Mental health problems among medical students in Brazil: a systematic review and meta-analysis

Cognitive Disengagement Syndrome (CDS) and Psychological Ill-Being in Young Adults Using the Adult Concentration Inventory (ACI)

Background: Young adulthood is a demanding developmental stage, in that individuals are often faced with making major and long-lasting decisions related to career and family. This is also a heightened time of mental health difficulties. There is recent evidence that cognitive disengagement syndrome (CDS; previously sluggish cognitive tempo) may also be more prevalent in young adults and associated with poorer functioning. However, the relation between CDS symptoms and anxiety, depression, stress, and insomnia remains insufficiently investigated among young adults. Given this, the aims of the present study were as follows: (1) to investigate the associations between CDS and symptoms of depression, anxiety, stress, and insomnia; (2) to investigate if and which dimensions of ill-being were more robustly related to higher CDS scores; (3) to explore if stress scores moderated the associations between CDS symptoms and insomnia; and (4) to explore if higher insomnia categories were associated with higher CDS scores. Methods: A total of 246 young adult students in Switzerland (mean age = 22.62; 56.3% females) completed a booklet of questionnaires covering socio-demographic information, cognitive disengagement syndrome (Adult Concentration Inventory; ACI), and symptoms of depression, anxiety, stress, and insomnia as part of this cross-sectional study. Results: Higher CDS scores on the ACI were associated with higher scores for depression, anxiety, stress, and insomnia. Depression, anxiety, stress, and insomnia were independently associated with higher scores for CDS. Higher categories of stress moderated the associations between higher CDS scores and higher insomnia. Higher insomnia categories were related to higher CDS scores. Conclusions: The present data showed that among a small sample of young adult students, higher CDS scores were associated with higher psychological ill-being (depression, anxiety, stress, and insomnia). If we consider CDS as a trait, specific performance-enhancing medication or psychotherapeutic interventions might favorably influence dimensions of psychological ill-being such as depression, anxiety, stress, and insomnia.

Measuring Mental Health in 2 Brazilian University Centers: Protocol for a Cohort Survey

BACKGROUND

Global concern for the mental well-being of university students is on the rise. Recent studies estimate that around 30% of students experience mental health disorders, and nearly 80% of these individuals do not receive adequate treatment. Brazil, home to around eight million university students, lacks sufficient research addressing their mental health. To address this gap, we aim to conduct a longitudinal mental health survey at 2 Brazilian universities.

OBJECTIVE

This paper outlines the research protocol for a web-based mental health survey designed to assess the well-being of Brazilian university students.

METHODS

The survey targets undergraduate students (N=8028) from 2 institutions: UniFAJ (Centro Universitário de Jaguariúna) and UniMAX (Centro Universitário Max Planck). Students will be invited to respond to self-reported questionnaires, including theSMILE-U (lifestyle and quality of life), the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) self-rated level 1 cross-cutting symptom measure, and a brief version of the Adult Self-Report Scale for attention-deficit/hyperactivity disorder. Students who exceed thresholds for conditions such as depression, anxiety, and attention-deficit/hyperactivity disorder will receive additional diagnostic instruments. The survey will be conducted annually, tracking individual and group trajectories and enrolling new cohorts each year. Data will be analyzed using cross-sectional and longitudinal methods, focusing on descriptive, associative, and trajectory analyses.

RESULTS

The first wave of data collection began in February 2024 and is expected to conclude in December 2024. As of October 2024, a total of 2034 of 7455 (27.2 in 100) eligible students had completed the questionnaire. Cross-sectional statistical analysis is planned to commence immediately after data collection and is expected to be completed by June 2025.

CONCLUSIONS

This survey uses a scalable, cost-effective design to evaluate mental health conditions among Brazilian university students. The longitudinal framework facilitates the monitoring of mental health trends, supports the development of targeted interventions, and informs policy initiatives in higher education.

TRIAL REGISTRATION

OSF Registries OSF.IO/AM5WS; https://doi.org/10.17605/OSF.IO/AM5WS.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/63636.

The impact of affective and cognitive empathy on stress in medical students

OBJECTIVE

To analyze the relationship between empathy and its domains (i.e., affective and cognitive) and stress in medical students.

METHODS

An online cross-sectional study with 543 medical students as respondents divided in three groups: pre-clinical cycle (n = 173), clinical cycle (n = 197), and internship (n = 173). The participants completed the sociodemographic questionnaire, the Interpersonal Reactivity Index, and the Perceived stress scale.

RESULTS

The participants were mostly female (71.5%) with an average age of 23.54 (± 4.54) years old. Medical students in the clinical cycle, when compared to the ones in their pre-clinical cycle and internship, showed higher stress levels. Pre-clinical students presented higher levels of total empathy and its affective domain. The highest levels of empathy, especially affective empathy, were associated with higher stress levels in all three groups. Regarding cognitive empathy, there was no observed association with stress among the groups.

CONCLUSIONS

The levels of empathy and its affective domain correlated significantly with the stress indicators among students of different cycles (i.e., pre-clinical, clinical cycle, and internship).

Prevalence of anxiety, depression, and post-traumatic stress disorder among paramedic students: a systematic review and meta-analysis

PURPOSE

There are elevated mental health concerns in paramedic students, but estimates vary between studies and countries, and no review has established the overall prevalence. This systematic review addressed this by estimating the global prevalence of common mental health disorders, namely anxiety, depression, and post-traumatic stress disorder (PTSD), in paramedic students internationally.

METHODS

A systematic search of six databases, including MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, and medRxiv, was conducted to identify studies relating to mental health among paramedicine students. The search encompassed studies from inception until February 2023. To be considered for inclusion in the review, the studies had to report prevalence data on at least one symptom of anxiety, depression, or PTSD in paramedicine students, using quantitative validated scales. The quality of the studies was assessed using Joanna Briggs Institute (JBI) Checklist, which is a specific methodological tool for assessing prevalence studies. Subgroup analyses were not conducted due to insufficient data.

RESULTS

1638 articles were identified from the searches, and 193 full texts were screened, resulting in 13 papers for the systematic review and meta-analysis. The total number of participants was 1064 from 10 countries. The pooled prevalence of moderate PTSD was 17.9% (95% CI 14.8-21.6%), anxiety was 56.4% (95% CI 35,9-75%), and depression was at 34.7% (95% CI 23.4-48.1%).

CONCLUSION

This systematic review and meta-analysis has found that paramedicine students globally exhibit a high prevalence of moderate PTSD, anxiety, and depression. The prevalence of these mental health conditions surpasses those among paramedic providers and the general population, as indicated by previous reviews. Further research is therefore warranted to determine appropriate support and interventions for this group.

Psychometric properties of the Epworth Sleepiness Scale in Brazilian medical students

BACKGROUND

 Excessive daytime sleepiness (EDS) refers to the propensity to become drowsy or fall asleep when the intention and expectation would be to stay awake, and the Epworth Sleepiness Scale (ESS) is an easy-to-apply instrument that can be used to assess the presence of EDS.

OBJECTIVE

 To evaluate the psychometric properties of the ESS, including its construct validity and internal consistency, in a population of university students.

METHODS

 Two samples of 400 students from the medicine program of a university located in the Midwest of Brazil were randomly selected from a cross-sectional academic study conducted in 2018. Construct validity was examined through exploratory and confirmatory factor analysis of the eight items of the ESS, and the internal consistency was evaluated using the Cronbach's α coefficient (α).

RESULTS

 It was found that factor analyses revealed better adjustment measures when considering the ESS to be two-dimensional, grouped into two main factors: the first factor referring to the evaluation of sleepiness at rest, and the second referring to drowsiness in activity (standardized root mean square residual [SRMR] = 0.053; root mean square error of approximation [RMSEA] = 0.095; Comparative Fit Index [CFI] = 0.937; and Tucker-Lewis Index [TLI] = 0.908; p < 0.05). Moreover, the ESS presented an adequate internal consistency (α = 0.75).

CONCLUSION

 The present study showed general psychometric properties adequate for the ESS in medical students, including an acceptable construct validity and internal consistency. Thus, the ESS may be suitable to assess EDS in university students, especially medical students.

Factors associated with mental health and quality of life among Brazilian medical students: a three-year longitudinal study

BACKGROUND

Despite several studies on the mental health of medical students, there is insufficient research on long-term follow-ups.

AIMS

To investigate the associated factors and changes in the quality of life and mental health of a group of medical students followed-up for three years.

METHODS

An observational, prospective cohort study was conducted. Four classes were followed during the first three years of the medical course. The study included sociodemographic data, mental health data using the DASS-21 scale, and quality-of-life data using the WHOQOL-BREF scale. Linear regression models were used for analysis.

RESULTS

A total of 201 (66.1%) medical students responded to both data collection waves after a three-year follow-up. Depressive symptoms(p < 0.001), anxiety(p = 0.037), and stress(p < 0.001) increased. Additionally, physical(p < 0.001), psychological(p < 0.001), and social(p = 0.003) quality of life decreased. Worse mental health at baseline and being a woman were associated with worse mental health after three years, while higher income at baseline was associated with better quality of life after three years.

CONCLUSIONS

The mental health and quality of life of the medical students worsened after three years, being influenced by gender, income, and mental health at baseline. Educators and managers must be aware of these factors to minimize suffering in medical schools.

Factors associated with the use of psychotropic drugs by students at a brazilian public university

BACKGROUND

Motivation for the study. College students are exposed to numerous stressful events, which predispose them to problems such as depression and anxiety, leading to increased consumption of psychotropic medications. Main findings. The use of psychotropic medications was reported by 12.0% of students, being higher among those with access to health insurance and diagnosed with depression and anxiety, as well as among those who reported using illicit drugs and who were dissatisfied with their academic performance. We found lower consumption of psychotropic drugs among women who consumed alcoholic beverages. Implications. The evidence from this study may support actions to promote not only rational drug use campaigns, but also measures to minimize and help students with the stress of academic life.

