICAL EDUCATION 2022; 22:132. [PMID: 35227281 PMCID: PMC8883651 DOI: 10.1186/s12909-022-03122-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/13/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND Medical students have a higher risk for depression, anxiety, stress-related symptoms, burnout, and suicide, and more rarely seek professional help or treatment than the general population. Appeals are being made to address the mental health and resilience of physicians-to-be. The novel program Training for Awareness, Resilience, and Action (TARA) was originally developed to treat depressed adolescents, targeting specific neuroscientific findings in this population. TARA has shown feasibility and preliminary efficacy in clinically depressed adolescents and corresponding brain-changes in mixed community adolescent samples. The present study investigated the feasibility and acceptability of TARA as a potential indicated prevention program for symptoms of depression, anxiety, stress and burnout in Swedish medical students. METHODS We conducted a single-arm trial with 23 self-selected students in their early semesters of medical school (mean age 25.38 years, 5 males and 18 females), with or without mental disorders. All participants received TARA. Self-reported symptoms of depression, anxiety, perceived stress and psychological inflexibility were collected before (T0) and after the intervention (T1). Qualitative data on the participants' experiences of TARA were collected in focus-group interviews conducted halfway through the program and upon completion of the program. Individual interviews were also conducted 2 years later. Qualitative content analysis was performed. RESULTS The mean attendance rate was 61.22% and the dropout rate was 17.40%. The Child Session Rating Scale administered after every session reflected an overall acceptable content, mean total score 34.99 out of 40.00. Trends towards improvement were seen across all outcome measures, including the Hospital Anxiety and Depression Scale Anxiety (t = 1.13, p = 0.29) and Depression (t = 1.71, p = 0.11) subscales, Perceived Stress Scale (t = 0.67, p = 0.51) and Avoidance and Fusion Questionnaire for youth (t = 1.64, p = 0.10). None of the participants deteriorated markedly during the intervention. Qualitative content analysis resulted in a main theme labeled: "An uncommon meeting-ground for personal empowerment", with 4 themes; "Acknowledging unmet needs", "Entering a free zone", "Feeling connected to oneself and others" and "Expanding self-efficacy". CONCLUSION TARA is feasible and acceptable in a mixed sample of Swedish medical students. The students' reports of entering an uncommon meeting-ground for personal empowerment supports effectiveness studies of TARA in this context.
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Affiliation(s)
- Erik Ekbäck
- Department of Clinical Science, Umeå University, Umeå, Sweden.
| | | | - Anna Burström
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - David Hunhammar
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Inga Dennhag
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Jenny Molin
- Department of Nursing, Department of Clinical Science, Umeå university, Umeå, Sweden
| | - Eva Henje
- Department of Clinical Science, Umeå University, Umeå, Sweden
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Domínguez-González AD, Guzmán-Valdivia G, Ángeles-Téllez FS, Manjarrez-Ángeles MA, Secín-Diep R. Depression and suicidal ideation in Mexican medical students during COVID-19 outbreak. A longitudinal study. Heliyon 2022; 8:e08851. [PMID: 35128117 PMCID: PMC8806407 DOI: 10.1016/j.heliyon.2022.e08851] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/16/2021] [Accepted: 01/14/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction The COVID-19 pandemic has been particularly difficult for populations at risk for mental health problems, such as healthcare professionals and medical students. In the present study, we evaluated the effect of the pandemic on mental health in a sample of Mexican medical students with and without a mental health diagnosis. Method Longitudinal and descriptive study based on scales of suicidal ideation, depressive symptoms and risk of alcohol consumption, conducted in April and December 2020. Results Sample includes 247 medical students, 64.4% are women. Prevalence of depression increased between April and December from 19.84% to 40.08%. In the case of women from 23.67% to 42.60% (χ2 = 0.000) and in men from 11.54% to 34.62% (χ2 = 0.001). In April 16.92% of healthy students presented some sign of depression and in December the percentage increased to 40.80% (χ2 = 0.000). Regarding medicated students, the prevalence in April was 32.61% and in December it was 36.96% (χ2 = 0.662). In April, the medicated students with risk of suicidal ideation were 17 out of 46 (36.96%), compared to the students without a diagnosis of psychiatric illness were 29 out of 201 (13.43%) (χ2 = 0.000). For December, the non-medicated students at risk of suicidal ideation were 34 out of 201 (16.91%), and the medicated students were 12 out of 46 (26.09%) (χ2 = 0.149). Conclusions The pandemic has increase the rate of depression in medical students, being more severe in women. Students under psychiatric treatment showed a higher prevalence of depression; however, the fact of being under treatment resulted in a protective factor for the increase in the prevalence of depression. It is important to deepen the understanding of the causes of depression and to disseminate among the university community the benefits of early detection and treatment of people with socio-emotional disorders.
