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Faghihzadeh E, Eghtesad A, Fawad M, Xu X. Exploring Connections Between Mental Health, Burnout, and Academic Factors Among Medical Students at an Iranian University: Cross-Sectional Questionnaire Study. JMIR MEDICAL EDUCATION 2025; 11:e58008. [PMID: 40372966 PMCID: PMC12097282 DOI: 10.2196/58008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 06/22/2024] [Accepted: 11/23/2024] [Indexed: 05/17/2025]
Abstract
Background Medical students face high levels of burnout and mental health issues during training. Understanding associated factors can inform supportive interventions. Objective This study aimed to examine burnout, psychological well-being, and related demographics among Iranian medical students. Methods A cross-sectional survey was conducted among 131 medical students at an Iranian University. The instruments used included the Maslach Burnout Inventory-Student Survey and the Symptom Checklist-90-Revised. Descriptive statistics, multivariate regression, and tests for group differences were used to analyze the data. Results The MBI-SS subscale scores indicated moderate emotional exhaustion, mean 15.00 (SD 7.08) and academic efficacy, mean 14.98 (SD 6.29), with lower cynicism, mean 10.85 (SD 5.89). The most commonly reported mental health issues were depression and obsessive-compulsive disorder. Poor psychological well-being was associated with higher overall burnout, but no significant gender differences were found. Burnout levels varied by academic year across all Maslach Burnout Inventory-Student Survey domains. Conclusions Despite their health education, medical students in this study reported significant burnout and mental health distress, with strong associations between the two. These issues may impact student retention and post-graduation practice plans. Supporting well-being during training is critical for positive student and physician outcomes.
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Affiliation(s)
- Elham Faghihzadeh
- Department of Biostatistics and Epidemiology, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Ali Eghtesad
- School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Muhammad Fawad
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, Zhejiang, 310058, China
| | - Xiaolin Xu
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, Zhejiang, 310058, China
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Abdelaziz MN, Moustafa ARA, Azzam H, Bshar AM, Ismail IS, Elhadidy OY. Association between beauty standards shaped by social media and body dysmorphia among Egyptian medical students. Sci Rep 2025; 15:12976. [PMID: 40234498 PMCID: PMC12000291 DOI: 10.1038/s41598-025-95617-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2024] [Accepted: 03/24/2025] [Indexed: 04/17/2025] Open
Abstract
This study examines the relationship between exposure to unattainable beauty standards via social media and the prevalence of Body Dysmorphic Disorder among medical students in Egypt. The rapid development of digital platforms, particularly social media, has brought about a wider dissemination of unattainable beauty standards that may contribute to body image disorders and psychological problems. Given the unique pressures faced by medical students, who represent both consumers and influencers in health-related content, the current study attempts to ascertain whether excessive engagement with distorted beauty portrayals correlates with higher rates of BDD symptoms in this population. This was a cross-sectional questionnaire-based study consisting of 1126 undergraduate medical students, with a mean age of 20.8 years enrolled in any Egyptian medical school registered in the academic year 2023-2024, specifically from August-October 2024, except non-medical, graduate, and non-Egyptian students who met the exclusion criteria. We privately gathered answers via colleagues and electronically via online Google forms posted on social media groups. To our knowledge, this is the first study to investigate the relationship between social media use and BDD among medical students. According to social media practices, WhatsApp, Facebook, Instagram, YouTube, and TikTok were mostly used for 4-7 h daily. Most rarely or sometimes, take selfies, edit them with filters, and share them with others. The summary of BDDQ answers demonstrated that 6.3% of Egyptian medical students enrolled met the criteria for BDD. The majority reported that they do not like their face, and this leads to suffering from bullying in school or work, resulting in avoiding certain clothes as an avoidance behavior. The majority reported engaging in positive self-talk, participating in offline activities or hobbies, and unfollowing accounts promoting unattainable beauty standards as a coping strategy against unattainable beauty standards shaped by social media. Our study found that BDD is highly prevalent among social media users, especially on text-based platforms. The prevalence of BDD among Egyptian medical students is 6.3%, which is higher than worldwide. Interestingly, Egyptian medical students enrolled in our study believe that promoting body positivity, educating users about the risks of body dysmorphia, restricting content that promotes unrealistic body standards, and providing resources and support for those affected, respectively, are the critical measures that social media platforms should take to address body dysmorphia.
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Affiliation(s)
| | - Ahmed R A Moustafa
- Medical Intern, Faculty of medicine, Mansoura University, Mansoura, Egypt
| | - Hajer Azzam
- Integrated Medical Program, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Anwar M Bshar
- Medical Intern, Faculty of medicine, Mansoura University, Mansoura, Egypt
| | - Ismail S Ismail
- Medical Intern, Faculty of medicine, Mansoura University, Mansoura, Egypt
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Rahman M, Kabir MHMI, Sultana S, Abdullah I, Shimu AT. Suicidal behaviours and associated factors among Bangladeshi medical students: a systematic review and meta-analysis (2000-2024). BMJ Open 2025; 15:e095573. [PMID: 40118476 PMCID: PMC11931929 DOI: 10.1136/bmjopen-2024-095573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2024] [Accepted: 02/28/2025] [Indexed: 03/23/2025] Open
Abstract
OBJECTIVES Suicidal behaviours are common among medical students, and the prevalence might vary across various regions. Even though various systematic reviews have been conducted to assess the suicidal behaviours among medical students in general, no review has ever explored or carried out a sub-analysis to show the burden of suicidal behaviours among Bangladeshi medical students. DESIGN This is a systematic review and meta-analysis of prevalence studies among Bangladeshi medical students. The review applied truncated and phrase-searched keywords and relevant subject headings for study identification using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. DATA SOURCES PubMed (Medline), Scopus, PsycINFO and Google Scholar databases were searched between January 2000 and May 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES The designed study included cross-sectional, case series, case reports and cohort studies of Bangladeshi medical students reporting suicidal behaviours (suicidal ideation, suicidal planning or suicidal attempts). Only freely accessible, full-text articles in English were included for analysis. DATA EXTRACTION AND SYNTHESIS Study screening, data extraction and methodological assessment were performed by two independent reviewers. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. A random-effects meta-analysis model was conducted to pool prevalence rates, complemented by narrative synthesis. Heterogeneity was assessed using the I 2 statistic. RESULTS Data were obtained from 6 eligible studies, including 1625 medical students (691 male) of Bangladesh. The pooled prevalence of lifetime suicidal behaviours was 25%, for suicidal ideation (95% CI: 14% - 37%, I 2=91%; p<0.01), 6% for suicidal plan (95% CI: 2% - 12%, I 2=91%; p<0.01), and 8% for suicidal attempt (95% CI: 1% - 17%, I 2=96%; p<0.01). The factors associated with suicidal ideation were female gender, depression, familial suicidal history and drug addiction. Only depression and drug addiction were significantly associated with suicidal attempts, while hanging was the most attempted method. CONCLUSIONS Suicidal behaviours particularly, suicidal ideation, are high among Bangladeshi medical students. However, very few studies were done in this country to quantify the burden and its associated factors. PROSPERO REGISTRATION NUMBER CDR 42023493595.
