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D'Alva-Teixeira V, Picó-Pérez M, Morgado P. Determinants of Poor Mental Health of Medical Students in Portugal-A Nationwide Study. Healthcare (Basel) 2023; 11:1991. [PMID: 37510433 PMCID: PMC10379586 DOI: 10.3390/healthcare11141991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Medical students are a population that is vulnerable to the development of anxiety, depression, and burnout. This observational cross-sectional study sought to assess the levels of distress and identify precipitating factors in all students enrolled in a Portuguese medical school during the academic year of 2022/23. Students (n = 768) were surveyed via validated instruments to measure anxiety, depression, and burnout. Sociodemographic information was also collected through a questionnaire. The study indicated that almost half of this population had depressive symptoms. No differences were found in distress levels between medical schools, and when comparing curricular years, higher levels of distress were found in the pre-clinical years in comparison to the clinical ones. Burnout, being a woman, the existence of physical health problems, homo- and bisexual orientations, affective family problems, problems with relationships in the academic community, difficulties in academic performance, and daily organization were identified as predictors of distress. On the other hand, satisfaction with the social support received and with academic ratings were identified as protective factors. In conclusion, there is a high prevalence of distress in medical students, which is associated with personal, physical, social, economic, and academic factors. The identification of predictive factors of distress may allow for the early identification of vulnerable students and for intervention and prevention strategies to be defined.
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Affiliation(s)
- Vânia D'Alva-Teixeira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga, Portugal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, 12071 Castelló de la Plana, Spain
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga, Portugal
- 2CA-Braga Cinical Academic Center, Hospital de Braga, 4710-243 Braga, Portugal
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Dabbagh R, Alwatban L, Alrubaiaan M, Alharbi S, Aldahkil S, AlMuteb M, Alsahli N, Almutairi R. Depression, stress, anxiety and burnout among undergraduate and postgraduate medical trainees in Saudi Arabia over two decades: A systematic review. Med Teach 2023; 45:499-509. [PMID: 36355388 DOI: 10.1080/0142159x.2022.2139669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Evidence suggests physicians have higher rates of mental distress than other professionals. Although multiple studies have been conducted among Saudi medical trainees to address this issue, no reviews assessed multiple psychological problems simultaneously. We aimed to examine the prevalence and trends of depression, anxiety, burnout and stress among Saudi medical trainees. METHODS A systematic review was conducted searching PubMed/Medline, OVID, Scopus, PsychInfo, EBSCOhost and the Directory of Open Access Journals (DOAJ) for studies addressing depression, burnout, stress and anxiety among Saudi medical trainees, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Joanna Briggs Critical Appraisal Checklist was used to evaluate quality. The main findings were summarised in tables. RESULTS We identified 57 records from 2001 to 2020. Overall (mild, moderate or severe) depression ranged from 28% to 70.6%, while stress ranged from 30.5% to 90.7%. Burnout was primarily assessed among residents with an overall prevalence reaching 85.5%. Overall anxiety ranged from 52.7% to 67%, and was only assessed among undergraduates. Higher levels of all four mental conditions were reported among females. CONCLUSION This review suggests high prevalence of depression, stress, burnout and anxiety among medical trainees, with higher estimates for females compared to males.
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Affiliation(s)
- Rufaidah Dabbagh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Lemmese Alwatban
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | - Sultan Alharbi
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Shahad Aldahkil
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mona AlMuteb
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nora Alsahli
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rahaf Almutairi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Kiupel S, Kupfer J, Kottlors S, Gieler U, Yosipovitch G, Schut C. Is stress related to itch in German students? Results of an online survey. Front Med (Lausanne) 2023; 10:1104110. [PMID: 37181359 PMCID: PMC10166863 DOI: 10.3389/fmed.2023.1104110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/07/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction German students report to be more stressed than the general population. Highly stressed students from other countries (United States, Australia, Saudi-Arabia) were found to have more skin symptoms, including itch, than lowly stressed students. The current study aimed to assess whether itch is associated with stress in a larger sample of German students. Methods 838 students (3.2% of all invited students) took part in the questionnaire based study and filled in the Perceived Stress Questionnaire as well as a modified version of the Self-Reported Skin Questionnaire. Students were categorized into highly (HSS) and lowly stressed students (LSS) by determination of the 25th and 75th percentile. Results Itch occurred significantly more often in HSS compared to LSS (OR = 3.41 (2.17-5.35)). In addition, itch intensity was significantly related to perceived stress. Discussion These findings not only highlight the importance of offering stress management trainings also to students in Germany in order to minimize itch, but also encourage future research on stress and itch in certain student subgroups.