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Affiliation(s)
- A D Domínguez-González
- Universidad La Salle-México, BenjamÃ-n Franklin 45, Mexico City 06140, Mexico.,Facultad Mexicana de Medicina, Las Fuentes 17, Mexico City 14000, Mexico
| | - G Guzmán-Valdivia
- Universidad La Salle-México, BenjamÃ-n Franklin 45, Mexico City 06140, Mexico.,Facultad Mexicana de Medicina, Las Fuentes 17, Mexico City 14000, Mexico
| | - F S Ángeles-Téllez
- Facultad Mexicana de Medicina, Las Fuentes 17, Mexico City 14000, Mexico
| | | | - R Secín-Diep
- Facultad Mexicana de Medicina, Las Fuentes 17, Mexico City 14000, Mexico.,Hospital Ãngeles Pedregal, Camino Santa Teresa 1055, Mexico City 10700, Mexico
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Guo J, Huang X, Zheng A, Chen W, Lei Z, Tang C, Chen H, Ma H, Li X. The Influence of Self-Esteem and Psychological Flexibility on Medical College Students' Mental Health: A Cross-Sectional Study. Front Psychiatry 2022; 13:836956. [PMID: 35651820 PMCID: PMC9148951 DOI: 10.3389/fpsyt.2022.836956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/20/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Mental health problems has become a major public health issue among medical students. Self-esteem and psychological flexibility were important associated factors for mental health, but their relations have not been discussed in medical students. The present study aimed to assess the status of mental health problems among medical students and identified whether psychological flexibility had a mediating role in the effects of self-esteem on the top three most common psychological symptoms. METHODS A total of 810 undergraduate students from 18 classes comprised in the sample. Nine dimensions of psychological symptoms was assessed by the Symptom Checklist-90-revised (SCL-90-R). Self-esteem was measured by the Self-esteem Scale (SES) and psychological flexibility was evaluated by the Acceptance and Action Questionnaire 2nd Edition (AAQ-II) and Cognitive Fusion Questionnaire (CFQ-F). Univariate analysis and logistic regression analysis were used to determine the relationship among the top three common psychological symptoms, self-esteem, psychological flexibility, and participants' characteristics. The mediating effect of psychological flexibility between self-esteem and psychological symptoms was detected by bootstrap method. RESULTS 57.8% of the medical undergraduate students reported positive at least one of the nine psychological symptom dimensions assessed by the SCL-90-R and 13.8% of students had moderate or more severe symptoms. The symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression were the three most common psychological symptoms among the medical students. Meanwhile, self-esteem and psychological flexibility were negatively associated to the symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression. And, almost 50% effects of self-esteem on these three symptoms in medical students exert indirect effects through psychological flexibility. CONCLUSIONS Psychological distress was quite common in the Chinese medical students. The three most common psychological symptoms were successively obsessive-compulsiveness, interpersonal sensitivity, and depression. Low self-esteem and psychological inflexibility might be the risk factors for these top three symptoms, and psychological flexibility might play a mediating role in the effects of self-esteem on these psychological symptoms.
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Affiliation(s)
- Jiamei Guo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Huang
- Department of Psychology, Hunan University of Medicine, Hunan, China
| | - Anhai Zheng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wanjun Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhongli Lei
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chenglu Tang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongyu Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongyan Ma
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Buige A, Nguyen M, Harris SC. Barriers to mental health care and stigma perception in doctor of pharmacy students across the United States. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1634-1645. [PMID: 34895673 DOI: 10.1016/j.cptl.2021.09.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 07/21/2021] [Accepted: 09/15/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Pharmacy students are significantly less likely than medical students to seek on-campus mental health services, though barriers are not well known. This study's objective is to expand on perceived barriers to seeking care for mental health concerns among doctor of pharmacy students in the United States. METHODS An institutional review board-exempt, online survey was disseminated to eight pharmacy programs' students assessing mental health barriers to care, resource interest, attitudes towards treatment, and stigma. Quantitative data were analyzed aggregately and by gender, program type, employment status, and education year. Free-text response analysis used thematic coding. RESULTS Common barriers to care included lack of time (20.2%), financial support or resources (13.2%), and preferring to solve the issue independently (13.2%). About half agreed their programs had sufficient resources to support mental health (58.4%). Suggested resources included on-site counselors (14.5%), pet therapy (13.4%), and wellness activities (12.3%). Students reported high rates of perceived internal stigma, yet low rates of stigma towards others. No significant differences were found among employment status or program type, but first-year students had more positive attitudes towards mental health treatment. Females were significantly more likely to agree mental health treatment was effective and less likely to view someone differently who received treatment. CONCLUSIONS Common barriers to care included lack of time, finances or resources, and concerns of being viewed differently. Additionally, substantial stigma exists, particularly public perception and concern for negative impact on future opportunities. Programs should take initiative to understand students' needs and interest in support services.
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Affiliation(s)
- Ashley Buige
- Virginia Commonwealth University Health System, 401 North 12th Street, Richmond, VA 23298, United States.
| | - Mimi Nguyen
- University of North Carolina Eshelman School of Pharmacy, 301 Pharmacy Lane, Chapel Hill, NC 27599, United States.
| | - Suzanne C Harris
- University of North Carolina Eshelman School of Pharmacy, 301 Pharmacy Lane, Chapel Hill, NC 27599, United States.
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Tamminga MA, Tomescu O. Medical student knowledge and concern regarding mental health disclosure requirements in medical licensing. Gen Hosp Psychiatry 2021; 72:31-35. [PMID: 34229281 DOI: 10.1016/j.genhosppsych.2021.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/16/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Two-thirds of United States medical boards require disclosure of mental health treatment or diagnosis during licensure, with negative influence on physician well-being but unknown impact on medical students. This study sought to understand whether medical students perceive mental health treatment to be a threat to their future medical license. METHOD Students at an American medical school in a state without disclosure questions completed an anonymous fourteen question survey. Analysis with univariate and multivariate statistics explored knowledge, opinion, and impact of disclosure questions. RESULTS Data was obtained from 327 medical students, a 53% response rate. The majority-91% (299)-were unsure or incorrect as to whether their state licensing board requires mental health disclosure. 33% (86) reported disclosure questions substantially discourage them from seeking mental health treatment. Of the 32% (105) who accessed mental health treatment during medical school, half-52% (74)-would not disclose during licensing. Those who believe that disclosure could impact their license were more likely to be discouraged from seeking care (OR, 5.23 [95% CI, 1.97-15.99]; P = 0.002). Most students-75% (245)-opposed mandatory disclosure. CONCLUSIONS Concern about mandatory mental health disclosure discourages medical students from seeking care, despite uncertainty about disclosure questions.