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Affiliation(s)
- Mantaka Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Data Science and Analytics (MSc), East-West University, Dhaka, Bangladesh
| | - M H M Imrul Kabir
- Mathematical & Physical Sciences, East West University, Dhaka, Bangladesh
| | - Sharmin Sultana
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Public Health, Independent University, Dhaka, Bangladesh
| | - Imtiaz Abdullah
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Public Health, North South University, Dhaka, Bangladesh
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Hawsawi AA, Nixon N, Nixon E. Navigating the medical journey: Insights into medical students' psychological wellbeing, coping, and personality. PLoS One 2025; 20:e0318399. [PMID: 39913638 PMCID: PMC11801719 DOI: 10.1371/journal.pone.0318399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 01/16/2025] [Indexed: 02/11/2025] Open
Abstract
BACKGROUND AND AIMS In recent years, increased awareness of the psychological wellbeing of healthcare professionals and students has become a pressing public health issue affecting care delivery. Medical students undergo rigorous training programs that can affect their psychological wellbeing. Despite increased awareness of mental health issues among medical students, research often focuses on negative aspects, overlooking potential positive contributors to wellbeing. This study aims to explore both negative and positive factors influencing medical students' psychological wellbeing, considering coping strategies and personality traits to inform targeted support measures for diverse student needs. METHODS A mixed-methods approach was employed to investigate medical students' psychological wellbeing, coping strategies, and personality traits. Quantitative data was gathered via self-report questionnaires and analysed using regression models. Additionally, qualitative insights were obtained from semi-structured interviews and analysed thematically to capture students' perceptions and experiences. RESULTS The analysis revealed moderate to high levels of stress, anxiety, and depression among medical students, along with decreased life satisfaction. Regression analysis showed that problem-focused coping positively impacted medical students' psychological wellbeing, whereas emotion-focused and avoidance coping showed less favourable effects. Notably, problem-focused coping partially mediated the relationship between stress and depression. Furthermore, personality traits, particularly agreeableness and conscientiousness, played a pivotal role in shaping medical students' coping strategies and mental health outcomes. Based on thematic analysis, codes gave rise to three overarching themes and corresponding subthemes. CONCLUSIONS The study underscores the significance of addressing both positive and negative factors impacting medical students' wellbeing and highlights the need for tailored support considering individual personality traits that influence coping strategies and mental health. It also identifies challenges within medical education, emphasising the necessity for stress management programs, mental health support, and curricula promoting problem-solving skills. Prioritising medical students' wellbeing may not only foster good mental health among future professionals but may also enhance future healthcare quality.
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Affiliation(s)
- Aisha Ali Hawsawi
- Institute of Mental Health, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- School of Education, Health and Behavioral Sciences, Dar Al-Hekma University, Jeddah, Saudi Arabia
| | - Neil Nixon
- Institute of Mental Health, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Elena Nixon
- Institute of Mental Health, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Aljuwaiser S, Brazzelli M, Arain I, Poobalan A. Common mental health problems in medical students and junior doctors - an overview of systematic reviews. J Ment Health 2024; 33:779-815. [PMID: 37933550 DOI: 10.1080/09638237.2023.2278095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 08/10/2023] [Accepted: 09/24/2023] [Indexed: 11/08/2023]
Abstract
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.
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Affiliation(s)
- Sameera Aljuwaiser
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Imran Arain
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Amudha Poobalan
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Vagiri R, Mphasha M, Bangalee V, Grootboom W, Makhele L, Padayachee N. Thriving beyond the stethoscope: Unveiling positive mental health among medical students at a University in South Africa. DIALOGUES IN HEALTH 2024; 5:100188. [PMID: 39296321 PMCID: PMC11407960 DOI: 10.1016/j.dialog.2024.100188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 08/15/2024] [Accepted: 08/30/2024] [Indexed: 09/21/2024]
Abstract
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.
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Affiliation(s)
- Rajesh Vagiri
- Department of Pharmacy, Faculty of Health Sciences, University of Limpopo, Mankweng, Limpopo Province 0727, South Africa
| | - Mabitsela Mphasha
- Department of Public Health, Faculty of Health Sciences, University of Limpopo, Mankweng, Limpopo Province 0727, South Africa
| | - Varsha Bangalee
- Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, University Road, Durban, KwaZulu-Natal 4000, South Africa
| | - Wandisile Grootboom
- Medical School, Nelson Mandela University, Uitenhage Road, Port Elizabeth 6031, South Africa
| | - Letlhogonolo Makhele
- School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi St., Ga-Rankuwa, Pretoria 0208, South Africa
| | - Neelaveni Padayachee
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, Gauteng 2193, South Africa
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Vadhanavikkit P, Srifuengfung M, Wiwattarangkul T, Wiwattanaworaset P, Oon-Arom A, Chiddaycha M, Piyavhatkul N, Wainipitapong S. Prevalence of Depression and Generalized Anxiety Among LGBTQ+ Medical Students in Thailand. JOURNAL OF HOMOSEXUALITY 2024:1-21. [PMID: 39230396 DOI: 10.1080/00918369.2024.2389905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
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.
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Affiliation(s)
- Papan Vadhanavikkit
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Maytinee Srifuengfung
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Teeravut Wiwattarangkul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | | | - Awirut Oon-Arom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Mayteewat Chiddaycha
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Nawanant Piyavhatkul
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sorawit Wainipitapong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Faculty of Medicine, Center of Excellence in Transgender Health, Chulalongkorn University, Bangkok, Thailand
- Department of Global Health and Social Medicine, King's College London, UK
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Islam MK, Kibria MG, Amin R, Sharna TI, Nahar S, Arafat SMY. 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. Health Sci Rep 2024; 7:e70024. [PMID: 39210992 PMCID: PMC11358216 DOI: 10.1002/hsr2.70024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 08/12/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024] Open
Abstract
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.
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Affiliation(s)
- Md. Khayrul Islam
- Department of PsychiatryTairunnessa Memorial Medical CollegeGazipurBangladesh
| | - Md. Golam Kibria
- Department of ResearchCentre for Development ActionDhakaBangladesh
| | - Rizwana Amin
- Department of PsychologyEffat UniversityJeddahSaudi Arabia
| | | | - Samsun Nahar
- Department of ResearchCentre for Development ActionDhakaBangladesh
| | - S. M. Yasir Arafat
- Department of PsychiatryBangladesh Specialized HospitalDhakaBangladesh
- Biomedical Research FoundationDhakaBangladesh
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Andargeery SY. The perception and association between depression and academic stress among female undergraduate nursing students: a cross-sectional study. Front Public Health 2024; 12:1414469. [PMID: 38957210 PMCID: PMC11217312 DOI: 10.3389/fpubh.2024.1414469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/13/2024] [Indexed: 07/04/2024] Open
Abstract
Introduction Academic demands and stressors put nursing students at increasing risk of depression. The aims of the study examine the perceived level of depression and academic stress and investigate the association between these variables among nursing students in Saudi Arabia. Methods A cross-sectional design was used in this study. Data was collected using depression subscale from DASS-21 scale and the Academic Stress Inventory scale. Results A total of 237 students participated in the study. Nursing students perceived normal to mild levels of depression. Students perceived moderate levels of academic stress in all subscales, except for time management and test stress which were high. All academic stress subscales had a positive statistically significant correlation with depression. The regression model explains 49.0% of the variance in the depression scale and indicated that the main significant predictor of depression is studying in group stress, followed by self-inflected stress, study year, and sleep problem. The mean score of depression for first year students was significantly different than students in other study years. Discussion Nurse educators should facilitate group formation and teach students about time-management, problem-solving, negotiation, and coping strategies to deal with academic expectations and demanding situations. Understanding the causes, limiting the exposure to negative influences, and seeking support as needed are important. To enhance the quality of sleep, students should maintain a consistent sleep schedule, while avoiding stimulating activities before bedtime. Future research should focus on a longitudinal study and other variables such as quality of life, satisfaction with the quality of teaching, and support from others.