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Affiliation(s)
- Stephanie Kiupel
- Institute of Medical Psychology, Faculty of Medicine, Justus Liebig University, Giessen, Germany
| | - Jörg Kupfer
- Institute of Medical Psychology, Faculty of Medicine, Justus Liebig University, Giessen, Germany
| | - Sophia Kottlors
- Institute of Medical Psychology, Faculty of Medicine, Justus Liebig University, Giessen, Germany
| | - Uwe Gieler
- Department of Dermatology and Allergology, Justus-Liebig-University, Giessen, Germany
- Clinic for Psychosomatics, Vitos Klinik, Giessen, Germany
| | - Gil Yosipovitch
- Department of Dermatology and Cutaneous Surgery and Itch Center, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Christina Schut
- Institute of Medical Psychology, Faculty of Medicine, Justus Liebig University, Giessen, Germany
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Al-Imam A, Motyka MA, Hoffmann B, Basil S, Al-Hemiary N. Suicidal Ideation in Iraqi Medical Students Based on Research Using PHQ-9 and SSI-C. Int J Environ Res Public Health 2023; 20:1795. [PMID: 36767164 PMCID: PMC9914454 DOI: 10.3390/ijerph20031795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Suicidal ideation is a spectrum of contemplations, wishes, and preoccupations with suicide. Its prevalence is ambiguous in Iraq, especially among the youth. We aim to survey the prevalence of suicidal ideation among Iraqi students and explore its risk factors. We surveyed Iraqi undergraduate medical students (n = 496) using two psychometric tools, the PHQ-9 and Beck's SSI-C. We also explored potential risk factors, including the students' attributes, socio-demographics, and history of mental illnesses. The current study included males (23.8%) and females (76.2%) in their early twenties (21.73 ± 0.11). Concerning PHQ-9 and SSI-C, most students had either moderate (28%) or mild depression (27.8%), while those with suicidal ideation accounted for an alarming 64.9%. The strongest association existed between the SSI-C and PHQ-9 scores (p = 0.001, OR = 4.70). Other associations existed with the personal history of mental illness (p < 0.001, OR = 2.87) and the family history of suicidality (p = 0.006, OR = 2.28). Path analysis highlighted four suicidal ideation predictors, including the PHQ-9 score (standardized estimate = 0.41, p < 0.001), personal history of mental illness (0.16, p < 0.001), previous psychiatric consultation (0.12, p = 0.002), and family history of suicidality (0.11, p = 0.005). Suicidal ideation is highly prevalent among Iraqi students. Univariable testing, multivariable analyses, and structural modeling yielded congruent results. The students' inherent rather than inherited attributes influenced the phenomenon the most, which is in harmony with Durkheim's theory on the social roots of suicide. We encourage psychiatrists and psychology counselors to be vigilant concerning these risk factors among potential suicidal ideation victims.