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Affiliation(s)
- Mila A Tamminga
- Perelman School of Medicine, Jordan Medical Education Center, 6th Floor, 3400 Civic Center Blvd, Building 421, Philadelphia, PA 19104, United States of America.
| | - Oana Tomescu
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, United States of America.
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Schutt A, Chretien KC, Woodruff JN, Press VG, Vela M, Lee WW. National Survey of Wellness Programs in U.S. and Canadian Medical Schools. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:728-735. [PMID: 33538474 DOI: 10.1097/acm.0000000000003953] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To describe the prevalence and scope of wellness programs at U.S. and Canadian medical schools. METHOD In July 2019, the authors surveyed 159 U.S. and Canadian medical schools regarding the prevalence, structure, and scope of their wellness programs. They inquired about the scope of programming, mental health initiatives, and evaluation strategies. RESULTS Of the 159 schools, 104 responded (65%). Ninety schools (93%, 90/97) had a formal wellness program, and across 75 schools, the mean full-time equivalent (FTE) support for leadership was 0.77 (standard deviation [SD] 0.76). The wellness budget did not correlate with school type or size (respectively, P = .24 and P = .88). Most schools reported adequate preventative programming (62%, 53/85), reactive programming (86%, 73/85), and cultural programming (52%, 44/85), but most reported too little focus on structural programming (56%, 48/85). The most commonly reported barrier was lack of financial support (52%, 45/86), followed by lack of administrative support (35%, 30/86). Most schools (65%, 55/84) reported in-house mental health professionals with dedicated time to see medical students; across 43 schools, overall mean FTE for mental health professions was 1.62 (SD 1.41) and mean FTE per student enrolled was 0.0024 (SD 0.0019). Most schools (62%, 52/84) evaluated their wellness programs; they used the Association of American Medical Colleges Graduation Questionnaire (83%, 43/52) and/or annual student surveys (62%, 32/52). The most commonly reported barrier to evaluation was lack of time (54%, 45/84), followed by lack of administrative support (43%, 36/84). CONCLUSIONS Wellness programs are widely established at U.S. and Canadian medical schools, and most focus on preventative and reactive programming, as opposed to structural programming. Rigorous evaluation of the effectiveness of programs on student well-being is needed to inform resource allocation and program development. Schools should ensure adequate financial and administrative support to promote students' well-being and success.
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Affiliation(s)
- Alison Schutt
- A. Schutt is a medical student, University of Chicago Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Katherine C Chretien
- K.C. Chretien is professor of medicine and associate dean, Student Affairs, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - James N Woodruff
- J.N. Woodruff is professor of medicine and dean of students, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Valerie G Press
- V.G. Press is associate professor, Department of Medicine, University of Chicago, Chicago, Illinois
| | - Monica Vela
- M. Vela is professor of medicine and associate dean, Multicultural Affairs, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Wei Wei Lee
- W.W. Lee is associate professor of medicine and associate dean, Professional Development and Engagement, University of Chicago Pritzker School of Medicine, Chicago, Illinois; ORCID: http://orcid.org/0000-0002-7694-1304
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Hiranwong T, Sitthiprawiat P, Siritikul S, Jiwtrakul J, Klaychaiya S, Chaipinchana P, Kuntawong P, Wongpakaran T, Wongpakaran N, Deesomchok A, Wedding D. Mental Strength and Challenges among Thai Medical Students in Their Clinical Years-Study Protocol. Healthcare (Basel) 2021; 9:305. [PMID: 33801800 PMCID: PMC8001773 DOI: 10.3390/healthcare9030305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/05/2021] [Accepted: 03/07/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Mental well-being and mental health problems are both important, especially among medical students who will be future doctors. The proposed study aimed to explore both positive and negative mental health experiences, especially mistreatment, occurring among medical students in their clinical years. (2) Methods/design: The study will conduct a cross-sectional survey between January 2021 and December 2021, among medical students studying in their clinical years across 23 medical schools throughout Thailand. Measurements regarding character strengths related to medical professionalism as well as other positive mental health strengths and negative mental health problems, e.g., anxiety, depression and experience of mistreatment will be completed. Both medical students and faculty members will be invited to participate in the study. (3) Discussion: this survey will provide an overall picture of medical students' mental well-being, positive and negative aspects of mental health and the magnitude of mistreatment and perspectives they experience. The limitations of the survey will be discussed.
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Affiliation(s)
- Tanrin Hiranwong
- Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (T.H.); (P.S.); (S.S.); (J.J.); (S.K.); (P.C.); (A.D.)
| | - Patipan Sitthiprawiat
- Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (T.H.); (P.S.); (S.S.); (J.J.); (S.K.); (P.C.); (A.D.)
| | - Sirinut Siritikul
- Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (T.H.); (P.S.); (S.S.); (J.J.); (S.K.); (P.C.); (A.D.)
| | - Jiraphat Jiwtrakul
- Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (T.H.); (P.S.); (S.S.); (J.J.); (S.K.); (P.C.); (A.D.)
| | - Sirilux Klaychaiya
- Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (T.H.); (P.S.); (S.S.); (J.J.); (S.K.); (P.C.); (A.D.)
| | - Pookit Chaipinchana
- Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (T.H.); (P.S.); (S.S.); (J.J.); (S.K.); (P.C.); (A.D.)
| | - Pimolpun Kuntawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (P.K.); (N.W.)