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Wiguna T, Dirjayanto VJ, Maharani ZS, Faisal EG, Teh SD, Kinzie E. Mental health disturbance in preclinical medical students and its association with screen time, sleep quality, and depression during the COVID-19 pandemic. BMC Psychiatry 2024; 24:85. [PMID: 38297243 PMCID: PMC10832144 DOI: 10.1186/s12888-024-05512-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/10/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Affected by various hurdles during COVID-19, preclinical medical students are at an elevated risk for mental health disturbances. However, the effects of modern mental health problems on preclinical medical students have not been adequately researched. Thus, this study was aimed to identify the proportions and implications of current mental health problems for depression, sleep quality and screen time among Indonesian medical preclinical students during the COVID-19 pandemic. METHODS This cross-sectional study was conducted using crowdsourcing between October 2020 and June 2021. During the study period, 1,335 subjects were recruited, and 1,023 datasets were identified as valid. General Health Questionnaire-12 (GHQ-12) was used to measure current mental health disturbances (categorized as without current mental health disturbances, psychological distress, social dysfunction, or both). The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, the Pittsburgh Sleep Quality Index (PSQI) was employed to assess sleep quality, and a questionnaire devised for this study was used to assess screen time length per day. Multivariate data analysis was conducted using SPSS version 24 for Mac. RESULTS According to the findings, 49.1% of the 1,023 participants had current mental health disturbances: 12.8% had psychological distress, 15.9% had social dysfunction, and the rest (20.4%) had both psychological distress and social dysfunction. The statistical analysis provided strong evidence of a difference (p < 0.001) between the medians of depression and sleep quality with at least one pair of current mental health disturbance groups, but the difference for screen time was not significant (p = 0.151). Dunn's post-hoc analysis showed that groups without current mental health problems had significantly lower mean ranks of depression and sleep quality compared to groups that had current mental health problems (p < 0.001). CONCLUSION Current mental health disturbances during the COVID-19 pandemic were significantly associated with preclinical medical students' depression and sleep quality in preclinical medical students. Thus, mental health programs for this specific population should be tailored to integrate mindfulness therapy, support groups, stress management, and skills training to promote mental wellbeing.
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Affiliation(s)
- Tjhin Wiguna
- Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Valerie Josephine Dirjayanto
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | | | | | - Sylvie Dominic Teh
- Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Erik Kinzie
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, USA
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Wang J, Liu M, Bai J, Chen Y, Xia J, Liang B, Wei R, Lin J, Wu J, Xiong P. Prevalence of common mental disorders among medical students in China: a systematic review and meta-analysis. Front Public Health 2023; 11:1116616. [PMID: 37719741 PMCID: PMC10501456 DOI: 10.3389/fpubh.2023.1116616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 08/04/2023] [Indexed: 09/19/2023] Open
Abstract
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.
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Affiliation(s)
- Jinxingyi Wang
- The Second Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Min Liu
- Zhuhai Center for Maternal and Child Health Care, Zhuhai Women and Children's Hospital, Zhuhai, China
| | - Jian Bai
- School of Medicine, Jinan University, Guangzhou, China
| | - Yuhan Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Jie Xia
- The Second Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Baolin Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Ruixuan Wei
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Jiayin Lin
- School of Stomatology, Jinan University, Guangzhou, China
| | - Jiajun Wu
- School of Nursing, Jinan University, Guangzhou, China
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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12
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Watanabe T, Akechi T. The mediating role of psychological flexibility in the association of autistic-like traits with burnout and depression in medical students during clinical clerkships in Japan: a university-based cross-sectional study. BMC Psychiatry 2023; 23:302. [PMID: 37127557 PMCID: PMC10150344 DOI: 10.1186/s12888-023-04811-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 04/21/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Burnout and depression among medical students is linked to serious problems that require appropriate solutions. Subthreshold autism traits or autistic-like traits (ALTs) may be possible factors associated with burnout and depression. The effectiveness of acceptance and commitment therapy (ACT) for burnout and depression has been widely reported. The treatment aims to improve psychological flexibility, a concept indicating engagement in personal value-based behaviors without avoiding uncomfortable private experiences. This study examined whether ALTs were associated with burnout or depression among medical students during clinical clerkships in Japan, and then investigated what psychological flexibility processes might mediate these associations. METHODS A cross-sectional survey was administered to 284 medical students at Nagoya City University School of Medical Sciences who had been in clinical clerkships for 10 months or longer. Linear multiple regressions were performed with each burnout factor or depression as the outcome variable using validated tools measuring burnout (Maslach Burnout Inventory), anxiety and depression (Hospital Anxiety and Depression Scale), ALT (Autism-Spectrum Quotient Japanese version-21), and psychological flexibility processes (Cognitive Fusion Questionnaire-7 and Valuing Questionnaire). Additionally, a mediation analysis was conducted using structural equation modeling. RESULTS A linear multiple regression analysis that controlled for age and gender found that ALTs were significantly associated with lower personal accomplishment, a factor of burnout, and depression. Lower personal accomplishment was also associated with males and lower progress toward values of the psychological flexibility process. Depression was also associated with males and higher cognitive fusion, lower progress towards values, and higher obstruction to values of the psychological flexibility process. Surprisingly, emotional exhaustion and depersonalization were not significantly associated with ALTs. The mediation analysis revealed that the relationship between ALTs and personal accomplishment was partially mediated by a process of progress toward values, while the relationship between ALTs and depression was partially mediated by both processes of progress toward values and cognitive fusion. CONCLUSIONS ALTs were significantly associated with lower personal accomplishment of burnout and depression among medical students in clinical clerkships. Consideration should be given to the psychological flexibility processes that focus on interventions targeting psychological flexibility for medical students with ALTs to reduce burnout and depression.
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Affiliation(s)
- Takafumi Watanabe
- Department of Psychiatry and Coginitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan.
| | - Tatsuo Akechi
- Department of Psychiatry and Coginitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
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13
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Ahmed I, Hazell CM, Edwards B, Glazebrook C, Davies EB. A systematic review and meta-analysis of studies exploring prevalence of non-specific anxiety in undergraduate university students. BMC Psychiatry 2023; 23:240. [PMID: 37041470 PMCID: PMC10088287 DOI: 10.1186/s12888-023-04645-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 02/28/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Anxiety is a common mental health problem in the general population, and is associated with functional impairment and negative impacts upon quality of life. There has been increased concern about university students' mental health in recent years, with a wide range of non-specific anxiety rates reported worldwide in undergraduate university students. We aimed to explore prevalence of non-specific anxiety in undergraduate university student populations. METHODS Four databases were searched to identify studies published between 1980 and 2020 which investigated prevalence of non-specific anxiety in undergraduate university students. Each study's quality was appraised using a checklist. Sub-analyses were undertaken reflecting outcome measure utilized, course of study, location of study, and whether study was before or during the COVID-19 pandemic. RESULTS A total of 89 studies - representing approx. 130,090 students-met inclusion criteria. Eighty-three were included in meta-analysis, calculating a weighted mean prevalence of 39.65% (95% CI: 35.72%-43.58%) for non-specific anxiety. Prevalence from diagnostic interview studies ranged from 0.3%-20.8% 12-month prevalence. Prevalence varied by outcome measure used to assess non-specific anxiety, the type of course studied by sample, and by study location. In half the studies, being female was associated with being more likely to have higher non-specific anxiety scores and/or screening above thresholds. Few of the included studies met all quality appraisal criteria. CONCLUSION The results suggest that approximately a third of undergraduate students are experiencing elevated levels of non-specific anxiety. Results from sub-analyses have identified some methodological issues that need consideration in appraising prevalence in this population.