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Affiliation(s)
- Ahmed Al-Imam
- Department of Computer Science and Statistics, Doctoral School, Poznan University of Medical Sciences, Rokietnicka 7 St. (1st Floor), 61-806 Poznan, Poland
- Department of Anatomy and Cellular Biology, College of Medicine, University of Baghdad, Baghdad 10047, Iraq
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
| | - Marek A. Motyka
- Institute of Sociological Sciences, University of Rzeszow, 35-959 Rzeszów, Poland
| | - Beata Hoffmann
- Institute of Applied Social Sciences, University of Warsaw, 00-927 Warsaw, Poland
| | - Safwa Basil
- Department of Psychiatry, Baghdad Medical City, Baghdad 10047, Iraq
| | - Nesif Al-Hemiary
- Department of Psychiatry, College of Medicine, University of Baghdad, Baghdad 10047, Iraq
- Psychiatry Council, The Iraqi Board for Medical Specializations, Baghdad 10047, Iraq
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Dai P, Yi G, Qian D, Wu Z, Fu M, Peng H. Social Support Mediates the Relationship Between Coping Styles and the Mental Health of Medical Students. Psychol Res Behav Manag 2023; 16:1299-1313. [PMID: 37155482 PMCID: PMC10122993 DOI: 10.2147/prbm.s405580] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/23/2023] [Indexed: 05/10/2023] Open
Abstract
Purpose This study aimed to explore the impact that coping styles and social support have on the mental health of medical students by constructing a corresponding structural situation model that reveals the complex relationship between these three factors. In doing so, it seeks to help medication students better manage mental health problems. Patients and Methods The online study was conducted between March 6, 2021 and May 6, 2021. A total of 318 participants from multiple medical schools were involved. The general information questionnaire, simple coping style questionnaire (SCSQ), perceived social support scale (PSSS) and symptom checklist 90 (SCL-90) were used to collect relevant information from the subjects by snowball sampling. An independent t-test, ANOVA, Pearson correlation coefficient analysis, and intermediary effect analysis were all used to analyze the relevant data and construct the structural equation model. Results There was a significant difference in SCL-90 between medical students and national college students (1.78±0.70, P < 0.001), and the positive rate of mental health status was as high as 40.3%. Sleep quality, regular diet, and positive coping style were positively correlated with mental health (P < 0.01), while negative coping styles and total scores of coping style as well as family, friends, and other sources of social support and total scores of social support were negatively correlated with mental health problems (P < 0.01). Positive and negative coping styles have an impact on mental health through the mediating effect of between social support and coping styles, as well as in the direct pathway. Conclusion The mental health status of medical students was significantly poor. Medical schools should thus pay close attention to the mental health status of students and encourage them to develop healthy living habits, optimize coping styles, and establish stable sources of social support to improve their psychological wellbeing.
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Affiliation(s)
- Peilin Dai
- School of Nursing, Hunan University of Medicine, Huaihua, Hunan, People’s Republic of China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China
| | - Guoguo Yi
- Department of Ophthalmology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Dandan Qian
- Department of Clinical Skills Training Center, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Zhe Wu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China
| | - Min Fu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, People’s Republic of China
- Correspondence: Min Fu, Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, No. 253, Industrial Avenue Middle, Haizhu, Guangzhou, People’s Republic of China, Tel +86 18665621066, Email
| | - Hui Peng
- School of Nursing, Hunan University of Medicine, Huaihua, Hunan, People’s Republic of China
- Hui Peng, School of Nursing, Hunan University of Medicine, No. 492, Jinxi South Road, Huaihua, Hunan, People’s Republic of China, Email
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Sudi R, Chang WL, Arshad NH, Zainal Abidin SN, Suderman U, Woon LSC. Perception of Current Educational Environment, Clinical Competency, and Depression among Malaysian Medical Students in Clinical Clerkship: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:16274. [PMID: 36498345 PMCID: PMC9735451 DOI: 10.3390/ijerph192316274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has altered the educational environment of medical students in clinical clerkship, with potential impacts on clinical competency and reported increased prevalence of depression. This study aimed to determine the relationship between the perception of the educational environment, self-perceived clinical competency, and depression among them. Subjects (N = 196) at the National University of Malaysia participated through convenience sampling in an online survey including sociodemographic data, COVID-19-related stressors, Dundee Ready Education Environment Measure (DREEM), self-perceived clinical competency, and Patient Health Questionnaire (PHQ-9). The cut-off point for depression was a PHQ-9 score ≥ 15. Multiple logistic regression followed bivariate analyses to identify factors for depression. The participants (mean age: 23.2 years, SD ± 0.98 years) were mainly female (71.9%) and Malay (59.2%). The prevalence of depression was 17.4% (95% CI: 12.3-23.4%). Most participants perceived the educational environment positively. In logistic regression, ethnicity (Adjusted OR = 3.1, 95% CI: 1.2-8.1) and DREEM score were significantly associated with depression, whereas self-perceived clinical competency was not. A higher DREEM score indicating a better perception of the educational environment was linked to a lower likelihood of depression (p = 0.046). Besides ethnicity, perception of the educational environment emerged as a factor associated with depression. This relationship between the educational environment and mental well-being warrants further exploration.