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (P.K.); (N.W.)
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (P.K.); (N.W.)
| | - Athavudh Deesomchok
- Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai 50200, Thailand; (T.H.); (P.S.); (S.S.); (J.J.); (S.K.); (P.C.); (A.D.)
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Zhou W, Pu J, Zhong X, Yang W, Teng T, Fan L, Wang H, Tian L, Liu Y, Xie P. Overlap of burnout-depression symptoms among Chinese neurology graduate students in a national cross-sectional study. BMC MEDICAL EDUCATION 2021; 21:83. [PMID: 33530985 PMCID: PMC7851928 DOI: 10.1186/s12909-021-02511-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/21/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND The overlap of burnout and depression is a phenomenon that can effectively reflect the psychological state of a group. However, whether burnout is a type of depression is still debated in current research. The high incidence of burnout and depressive symptoms among medical students indicates that it is urgent to provide appropriate health services for them. However, the proportion of burnout and depression in the overlapping symptoms experienced by medical students, and the characteristics of the relative influencing factors, remain unclear. Therefore, we addressed these issues for neurology graduate students in China. METHODS Using data from a cross-sectional survey of Chinese neurology graduate students, a diagnostic model was established according to their burnout and/or depression symptoms. Burnout was assessed by using the Maslach Burnout Inventory. Depression symptoms were assessed with a two-item depression screening tool for primary care evaluation of mental disorders. Univariate analyses with chi-squared tests were conducted to assess associations between variables. Multinomial logistic regression models were used to analyze the effects of multiple factors on dependent variables. The factors included demographic information and three medical-study related problems. RESULTS In total, 32.2% of surveyed students evidenced overlapping burnout and depression symptoms. Students with depressive symptoms tended to be included in the burnout students' category. In the regression model, being unmarried, having children, and career choice regret were related to students who had only burnout, while the students with overlapping symptoms were affected by more factors such as family income, the consideration of dropping out once. CONCLUSIONS The symptoms and related factors of burnout and depression among Chinese neurology postgraduates have obvious overlap and show a significant trend. The occurrence of depressive symptoms among medical students is closely related to whether they are burned out. Students with only burnout were common, but students with only depressive symptoms were uncommon. Finally, burnout may be a pre-depression state.
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Affiliation(s)
- Wei Zhou
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Juncai Pu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiaogang Zhong
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
- Key Laboratory of Psychoseomadsy, Stomatological Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Wensong Yang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Teng Teng
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Li Fan
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Haiyang Wang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
- Stomatological Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Lu Tian
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Yiyun Liu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Peng Xie
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, China.
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
- China Neurologist Association of Chinese Medical Doctor Association, Beijing, 100010, China.
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Watanabe T, Kondo M, Sakai M, Takabatake S, Furukawa TA, Akechi T. Association of Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder Traits with Depression and Empathy Among Medical Students. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:1259-1265. [PMID: 34737666 PMCID: PMC8560068 DOI: 10.2147/amep.s334155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/18/2021] [Indexed: 05/19/2023]
Abstract
PURPOSE This study aimed to investigate the associations of the traits of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) with depression and empathy among medical students. PATIENTS AND METHODS A cross-sectional survey was conducted with 202 fifth-year students at a Japanese medical school for 10 months during their clinical clerkship. The survey included sociodemographic questions and validated tools to measure depressive symptoms (Hospital Anxiety and Depression Scale [HADS]), medical students' empathy for patients (Jefferson Scale of Empathy-Student version [JSE]), ADHD traits (ADHD Self-Report Scale Screener [ASRS Screener]), and ASD traits (Autism-Spectrum Quotient Japanese version-21 [AQ-J-21]). RESULTS A total of 151 students (response rate: 74.7%) participated in the survey. Of these, 41 (27.2%) reported a total score of ≥ 20 on the HADS and were categorized as depressed. Depressed students reported significantly lower and higher rates of having a part-time job and a history of enrolment in other faculties, respectively, than non-depressed students. According to the cutoff criteria of the ASRS Screener and AQ-J-21, 31 (20.5%) and 42 (27.8%) students reported ADHD and ASD traits, respectively. Multivariate regression analysis, controlling for age and sex, reported that higher age, ASRS Screener scores, and AQ-J-21 scores were significant predictors of higher HADS total scores. Additionally, higher AQ-J-21 scores significantly predicted lower JSE scores. CONCLUSION The degree of ADHD and ASD traits was significantly associated with depression. Moreover, the degree of ASD traits was significantly associated with lower empathy for their patients. It is important to consider that about 20-30% of medical students have these neurodevelopmental traits and to develop intervention strategies for improving depression and empathy.