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Affiliation(s)
- Irtiqa Ahmed
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Cassie M Hazell
- Department of Psychological Interventions, University of Surrey, Guildford, UK.
| | - Bethany Edwards
- School of Social Sciences and Humanities, University of Westminster, London, UK
| | - Cris Glazebrook
- Clinical Neurosciences and Mental Health, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - E Bethan Davies
- Clinical Neurosciences and Mental Health, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
- NIHR MindTech MedTech Co-Operative, Institute of Mental Health, School of Medicine, The University of Nottingham, Nottingham, UK
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14
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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: 1.0] [Reference Citation Analysis] [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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Carpi M, Vestri A. The Mediating Role of Sleep Quality in the Relationship between Negative Emotional States and Health-Related Quality of Life among Italian Medical Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:26. [PMID: 36612348 PMCID: PMC9819068 DOI: 10.3390/ijerph20010026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Sleep problems have been shown to be related to adverse outcomes concerning physical and mental well-being. Furthermore, mental health issues and sleep problems were reported to be highly prevalent among medical students and physicians, and were found to be associated with worse academic and clinical performance in these populations. This study aims to investigate the prevalence of poor sleep to examine the associations between sleep quality and health-related quality of life (HRQoL), and to explore the possible mediating role of sleep in the relationship between psychological distress and HRQoL itself in a sample of medical and dental students attending a large Italian university. Participants (n = 407, mean age: 24.2 ± 2.4) answered an online questionnaire comprising the 21-item Depression Anxiety Stress Scale, the Pittsburgh Sleep Quality Index, and the Short Form-12 health survey. Up to 62% of the participants reported poor sleep quality. Controlling for psychological distress, sleep quality components were found to be associated with physical and mental HRQoL. Mediation analysis showed that overall sleep quality mediated all the single associations between anxiety, depression, and stress and HRQoL. These preliminary findings suggest that the quality of sleep is important for the well-being of medical students and that targeting sleep issues in this academic population may be beneficial.
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Affiliation(s)
- Matteo Carpi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Annarita Vestri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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16
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Ghali H, Ghammem R, Baccouche I, Hamrouni M, Jedidi N, Smaali H, Earbi S, Hajji B, Kastalli A, Khalifa H, Maagli KB, Romdhani R, Halleb H, Jdidi F. Association between lifestyle choices and mental health among medical students during the COVID-19 pandemic: A cross-sectional study. PLoS One 2022; 17:e0274525. [PMID: 36206267 PMCID: PMC9543638 DOI: 10.1371/journal.pone.0274525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/28/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Mental health is recognized as a critical component of public health Given the close relationship between mental health and life style and the importance of students as valuable human resources, the present study aimed at determining the relationship between life style and mental health among medical students in Sousse during COVID-19 pandemic. METHODS We conducted a cross-sectional observational study in university students from the first to the fifth grade of the Faculty of Medicine of Sousse during the academic year 2020/2021. Data were collected anonymously via an online questionnaire published on the Facebook groups of each grade, on december 2020. The online survey consisted of three sections. The first one aimed to collect sociodemographic information. The second section of the survey addressed recent lifestyle choices and the third one assessed psychological distress using the French version of 12 items of The General Health Questionnaire (GHQ-12). The significance level was considered 0.05. RESULTS Overall 147 were studied. Using the bimodal scoring, the total score was between 0 and 12, to evoke psychiatric disorders, we set the threshold of 4. For our sample, the median scale was 7 [4-9], and more than half of the students (68%; n = 100) had a score higher than 4. Psychiatric disorder was significantly more frequent in female students (73.3% vs 42.3%; p = 0.002). Higher GHQ-scale was found in younger students, foreigners, students who need more than 30 minutes to get to the faculty, unemployed students, and students of fifth grade. However, differences were not statistically significant. Regarding lifestyle choices, we found that physical inactivity, no smoking habits, no alcohol use, no illicit substance use, other substance use, changing in eating habits, and absence of coping methods of stress were higher in students with psychiatric disorders. However, this association was statistically significant only for physical activity (p = 0.016). The results of the regression analysis suggest female gender as an independent predictor of high GHQ-12 scores. Practicing physical activity was found as protective factor for psychiatric disorders. CONCLUSION Considering the vital role of medical students in providing and promoting community health, the need for more detailed planning and interventions to improve their life style and mental health is essential.
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Affiliation(s)
- Hela Ghali
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Department of Prevention and Security of Care, Sahloul University Hospital, Sousse, Tunisia
- * E-mail:
| | - Rim Ghammem
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Department of Epidemiology, Farhat Hached Hospital, «LR19SP03», Sousse, Tunisia
| | - Imen Baccouche
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Mouna Hamrouni
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Nada Jedidi
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Hichem Smaali
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Souha Earbi
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Balkis Hajji
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Amina Kastalli
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Hind Khalifa
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | | | - Rawia Romdhani
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Heni Halleb
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Farouk Jdidi
- Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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Dhanoa S, Oluwasina F, Shalaby R, Kim E, Agyapong B, Hrabok M, Eboreime E, Kravtsenyuk M, Yang A, Nwachukwu I, Moreau C, Abba-Aji A, Li D, Agyapong VIO. Prevalence and Correlates of Likely Major Depressive Disorder among Medical Students in Alberta, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811496. [PMID: 36141768 PMCID: PMC9517002 DOI: 10.3390/ijerph191811496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Medical students are exposed to multiple factors during their academic and clinical studies that contribute to depression. AIMS This study aims to examine the prevalence and correlates of likely major depressive disorder (MDD) among medical students. METHODS This study utilized a descriptive cross-sectional design. Data were collected through a self-administered online survey, which included questions on sociodemographic characteristics and likely MDD using the PHQ-9. Data were analyzed using a descriptive, Chi-square test and logistic regression model. RESULTS There were 246 medical students who participated in the survey. The majority were females, 155 (65.1%); Caucasian, 158 (66.4%); and in a relationship, 168 (70.5%). The prevalence of likely MDD was 29.1%. Respondents who did not feel supported and respondents who were neutral about their social support, friends, and family, were 11 and 4 times more likely to experience MDD than those who felt well supported (OR = 11.14; 95% CI: 1.14-108.80) and (OR = 4.65; 95% CI: 1.10-19.56), respectively. CONCLUSIONS This study suggests a high prevalence of likely MDD among medical students who do not feel they have sufficient social support from friends and family. Social adjustments, including talking to friends and family and participating in leisure activities, could reduce the level of depression among medical students.