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Chen J, Tuersun Y, Yang J, Xiong M, Wang Y, Rao X, Jiang S. Association of depression symptoms and sleep quality with state-trait anxiety in medical university students in Anhui Province, China: a mediation analysis. BMC Med Educ 2022; 22:627. [PMID: 35982434 PMCID: PMC9388213 DOI: 10.1186/s12909-022-03683-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The prevalence of depression symptoms among medical students is particularly high, and it has increased during the COVID-19 epidemic. Sleep quality and state-trait anxiety are risk factors for depression, but no study has yet investigated the mediating role of state-trait anxiety in the relationship between poor sleep quality and depression symptoms in medical students. This study aims to investigate the relationship among depression symptoms, sleep quality and state-trait anxiety in medical university students in Anhui Province. METHODS This was a cross-sectional survey of 1227 students' online questionnaires collected from four medical universities in Anhui Province using a convenience sampling method. We measured respondents' sleep quality, state-trait anxiety, and depression symptoms using three scales: the Pittsburgh Sleep Quality Index (PSQI), the State-Trait Anxiety Inventory (STAI) and the Self-rating Depression Scale (SDS). We analysed the mediating role of STAI scores on the association between PSQI scores and SDS scores through the Sobel-Goodman Mediation Test while controlling for covariates. P < 0.05 was considered statistically significant. RESULTS A total of 74.33% (912) and 41.40% (518) of the respondents reported suffering from poor sleep quality and depression symptoms. Sleep quality, state-trait anxiety, and depression symptoms were positively associated with each other (β = 0.381 ~ 0.775, P < 0.001). State-trait anxiety partially mediated the association between sleep quality and depression symptoms (Sobel test Z = 15.090, P < 0.001), and this mediating variable accounted for 83.79% of the association when adjusting for potential confounders. Subgroup analysis further revealed that STAI scores partially mediated the association between PSQI scores and SDS scores in females and rural students and fully mediated the association between PSQI scores and SDS scores in males and urban students. CONCLUSIONS This study found that sleep quality and state-trait anxiety have a significant predictive effect on depression symptoms. State-trait anxiety mediated the relationship between sleep quality and depression symptoms, with a more complex mechanism observed among rural and female medical students. Multiple pathways of intervention should be adopted, such as encouraging students to self-adjust, providing professional psychological intervention and timely monitoring, enriching extracurricular activities, and making changes in policies regarding long shifts and working hours.
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Affiliation(s)
- Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
| | | | - Jiao Yang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Man Xiong
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yueying Wang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Xinyi Rao
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Shuai Jiang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
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Wen LY, Shi LX, Zhu LJ, Zhou MJ, Hua L, Jin YL, Chang WW. Associations between Chinese college students’ anxiety and depression: A chain mediation analysis. PLoS One 2022; 17:e0268773. [PMID: 35653383 PMCID: PMC9162318 DOI: 10.1371/journal.pone.0268773] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/07/2022] [Indexed: 11/19/2022] Open
Abstract
Objective Anxiety and depression are great public health concerns among college students. The purpose of this study was to explore whether sleep quality and quality of life (QoL) play mediating roles in anxiety and depression among Chinese college students. Method A total of 2757 college students (mean age = 19.07; SD = 1.14) completed the questionnaires, including a brief demographic survey. The 2-item General Anxiety Disorder (GAD-2) and the 2-item Patient Health Questionnaire (PHQ-2) were used to assess the symptoms of anxiety and depression, respectively. And the Pittsburgh Sleep Quality Index (PSQI) and the Short-Form 36 Health Survey (SF-36) were used to evaluate college students’ sleep quality and QoL, respectively. Mediation analyses were conducted by using PROCESS macro in the SPSS software. Result Anxiety had both direct and indirect effects on depression. Sleep quality and QoL were not only independent mediators in the relationship between anxiety and depression but also chain mediators. Conclusion The results of the current study highlight the crucial role of early intervention for depression with a focus on college students with anxiety, more especially, on those with poorer sleep quality and lower QoL.