OBJECTIVE.

To analyze the consumption of psychotropic drugs and their associated factors in university students, stratified by sex.

MATERIALS AND METHODS.

We conducted a cross-sectional study with undergraduate students of a public university in Brazil. The instrument was an online self-administered questionnaire. The outcome variable was the use of psychotropic drugs, based on the Anatomical Therapeutic Chemical (ATC) classification system, and the exposure variables were socio-demographic, academic and health-related. The association between the exposure variables and the outcome was verified by calculating prevalence ratios and their 95% confidence intervals.

RESULTS.

We found that 12.2% (n=396) of the 3238 participants used psychotropic drugs; most were women (78.3%). The prevalence of psychotropic drug use was higher among students with access to health insurance, diagnosis of depression and diagnosis of anxiety. It was also higher in the group of women who reported using illicit drugs in the last three months and in the group of men who reported being dissatisfied or very dissatisfied with their academic performance. We detected low frequency of psychotropic drug use among women who consume alcohol on a weekly basis.

CONCLUSIONS.

Our results show a higher frequency of psychotropic medication use in females, as well as in students with access to health insurance, diagnosis of depression and diagnosis of anxiety, regardless of sex.

Prevalence of depression among medical students in Africa: Systematic review and meta-analysis

INTRODUCTION

Depression has become a major health problem that students in a University encounter during their study life. At least one-third and possibly up to one-half of medical students show some form of psychological distress during their medical school. Aggregated evidence is scarce in Africa though there are published articles with various outputs. Therefore, this systematic review and meta-analysis aimed to pool those outputs to draw concert information crucial for devising strategies to tackle depression among students at the University.

OBJECTIVE

To determine the pooled prevalence of depression among African medical students.

METHOD

Original articles about the prevalence of depression among African medical students were searched through known and international databases (PubMed, Scopus, Web of Science, and Cochran Library) and search engines (Google and Google Scholar). Data were extracted using a standard data extraction checklist that was developed according to Joanna Briggs Institute (JBI). The I2 statistics were used to identify heterogeneity across studies. Funnel plot asymmetry and Egger's tests were used to check for publication bias. A Random effect model was used to estimate the pooled prevalence of depression among medical students in Africa. Statistical analysis was conducted using STATA version 11 software.

RESULT

A total of 31 cross-sectional observational studies which provided information about the prevalence of depression among medical students were included in this systematic review and meta-analysis. The overall pooled prevalence of depression among medical students in Africa was 38.80% [95%CI (29.55, 48.05). Being a female medical student was [AOR = 0.25, 95%CI (0.15, 0.42)] and being a second-year medical student was [AOR = 0.26, 95%CI (0.10, 0.68)] times less likely to have depression.

CONCLUSION

Depression affects well over one-third of medical students in Africa. Moreover, this systematic review and meta-analysis revealed that female medical students were less likely to develop depression. Therefore, this result suggested that medical schools or Universities and concerned authorities better offer possible early detection and prevention programs as per the magnitude. Furthermore, there has to be further research to figure out the potential factors perhaps using both qualitative and quantitative research approaches.

Anxiety and depression in healthcare workers are associated with work stress and poor work ability

Background

Symptoms of anxiety and depression are very common among healthcare workers (HCWs) and could impact the quality of care.

Objective

This study aimed to evaluate the prevalence of these disorders in a public health company and their association with work ability and work-related stress.

Methods

A cross-sectional study involved 80 HCWs being treated for mental disorders (MD), 55 HCWs who said they suffered from MD but were not being treated, and 824 healthy colleagues. All workers completed the Work Ability Index (WAI), the Siegrist's Effort/Reward Imbalance questionnaire (ERI), the Goldberg's scales of anxiety and depression (GADS), and the Warr's scale of job satisfaction.

Results

Three-quarters of workers with MD suffered from anxiety and/or depression. Workers who declared at the periodic medical examination in the workplace that they were being treated for MD had significantly lower levels of work ability than those of their colleagues who declared good mental health. They also reported greater work stress (high effort, low rewards, high overcommitment) and lower job satisfaction than their healthy colleagues. Symptomatic but untreated workers reported significantly lower work ability, lower satisfaction, and greater occupational stress than their healthy colleagues. In the entire sample, there were many workers with symptoms of anxiety or depression who did not declare these disorders during the examination. Overall, there were 328 suspected cases of anxiety (34.2%) and 334 cases of depression (34.8%). Anxious workers [OR = 8.11, 95% confidence interval (CI) = 3.74-17.58] and depressed workers (OR = 4.49, 95% CI = 2.22-9.10) had an increased risk of being classified as having "poor work ability".

Conclusion

The negative association between psychological symptoms and work ability even in undiagnosed/untreated workers demonstrates the usefulness of screening for these symptoms in work environments.

Development of the psychopathological vulnerability index for screening at-risk youths: a Rasch model approach

Accumulating research on mental health emphasizes the general factor of psychopathology (p-factor) that unites various mental health issues. This study develops a psychopathological vulnerability assessment for youths, evaluating its psychometric properties and clinical utility. An umbrella review conceptualized multifactor psychopathological vulnerability, leading to a 57-item pool. A total of 11,224 individuals participated in this study. The resulting 22-item psychopathological vulnerability index (PVI) fitted the unidimensional Rasch model, demonstrating a person separation reliability of 0.78 and a Cronbach's alpha of 0.84. Cut-off points of 11 and 5, derived from latent class analysis, were used to distinguish vulnerable and high-protection populations. The PVI's concurrent and predictive hit rates ranged from 36.00% to 53.57% in clinical samples. The PVI concretized the vulnerability-stress model for identifying at-risk youths and may facilitate universal interventions by integrating the theoretical foundations of bifactor S-1 models with key symptoms from network models for theoretically grounded approaches.

Common mental health problems in medical students and junior doctors - an overview of systematic reviews

BACKGROUND

Common mental health problems (CMHP) are prevalent among junior doctors and medical students, and the COVID-19 pandemic has brought challenging situations with education disruptions, early graduations, and front-line work. CMHPs can have detrimental consequences on clinical safety and healthcare colleagues; thus, it is vital to assess the overall prevalence and available interventions to provide institutional-level support.

AIMS

This overview summarises the prevalence of CMHPs from existing published systematic reviews and informs public health prevention and early intervention practice.

METHODS

Four electronic databases were searched from 2012 to identify systematic reviews on the prevalence of CMHPs and/or interventions to tackle them.

RESULTS

Thirty-six reviews were included: 25 assessing prevalence and 11 assessing interventions. Across systematic reviews, the prevalence of anxiety ranged from 7.04 to 88.30%, burnout from 7.0 to 86.0%, depression from 11.0 to 66.5%, stress from 29.6 to 49.9%, suicidal ideation from 3.0 to 53.9% and one obsessive-compulsive disorder review reported a prevalence of 3.8%. Mindfulness-based interventions were included in all reviews, with mixed findings for each CMHP.

CONCLUSIONS

The prevalence of CMHPs is high among junior doctors and medical students, with anxiety remaining relatively stable and depression slightly increasing during the COVID-19 pandemic. Future research on mindfulness-based interventions is required for a resilient and healthy future workforce.

PRISMA/PROSPERO

the researchers have followed PRISMA guidance. This overview was not registered with PROSPERO as it was conducted as part of an MSc research project.

Thriving beyond the stethoscope: Unveiling positive mental health among medical students at a University in South Africa

Introduction

Medical education presents significant challenges for medical students' mental health. Medical students are a vulnerable group, experiencing higher rates of mental health disorders, which can have implications for their well-being and academic performance. Consequently, evaluating Positive mental health (PMH) has become significant in a contemporary and demanding society, particularly among university students.

Aim

This study aimed to assess the levels of PMH and identify the association between PMH domains and socio-demographic and health related variables among medical students enrolled at a university in South Africa.

Methods

This quantitative, descriptive, and cross-sectional survey was conducted with 144 undergraduate medical students. Data were collected using a multi-dimensional PMH instrument and a sociodemographic and health related questionnaire, from 144 undergraduate medical students. The university's Research and Ethics Committee granted ethical clearance for the study. Results: The data were analysed using IBM SPSS version 29. The majority of the students were older than 20 years (79.2 %, n = 114), had no prior history of psychiatric illness, and had not previously taken any psychiatric medication (94.4 %, n = 136). More than half of the participants were single (66 %, n = 95), identified as Christians (76.4 %, n = 110), received a bursary (78.5 %, n = 113), had families living in rural areas (71.5 %, n = 103) and resided in the university housing (73.6 %, n = 106). Gender (p = 0.01), age (p = 0.02), religious affiliation (p = 0.03), history of psychiatric illness (p = 0.05) and treatment for psychiatric illness (p = 0.05) had a significant influence on the Total PMH score. Male participants reported higher mean scores in most PMH domains, excluding emotional support and spirituality domains. Participants aged between 22 and 23 years reported lower mean scores in Total PMH and most PMH domains. There is a significant difference in mean scores with gender (p = 0.02) and religious affiliation (p = 0.00) in the spirituality domain.

Conclusion

The study results emphasised the complex nature of mental health and provided a rationale for assessing the various aspects of PMH in university students. By implementing evidence-based strategies and providing adequate support, medical schools can better support the mental health and well-being of their students, ultimately cultivating a healthier and more resilient future healthcare workforce.

The prevalence of sleep disturbance and its possible associated factors among iranian medical students: A cross-sectional study with a national meta-analysis

Background

The aim of this cross-sectional study was to investigate the prevalence of sleep disturbance and its possible associated factors among Iranian medical students. Additionally, a national meta-analysis was conducted to provide a comprehensive overview of sleep disturbance in this population.