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Affiliation(s)
- Sumeet Dhanoa
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Esther Kim
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Marianne Hrabok
- Department of Psychiatry, University of British Columbia, Vancouver Island, BC V6T 1Z4, Canada
| | | | - Maryana Kravtsenyuk
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Alicia Yang
- Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Izu Nwachukwu
- Department of Psychiatry, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Chantal Moreau
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Adam Abba-Aji
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Daniel Li
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
- QEII Health Sciences Centre, Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veterans Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, Halifax, NS B3H 2E2, Canada
- Correspondence: ; Tel.: +1-780-215-7771; Fax: +1-902-473-4887
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18
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Liu H, Liu X, Xu W. Prevalence and influencing factors of anxiety in medical students during the COVID-19 pandemic. Heliyon 2022; 8:e10487. [PMID: 36091964 PMCID: PMC9444338 DOI: 10.1016/j.heliyon.2022.e10487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/06/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objective The novel coronavirus disease (COVID-19) pandemic has caused a traumatic impact on the whole world in all aspects including physical health, economic condition, and mental health. Psychological problems are commonly neglected for their inconspicuous symptoms. Little is known about the medical students' psychological status during the COVID-19 pandemic. Our study aimed to investigate the prevalence and influencing factors of anxiety among medical students during the COVID-19 pandemic. Methods Two thousand and two medical students were investigated in this cross-sectional study. Zung's self-rating anxiety scale was used to evaluate their anxiety symptoms. A total of 1917 questionnaires were collected, and the response rate was 95.8%. Results There were 1735 (90.5%) complete and valid questionnaires. The average SAS standard score was 42.8 ± 11.0. The results indicated that the prevalence of anxiety in medical students was 25.9%. Less social support (OR = 1.4, 95%CI 1.2-1.7) is an independent risk factor of anxiety syndrome, while the female (OR = 0.6, 95%CI 0.5-0.8) is less likely to have anxiety syndrome. Conclusion The prevalence of anxiety in medical students is higher during the COVID-19 pandemic. Male students and students with less social support are more likely to have anxiety syndrome. Medical educators and students themselves should take serious steps to prevent, recognize and deal with the anxiety prevalence.
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19
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Mahgoub Y, Daher-Nashif S, Al-Shebly R, Wali HS, Khan A, Almarkhi A, Al-Motawa M, AlObaidan G, Al-Muhannadi Z. Prevalence and Determinants of Mental Health Problems and Mental Health Stigma Among Medical Students of Different Nationalities in Qatar. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:969-979. [PMID: 36046600 PMCID: PMC9420740 DOI: 10.2147/amep.s371053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Past studies have shown high prevalence of mental illness among medical students. This is often linked to the demands of the medical curriculum, and to mental health stigma that prevents students from seeking help. This study aimed to examine experiences of mental health problems among medical students of different nationalities in Qatar and to uncover sociodemographic factors related to their prevalence and associated stigma. METHODS A cross-sectional online survey was conducted with medical students in their second through fifth years at the College of Medicine at Qatar University. The survey began with a consent form, and those agreed to take the survey were directed to the questionnaire. The survey comprised 64 items across three sections. The first section collected sociodemographic data. The second section screened depressive symptoms using the PHQ-9; anxiety symptoms using GAD-7; and psychological distress symptoms using Kessler-6. The third section included 27 questions adopted from Schwenk et al, which evaluate students' perceptions of stigma and their attitudes toward seeking help with their mental health. RESULTS One hundred and eighty-two students participated in the study. The prevalence of self-reported symptoms of severe depression, anxiety, and psychological distress was 4.4% (95% CI 2-9), 10.4% (95% CI 7-16), and 39.6% (95% CI 33-47), respectively; the prevalence of high stigma was 31.9% (95% CI 25-39). Parental education, repetition of an academic year, progress in medical studies, gender, and nationality had statistically significant correlations with mental health problems and stigma. CONCLUSION In addition to the impact of the requirements of medical study, the high prevalence of reported mental illness among medical students is impacted by sociodemographic factors and the mental health stigma that constitutes a barrier to seeking help. Preventive wellbeing programs should be an essential component of medical curricula.
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Affiliation(s)
- Yasmine Mahgoub
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Suhad Daher-Nashif
- Population Medicine Department, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Rafal Al-Shebly
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hamza Said Wali
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Aisha Khan
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ameera Almarkhi
- College of Medicine, QU Health, Qatar University, Doha, Qatar
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Oláh B, Rádi BM, Kósa K. Barriers to Seeking Mental Help and Interventions to Remove Them in Medical School during the COVID-19 Pandemic: Perspectives of Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137662. [PMID: 35805319 PMCID: PMC9265856 DOI: 10.3390/ijerph19137662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022]
Abstract
Medical students are at increased risk for psychological morbidity but the majority of those with mental health problems do not seek professional care. We aimed to uncover the viewpoints of medical students regarding barriers and facilitators to using university mental health services and their attitudes and preferences towards online counselling. Four semi-structured focus groups were conducted (n = 26, mean age = 21.8, ±1.88, 73% males). After reaching data saturation, interviews were audio-recorded, transcribed and content-analysed by two independent coders. Intrapersonal barriers emerged to be perceived low risk, excessive self-reliance, lack of belief in the effectiveness of service, lack of openness. Interpersonal factors were the following: assumed long waiting list, insufficient provision of service information, fear of exposure, and not being familiar with the counsellor and the process. Extrapersonal barriers such as insurance problems, the number of available sessions, adverse sociocultural attitudes, fear of stigmatisation were identified. Students suggested that the university should provide psychoeducation and routine screening, apply social marketing and stigma reduction campaigns, improve information flow, and offer not only personal but also online video counselling to target removing these barriers. The results provide a reference for the redesign of mental health services to facilitate their access by students. Implications and limitations are discussed.
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Affiliation(s)
- Barnabás Oláh
- Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.M.R.); (K.K.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
- Correspondence: ; Tel.: +36-52-411-600 (ext. 54360)
| | - Bence Márk Rádi
- Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.M.R.); (K.K.)
| | - Karolina Kósa
- Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (B.M.R.); (K.K.)
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
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Chiddaycha M, Wainipitapong S. Mental health among Thai medical students: Preadmission evaluation and service utilization. Health Sci Rep 2021; 4:e416. [PMID: 34646944 PMCID: PMC8501376 DOI: 10.1002/hsr2.416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND AIMS Mental illness among medical students is common. Identifying at-risk students can be beneficial in terms of prevention and treatment. This study examined the association between preadmission mental health evaluation and mental health service utilization among Thai medical students. METHODS The authors collected data from all first- to sixth-year students at one university hospital and three affiliated hospitals during the 2014 to 2019 academic year (n = 1642). Preadmission mental health was evaluated using the Thai Mental Health Indicators 66 (TMHI-66) questionnaire. Data from mental health service utilization included the dates of service and the clinical diagnosis. Data were analyzed using Cox regression, adjusted for sex, hometown, and affiliated hospital. RESULTS The prevalence of poor mental health was found to be 3.7% based on TMHI-66 results. The proportion of all students who sought mental health services was 8.3%, and they were mostly diagnosed with depressive disorder (3%), adjustment disorder (1.9%), and anxiety disorder (1.9%). Students with positive TMHI-66 results were more likely to seek out services at the faculty counseling center for one or more mental health problems (Hazard ratio [HR] = 2.11, 95% CI 1.11-4.04, P = .024). CONCLUSION Preadmission mental health was found to be associated with mental health service utilization. Depressive disorder was the most frequent mental illness among Thai medical students utilizing the faculty counseling services. Still, the number was far lower than the reported prevalence of mental disorders due to various reasons. Further studies are needed to investigate risk and protective factors for mental disorders to better promote mental health and encourage mental health service utilization in targeted students throughout medical education.