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Affiliation(s)
- Takafumi Watanabe
- Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
- Correspondence: Takafumi Watanabe Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya City, Aichi, 467-8601, JapanTel +81 52 853 8271Fax +81 52 852 0837 Email
| | - Masaki Kondo
- Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - Mie Sakai
- Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - So Takabatake
- Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto City, Japan
| | - Tatsuo Akechi
- Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
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Kent C, Tabacof L, Delgado A, Turner D, Cortes M, Cardozo E, Escalon MX. Redeployed PM&R Trainees Rely on Pro-Social Behavior during COVID-19 Pandemic: A Qualitative Survey Analysis. JOURNAL OF SCIENTIFIC INNOVATION IN MEDICINE 2020. [DOI: 10.29024/jsim.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mikhaiel JP, Pollack J, Buck E, Williams M, Lott A, Penner JC, Ann Cary M. Graduating With Honors in Resilience: Creating a Whole New Doctor. Glob Adv Health Med 2020; 9:2164956120976356. [PMID: 33329942 PMCID: PMC7720294 DOI: 10.1177/2164956120976356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022] Open
Abstract
Background Although coaching programs have become a prominent piece of graduate medical education, they have yet to become an integral part of undergraduate medical education. A handful of medical schools have utilized longitudinal coaching experiences as a method for professional identity formation, developing emotional intelligence and leadership. Objective We developed A Whole New Doctor (AWND), a medical student leadership development and coaching program at Georgetown University, with the aim of fostering resilience, leadership, and emotional intelligence at the nascent stage of physician training. To our knowledge, ours is the only program that is largely student-managed and uses certified executive coaches in the medical student population. Methods Cohort 1 of AWND started in October 2016. For each cohort, we hold a kickoff workshop that is highly interactive, fast-paced and covers coaching, complex thinking, reflective writing, and a coaching panel for Q&A. Following the workshop, students work with coaches individually to address self-identified weaknesses, tensions, and areas of conflict. We believe the program's student-driven nature provides a new structural approach to professional development and leadership programs, offering students a simultaneously reflective and growth-oriented opportunity to develop essential non-technical skills for physician leaders. Results Of the 132 students in the program, 107 have worked with one of our coaches (81%). Student testimonials have been uniformly positive with students remarking on an increased sense of presence, improvements in communication, and more specific direction in their careers. Conclusion Our pilot coaching program has received positive feedback from students early in their medical training. It will be important to further scale the program to reach an increasing number of students and quantitatively evaluate participants for the long-term effects of our interventions.
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Affiliation(s)
- John Paul Mikhaiel
- School of Medicine, Georgetown University, Washington, District of Columbia
| | - Jack Pollack
- School of Medicine, Georgetown University, Washington, District of Columbia
| | - Emory Buck
- School of Medicine, Georgetown University, Washington, District of Columbia
| | - Matt Williams
- School of Medicine, Georgetown University, Washington, District of Columbia
| | - Aisha Lott
- School of Medicine, Georgetown University, Washington, District of Columbia
| | - John C Penner
- Department of Medicine, University of California, San Francisco, California
| | - Margaret Ann Cary
- Department of Family Medicine, School of Medicine, Georgetown University, Washington, District of Columbia
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Hays RB, Ramani S, Hassell A. Healthcare systems and the sciences of health professional education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:1149-1162. [PMID: 33206272 PMCID: PMC7672408 DOI: 10.1007/s10459-020-10010-1] [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: 07/28/2020] [Accepted: 10/27/2020] [Indexed: 05/02/2023]
Abstract
Health professions education is that part of the education system which applies educational philosophy, theory, principles and practice in a complex relationship with busy clinical services, where education is not the primary role. While the goals are clear-to produce the health workforce that society needs to improve health outcomes-both education and healthcare systems continue to evolve concurrently amidst changes in knowledge, skills, population demographics and social contracts. In observing a significant anniversary of this journal, which sits at the junction of education and healthcare systems, it is appropriate to reflect on how the relationship is evolving. Health professions educators must listen to the voices of regulators, employers, students and patients when adapting to new service delivery models that emerge in response to pressures for change. The recent COVID-19 pandemic is one example of disruptive change, but other factors, such as population pressures and climate change, can also drive innovations that result in lasting change. Emerging technology may act as either a servant of change or a disruptor. There is a pressing need for interdisciplinary research that develops a theory and evidence base to strengthen sustainability of change.
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Affiliation(s)
- R B Hays
- College of Medicine & Dentistry, James Cook University, Townsville, Australia.
| | - S Ramani
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - A Hassell
- School of Medicine, Keele University, Newcastle upon Tyne, UK
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Coffey CS, MacDonald BV, Shahrvini B, Baxter SL, Lander L. Student Perspectives on Remote Medical Education in Clinical Core Clerkships During the COVID-19 Pandemic. MEDICAL SCIENCE EDUCATOR 2020; 30:1577-1584. [PMID: 33078085 PMCID: PMC7556768 DOI: 10.1007/s40670-020-01114-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 05/17/2023]
Abstract
PURPOSE To assess student perceptions of remote learning curricula implemented by clinical clerkships at a single US medical school during the COVID-19 pandemic. METHOD Students enrolled in core clinical clerkships at the UC San Diego School of Medicine from March to April 2020 were sent an anonymous online survey, assessing components of remote learning curricula via quantitative rating and free-response questions. RESULTS Of 132 students enrolled, 96 (73%) completed the survey. Online question banks, remote progress reviews, and telehealth sessions were rated as the most valuable resources, while textbooks were rated least valuable. Most students felt that the number of resources was adequate (69/94, 74%), the quantity of required content was appropriate (77/93, 83%), and there was a good balance of rigidity versus flexibility in the schedule (81/94, 86%). Most students felt "prepared" or "somewhat prepared" for the shelf examination (61/91, 67%) and for the next year of medical training (73/94, 78%). In narrative reflections, students valued the flexibility afforded by remote curricula but desired some weekly structure. Students enjoyed expanded access to learning resources and participating in interactive remote sessions. Students expressed anxiety about the pandemic and uncertainty regarding medical education, but transparent communication from clerkship directors helped assuage these concerns. CONCLUSIONS Student participation in direct patient care is fundamental to medical school core clerkships and was negatively impacted by the COVID-19 pandemic. Strategic incorporation of select remote learning components into clinical clerkships may permit a favorable student experience even when opportunities for on-site participation are limited.