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Affiliation(s)
- Li-ying Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Liu-xia Shi
- Department of Oral Medicine, School of Stomatology, Wannan Medical College, Wuhu, China
| | - Li-jun Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Meng-jie Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Long Hua
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Yue-long Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
- * E-mail: (YLJ); (WWC)
| | - Wei-wei Chang
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
- * E-mail: (YLJ); (WWC)
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Kirtchuk D, Wells G, Levett T, Castledine C, de Visser R. Understanding the impact of academic difficulties among medical students: A scoping review. Med Educ 2022; 56:262-269. [PMID: 34449921 DOI: 10.1111/medu.14624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/04/2021] [Accepted: 08/13/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND Many medical students may encounter a range of academic and personal challenges during their course of study, but very little is known about their experiences. Our aim was to review the literature to inform future scholarship and to inform policy change. METHODS A scoping review was conducted searching PubMed, MEDLINE, EMBASE, PsycInfo, British Education Index, Web of Science and ERIC for English language primary research with no date limits. This retrieved 822 papers of which eight met the requirements for inclusion in the review. Data were independently reviewed by two researchers and underwent thematic analysis by the research team. RESULTS Three major themes emerged. Theme 1: 'Identity preservation' addressed students' aim to preserve their sense of self in the face of academic difficulty and their tendency to seek support. This connected the apprehension many students expressed about their educational institutions to Theme 2: 'The dual role of the medical school'-medical schools are required to support struggling students but are predominantly seen as a punitive structure acting as the gatekeeper to a successful career in medicine. Students' apprehension and attempts to protect their identities within this complex landscape often resulted in 'maladaptive coping strategies' (Theme 3). CONCLUSION Understanding and exploring the academic challenges faced by medical students through their own experiences highlight the need for the development of more individualised remediation strategies. Educators may need to do more to bridge the gap between students and institutions. There is a need to build trust and to work with students to enhance their sense of self and remediate approaches to engagement with learning, rather than focusing efforts on success in assessments and progression.
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Affiliation(s)
- David Kirtchuk
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Geoffrey Wells
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Tom Levett
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Clare Castledine
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Richard de Visser
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
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Yuryeva LM, Shusterman TY, Podolska LV. DEPRESSION IN THE STRUCTURE OF ADJUSTMENT DISORDERS IN FOREIGN APPLICANTS FOR HIGHER EDUCATION AT DIFFERENT STAGES OF STUDYING. VPBM 2022. [DOI: 10.29254/2077-4214-2022-3-166-287-295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Chalmers T, Hickey BA, Newton P, Lin CT, Sibbritt D, McLachlan CS, Clifton-Bligh R, Morley J, Lal S. Stress Watch: The Use of Heart Rate and Heart Rate Variability to Detect Stress: A Pilot Study Using Smart Watch Wearables. Sensors (Basel) 2021; 22:151. [PMID: 35009696 DOI: 10.3390/s22010151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 01/01/2023]
Abstract
Stress is an inherent part of the normal human experience. Although, for the most part, this stress response is advantageous, chronic, heightened, or inappropriate stress responses can have deleterious effects on the human body. It has been suggested that individuals who experience repeated or prolonged stress exhibit blunted biological stress responses when compared to the general population. Thus, when assessing whether a ubiquitous stress response exists, it is important to stratify based on resting levels in the absence of stress. Research has shown that stress that causes symptomatic responses requires early intervention in order to mitigate possible associated mental health decline and personal risks. Given this, real-time monitoring of stress may provide immediate biofeedback to the individual and allow for early self-intervention. This study aimed to determine if the change in heart rate variability could predict, in two different cohorts, the quality of response to acute stress when exposed to an acute stressor and, in turn, contribute to the development of a physiological algorithm for stress which could be utilized in future smartwatch technologies. This study also aimed to assess whether baseline stress levels may affect the changes seen in heart rate variability at baseline and following stress tasks. A total of 30 student doctor participants and 30 participants from the general population were recruited for the study. The Trier Stress Test was utilized to induce stress, with resting and stress phase ECGs recorded, as well as inter-second heart rate (recorded using a FitBit). Although the present study failed to identify ubiquitous patterns of HRV and HR changes during stress, it did identify novel changes in these parameters between resting and stress states. This study has shown that the utilization of HRV as a measure of stress should be calculated with consideration of resting (baseline) anxiety and stress states in order to ensure an accurate measure of the effects of additive acute stress.