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Affiliation(s)
- Mayteewat Chiddaycha
- Department of Psychiatry, Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial Hospital, the Thai Red Cross SocietyBangkokThailand
| | - Sorawit Wainipitapong
- Department of Psychiatry, Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial Hospital, the Thai Red Cross SocietyBangkokThailand
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22
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Dessauvagie AS, Dang HM, Nguyen TAT, Groen G. Mental Health of University Students in Southeastern Asia: A Systematic Review. Asia Pac J Public Health 2021; 34:172-181. [PMID: 34798781 PMCID: PMC8978462 DOI: 10.1177/10105395211055545] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Mental health in young people is a public health challenge worldwide, with around
one-fifth of university students suffering from a 12-month mental disorder. In
low- and middle-income countries (LMICs) of Southeastern Asia, resources for
mental health are limited and counseling services are not regularly established
at universities. This review aims to determine the prevalence of mental health
problems among university students in six ASEAN (Association of Southeast Asian
Nations) countries (Cambodia, Laos, Malaysia, Myanmar, Thailand, and Vietnam)
and to identify the determinants of mental health. A systematic database search
(PubMed, CINAHL, PsycINFO, PubPsych, and Scopus) for peer-reviewed, English
language articles, published 2010-2020, reporting prevalence data based on
standardized screening instruments resulted in 335 articles; 108 were eligible
for full-text analysis, of which 34 could be included in the review. Median
point prevalence was 29.4% for depression, 42.4% for anxiety, 16.4% for stress,
and 13.9% for disordered eating. Current suicidality was present in 7% to 8% of
students. There was a high rate of psychiatric comorbidity. Despite the high
prevalence of mental health problems, the willingness to seek professional help
was comparatively low. Implications for mental health promotion and prevention
in university settings are discussed.
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Affiliation(s)
| | - Hoang-Minh Dang
- Center for Research, Information and Service in Psychology (CRISP), VNU University of Education, Hanoi, Vietnam
| | - Thi Anh Thu Nguyen
- Department of Educational Psychology, VNUHCM-University of Social Sciences and Humanities, Ho Chi Minh City, Vietnam
| | - Gunter Groen
- Department of Social Work, Hamburg University of Applied Sciences, Hamburg, Germany
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23
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Fino E, Martoni M, Russo PM. Specific mindfulness traits protect against negative effects of trait anxiety on medical student wellbeing during high-pressure periods. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1095-1111. [PMID: 33675487 PMCID: PMC8338863 DOI: 10.1007/s10459-021-10039-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 02/16/2021] [Indexed: 05/03/2023]
Abstract
Medical education is highly demanding and evidence shows that medical students are three times more susceptible to deteriorating physical and mental health than the average college student. While trait anxiety may further increase such risk, little is known about the role of trait mindfulness in mitigating these effects. Here we examine the protective role of specific mindfulness facets as mediators in pathways from trait anxiety to perceived stress, psychosomatic burden and sleep-wake quality in medical students, across repeated measurements throughout the first trimester of the school year. Preclinical medical students enrolled in the second year of the Medical School of University of Bologna completed self-report questionnaires examining personality traits as well as physical and psychological wellbeing. Data were collected at the beginning (Time 1: N = 349) and the end of the first trimester (Time 2: N = 305). As students approached the end of the trimester and upcoming exams, reported levels of perceived stress, psychosomatic problems and difficulties in wakefulness increased significantly compared to the beginning of the trimester. Mediation results showed that trait anxiety predicted such outcomes whereas the protective role of mindfulness facets in mitigating these effects was significant only at Time 2. Specific facets of Nonjudging of inner experience and Acting with awareness proved to be the most effective mediators. Findings highlight that the beneficial role of mindfulness facets in mitigating negative consequences of trait anxiety on medical student wellbeing is revealed in high-pressure periods and when self-regulation is needed the most. Cultivating awareness and nonjudgmental acceptance of one's inner experiences is a crucial self-regulation resource that can help medical students sustain their wellbeing as they learn and throughout their high-pressure education and professional careers.
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Affiliation(s)
- E Fino
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum - University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy.
| | - M Martoni
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum - University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy.
| | - P M Russo
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum - University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
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Tiaprapong K, Sirikul A, Krajangmek C, Duangthongkul N, Pandam N, Piya-amornphan N. Awareness of COVID-19 influences on the wellness of Thai health professional students: An ambulatory assessment during the early "new normal" informing policy. PLoS One 2021; 16:e0252681. [PMID: 34125868 PMCID: PMC8202936 DOI: 10.1371/journal.pone.0252681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/19/2021] [Indexed: 11/19/2022] Open
Abstract
The COVID-19 global pandemic has had a socioeconomic effect, including many people suffering from stress and mental disorders. Health professional students are at risk of health issues as well when compared to their age-matched counterpart in the population. The present study aimed to find out the impact of COVID-19 awareness on the wellness of Thai health professional students. The awareness of COVID-19 and wellness among Thai health professional students, such as medical, physical therapy, nursing, pharmacy, and medical technology students were surveyed during the early “new normal” informing policy. The participants included 1,001 students, aged 17 to 25 years old, who responded to a Google form questionnaire set by request. The results showed that the prominent health risks among the Thai health professional students included sedentary behavior, obesity, and mental symptoms. A positive rating in attitude towards the COVID-19 epidemic was mostly observed. There was a negative influence on anxiety symptoms (standardized coefficient beta = -0.079, p-value = 0.012), but a positive impact on social well-being (standardized coefficient beta = 0.158, p-value < 0.001) and quality of life (standardized coefficient beta = 0.136, p-value < 0.001) among the students even when the situation was improving. To relieve the domino effect of the COVID-19 pandemic on students’ wellness, an updated policy for enhancing awareness and providing updated information is continuously required. Improvements on self and situational awareness may help prevent health risk behaviors and promote health among Thai health professional students.