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Affiliation(s)
- Charles S. Coffey
- Department of Surgery, Division of Otolaryngology/Head and Neck Surgery, University of California San Diego Moores Cancer Center, 3855 Health Sciences Dr. #0987, La Jolla, CA 92093-0987 USA
| | | | - Bita Shahrvini
- University of California San Diego School of Medicine, La Jolla, CA USA
| | - Sally L. Baxter
- Health Sciences Department of Biomedical Informatics, University of California San Diego, La Jolla, CA USA
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA USA
| | - Lina Lander
- Innovation and Medical Education, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA USA
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Thuma T, Lawandy M, Lotfalla A, Terrell M, Lomiguen C. Mental Health Matters: Mental Health and Overall Well-Being Among First- and Second-Year Medical Students. HEALTH PROFESSIONS EDUCATION 2020. [DOI: 10.1016/j.hpe.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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25
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Dhahri AA, Arain SY, Memon AM, Rao A, Mian MA. "The psychological impact of COVID-19 on medical education of final year students in Pakistan: A cross-sectional study". Ann Med Surg (Lond) 2020; 60:445-450. [PMID: 33251004 PMCID: PMC7683177 DOI: 10.1016/j.amsu.2020.11.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 10/29/2022] Open
Abstract
Introduction COVID-19 pandemic has resulted in a strong impact on students' wellbeing, with associated uncertainty about the future. We conducted a cross-sectional survey to assess the psychological effects of COVID-19 on the medical education of final year students in Pakistan. Methods We conducted prospective, cross-sectional survey, as a snapshot, from June 07, 2020 till June 16, 2020, among final year medical and dental students. The 20-questions survey questionnaire was based on rating-scale items to focus on psychological symptoms, institutional preparedness for such crisis and confidence in becoming a future doctor. Descriptive statistics were calculated using Multivariate regression analysis. Results Majority of participants (n = 1753/2661, 65.9%) were female. Despite timely closure of institutes, delay in the start of the online teaching (beta coefficient 0.08, P-value 0.02) was significantly correlated with the depressive symptoms. A significant percentage of students (n = 1594, 59.9%) wanted a delay in exit exams due to intimidation. A similar proportion of students also lost confidence to be a competent doctor in future which was positively associated with male gender (beta coefficient 0.21, P-value < 0.001). Conclusion Our study shows that COVID-19 pandemic has brought significant psychological influence on the medical education of final year students. Despite a stressful crisis, final year medical and dental students are still willing to serve the community. In addition to supporting their emotions and psychological wellbeing, stress counselling, and transforming current medical curricula is crucial to pursue ceaseless medical education and to become a safe future doctor.
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Affiliation(s)
| | | | | | - Ahsan Rao
- Cambridge University Hospitals NHS Foundation Trust, UK
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Association between nutritional level, menstrual-related symptoms, and mental health in female medical students. PLoS One 2020; 15:e0235909. [PMID: 32658906 PMCID: PMC7357753 DOI: 10.1371/journal.pone.0235909] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/24/2020] [Indexed: 11/19/2022] Open
Abstract
Objective Research suggests that medical students as well as women are at greater risk of depression compared to the general population and men. This suggests that female medical students are crucial targets requiring specific monitoring for mental health disorder prevention and intervention. However, little is known regarding the risk factors for poor mental health among this population. Therefore, we investigated whether menstrual symptoms and nutritional status are associated with psychological distress in Japanese female medical students. Methods This cross-sectional study assessed 326 female medical students who attended a school medical check-up, which included blood sampling in 2018. The levels of psychological distress were evaluated using the Japanese General Health Questionnaire (J-GHQ)-30. We defined high GHQ scores as GHQ-30 ≥7. We checked dysmenorrhea levels and assessed menstrual symptoms according to the presence of premenstrual syndrome (PMS). Dysmenorrhea was evaluated according to quartiles of the sum of the Menstrual Distress Questionnaire (MDQ). PMS was assessed using the Premenstrual Symptoms Questionnaire (PSQ). We evaluated levels of serum albumin, hemoglobin, ferritin, and lipid metabolite as nutritional factors. A multivariate logistic regression analysis was used to identify the association between menstrual-related symptoms or nutritional factors and the levels of psychological distress. Results A total of 45 female medical students (15%) experienced psychological distress. Serum albumin levels were associated with psychological distress, while lipid metabolite levels were not. The intensity of dysmenorrhea and the presence of PMS were associated with psychological distress, independent of nutritional status. Conclusion Both menstrual symptoms and nutrition markers were associated with the levels of psychological distress in Japanese female medical students. School doctors and nurses can help improve the mental health of young female medical students by encouraging a healthy diet and checking for the presence of menstrual symptoms.