Methods

A sample of medical students from Guilan University of Medical Sciences, Iran was included in the study. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep disturbance. Demographic and lifestyle factors, as well as academic performance, were collected through a self-administered questionnaire. The data collected from this study were combined with existing studies through a meta-analysis to estimate the overall prevalence of sleep disturbance among Iranian medical students using the random effects model.

Results

A total of 249 medical students participated in the study. The prevalence of sleep disturbance among Guilan University of Medical Sciences medical students was found to be 71.1%. A significant difference was observed in total PSQI means regarding medical students' residency (p < 0.001) and their duration of sleep in the last 24 h (p = 0.006). The national prevalence of sleep disturbances was 59% (95% CI: [51%-66%], I2 = 97%).

Conclusion

Sleep disturbance is highly prevalent among Iranian medical students, with various factors contributing to its occurrence. The findings of this study highlight the need for interventions and strategies to improve sleep quality and overall well-being among this population. The national meta-analysis provides valuable insights into the overall burden of sleep disturbance among Iranian medical students and can serve as a reference for future studies and public health initiatives targeting this issue.

The role of fatty acids in the emotional well-being of young adults: associations between fatty acid levels and symptoms of depression, anxiety, stress, and sleep disturbances

Purpose

Young adults experience high stress levels, leading to mood disorders. This study investigates the associations between specific fatty acid levels, lipid profiles, inflammatory markers, and emotional well-being among young adults.

Methods

Seventy-two young adults aged 18-35 participated in this study. Participants completed self-assessments of depression severity (PHQ-9), stress (PSS-10), insomnia (ISI), and anxiety (GAD-7). Blood samples were collected and analyzed for plasma fatty acid profiles, lipid profiles, C-reactive protein (CRP) and kynurenine pathway metabolites. Classification and Regression Tree (C&RT) and multivariate stepwise regression analyses were employed to identify potential predictors of mental health outcomes.

Results

The analyses revealed significant associations between certain fatty acids, lipid markers, and mental health conditions. Lauric acid, myristic acid, and eicosatrienoic acid were identified as potential indicators of mental health issues. Higher levels of palmitoleic acid were linked to increased depressive symptoms, while higher oleic acid levels were associated with reduced depression. Anxiety was influenced by myristoleic acid and docosahexaenoic acid. Stress and sleep disturbances correlated with specific fatty acids. The models explained a significant percentage of variability in mental health outcomes, accounting for 25% in both depressive symptoms and anxiety, 23% in stress, and 43% in sleep disturbances.

Conclusions

Specific fatty acids, associated with lipid profiles, kynurenic acid, and CRP, significantly impact the mental health of young adults. Monitoring biomarkers may assist in managing mental health disorders. Personalized dietary interventions could improve well-being and sleep quality. Further research is needed to confirm these findings and establish causal relationships.

How to combat stigma surrounding mental health disorders: a scoping review of the experiences of different stakeholders

BACKGROUND

The stigma associated with mental health disorders (MHDs) results in delayed help-seeking, limited access to health services, suboptimal treatment, poor treatment outcomes, and an increased risk of human rights violations. This scoping review summarizes qualitative research on the lived experiences of different stakeholders regarding strategies and interventions to combat stigma for people with MHDs.

METHODS

This study was a six-step scoping review using the Arksey and O'Malley framework. A comprehensive search of the following electronic databases was conducted to identify relevant records: PubMed, Scopus, Web of Science (WoS) and Google Scholar, as well as a manual search of the reference lists. All steps, including screening of eligible studies, data extraction, and analysis, were performed independently by multiple reviewers, with disagreements resolved by discussion. The data were synthesized based on the for-content synthesis guidelines.

RESULTS

A total of 25 studies were included in this review of the 32,976 initial identified citations. The included studies were from all countries (low, middle, and high income), stigmatized disorders (e.g., schizophrenia, bipolar disorder, etc.) and target populations (e.g., people with MHDs and their families, health care providers, the general community, and students and school members). The thematic synthesis revealed six types of interventions and strategies and 17 themes related to reducing stigma in patients on MHDs. Strategies and interventions were classified by patient (self-stigma), family (family stigma), healthcare professionals' stigma, workplace stigma, public/societal stigma, and structural type of stigma (institutional stigma).

CONCLUSIONS

This review contributes new evidence that should be considered in future interventions and policies to reduce stigma against MHDs. Multilevel and multistakeholder strategies and interventions are needed to reduce the stigmatization of MHDs.

Burnout level evaluation of undergraduate dental college students at middle eastern university

BACKGROUND

Pressure faced by dental students from academic activities, clinical skills training, and patient care may lead to high stress and potential burnout, negatively impacting their well-being and patient safety.

AIM

The study aimed to explore the burnout level of dental students at Qassim University, Saudi Arabia and to identify the factors that are associated with the level of burnout.

METHODS

The descriptive cross-sectional study was carried out at Dental College, Qassim University, Saudi Arabia, from January to February 2024. The study was conducted to evaluate burnout levels among first to final-year undergraduate dental students enrolled at Qassim University using a pre-validated questionnaire; Burnout Clinical Subtype Questionnaire, via Google Forms. Analysis was performed with IBM SPSS-24, utilizing descriptive statistics and non-parametric tests, Mann-Whitney-U and Kruskal-Wallis. A multiple linear regression analysis was conducted to predict Burnout from demographic and academic factors.

RESULTS

151 participants responded to the survey, with 49.7% male and 50.3% female. Results showed that burnout scores increased significantly (p < 0.05) with age and decreased family support. Males had lower burnout levels in comparison to their counterparts. The survey had three domains: Overload, Neglect, and Development, with 'Overload' having the highest mean score of 17.79 and a median score of 17.00. Age showed significant difference (p < .05) in the burnout scores amongst the groups across all three domains. 70.9% of the participants agreed that they invested an unhealthy amount of time towards their studies. The multiple regression model statistically significantly predicted Burnout, F (21, 129) = 2.190, p = .004, adj. R2 = 0.143. Gender was significant predictor, with female students reporting lower burnout scores compared to males (B=-5.633, p = .012). Family support also emerged as significant, with students reporting merely good family support showing higher burnout scores compared to those reporting very good family support (B = 6.147, p = .009).

CONCLUSION

Factors like age, family support and gender were found to have a significant with burnout levels and its domains. The study highlighted overload as the main contributing the most towards burnout in dental students of Qassim University, emphasizing the importance of tailored interventions to promote student well-being.

The influence of perceived formative assessment on the learning autonomy of medical students: the chain mediating role of psychological empowerment and positive academic emotions

INTRODUCTION

Medical students' autonomous learning is a cornerstone of their educational journey. Formative assessment is defined as a process to enhance learning and improve academic performance, and the key to the effectiveness of formative assessment is the students' perceptions of it. The present study investigates the impacts of perceived formative assessment on the learning autonomy of medical students, explores the chain mediating role of psychological empowerment and positive academic emotions, and offers strategies for facilitating medical students' autonomous learning.

METHODS

A cross-sectional investigation was conducted using a convenience sampling method involving 713 medical students (mean age 19.72 ± 1.18 years; 207 male and 506 female students; the proportion of participants is 93.69%) in Shandong Second Medical University. Perceived formative assessment was performed using a self-designed questionnaire of Perceived Formative Evaluation for Medical Students, learning autonomy using the Autonomy in Learning Rating Scale for College Students, positive academic emotions using the General Academic Emotion Questionnaire for College Students, and psychological empowerment of medical students using the Chinese version of Psychological Empowerment Scale (PES). The data were analyzed using descriptive statistics, Pearson's correlation, multiple regression, and mediation analysis using the SPSS26.0 program and PROCESS3.1.

RESULTS

Perceived formative assessment significantly predicted learning autonomy (β = 0.06, p < 0.05). It also positively predicted psychological empowerment (β = 0.20, p < 0.001), and psychological empowerment positively predicted the learning autonomy of medical students (β = 0.36, p < 0.001). Psychological empowerment also positively predicted positive academic emotions (β = 0.64, p < 0.001), and positive academic emotions positively predicted learning autonomy (β = 0.44, p < 0.001). The direct effect value of perceived formative assessment on learning autonomy was 0.18, while the total indirect effect was 0.43. The mediation effect of psychological empowerment on the relationship between perceived formative assessment and learning autonomy was 0.22, and the chain mediation effect of psychological empowerment and positive academic emotions was 0.18, accounting for 30%, 70%, 36%, and 30% of the total effect, respectively.

CONCLUSION

Perceived formative assessment directly enhances medical students' learning autonomy. This relationship is partially mediated by psychological empowerment and positive academic emotions. The results suggest that formative evaluation boosts psychological empowerment, which fosters positive academic emotions and further promotes learning autonomy.

The associations between resilience, self-care, and burnout among medical students

Burnout is a work-related stress syndrome with substantial consequences for patients, physicians, and medical students. Personal resilience, i.e., the ability to bounce back and thrive despite challenging circumstances, and certain practices, such as self-care, may protect individuals from burnout. However, limited information exists on the complex relationships between resilience, different self-care practices, and burnout. Understanding these associations is important for designing efficient interventions within medical schools. Therefore, the present study examined the direct and indirect associations through a cross-sectional study among 95 fourth-year medical students. Self-reported questionnaires measured resilience, self-care dimensions (stress management, spiritual growth, interpersonal relations, health responsibility), and burnout dimensions (emotional exhaustion, depersonalization, personal accomplishment). Data were analyzed via IBM-SPSS and PROCESS-macro. The main results demonstrated that self-care mediated the associations between resilience and burnout: stress management and interpersonal relations mediated the associations with emotional exhaustion, while spiritual growth mediated the association with personal accomplishment. These results highlight that medical students' resilience may encourage self-care behaviors, thus decreasing levels of the burnout dimensions of emotional exhaustion and personal accomplishment. Developing curricula that enhance students' resilience through applying self-care techniques in stressful situations may reduce the negative impact of burnout in healthcare.