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Affiliation(s)
- Krueakaew Tiaprapong
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Achiraporn Sirikul
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Chamawee Krajangmek
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Namfon Duangthongkul
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Nichaya Pandam
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Nitita Piya-amornphan
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
- * E-mail:
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25
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Maghbouli N, Fatehi F, Mafinejad MK, Pourhassan S, Sohrabpour AA, Ali JH. Burnout and clinical learning environment among residents in Tehran: A cross-sectional study. Heliyon 2021; 7:e07238. [PMID: 34189297 PMCID: PMC8215171 DOI: 10.1016/j.heliyon.2021.e07238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/30/2021] [Accepted: 06/03/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to evaluate the quality of the educational environment in Tehran University of Medical Sciences across different medical specialties and its correlation with residents’ burnout. Materials and methods This cross-sectional study was conducted at Tehran University of Medical Sciences among residents drawn from three largest teaching hospitals affiliated. The Maslach Burnout Inventory and Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire were used to collect data through web-based, as well as paper-and pencil questionnaires. The data was analyzed using SPSS. Results A total of 221 residents completed the survey, with a response rate of 82%. Burnout was reported by 67.4% of medical residents. The total PHEEM score had a negative correlation with emotional exhaustion (r = - 0.57, P < 0.001), depersonalization (r = - 0.40, P < 0.001), and a positive one with personal accomplishment (r = 0.42, P < 0.001). Perception of social support significantly predicted burnout subscales (P < 0.05). PHEEM subscales also explained a small proportion of variance in emotional exhaustion (R = 0.55, R2 = 0.308, P < .001). Clinical learning environment independent of personal characteristics was associated with residents' burnout according to multivariate regression analysis [OR = 0.567 (0.170–0.883), P = 0.012]. Conclusion Clinical learning environment independent of personal characteristics was associated with residents' burnout in Iran. We suggest some initiatives to be introduced ranging from improving the clinical environments, reduce workloads and provide social support to all residents as well as encouraging them to involve in other extracurricular activities like music and physical exercise.
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Affiliation(s)
- Nastaran Maghbouli
- Department of Physical Medicine and Rehabilitation, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Mentoring Office, Faculty Education Deputy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Department of Neurology, Iranian Center of Neurological Research, Neuroscience Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Khabaz Mafinejad
- Department of Medical Education, Education Development Center (EDC), Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Pourhassan
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author.
| | - Amir Ali Sohrabpour
- Department of Internal Medicine, Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Jemal Haidar Ali
- Addis Ababa University, College of Health Sciences, School of Public Health, Addis Ababa, Ethiopia
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Noman M, Kaur A, Nafees N. Covid-19 fallout: Interplay between stressors and support on academic functioning of Malaysian university students. CHILDREN AND YOUTH SERVICES REVIEW 2021; 125:106001. [PMID: 35990216 PMCID: PMC9375173 DOI: 10.1016/j.childyouth.2021.106001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/05/2021] [Accepted: 03/18/2021] [Indexed: 06/15/2023]
Abstract
Covid-19 has impacted the lives of everyone around the world, including university students. The pandemic has wreaked havoc on all economies, resulting in a huge loss of employment. As a result, university students are anxious about their job prospects upon graduation. The purpose of this study was to identify the effects of two stressors - employment anxiety and financial anxiety and two supports - university support and lecturer support on dropout intention and academic performance on university students with well-being and purpose in life being the mediators. This quantitative was carried out in Malaysia using 436 final-year undergraduate students. The full mediation model indicated that the university and lecturer support mitigates the two stressors' effects through well-being and purpose in life. Students who reported better support systems reported lower academic concerns and were less likely to drop out than those who reported less support from their university and lectures. The significance of this study and its implications are discussed, along with the findings.
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Affiliation(s)
- Mohammad Noman
- Wenzhou-Kean University, Wenzhou-Zhejiang Province, China
| | - Amrita Kaur
- Wenzhou-Kean University, Wenzhou-Zhejiang Province, China
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Blanco V, Salmerón M, Otero P, Vázquez FL. Symptoms of Depression, Anxiety, and Stress and Prevalence of Major Depression and Its Predictors in Female University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115845. [PMID: 34072413 PMCID: PMC8198394 DOI: 10.3390/ijerph18115845] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/24/2022]
Abstract
Depression, anxiety and stress are increasingly concerning phenomena in our society, with serious consequences on physical and mental health. The repercussions may be particularly devastating in particular population subgroups, such as female university students. The purpose of this study was to determine the levels of depression, anxiety, and stress and the prevalence of depression and associated factors, in Spanish university women. A cross-sectional study was conducted with a random sample of 871 students from the Santiago de Compostela University (mean age 20.7 years, SD = 2.8). Information was collected on sociodemographic and academic characteristics; symptoms of depression, anxiety, and stress; diagnosis of major depression; optimism, resilience, social support, life engagement, and five personality domains, using validated instruments. Of the participants, 18.1%, 22.8% and 13.5% presented with severe/very severe levels of depression, anxiety and stress, respectively. A total of 12.9% had major depression. Higher life engagement was associated with lower risk of depression (OR = 0.92, 95% CI 0.87–0.98), while higher levels of neuroticism (OR = 1.20, 95% CI, 1.12–1.28) and openness to experience (OR = 1.08, 95% CI, 1.02–1.14) were associated with greater risk. These findings reveal an alarming percentage of female university students who experience major depression and severe/very severe stress.
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Affiliation(s)
- Vanessa Blanco
- Department of Evolutionary and Educational Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Correspondence: ; Tel.: +34-881-813-744
| | - Mar Salmerón
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (M.S.); (F.L.V.)
| | - Patricia Otero
- Department of Psychology, University of A Coruña, 15008 A Coruña, Spain;
| | - Fernando L. Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (M.S.); (F.L.V.)
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Kaligis F, Ismail RI, Wiguna T, Prasetyo S, Indriatmi W, Gunardi H, Pandia V, Magdalena CC. Mental Health Problems and Needs among Transitional-Age Youth in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084046. [PMID: 33921344 PMCID: PMC8070090 DOI: 10.3390/ijerph18084046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022]
Abstract
“Transitional-age youth” describes those whose ages range from 16–24 years old. In this phase, the youth face new challenges and new experiences which may increase the risk for having mental health problems, yet not very many seek help from mental health professionals. In Indonesia, no data are available about mental health problems and the needs of transitional-age youth. This study explores common mental health problems experienced during this stage and assesses how they cope with problems and their expectations from health services. This was a cross-sectional study involving 393 Indonesians aged 16–24 years in May 2020. More than 90% of students had financial and academic difficulties and felt lonely. The most prevalent mental health problem among students was anxiety (95.4%). Most of the students, ranging from 90% to 96.4%, had positive coping strategies. However, around 50% of respondents reported self-harming and having suicidal thoughts. The results of subcategories analysis between ages and faculties were similar. Their most important expectations from mental health services included confidentiality (99.2%) and being welcoming and friendly (99.2%). In conclusion, this study highlighted the most common problems transitional-age youth experience in Indonesia. While some of them already knew how to deal with their problems, not all the participants had good coping mechanisms. Their healthcare expectations were also explored, thereby providing a useful background to revise and amend the current conditions.
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Affiliation(s)
- Fransiska Kaligis
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (R.I.I.); (T.W.); (C.C.M.)
- Correspondence:
| | - Raden Irawati Ismail
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (R.I.I.); (T.W.); (C.C.M.)
| | - Tjhin Wiguna
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (R.I.I.); (T.W.); (C.C.M.)
| | - Sabarinah Prasetyo
- Faculty of Public Health, Universitas Indonesia, Depok 16424, West Java, Indonesia;
| | - Wresti Indriatmi
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
- Department of Dermatovenereology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Hartono Gunardi
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
| | - Veranita Pandia
- Department of Psychiatry, Faculty of Medicine, Universitas Padjajaran, Bandung 40115, West Java, Indonesia;
| | - Clarissa Cita Magdalena
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (R.I.I.); (T.W.); (C.C.M.)