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Jacob R, Li TY, Martin Z, Burren A, Watson P, Kant R, Davies R, Wood DF. Taking care of our future doctors: a service evaluation of a medical student mental health service. BMC MEDICAL EDUCATION 2020; 20:172. [PMID: 32471406 PMCID: PMC7257172 DOI: 10.1186/s12909-020-02075-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 05/12/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND Studies suggest medical students experience high levels of mental distress during training but are less likely, than other students, to access care due to stigma and concerns regarding career progression. In response, The School of Clinical Medicine, University of Cambridge supported the development of the 'Clinical Student Mental Health Service' to provide specialist input for this vulnerable group. This study evaluates the efficiency and effectiveness of this service. METHODS Using mixed-methods, cross-sectional analysis of validated psychiatric rating scales and qualitative feedback, 89 responses were analysed from 143 clinical students referred, between 2015 and 2019. The care pathway included initial review by a psychiatrist, who triaged students to psychologists delivering therapies including: Cognitive Behavioural Therapy, Interpersonal Therapy, Eye Movement Desensitization Reprocessing Therapy or Cognitive Analytic Therapy. Efficiency was assessed by waiting times for psychiatry and psychology interventions, and number of sessions. Academic outcomes included school intermission and graduation. Clinical effectiveness was analysed by measuring global distress, depression, anxiety, functioning and suicidal risk. Pre/post intervention changes were captured using t-test and McNemar test with thematic analysis of qualitative feedback. RESULTS Referral rates increased from 3.93% (22/560) in 2015 to 6.74% (45/668) in 2018. Median waiting times for initial psychiatric assessment and start of therapy was 26 and 33 days, respectively. All graduating students moved on to work as junior doctors. Levels of distress, (t = 7.73, p < 0.001, df = 31), depression (t = 7.26, p < 0.001, df = 34) anxiety (Z = - 4.63, p < 0.001) and suicide risk (Z = - 3.89, p < 0.001) were significantly reduced. Participant's functioning was significantly improved (p < 0.001, 99.5% CI 4.55 to 14.62). Feedback indicated high satisfaction with the rapid access and flexibility of the service and the team clinicians. CONCLUSIONS A significant proportion of medical students attending the service scored highly on validated rating scales measuring emotional distress, suicidality and mental illness. Reassuringly they benefitted from timely specialist mental health input, showing improvements in mental well-being and improved functioning. The development and design of this service might serve as an exemplar for medical schools developing similar support for their students.
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Affiliation(s)
- Rebecca Jacob
- Dept of Liaison Psychiatry, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Dept of Liaison Psychiatry, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ UK
| | - Tsz-yan Li
- Dept of Liaison Psychiatry, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Zoe Martin
- Dept of Liaison Psychiatry, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Amanda Burren
- Dept of Liaison Psychiatry, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Peter Watson
- MRC Cognition & Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Rhian Kant
- Dept of Liaison Psychiatry, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Richard Davies
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Diana F. Wood
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Suarez DE, Cardozo AC, Ellmer D, Trujillo EM. Short report: cross sectional comparison of anxiety and depression symptoms in medical students and the general population in Colombia. PSYCHOL HEALTH MED 2020; 26:375-380. [DOI: 10.1080/13548506.2020.1757130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
| | | | - David Ellmer
- School of Medicine, Universidad los Andes, Bogota, Colombia
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29
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Bert F, Lo Moro G, Corradi A, Acampora A, Agodi A, Brunelli L, Chironna M, Cocchio S, Cofini V, D’Errico MM, Marzuillo C, Pasquarella C, Pavia M, Restivo V, Gualano MR, Leombruni P, Siliquini R. Prevalence of depressive symptoms among Italian medical students: The multicentre cross-sectional "PRIMES" study. PLoS One 2020; 15:e0231845. [PMID: 32302354 PMCID: PMC7164645 DOI: 10.1371/journal.pone.0231845] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/01/2020] [Indexed: 01/12/2023] Open
Abstract
Background Four percent of the world’s population suffers from depression, which is a major public health issue. Medical students are at risk, as their depressive symptoms (DS) prevalence is reported to be approximately 27% worldwide. Since few data on Italian medical students exist, this study aimed to estimate their DS prevalence and assess risk and protective factors. Methods The PRIMES was a multicentre cross-sectional study performed in 12 Italian medical schools. Questionnaires were self-reported and included 30 sociodemographic items and the Beck Depression Inventory-II (BDI-II). The primary outcome was the presence of DS (BDI-II score≥14). The main analyses were chi-squared tests and multivariable logistic regressions with a p-value<0.05 considered significant. Results The number of collected questionnaires was 2,513 (117 BDI-II incomplete). Females accounted for 61.3% of the respondents, and the median age was 22 years (IQR = 4). The prevalence of DS was 29.5%. Specifically, 14.0% had mild depression, 11.1% had moderate depression, and 4.5% had severe depression. The main risk factors for DS were age, being female, bisexual/asexual orientation, living with partner/housemates, poor economic status (worsened by living far from home), less than 90 min of weekly exercise, relatives with psychiatric disorders, personal chronic disease, judging medical school choice negatively, unsatisfying friendships with classmates, competitive and hostile climate among classmates, thinking that medical school hinders specific activities and being worried about not measuring up to the profession. Protective factors included family cohesion, hobbies, intellectual curiosity as a career motivation and no worries about the future. Conclusion Italian medical students are at high risk of reporting DS, similar to the global population of medical students’. Medical schools must make efforts to implement preventive and treatment interventions by offering counselling and working on modifiable factors, such as lifestyle and learning climate.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health Sciences, University of Torino, Torino, Italy
- A.O.U. City of Health and Science of Torino, Torino, Italy
| | - Giuseppina Lo Moro
- Department of Public Health Sciences, University of Torino, Torino, Italy
- * E-mail:
| | - Alessio Corradi
- Department of Public Health Sciences, University of Torino, Torino, Italy
| | - Anna Acampora