Prevalence of Depression and Generalized Anxiety Among LGBTQ+ Medical Students in Thailand

This study evaluated the prevalence and associated factors of depression and generalized anxiety among LGBTQ+ in five medical schools in Thailand. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively, and multivariable logistic regression was employed to identify associated factors. Of 1,322 students, 412 (31.16%) identified as LGBTQ+. The prevalence for MDD and GAD among LGBTQ+ students were 32.77% and 17.23%, respectively. Significant associated factors for both MDD and GAD were a history of psychiatric illness (AOR for MDD = 2.32, p = .020; AOR for GAD = 3.67, p < .001), educational problems (AOR for MDD = 6.62, p < .001; AOR for GAD = 5.12, p < .001), and dissatisfaction with gender identity or sexual orientation (AOR for MDD = 1.92, p = .019; AOR for GAD = 2.47, p = .005). Additional factors associated with MDD were preclinical years (AOR = 2.30, p = .023), financial struggles (AOR = 2.05, p = .021), and inadequate peer support (AOR = 2.57, p = .044). In conclusion, nearly one-third and one-fifth of Thai LGBTQ+ medical students suffer from MDD and GAD, respectively. Our findings suggest that Thai medical schools should promote LGBTQ+ inclusivity to enhance students' identity satisfaction. Peer support groups should be encouraged, especially for preclinical LGBTQ+ students who face educational and financial challenges.

Rate and sociodemographic correlates of depression, anxiety, and stress among domestic and overseas medical students: A cross-sectional observation from a private medical college in Bangladesh

Background

Depression, anxiety, and stress are the commonly encountered mental health conditions among medical students. Overseas environment may add additional burden to the existing environment. However, comparison of the rate and associated factors of depression, anxiety, stress among domestic and overseas students has not been attempted in Bangladesh. We aimed to assess the rate and associated factors of depression, anxiety, stress among domestic and overseas medical students in the country.

Methods

This cross-sectional study was conducted among 360 undergraduate medical students in 2021. Data were collected by self-reporting instruments by a stratified random sampling method by the Depression, Anxiety, and Stress Scale-21 scale. Bivariable and multivariable binary logistic regression analyses were done by computing crude odds ratio and adjusted odds ratio with 95% confidence interval to identify the associated factors.

Results

Among the 360 undergraduate medical students, 181 were domestic and 179 overseas ones. 44.8% of domestic students reported depressive symptoms, 45.3% reported anxiety symptoms, and 33.1% reported stress. On the other hand, half of overseas students experienced depression (50.3%) and anxiety (52.5%), and 41.3% experienced stress. Female medical students were found vulnerable for developing depression, anxiety, and stress than males.

Conclusions

The study revealed higher rates of depression, anxiety, and stress among overseas undergraduate medical students enrolled in a private medical school of Bangladesh. Private medical college authorities could consider special services for overseas students to ensure adequate psychosocial support.

Effects of circuit training and Yoga on biochemical and psychological responses to stress and cardiovascular markers: A randomized clinical trial with nursing and medical students in Southern Brazil

A Randomized Controlled Trial involving 158 Brazilian medical and nursing students assessed one of three conditions over an 8-week period: 1) a circuit training protocol (CTG); 2) a yoga protocol (YG); or 3) no intervention (CG). The objective was to evaluate the effectiveness of circuit training and yoga protocols in reducing perceived mental stress and examining their effects on serum cortisol levels, as well as on traditional cardiovascular risk factors (CRFs), during an academic semester. Mental stress was measured using self-reported stress questionnaires. For the CTG, comparisons of pre- vs. post-intervention data indicated a reduction in self-reported stress levels on a Brazilian scale (p < 0.001) and an international scale (p < 0.05). Regarding CRFs, there was a reduction in waist circumference (WC) (p < 0.05), systolic blood pressure (SBP) (p < 0.05), and heart rate (HR) (p < 0.001). No changes were observed in diastolic blood pressure (DBP) (p = 0.211) and serum cortisol (SC) (p = 0.423). In the YG, pre- vs. post-intervention data indicated a reduction in self-reported stress levels on the ISSL (p < 0.001), in both resistance and exhaustion stress levels on the PSS scale (p < 0.001), and in SC levels (p < 0.001), WC (p < 0.05), and SBP (p < 0.05); however, HR and DBP did not change (p = 0.168 and p = 0.07, respectively) in this group. No changes were noted in any measures in the CG. The intervention protocols demonstrated that both CTG and YG can positively impact mental or biochemical stress responses, as well as CRFs.

Associations between sugar-sweetened beverages consumption, duration of physical exercise, and depressive symptoms among Tibetan university students at high altitude

Background

Depressive symptoms have become a public health issue of common concern in countries all over the world, and have many negative impacts on university students' study and life. Depressive symptoms are influenced by many factors, including sugar-sweetened beverages (SSBs) consumption and duration of physical activity. However, no study has been conducted on the association between sugar-sweetened beverage consumption, duration of physical exercise, and depressive symptoms among Tibetan university students at high altitudes.

Methods

In this study, a self-assessment survey of SSBs consumption, duration of physical exercise, and depressive symptoms was conducted on 6,259 (2,745 boys, 43.86%) Tibetan university students aged 19-22 years in Lhasa and Ganzi areas, China, using stratified whole population sampling. The associations were also analyzed using one-way analysis of variance, binary logistic regression analysis, and ordered logistic regression analysis in the generalised linear model.

Results

The proportions of mild depression symptoms, moderate depression symptoms, and major depressive symptoms among Tibetan boys university students in high-altitude areas of China were 18.0, 22.9, and 1.5%, respectively; the proportions of girls students were 20.1, 21.9, and 1.5%, respectively, 1.5%, and the differences in the detection rates of depressive symptoms between sex were statistically significant (χ 2 value = 14.253, p < 0.01). Ordered logistic regression analyses showed that using duration of physical exercise >60 min/d and SSBs ≤1 times/week as the reference group, the duration of physical exercise <30 min/d and SSBs ≥5 times/week groups had the highest risk of developing depressive symptoms was the highest risk (OR = 6.98, 95% CI: 5.05-9.65; p < 0.001).

Conclusion

This study confirmed that there was a positive association between SSBs consumption and depressive symptoms and a negative association between the duration of physical exercise and depressive symptoms among Tibetan university students at high altitudes in China. In the future, SSBs consumption should be effectively controlled and the duration of physical exercise should be increased to reduce the occurrence of depressive symptoms and promote the physical and mental health of Tibetan university students in high-altitude areas.

The role of mindfulness in stress, productivity and wellbeing of foundation year doctors: a mixed-methods feasibility study of the mindful resilience and effectiveness training programme

BACKGROUND

Medical Foundation Year (FY) doctors demonstrate greater psychological distress compared with the general population and other student groups. This feasibility study investigated FY doctors' perceptions of mindfulness and the impact of a mindful resilience and effectiveness training (MRET) programme on stress, wellbeing, and performance.

METHODS

Mixed-methods study utilising a questionnaire (study 1, N = 144) and a pre-post analysis design of MRET programme (study 2, N = 13), along with focus groups (N = 7).

RESULTS

In study 1 28.5% of FY's reported using mindfulness. All five mindfulness facets were significantly, and positively, associated with mental wellbeing (p < 0.05). Acting with awareness (AA) and non-reactivity (NR) were significantly, positively associated with a challenge responses to stress (p < 0.05). Threat and loss appraisals were negatively associated with AA, NR, and non-judging (p < 0.01). Perceived productivity was positively associated with mindfulness facets: describing, AA, and NR (p < 0.001). In study 2, there were significant increases in wellbeing and mindfulness facets observing, describing, AA, and NR, and threat appraisals decreased (p < 0.05). The main themes identified across the focus group included Reframed Mindset, Values-Based Action, Embodied Leadership and Pedagogy.

CONCLUSIONS

There exists a relationship between mindfulness, psychological wellbeing, and performance in FYs. The MRET prorgamme improved psychological wellbeing and reduced threat appraisals. Future work could focus resources on enhancing the skills of AA and NR, as this may be sufficient to bring about meaningful improvements in wellbeing, percieved productivity and cognitive reappraisal of stressful life events.

Exercise, mental well-being and burnout in Thai medical students in 2020-2021: an online cross-sectional survey

INTRODUCTION

Within the Thai medical curriculum, its rigorous education framework, demanding schedules and high academic standards can contribute to psychological distress. Regular physical activity has consistently shown positive effects on mental health. The aim of the study was to investigate the association between exercise and psychological well-being, including depression, anxiety, and burnout, in Thai medical students, and factors related to insufficient exercise and depression.

METHODS

The cross-sectional study was conducted among medical students in the university hospital during 2020-2021. Participants completed self-administered questionnaires consisting of demographic data, Godin-Shephard Leisure-Time Physical Activity Questionnaire, depression screening (9Q), Thai General Health Question-28 (4 domains: somatic symptoms, anxiety and insomnia, social dysfunction, severe depression), and Maslach burnout inventory (Emotional exhaustion (EE), Depersonalization (DP), Reduced Personal Achievement (rPA).