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Watanabe T, Kondo M, Sakai M, Takabatake S, Furukawa TA, Akechi T. Association of Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder Traits with Depression and Empathy Among Medical Students. Adv Med Educ Pract 2021; 12:1259-1265. [PMID: 34737666 PMCID: PMC8560068 DOI: 10.2147/amep.s334155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/18/2021] [Indexed: 05/19/2023]
Abstract
PURPOSE This study aimed to investigate the associations of the traits of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) with depression and empathy among medical students. PATIENTS AND METHODS A cross-sectional survey was conducted with 202 fifth-year students at a Japanese medical school for 10 months during their clinical clerkship. The survey included sociodemographic questions and validated tools to measure depressive symptoms (Hospital Anxiety and Depression Scale [HADS]), medical students' empathy for patients (Jefferson Scale of Empathy-Student version [JSE]), ADHD traits (ADHD Self-Report Scale Screener [ASRS Screener]), and ASD traits (Autism-Spectrum Quotient Japanese version-21 [AQ-J-21]). RESULTS A total of 151 students (response rate: 74.7%) participated in the survey. Of these, 41 (27.2%) reported a total score of ≥ 20 on the HADS and were categorized as depressed. Depressed students reported significantly lower and higher rates of having a part-time job and a history of enrolment in other faculties, respectively, than non-depressed students. According to the cutoff criteria of the ASRS Screener and AQ-J-21, 31 (20.5%) and 42 (27.8%) students reported ADHD and ASD traits, respectively. Multivariate regression analysis, controlling for age and sex, reported that higher age, ASRS Screener scores, and AQ-J-21 scores were significant predictors of higher HADS total scores. Additionally, higher AQ-J-21 scores significantly predicted lower JSE scores. CONCLUSION The degree of ADHD and ASD traits was significantly associated with depression. Moreover, the degree of ASD traits was significantly associated with lower empathy for their patients. It is important to consider that about 20-30% of medical students have these neurodevelopmental traits and to develop intervention strategies for improving depression and empathy.
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Affiliation(s)
- Takafumi Watanabe
- Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
- Correspondence: Takafumi Watanabe Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya City, Aichi, 467-8601, JapanTel +81 52 853 8271Fax +81 52 852 0837 Email
| | - Masaki Kondo
- Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - Mie Sakai
- Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - So Takabatake
- Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto City, Japan
| | - Tatsuo Akechi
- Department of Psychiatry, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
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Qureshi MFH, Mohammad D, Sadiq S, Abubaker ZJ, Kumari U, Devnani J, Dawani N, Soleja FK, Haroon A. A comparative cross-sectional analysis on prevalence of depression and associated risk factors among medical students and doctors of Karachi, Pakistan. Middle East Curr Psychiatry 2020. [DOI: 10.1186/s43045-020-00066-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
It has been noted that there is high prevalence of depression among medical personnel whether it is a student or an on-duty doctor. However, no study has been done to highlight these two vulnerable groups. Accordingly, the objective of current study is to compare the prevalence of depression among medical students and doctors working in hospitals, and its correlation with demographic variables, associated symptoms and history of any recent trauma. A descriptive cross-sectional study design was selected for this study. PHQ-9 was used as study tool.
Result
Mean age of students was 21 ± 1.83 while the mean age of the doctors included in study was 31 ± 7.8. A multivariate analysis model (MANOVA) was applied where male doctor and students were found to have a significantly high association (p = < 0.001) with depression scores as compared to their counterpart and students. Positive association was observed among sector and symptom of hopelessness, sleep changes and appetite/weight changes. The most common symptom among both groups was sleep changes while the least common symptom among doctors was concentration problem and among students was feeling of helplessness. It was also found that 26% of the students were having suicidal thoughts while only 16% of the doctors were having suicidal intentions.
Conclusion
It is concluded that depression is highly prevalent among medical students when comparing with on-duty doctors, so they should be screened with regular intervals and good counselling sessions to prepare them for a better health care system.