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Laura Brunelli
- Department of Medicine, University of Udine, Udine, Italy
| | - Maria Chironna
- Department of Biomedical Sciences and Human Oncology, University of Bari—Aldo Moro, Bari, Italy
| | - Silvia Cocchio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Vincenza Cofini
- Biostatistics and Epidemiology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Marcello Mario D’Errico
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Carolina Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Roma, Roma, Italy
| | | | - Maria Pavia
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Vincenzo Restivo
- Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | | | - Paolo Leombruni
- A.O.U. City of Health and Science of Torino, Torino, Italy
- Clinical Psychology and Psycho-Oncology Unit, Department of Neurosciences, University of Torino, Torino, Italy
| | - Roberta Siliquini
- Department of Public Health Sciences, University of Torino, Torino, Italy
- A.O.U. City of Health and Science of Torino, Torino, Italy
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Choi AMK, Moon JE, Friedman RA. Meeting the challenges of medical student mental health and well-being today. MEDICAL EDUCATION 2020; 54:183-185. [PMID: 31958172 DOI: 10.1111/medu.14064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Augustine M K Choi
- Office of the Dean, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Jennifer E Moon
- Office of the Dean, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Richard A Friedman
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, New York, USA
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Milic M, Gazibara T, Pekmezovic T, Kisic Tepavcevic D, Maric G, Popovic A, Stevanovic J, Patil KH, Levine H. Tobacco smoking and health-related quality of life among university students: Mediating effect of depression. PLoS One 2020; 15:e0227042. [PMID: 31914158 PMCID: PMC6948726 DOI: 10.1371/journal.pone.0227042] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 12/10/2019] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to assess the association between cigarette smoking and health-related quality of life (HRQoL) among students in two different universities, and the potential mediating effect of depression. Participants were students who came for mandatory check-ups at Student Health Care Centers in two Universities in Serbia, differing by socio-politically and economically environments. Students completed socio-demographic questionnaire, Beck Depression Inventory (BDI) and the SF-36 questionnaire for assessment of HRQoL. In both populations, after adjustment for socio-demographic, behavioral and health factors, smoking was associated with poorer Mental Composite Score (MCS) and Physical Composite Score (PCS) (Belgrade 1,624 students: MCS β = 3.38, 95% confidence interval [CI] 1.31, 5.44, PCS β = 1.01, 95% CI -0.50, 2.52; Kosovska Mitrovica 514 students: MCS β = 5.06, 95% CI 1.74, 8.37, PCS β = 3.29, 95% CI 0.75, 5.83). After additional adjustment for BDI score, the observed associations were lost (Belgrade: MCS β = 1.12, 95% CI -0.57, 2.80, PCS β = -0.40, 95% CI -1.71, 0.92; Kosovska Mitrovica: MCS β = 0.77, 95% CI -2.06, 3.60, PCS β = 0.56, 95% CI -1.75, 2.87). Higher BDI score was associated with poorer PCS and MCS across all quintiles. The association of smoking with impairment of HRQoL among university students in two different settings was mediated by higher levels of depressive symptoms. These findings highlight the need for further research on the interaction between smoking, mental health and quality of life, with implications for prevention, diagnosis and treatment.
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Affiliation(s)
- Marija Milic
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
- Department of Epidemiology, School of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tatjana Pekmezovic
- Institute of Epidemiology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Gorica Maric
- Institute of Epidemiology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Popovic
- School for Sports and Physical Education, University of Belgrade, Belgrade, Serbia
| | - Jasmina Stevanovic
- Department of Epidemiology, School of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | | | - Hagai Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
- * E-mail:
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Repeated Cross-sectional Surveys of Burnout, Distress, and Depression among Anesthesiology Residents and First-year Graduates. Anesthesiology 2019; 131:668-677. [DOI: 10.1097/aln.0000000000002777] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
Editor’s Perspective
What We Already Know about This Topic
What This Article Tells Us That Is New
Background
This repeated cross-sectional survey study was conducted to determine the prevalence of, and factors associated with, burnout, distress, and depression among anesthesiology residents and first-year graduates. We hypothesized that heavy workload and student debt burden were associated with a higher risk of physician burnout, distress, and depression, and that perception of having adequate workplace resources, work–life balance, and social support were associated with a lower risk.
Methods
Physicians beginning U.S. anesthesiology residency between 2013 and 2016 were invited to take online surveys annually from their clinical anesthesia year 1 to 1 yr after residency graduation. The Maslach Burnout Inventory, the Physician Well-Being Index, and the Harvard Department of Psychiatry/National Depression Screening Day Scale were used to measure burnout, distress, and depression, respectively. Logistic regression analyses were conducted to examine whether self-reported demographics, personal, and professional factors were associated with the risk of burnout, distress, and depression.
Results
The response rate was 36% (5,295 of 14,529). The prevalence of burnout, distress, and depression was 51% (2,531 of 4,966), 32% (1,575 of 4,941), and 12% (565 of 4,840), respectively. Factors associated with a lower risk of all three outcomes included respondents’ perceived workplace resource availability, (odds ratio = 0.51 [95% CI, 0.45 to 0.57] for burnout; 0.51 [95% CI, 0.45 to 0.56] for distress; 0.52 [95% CI, 0.45 to 0.60] for depression) and perceived ability to maintain work–life balance (0.61 [95% CI, 0.56 to 0.67] for burnout; 0.50 [95% CI, 0.46 to 0.55] for distress; 0.58 [95% CI, 0.51 to 0.65] for depression). A greater number of hours worked per week and a higher amount of student debt were associated with a higher risk of distress and depression, but not burnout.
Conclusions
Burnout, distress, and depression are notable among anesthesiology residents. Perceived institutional support, work–life balance, strength of social support, workload, and student debt impact physician well-being.
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Prevalence of and Predictive Factors for Burnout Among French Urologists in Training. Eur Urol 2019; 75:702-703. [DOI: 10.1016/j.eururo.2018.12.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 12/20/2018] [Indexed: 11/19/2022]
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