RESULTS

Of the 404 participants, 50.5% were women, the mean age (SD) was 21.06 (1.8) years, and 52% were in clinical years. The prevalence of insufficient exercise was 59.6%, depression (30.2%), somatic symptoms (27.7%), anxiety (30.7%), insomnia (89.4%), social dysfunction (89.4%), high level of EE (32.4%), DP (21%), and rPA (56.7%). Insufficient exercise was associated with moderate to severe depression (OR 2.89, 95% CI 1.16-7.25), anxiety and insomnia (OR 1.56, 95% CI 1.01-2.43), social dysfunction (OR 2.51, 95% CI 1.31-4.78), burnout in part due to high rPA (OR 2.4, 95% CI 1.4-4.13), and study in clinical years (OR 1.91, 95% CI 1.28-2.87). After adjusted significant factors, only studying in the clinical year, social dysfunction, and burnout in part of rPA were related to insufficient exercise.

CONCLUSIONS

High rates of insufficient exercise, psychological challenges, and burnout were prevalent among medical students. To effectively address these issues, medical school should advise students to participate in regular exercise, promoting mental well-being and healthier lifestyles.

The Relationship between Religion, Spirituality, Psychological Well-Being, Psychological Resilience, Life Satisfaction of Medical Students in the Gaziantep, Turkey

Religion and spirituality have been associated with better psychological health. The present study aims to investigate the relationship between the psychological well-being, psychological resilience, life satisfaction and religion/spirituality. An online cross-sectional study was conducted at the Gaziantep University School of Medicine, Turkey. The data were collected by using Personal Information Form, Individual Religion Inventory (IRI), Psychological Wellbeing Scale (PWBS), Brief Psychological Resilience Scale (BPRS), and Satisfaction with Life Scale (SWLS). A total of 399 students participated in the study, 84% of them stated that they were Muslim. The perception of good psychological health was significantly higher among Muslims (32.7%) than non-Muslims (14.3%) (p = 0.013). The PWBS, BPRS, SWLS scores were significantly higher in those who attached very importance to religious/spiritual practices compared to those who attached little importance. While PWBS scores and BPRS scores did not differ, the SWLS scores was significantly higher in Muslims compared with the non-Muslims. A positive correlation was found between the IRI scores and PWBS (r = 0.446 p < 0.001), BPRS (r = 0.252 p < 0.001), and SWLS scores (r = 0.450 p < 0.001) for Muslim participants. The study showed that giving importance to religious/spiritual practices is associated with better psychological health.

Prevalence and correlates of depressive symptoms among undergraduate health science students at the University of Parakou, Benin

OBJECTIVES

Research on psychological distress in African students is scarce. This study aimed at exploring the epidemiology (prevalence and correlates) of depressive symptoms among undergraduate health sciences students at the University of Parakou (Benin).

METHODS

We conducted a cross-sectional survey from June to July 2022 at the University of Parakou, the second-largest university in the Republic of Benin. Depressive symptoms were assessed using the Patient Health Questionnaire depression scale (PHQ-9). Information on several independent factors was collected and their associations with depressive symptoms were investigated using logistic regression models.

RESULTS

Data from 560 students were analyzed (mean age: 21.3± 2.3 years, 60 % were male, and 50.4 % were registered in the first year of study). The overall prevalence of depressive symptoms was 39.1 % [95 % CI: 35.2 %-43.1 %]. Moderate and severe depressive symptoms were observed in 15.3 % and 1.8 % of participants, respectively. In the multivariable model, being aged 21-23 (adjusted Odds Ratio=1.8, p-value: 0.007), a female (aOR=1.5, p-value: 0.050), a medical student (aOR=2.9, p-value: <0.001), a public health student (aOR=3.6, p-value: <0.001), belonging to households with higher incomes (aOR= 2.4, p<0.001), and experiencing stress (aOR=1.5, p-value: 0.048) independently increased the probability of having depressive symptoms. However, having support from close relatives (aOR= 0.5, p-value: 0.026) was associated with a lower probability of depressive symptoms.

CONCLUSIONS

Our findings revealed a high prevalence of depressive symptoms among undergraduate health science students. Given the correlates identified, actions to promote coping skills in stress and encourage more parental support may be real avenues likely to help reduce the frequency and consequences of depressive symptoms.

Psychiatric Characteristics, Symptoms of Insomnia and Depression, Emotion Regulation, and Social Activity among Swiss Medical Students

Background: Almost by default, young adult students are at increased risk of suffering from mental health issues, and this holds particularly true for medical students. Indeed, compared to the general population and non-medical students, medical students report higher scores for symptoms of depression. For Swiss medical students, research on the associations between psychiatric characteristics and symptoms of depression and insomnia, including cognitive-emotional processes and social activity, has been lacking so far. Given this, the aims of the present study were to relate self-declared psychiatric characteristics to symptoms of depression, insomnia, emotion regulation, and social activity. Methods: A total of 575 medical students (mean age: 22.4 years; 68.9% females) completed an online survey covering sociodemographic information (age and gender), study context (year of study), self-declared psychiatric characteristics and symptoms of depression, insomnia, emotion regulation (cognitive reappraisal vs. emotion suppression), and social activity. Data on insomnia sum scores and categories of historical samples (862 non-medical students and 533 police and emergency response service officers) were used for comparison. Results: Of the 575 participants, 190 participants (33%) self-declared psychiatric issues, such as major depressive disorder; anxiety disorders, including PTSD and adjustment disorders; eating disorders; ADHD; or a combination of such psychiatric issues. Self-reporting a psychiatric issue was related to higher symptoms of depression and insomnia and lower symptoms of social activity and cognitive reappraisal (always with significant p-values and medium effect sizes). Compared to historical data for non-medical students and police and emergency response service officers, medical students reported higher insomnia scores. In a regression model, current self-declared psychiatric issues, female gender, higher scores for insomnia, and lower scores for social activity were associated with higher scores for depression. Conclusions: Among a sample of Swiss medical students, the occurrence of self-declared psychiatric issues was associated with higher scores for depression and insomnia and lower cognitive reappraisal and social activity. Further, insomnia scores and insomnia categories were higher when compared to non-medical students and to police and emergency response service officers. The data suggest that medical schools might introduce specifically tailored intervention and support programs to mitigate medical students' mental health issues. This holds particularly true for insomnia, as standardized and online-delivered treatment programs for insomnia (eCBTi) are available.

Association of Personality Traits With the Efficacy of Stress Management Interventions for Medical Students Taking Objective Structured Clinical Examinations

PURPOSE

Personality traits are associated with psychophysiological stress, but few studies focus on medical students. This study aimed to better understand the association of personality traits with the efficacy of stress management interventions for medical students.

METHOD

A randomized controlled trial was conducted with fourth-year students who took the objective structured clinical examination at Bernard University Lyon 1 in December 2021. Students were randomized in cardiac biofeedback, mindfulness, and control groups. Each intervention was implemented for 6 minutes before the examination. Physiological stress levels were collected during the intervention. Psychological stress levels were rated by students at baseline and after the intervention. Personality traits were assessed via the Big-Five Inventory. Interactions between personality traits and the efficacy of the interventions were analyzed using multivariable linear regression models.

RESULTS

Four hundred eighty-one students participated. Higher baseline psychological stress levels were associated with higher neuroticism and agreeableness ( β = 10.27 [95% confidence interval {CI}, 7.40-13.13; P < .001] and β = 3.42 [95% CI, 0.98-5.85; P = .006], respectively) and lower openness ( β = -4.95; 95% CI, -7.40 to -2.49; P < .001). As compared with the control intervention, both stress management interventions led to lower levels of psychological ( P < .001 for both) and physiological stress levels (biofeedback: P < .001 and mindfulness: P = .009). Biofeedback efficacy varied by extraversion score for psychological ( β = -5.66; 95% CI, -10.83 to -0.50; P = .03) and physiological stress reduction ( β = -0.002; 95% CI, -0.003 to -0.00004; P = .045). Mindfulness efficacy varied by agreeableness score for psychological stress reduction ( β = -7.87; 95% CI, -13.05 to -2.68; P = .003).

CONCLUSIONS

Students with a high score in extraversion may benefit more from biofeedback interventions, while students with high scores in agreeableness may benefit more from mindfulness interventions.

Profiles of mental illness in college students and associated factors: A latent class analysis

Mental illness among university students poses a pressing challenge for educational institutions, urging the need for strategies that foster health and mitigate mental distress, with an emphasis on preventing suicide. Our study sought to discern the profiles of mental illness among college students and explore the factors associated with them. We examined data from 918 students at a Brazilian Federal Institute, utilizing Latent Class Analysis and multinomial regression for our analyses. We identified three distinct mental illness profiles: Anxiety with Low Suicide Risk; Mental Illness with Moderate Suicide Risk; and Mental Illness with High Suicide Risk. We observed a reduced association of these profiles with religious beliefs. Conversely, there was a heightened association with cisgender women, individuals identifying as LGBTQI+, those with learning disabilities, and victims of sexual violence. Our findings underscore the importance of tailored prevention and health promotion programs to enhance student well-being. There's a compelling need to devise mental health strategies tailored to the specific needs of the identified groups, particularly students from the LGBTQI + community, survivors of sexual abuse, and those grappling with learning disabilities.

Is Mental Health Worse in Medical Students than in the General Population? A Cross-Sectional Study

Background and Objectives: In recent years, there has been a notable increase in university students experiencing severe mental illness. The transition to university life can be demanding, leading to mental health disorders. Persistent stress and anxiety can cause demotivation, difficulties with concentration, cognitive impairment, and reduced academic performance. Mental health issues can also impact social relationships and overall well-being. This cross-sectional study aims to investigate the mental health of medical students and compare it with the mental health of the non-student population. Materials and Methods: The survey collected demographic information such as age and gender. Participants were questioned about their self-perceived mental distress, diagnosed mental disorders, and history of therapy for mental distress. Various validated assessment tools were utilized to assess mental health and quality of life. Results: Medical students exhibit a higher self-perception of mental symptoms that does not translate into a significantly higher prevalence of diagnosed mental disorders. Medical students experience higher levels of anxiety and subclinical depressive symptoms and lower quality of life. Female participants reported lower QoL scores and higher levels of anxiety symptoms compared with male participants. While the prevalence of mental disorders did not differ significantly between genders (except for clinical anxiety), females tended to perceive a higher burden of mental health challenges. Conclusions: By addressing mental health issues among medical students, especially females, institutions can create a more supportive and conducive learning environment. Encouraging open conversations about mental health and providing accessible mental health services can help in destigmatizing mental health challenges and promoting early intervention when needed.