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Seera G, Arya S, Sethi S, Nimmawitt N, Ratta-Apha W. Help-seeking behaviors for mental health problems in medical students: Studies in Thailand and India. Asian J Psychiatr 2020; 54:102453. [PMID: 33271732 DOI: 10.1016/j.ajp.2020.102453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/06/2020] [Accepted: 10/12/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To compare the rate of help-seeking from mental health professionals (MHPs) and other sources of help for mental health problems of medical students in Thailand and India, and explore factors associated with help-seeking from MHPs. METHODS Cross-sectional survey-based study was conducted in two medical schools in Thailand and India. Students were asked to rate their preferences for each source of help on a Likert-scale basis. Mental health status was measured by the General health questionnaire-12 (GHQ-12). Attitudes and stigma toward mental illness were collected using the Mental illness clinician's attitude scale: medical student version or MICA v2. RESULTS 593 students participated in the survey. The percentage of students who chose to seek help from any source was lower in Thailand than in India. 81 % of students in India site chose to seek help from MHPs, compared to 66 % in Thailand site. The risk factors for avoiding seeking help from MHPs in Thailand were history of alcohol use (OR = 1.88, p = .014) and total GHQ score (OR = 1.11, p = .006), whereas having GHQ score ≥ 2 was a significant risk factor in India (OR = 2.20, p = .044). Total MICA score, which reflected overall attitude toward mental illness, was not associated with seeking help from MHPs. CONCLUSIONS The rate of help-seeking behaviors for mental health problems and factors associated differed between medical students in Thailand and India. A high GHQ score was a common risk factor of not seeking help from MHPs in both countries.
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Affiliation(s)
- Genis Seera
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
| | - Sidharth Arya
- Department of Psychiatry, Pt BDS University of Health Sciences, Rohtak, India.
| | - Sujata Sethi
- Department of Psychiatry, Pt BDS University of Health Sciences, Rohtak, India.
| | - Neshda Nimmawitt
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
| | - Woraphat Ratta-Apha
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
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Abstract
Physically active health care providers are more likely to provide physical activity (PA) counseling to their patients, but barriers in PA counseling exist. Common barriers include knowledge, time constraints, lack of reimbursement, as well as lack of personal habits. This article will summarize evidence-based knowledge regarding provider PA habits as a means of improving rapport, compliance, and empathy for patients when prescribing PA. Clinical pearls for successful PA counseling scenarios also will be discussed.
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Olum R, Nakwagala FN, Odokonyero R. Prevalence and Factors Associated with Depression among Medical Students at Makerere University, Uganda. Adv Med Educ Pract 2020; 11:853-860. [PMID: 33209071 PMCID: PMC7669518 DOI: 10.2147/amep.s278841] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/13/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND Depression affects about a third of medical students worldwide. There is paucity of data on depression among medical students in Uganda. The purpose of this study was to establish the prevalence and factors associated with depression among medical students at Makerere University College of Health Science (MakCHS), Uganda. METHODS A cross-sectional study was conducted among students pursuing a Bachelor of Medicine and Surgery at MakCHS in May and July 2019. Students were enrolled by consecutive sampling, both online using Google Forms and in person for those unable to access internet. The self-reported Patient Health Questionnaire 9 (PHQ9) was administered to assess depression, defined as a PHQ9 score ≥10. Microsoft Excel 2016 and Stata 16 were used for data analysis. RESULTS Overall, 331 valid responses (mean age 23.1±3.3 years) were submitted (response rate 93.8%). In a majority of participants, the prevalence of depression was 21.5% (n=71) of which 64.1% had moderate depression (n=50). On bivariate analysis, year of study, worrying about academic performance, and lectures were significantly associated with depression. On multivariate analysis, worrying about academic performance (aOR 2.52, 95% CI 1.50-4.22; P<0.001) and lectures (aOR 1.89, 95% CI 1.11-3.22; P=0.018) were significantly associated with depression. CONCLUSION Depression affects a significant number of medical students at MakCHS. About one in five medical students have depression. Year of study and academic performance were significantly associated with depression. Efforts aimed at identification and evaluation of students at risk, administering appropriate interventions, and follow-up of affected students are vital. Analytical studies aimed at establishing the causative factors and the effects of depression on medical students are recommended.
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Affiliation(s)
- Ronald Olum
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Correspondence: Ronald OlumSchool of Medicine, College of Health Sciences, PO Box 7072, Kampala, UgandaTel +256-775-512-540 Email
| | | | - Raymond Odokonyero
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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