Evaluation of mental health of students in healthcare education programs at Qatar University

Introduction

Mental health issues among undergraduate health-care students are a growing concern. This research aims to explore the frequency of mental health issues among health-care students in medicine, dentistry, pharmacy, nutrition, biomedical sciences, nursing, and public health at Qatar University.

Methods

Ethics approval was obtained from the institutional review board. A total of 1,378 health-care students were invited to participate. Data were collected online using two validated questionnaires including the Patient Health Questionnaire (PHQ-9) to assess symptoms of depression, and Depression, Anxiety, and Stress Scale (DASS-21), and two open-ended questions investigating risk factors and recommendations for enhancing institutional support.

Results

A total of 270 health-care students completed the survey; 227 female, and 43 male students. According to PHQ-9 cut-off values, 37.7% of students had mild depression symptoms, 25.5% moderate, 14.8% moderately severe and 10% severe symptoms. DASS-21 responses revealed 34.7% displayed severe to extremely severe anxiety symptoms, 15.4% severe to extremely severe stress symptoms and 21% severe to extremely severe depression symptoms. Students aged 18-21 years had significantly higher depression (p=0.03) and stress scores (p=0.05). Qatari students had significantly higher anxiety scores (p=0.05). Responses to open-ended questions were categorized into sub-themes and grouped together into broader themes. Most students reported exam stress and workload as key factors contributing to their negative mental health. Participants' recommendations included reducing academic workload through better curricular planning, providing training to faculty to better support students with mental health issues, and improving mental health services.

Conclusion

This study showed a significant percentage of respondents reported symptoms of stress, anxiety, and depression during undergraduate studies. Participants represent the future healthcare force for the country and there is a need to identify and support students with mental health issues through close monitoring, and work with all stakeholders to improve student support services.

The prevalence of depression and anxiety among medical students in Yemen: A cross-sectional study

BACKGROUND

Medical students may experience mental health disorders like anxiety and depression during medical school, which can negatively impact their productivity, education, and overall quality of life. Currently, there are no studies examining the mental health of medical students in Yemen. Our study aimed to estimate prevalence of depression and anxiety among Yemeni medical students.

METHODS

The study utilized a cross-sectional design. A survey was conducted using validated psychometric tests: the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. A survey of medical students from 10 Yemeni medical schools took place from June 6 to July 20, 2023. It included only actively enrolled students in the 7-year undergraduate program.

RESULTS

A total of 706 responses were collected. The prevalence of depression was 48.4 % for cases classified as moderate, moderately severe, and severe, while it was 20 % for cases categorized as moderately severe and severe. The rate of suicide ideation was 14.7 %. Anxiety was found to have a prevalence of 34.8 % for cases categorized as moderate and severe. Furthermore, both depression and anxiety were higher among females, and in earlier academic years; all of these associations had a p-value <0.05. Conversely, age, living status, income stability, and displacement risk all showed no significant association with depression or anxiety.

CONCLUSION

Our study highlighted the prevalence of depression and anxiety among Yemeni medical students. Tailored interventions are imperative to address these challenges. Future research needs to examine the root causes that might contribute to these disorders.

Mental health and burnout during medical school: Longitudinal evolution and covariates

BACKGROUND

Medical students' rate of depression, suicidal ideation, anxiety, and burnout have been shown to be higher than those of the same-age general population. However, longitudinal studies spanning the whole course of medical school are scarce and present contradictory findings. This study aims to analyze the longitudinal evolution of mental health and burnout from the first to the last year of medical school using a wide range of indicators. Moreover, biopsychosocial covariates that can influence this evolution are explored.

METHOD

In an open cohort study design, 3066 annual questionnaires were filled in by 1595 different students from the first to the sixth year of the Lausanne Medical School (Switzerland). Depression symptoms, suicidal ideation, anxiety symptoms, stress, and burnout were measured along with biopsychosocial covariates. The longitudinal evolution of mental health and burnout and the impact of covariates were modelled with linear mixed models.

RESULTS

Comparison to a same-aged general population sample shows that medical students reported significantly more depression symptoms and anxiety symptoms. Medical students' mental health improved during the course of the studies in terms of depression symptoms, suicidal ideation, and stress, although suicidal ideation increased again in the last year and anxiety symptoms remained stable. Conversely, the results regarding burnout globally showed a significant worsening from beginning to end of medical school. The covariates most strongly related to better mental health and less burnout were less emotion-focused coping, more social support, and more satisfaction with health.

CONCLUSION

Both improvement of mental health and worsening of burnout were observed during the course of medical school. This underlines that the beginning and the end of medical school bring specific challenges with the first years' stressors negatively impacting mental health and the last year's difficulties negatively impacting burnout.

Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study

Background

Poor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa.

Methods

The databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done.

Results

A total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality.

Conclusion

This study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42023493140.

Mental health and quality of life across 6 years of medical training: A year-by-year analysis

BACKGROUND

Despite growing evidence on medical students' mental health deterioration, studies have primarily used short follow-up periods and not followed the students throughout their medical training.

OBJECTIVE

To assess mental health (stress, anxiety, and depression) and quality of life changes throughout their medical program, we followed up with the same cohort of students for 6 years.

METHODS

This longitudinal prospective study followed up with the same group of medical students at a Brazilian public medical school from 2014 to 2020. The study analyzed sociodemographic data, mental health (including depression, anxiety, and stress [DASS-21]), quality of life (WHOQOL-BREF), satisfaction from studying to be a physician, and happiness with life. General linear mixed models were used for the analyses.

RESULTS

The cohort included 80 Brazilian medical students (63.7% women; mean age = 19.6 years [SD = 2.21]). A high prevalence of depressive symptoms, anxiety, and stress was found throughout medical training, with more than 50% of students having significant symptoms. Mental health, happiness, and quality of life levels tended to be better in the first and last semesters, being worse in the middle of the program. However, satisfaction from studying to become a doctor decreased in the second semester, remained low throughout the program, and never returned to baseline levels.

CONCLUSION

Mental health and quality of life levels remained high throughout the medical program, with better levels in the first and last semesters and falling in the middle of the program. These data can help managers and educators understand how psychological distress affects medical students.

Quality of life and quality of education among physiotherapy students in Europe

Background

The study of physiotherapy is challenging and can affect the students' well-being and quality of life. The aim of this study was to describe and compare factors that could affect well-being among students across Europe.

Methods

In this descriptive cross-sectional study using an online questionnaire survey, students of bachelor's physiotherapy programs from 23 European faculties, from 8 countries, were interviewed on mental health and stress burden, sleep quality, dietary habits, and physical activity.

Results

Although 75% of students rated their quality of life positively and 47% were satisfied with their mental health, 65% showed higher levels of stress and 51% described impaired sleep quality. The minimum physical activity of 150 min weekly was described by 79% of students, within which 67% engaged in strengthening twice a week. Students with a higher stress load/worse psychological health also showed worse sleep quality and lower amount of physical activity, women were significantly worse off. In terms of physical activity and sleep quality, students from Finland and Kosovo achieved the best results, while students from Italy, Greece, and Portugal achieved the worst. Students from Italy indicated the greatest dissatisfaction with the organisation of the study system and communication with teachers, while in Kosovo students rated the communication and study organisation the highest. All students had a problem with adhering to nutritional habits. Students from Italy and Spain, with the lowest body mass indexes and weight averages, were closest to the nutrition recommendations.

Conclusion

We demonstrated that physiotherapy students are burdened with stress, suffer from sleep disorders, and do not follow the recommendations regarding nutrition nor physical activity. There are significant differences between universities and countries in some aspects.

Levels of depression, anxiety and subjective happiness among health sciences students in Croatia: a multi-centric cross-sectional study

BACKGROUND

Previous studies have shown that symptoms of depression and anxiety were highly prevalent among health sciences students. This may lead to other professional and personal difficulties and a decrease in individuals' well-being. This study aimed to analyze levels of depression, anxiety and subjective happiness among health sciences students in Croatia.

METHODS

We conducted a cross-sectional study in 10 higher education institutions in Croatia during March 2023. Eligible participants were health sciences students. Participants filled out an online survey consisting of sociodemographic questions and validated scales for determining the levels of depression (9-question Patient Health Questionnaire, PHQ-9), anxiety (General Anxiety Disorder 7-item scale, GAD-7), and happiness (Subjective Happiness Scale, SHS).

RESULTS

Of 7460 invited students, 2137 students participated in the study (29% response rate). There were 41.4% of students that exhibited at least mild depressive symptoms, with 8% of students exhibiting moderately severe symptoms and 1.8% severe depressive symptoms. Mild anxiety was found in 36.8%, moderate anxiety in 23.9% and severe anxiety in 15.8% of students. The median SHS score was 19 (15.25-22). Women students had significantly higher levels of depression (p < 0.001) and anxiety (p < 0.001) than their men peers. Students in earlier study years showed higher levels of depression, anxiety and lower levels of subjective happiness compared to those in later study years. Students with lower self-assessed financial status had higher levels of depression (p < 0.001) and anxiety (p < 0.001). Students that failed an academic year had higher levels of depression (p < 0.001), but lower levels of anxiety (p = 0.005).

CONCLUSION

In this study, we have shown that health sciences students exhibit high levels of depression and anxiety, at rates exceeding those in the general population reported in other studies. Our results may help educational institutions to put greater effort into the battle against mental health stigma, foster acceptance of mental health issues and encourage students to seek help when needed. Adequate mental health services are needed at universities to promote timely diagnosis and treatment of mental health problems.

Depression and Anxiety of Portuguese University Students: A Cross-Sectional Study about Prevalence and Associated Factors

Background

The mental health of university students has worsened over time, and it is young people who have suffered the most from the COVID-19 pandemic in terms of mental health. Anxiety and depression are the most common symptoms reported by university students and are often the cause of disabilities, either in academic performance or in other spheres of life.

Aim

The aim of this study was to both assess the prevalence of depressive and anxiety symptoms in Portuguese university students and analyze the factors associated with these symptoms.

Methods

A quantitative cross-sectional study with a sample of 3,399 university students from seven Portuguese higher education institutions was conducted. The following questionnaires were used: the generalized anxiety disorder assessment scale (GAD-7), the patient health questionnaire (PHQ-9), and a study-created sociodemographic questionnaire. The Kendall correlation coefficient, chi-square test of independence, Spearman correlation coefficient, Shapiro-Wilk test, Mann-Whitney-Wilcoxon test, and Kruskall-Wallis test were used to analyze the association between variables. The statistical analysis was done using the software R Statistics (Version 4.0.4), using a significance level of 0.05.

Results

Mild to severe anxiety symptoms were reported by 75% of the participants, and 61.2% described mild to severe depressive symptoms. Of the sample, 19.5% reported a previous diagnosis of a mental disorder, with 38.7% diagnosed after the pandemic began. Additionally, 23% reported taking medication for mental health issues, and 26.7% had considered self-harm or harbored thoughts of being "better off dead." The study found lower anxiety and depressive symptoms (p < 0.05) among men, students with higher socioeconomic status, those who frequently traveled home, individuals without prior mental health diagnoses, those with better academic performance, and those who avoided substances like coffee, tobacco, cannabis, and other illegal psychoactive substances. Interestingly, students in romantic relationships exhibited more anxiety symptoms (p < 0.05). Moreover, participants who believed they had experienced moral or sexual harassment displayed higher levels of anxiety and depressive symptoms (p < 0.001).

Conclusions

There was a decrease in the mental health of university students after the pandemic compared to prepandemic studies, and the proportion of students with anxiety and depressive symptoms was alarming. There is an urgent need to implement programs in universities to promote students' mental health.

Prevalence and associated factors of overweight and obesity among medical students from the Western Balkans (South-East Europe Region)

Being overweight and obese is associated with an elevated risk of developing noncommunicable diseases, which are the leading causes of mortality worldwide. It is a warning that global prevalence of overweight among university students ranges from 20 to 40%, which presents a significant public health problem. To date, there was no research conducted on medical students regarding the prevalence and associated factors of overweight and obesity in the countries of the Western Balkans (Slovenia, Croatia, Bosnia and Herzegovina, North Macedonia, and Serbia). The aim of this study was to determine the prevalence and potential demographic, socioeconomic, and health-related behavioral factors associated with overweight and obesity of medical students from Western Balkans. A cross-sectional study was conducted, surveying 2452 students from 14 medical faculties from 5 countries in the region. The prevalence of overweight was 12% and obesity was 2.3% among medical students from Western Balkans. Male gender and smoking status are significant positive predictors of overweight and obesity. Daily level of physical activity up to 1 h per day, going to preventive check-ups once a year or as a part of annual dormitory check-ups are associated with lower odds of being overweight and obese. By creating adequate public health educational programs, students can be influenced to acquire proper health-related lifestyle habits, which would lead to reducing the prevalence of overweight and obesity among the student population, as well as risk of developing noncommunicable diseases and improving the overall health of the population.

Gender differences in alcohol abuse/dependence among medical undergraduates during the post-COVID‑19 pandemic period (October 20, 2020-April 5, 2021) in China

BACKGROUND

This study aimed to assess the prevalence and the gender-specific risk factors of alcohol abuse/dependence among medical undergraduates during the post-COVID‑19 pandemic period in China.

METHOD

The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was used to identify respondents with alcohol abuse/dependence. A questionnaire on basic demographics and mental distresses (learning burnout, depression symptoms, anxiety symptoms, excessive daytime sleepiness, and history of mental disorders) was used. The logistic regression model was used to explore the associations between the above characteristics and alcohol abuse/dependence.

RESULTS

A total of 3,412 medical undergraduates were included in the analysis. Males showed a higher prevalence of alcohol abuse/dependence than females (16.6% vs 7.4%, p < 0.001). Alcohol abuse/dependence was associated with learning burnout (OR: 2.168, p < 0.001) and having a partner (OR: 1.788 p = 0.001) among female medical undergraduates. Among male medical undergraduates, excessive daytime sleepiness (OR: 1.788 p = 0.001) and older age (OR: 1.788, p = 0.001) were independently associated with alcohol abuse/dependence.

CONCLUSION

Alcohol abuse/dependence was common among medical undergraduates during the post-COVID‑19 pandemic period. Substantial gender differences in the prevalence and risk factors of alcohol abuse/dependence were found among medical undergraduates in this study, which highlighted the need for timely gender-specific screening and interventions. However, the cross-sectional design adopted in this study has limited the examination of causality, thus further longitudinal studies are warranted.

The worldwide prevalence of self-reported psychological and behavioral symptoms in medical students: An umbrella review and meta-analysis of meta-analyses

OBJECTIVE

Medical students frequently experience a range of stressors, such as demanding academic requirements, competition and rivalry, self-doubt, and financial distress. As a result, they are at risk for psychological and behavioral symptoms (PBS) including: depression, anxiety, and sleep difficulties as well as maladaptive substance use.

METHODS

To determine the degree of risk for these symptoms, 13 databases, without language restriction., were searched.

RESULTS

A total of 32 meta-analyses were included in this umbrella review. A global analysis of all self-reported PBS combined yielded a pooled prevalence rate of 30.3% [26.9%; 33.7%]; 95% PI [2.2%; 58.3%]. The highest reported prevalence was for sleep problems 42.0% [35.6%; 48.4%], followed by stress 41.7% [35.3%; 48.1%], burnout 35.8% [25.7%; 45.8%], anxiety 32.5% [27.9%; 37.1%], depression 32.5% [28.8%; 36.1%], internet addiction 26.0% [5.5%; 46.5%], substance use 25.2% [18.9%; 31.6%], eating disorders 9.8% [1.1%; 18.4%], and suicidal thoughts/gestures/acts 8.9% [4.8%; 12.9%]. The prevalence estimates were deemed acceptable for all PBS.

CONCLUSION

The evidence shows that fully one-third of medical students experience a range of problematic PBS, likely attributable to the demanding and intense study environment, the hierarchical structure of medical training facilities, and the vulnerability of the young adulthood time period. Appropriately targeted assessment and intervention efforts are clearly warranted to decrease the psychological burden of medical student training. PROSPERO Identifier: CRD42023391800. Open Science Network (OSF) Identifier: DOI 10.17605/OSF.IO/SXQYN.

Sleep Quality as a Mediator of Burnout, Stress and Multisite Musculoskeletal Pain in Healthcare Workers: A Longitudinal Study

This study aimed to verify whether sleep quality is a mediator of the relationship between burnout, stress and multisite pain in healthcare workers in a longitudinal study with 12 months of follow-up during the COVID-19 pandemic. Online questionnaires were used for data collection. The sociodemographic questionnaire contained personal and occupational data. The short version of the Copenhagen Psychosocial Questionnaire (COPSOQ II-Br) was used to assess burnout and stress. The Pittsburgh Sleep Quality Index (PSQI-Br) assessed sleep quality over one month. The Nordic Musculoskeletal Questionnaire (NMQ) aimed to identify the presence of multisite musculoskeletal pain in the last 12 months and the last 7 days. Mediation analysis was used to verify whether the effect of the predictor variables (burnout and stress) on the dependent variable (number of pain sites in the last 12 months and 7 days) was due to an intervening variable (sleep quality). Stress and burnout were associated with multisite pain in healthcare workers in the last 12 months and the last 7 days. Sleep quality was a significant mediator of this association in the last 12 months, indicating that some of the association between burnout, stress and multisite pain can be explained by poor sleep quality. Thus, a comprehensive approach to long-term multisite pain should consider psychosocial aspects such as burnout, stress and sleep quality.

Prevalence of common mental disorders among medical students in China: a systematic review and meta-analysis

Background

The prevalence of mental distress is common for medical students in China due to factors such as the long duration of schooling, stressful doctor-patient relationship, numerous patient population, and limited medical resources. However, previous studies have failed to provide a comprehensive prevalence of these mental disorders in this population. This meta-analysis aimed to estimate the prevalence of common mental disorders (CMDs), including depression, anxiety, and suicidal behaviors, among medical students in China.

Methods

We conducted a systematic search for empirical studies on the prevalence of depression, anxiety, suicide attempt, suicide ideation, and suicide plan in Chinese medical students published from January 2000 to December 2020. All data were collected pre-COVID-19. The prevalence and heterogeneity estimations were computed by using a random-effects model and univariate meta-regression analyses.

Results

A total of 197 studies conducted in 23 provinces in China were included in the final meta-analysis. The prevalence data of depression, anxiety, suicide attempt, suicide ideation, and suicide plan were extracted from 129, 80, 21, 53, and 14 studies, respectively. The overall pooled crude prevalence for depression was 29% [38,309/132,343; 95% confidence interval (CI): 26%-32%]; anxiety, 18% (19,479/105,397; 95% CI: 15%-20%); suicide ideation, 13% (15,546/119,069; 95% CI: 11%-15%); suicide attempt, 3% (1,730/69,786; 95% CI: 1%-4%); and suicide plan, 4% (1,188/27,025; 95% CI: 3%-6%).

Conclusion

This meta-analysis demonstrated the high prevalence of CMDs among Chinese medical students. Further research is needed to identify targeted strategies to improve the mental health of this population.

The effect of interpersonal relationship and epidemic attention on negative emotion among medical students: the mediating role of social satisfaction

BACKGROUND

Individuals are required to avoid close contact to reduce the probability of contracting the virus during the epidemics, which can lead to social isolation and exacerbate interpersonal relationship issues. Social satisfaction plays a crucial role in management in the period of pandemics and is strongly correlated with negative emotion. Medical students, as a special group of students, have a heavier burden of academic workload and greater pressure. They are also more likely to have access to epidemic information, which increases their susceptibility to negative emotions such as depression and anxiety. Therefore, it is necessary to investigate the impact and mechanisms among interpersonal, epidemic attention, social satisfaction, and negative emotions during the epidemics outbreak among medical students for improving the level of mental health in the post-epidemic era.

METHODS

A total of 1,451 university students were included in this study. Self-administered questionnaires, including the Comprehensive Interpersonal Relationship Diagnostic Scale, the Self-Rating Anxiety Scale, and the Self-Rating Depression Scale, were utilized to construct structural equations to examine the mediating effects of social satisfaction. The study employed a multi-stage whole-group sampling approach for university students.

RESULTS

Interpersonal relationships and epidemic attention positively predicted negative emotion levels. Interpersonal relationships negatively predicted social satisfaction, while epidemic attention positively predicted social satisfaction. Moreover, social satisfaction negatively predicted negative emotion levels. Notably, both interpersonal relationships and epidemic attention indirectly affected negative emotions through the mediating effect of social satisfaction.

CONCLUSIONS

Social satisfaction plays a mediating role in the effect of interpersonal relationships and epidemic attention on negative emotion. In the post-epidemic era, it is crucial to enhance support from family, school and society to improve social satisfaction of medical students. Immediate identification of negative emotions is essential, and targeted strategies should be developed to address mental health issues among medical students.

The role of spirituality and religiosity on the suicidal ideation of medical students

BACKGROUND

There is solid evidence that spirituality and religiousness may reduce the suicidal ideation of individuals. However, studies are scarce on medical students.

AIMS

To investigate the relationship between spirituality, religiousness, and suicidal ideation among Brazilian medical students.

METHODS

This is a cross-sectional study including Brazilian medical students. Sociodemographic and health variables, suicidal ideation (item 9 of the Beck Depression Inventory - BDI), spiritual and religious Coping (Brief SRC), religiousness (Duke Religion Index), spiritual well-being - Meaning, Peace and Faith (FACIT SP-12), and depressive (PHQ-9) and anxiety (GAD-7) symptoms were assessed.

RESULTS

A total of 353 medical students were included, 62.0% presented significant depressive symptoms, 44.2% presented significant anxiety symptoms, and 14.2% presented suicidal ideation. In the adjusted Logistic Regression models, meaning (OR = 0.90, p = .035) and faith (OR = 0.91, p = .042) were associated with lower suicidal ideation, while negative spiritual and religious coping was associated with greater suicidal ideation (OR = 1.08; p = .006).

CONCLUSION

There was a high prevalence of suicidal ideation among Brazilian medical students. Spirituality and religiousness were associated with suicidal ideation in two different directions. These findings could help educators and health professionals to understand suicidal ideation among medical students, helping in the development of preventive strategies to mitigate such problem.

Suicide risk among undergraduate students in Brazil in the periods before and during the COVID-19 pandemic: results of the SABES-Grad national survey

BACKGROUND

Undergraduate students present high rates of psychological distress, including suicide risk. Due to the coronavirus disease 2019 (COVID-19) pandemic, this scenario may have been aggravated. Thus, the objective of the current study was to evaluate changes in the suicide risk rate from the period before to during the COVID-19 pandemic, as well as the factors associated with this outcome among Brazilian undergraduate students.

METHODS

This was a nationwide survey carried out in Brazil with a cross-sectional design, including two data collection periods: a single-center in-person collection in 2019 and another multicenter online collection in 2020/2021. Data were collected using self-administered instruments. The outcome was a high risk of suicide, measured through the Mini International Neuropsychiatric Interview. Analyses were carried out on data from two periods, i.e. before and during the pandemic (bivariate analysis and interaction tests), and a model of associated factors (multivariate analysis using Poisson regression) was developed including all participating universities distributed in the five regions of Brazil.

RESULTS

In total, 6716 Brazilian undergraduate students participated (996 in 2019 and 5720 in 2020/2021). The prevalence of a high suicide risk rose from 11.3% to 17.0%, especially among women and poorer individuals. The prevalence of a high risk of suicide among Brazilian undergraduates was 19.6% and was associated with several socioeconomic, academic, pandemic, and mental health factors.

CONCLUSIONS

The prevalence of a high suicide risk increased from prepandemic to during the pandemic, appearing to be largely influenced by social determinants, in conjunction with the implications of the COVID-19 pandemic.

Examining factors that drive health-related students to seek help for psychological challenges

Objectives

This study aims to find the prevalence of mental health problems and the rates of seeking mental health care among health-related students, as well as identifying factors associated with seeking mental health care.

Methods

A cross-sectional online survey was conducted among students from the Faculty of Medicine at a university in the 2021 academic year. A total of 832 students voluntarily completed an online survey measuring mental health problems and factors influencing mental health care seeking. Descriptive and analytic statistics including t-test, Pearson's chi-square test, and binary logistic regression analysis, were used to analyze the data.

Results

Among the participants, 46.80% (n = 389) reported experiencing mental health problems, but only 16.97% (n = 66) of them sought mental health care. Binary logistic regression analysis revealed that female (OR = 2.63 (1.08 - 6.43)) and LGBTQ (OR = 4.26 (1.36 - 13.37)) students, and those with a positive attitude toward professionals (OR = 1.10 (1.02 - 0.19)), were more likely to seek formal mental health care than those who did not.

Conclusions

The study findings indicate that mental health problems are prevalent among health-related students, yet formal mental health care uptake is low. To address this issue, mental health screening programs, improved knowledge and attitudes about mental health care, and mental health training for academic staffs who work with health-related students are necessary. Future studies should explore interventions to increase the uptake of mental health services among health-related students.

Association of Emotional Self-Regulation with Psychological Distress and Positive Functioning Dimensions in Brazilian University Students during the COVID-19 Pandemic

Emotional self-regulation is a relevant factor for human development capable of minimizing emotional difficulties in the face of adverse events, as was particularly useful during the COVID-19 pandemic. The present study aimed to evaluate emotional self-regulation in Brazilian health science university students and its relationship with positive psychology constructs (subjective well-being, hope, optimism, spirituality, self-compassion, and self-efficacy) and psychological distress (depression, anxiety, and stress). This was a prospective, cross-sectional, observational, analytic study of 1062 Brazilian undergraduate students with data collected using self-administered online questionnaires. Students in the first years of their undergraduate degree programs had significantly higher dysregulation scores than those in the final years. Multiple linear regression yielded a model that explained 71.8% of the variation in emotion dysregulation. The correlations of emotion dysregulation were significant and strong, scoring negatively with self-compassion, optimism, and subjective well-being and positively with psychological distress.

The Prevalence and Associated Factors of Academic Stress among Medical Students of King Khalid University: An Analytical Cross-Sectional Study

Medical students are the category of academic population with the highest levels of stress. This study aimed to assess the prevalence of academic stress among medical students in Saudi Arabia and to identify its associated factors. This cross-sectional study was conducted at the College of Medicine at King Khalid University, Abha. The Medical Student Stressor Questionnaire (MSSQ) was used to evaluate the stress caused by different factors. A total of 422 medical students participated in this study. Among the participants, 115 (27.3%) were male and 307 (72.7%) were female. The highest percentage of students were perceiving moderate to severe stress due to academic-related stressors (97.1%), followed by teaching- and learning-related stressors (93.9%) and group activities-related stressors (88.3%). The lowest domain in which students perceived moderate to severe stress was drive and desire-related stressors (65.8%). The mean percentage of students who perceived moderate-to-severe stress in all domains of stressors was 85.5%. We can conclude that medical students have a high degree of stress, and we emphasize the importance of implementing stress management programs to teach students how to handle stress in order to avoid negative effects on their health and academic performance.

Relationship of Burnout and Extra-Curricular Activities among Dental Students: An Original Research

Introduction

"Burnout syndrome (BS)" is a work-associated condition which is frequently observed in medical professionals, especially students. Extra-curricular activities (ECAs) are one of the coping techniques that students employ to deal with stress and exhaustion.

Goal

The study's goal is to evaluate dental students' levels of burnout and how it correlates with their participation in ECAs.

Materials and Procedures

In South India, a dentistry school conducted a cross-sectional questionnaire research with its students. Both the regular and supplemental batches of students from the first year through the fifth year (internship) were included. The "Maslach Burnout Inventory Student Survey", which has 15 items in three areas-"Emotional Fatigue (EE), Cynicism (CY), & Professional Efficacy (PE)"-was used to assess burnout. A 5-point Likert scale was used to grade each response. Poisson log linear model and the Mann-Whitney U test were employed. The threshold for statistical significance was 5 out of 100.

Results

Four hundred participants were finalized after the criteria. Over 80% of the participants were women students as in accordance with the routine proportion of the dental students. The participants' average age was 22.1 ± 12 years. Burnout was seen in nearly 20% of subjects. Significant variation was seen for all the three domains of the burnout when they were compared against the ECA (P = 0.019(EE), 0.003(CY), and 0.005(PE)).

Conclusion

It is safe to say that among the participants, burnout is a common occurrence. There is a need for early detection of burnout in dental students and prompt, efficient management.