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Stress, Anxiety and Depression among a Cohort of Health Sciences Undergraduate Students: The Prevalence and Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063269. [PMID: 33809939 PMCID: PMC8004268 DOI: 10.3390/ijerph18063269] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/26/2021] [Accepted: 02/28/2021] [Indexed: 01/04/2023]
Abstract
Stress, anxiety, and depression (SAD) have a negative impact on the learning and academic performance of university students. Hence, this study aimed to determine the prevalence, as well as the risk factors associated with SAD among a cohort of students pursuing undergraduate degree courses in health sciences. This is part of the strategy in building a healthy nation. A questionnaire containing socio-demographic factors and the short version of Depression, Anxiety, and Stress Scale-21 (DASS-21) was used to assess the likelihood of psychological distress. Logistic regression analysis was conducted to determine the risk factors of SAD. In total, 449 students completed the questionnaire (93.9% response rate). Of these, 65% had stress, 85.1% had anxiety and 51.4% had depression. Most cases of stress (74.6%) and depression (66.2%) were of normal-to-mild level, while 74.6% of them showed moderate-to-extremely severe anxiety. There was a statistically significant association between stress score and the year of study. In the regression analysis, poor sleep quality and fatigue were risk factors of anxiety and depression, whereas low-grade fever and frequent headaches were risk factors for stress and anxiety. Stress, anxiety, and depression scores were significantly higher among students studying medical imaging. A substantial proportion of health science students are suffering from SAD. This study recommends screening and close monitoring of the above-mentioned predictors and the formulation of comprehensive intervention strategies for students with SAD.
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Zhang C, Wang T, Zeng P, Zhao M, Zhang G, Zhai S, Meng L, Wang Y, Liu D. Reliability, Validity, and Measurement Invariance of the General Anxiety Disorder Scale Among Chinese Medical University Students. Front Psychiatry 2021; 12:648755. [PMID: 34093269 PMCID: PMC8170102 DOI: 10.3389/fpsyt.2021.648755] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Medical students are affected by high levels of general anxiety disorder. However, few studies have specifically focused on the applicability of universal anxiety screening tools in this sample. This study was aimed to evaluate the psychometric property of the 7-item Generalized Anxiety Disorder Scale (GAD-7) among Chinese medical university students. Methods: A questionnaire survey was conducted among 1,021 medical postgraduates from six polyclinic hospitals. Internal consistency and convergent validity of the GAD-7 were evaluated. Factor analyses were used to test the construct validity of the scale. An item response theory (IRT) framework was used to estimate the parameters of each item. Multi-group confirmatory analyses and differential item function analyses were used to evaluate the measurement equivalence of the GAD-7 across age, gender, educational status, and residence. Results: Cronbach's α coefficient was 0.93 and the intraclass correlation coefficients ranged from 0.71 to 0.87. The GAD-7 summed score was significantly correlated with measures of depression symptoms, perceived stress, sleep disorders, and life satisfaction. Parallel analysis and confirmatory factor analysis supported the one-factor structure of the GAD-7. Seven items showed appropriate discrimination and difficulty parameters. The GAD-7 showed good measurement equivalence across demographic characteristics. The total test information of the scale was 22.85, but the test information within the range of mild symptoms was relatively low. Conclusions: The GAD-7 has good reliability, validity, and measurement invariance among Chinese medical postgraduate students, but its measurement precision for mild anxiety symptoms is insufficient.
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Affiliation(s)
- Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Beijing, China.,Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Tingting Wang
- International Student Office of International Cooperation Department, Peking University Health Science Center, Beijing, China
| | - Ping Zeng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Beijing, China.,Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Minghao Zhao
- School of Basic Medicine, Peking University Health Science Center, Beijing, China
| | - Guifang Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Beijing, China.,Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuo Zhai
- Department of Education, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Lingbing Meng
- Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Yuanyuan Wang
- National Center for Health Professions Education Development, Peking University Health Science Center, Beijing, China
| | - Deping Liu
- Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, China
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Arima M, Takamiya Y, Furuta A, Siriratsivawong K, Tsuchiya S, Izumi M. Factors associated with the mental health status of medical students during the COVID-19 pandemic: a cross-sectional study in Japan. BMJ Open 2020; 10:e043728. [PMID: 33303472 PMCID: PMC7733210 DOI: 10.1136/bmjopen-2020-043728] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic had a substantial impact on university students, including those in medical schools, with disruption in routine education causing significant psychological distress. The objective of this study was to evaluate the factors associated with psychological distress among medical students during the period of enforced home quarantine from March through May 2020. DESIGN A cross-sectional study. SETTING One Japanese medical school. PARTICIPANTS 571 medical students. PRIMARY AND SECONDARY OUTCOME MEASURES Self-administered electronic questionnaires including the K-6 scale for psychological distress, the Rosenberg Self-Esteem Scale (RSES) for self-esteem and the General Self-Efficacy Scale (GSES) for self-efficacy were distributed. To assess the determinant factor for psychological distress, variables such as sex, grade in school, living conditions, and RSES and GSES scores were evaluated in regression analysis. RESULTS 163 respondents (28.5%) scored ≥5 on the K-6 scale, indicating a significant degree of psychological distress. Logistic regression revealed that a higher score on RSES (p<0.001) and GSES (p<0.01) was an independent factor associated with lower levels of psychological distress. Multiple regression analysis focusing on students with a K-6 score ≥5 revealed that higher scores on RSES correlated with lower levels of psychological distress. By contrast, those with higher GSES scores also scored higher for indicators of psychological distress. CONCLUSIONS This study identified that self-efficacy and self-esteem were both influential factors for predicting psychological distress during the current COVID-19 pandemic. Medical schools should provide support for mental health and educational initiatives directed at enhancing self-esteem and self-efficacy, with a focus on improving personal resilience. In emergency situations, such as that faced in response to the COVID-19 pandemic, initial programmes might target students with higher levels of self-efficacy. By contrast, under routine situations, these efforts should be directed towards students with lower self-esteem as primary means to prevent depression.
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Affiliation(s)
- Makiko Arima
- Department of Medical Education, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Yusuke Takamiya
- Department of Medical Education, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Atsuko Furuta
- Department of Medical Education, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Kris Siriratsivawong
- Department of Medical Education, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Shizuma Tsuchiya
- Department of Medical Education, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Miki Izumi
- Department of Medical Education, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
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Ma Z, Zhao J, Li Y, Chen D, Wang T, Zhang Z, Chen Z, Yu Q, Jiang J, Fan F, Liu X. Mental health problems and correlates among 746 217 college students during the coronavirus disease 2019 outbreak in China. Epidemiol Psychiatr Sci 2020; 29:e181. [PMID: 33185174 PMCID: PMC7681173 DOI: 10.1017/s2045796020000931] [Citation(s) in RCA: 244] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/07/2020] [Accepted: 10/08/2020] [Indexed: 12/13/2022] Open
Abstract
AIMS Coronavirus disease 2019 (COVID-19) pandemic is a major public health concern all over the world. Little is known about the impact of COVID-19 pandemic on mental health in the general population. This study aimed to assess the mental health problems and associated factors among a large sample of college students during the COVID-19 outbreak in China. METHODS This cross-sectional and nation-wide survey of college students was conducted in China from 3 to 10 February 2020. A self-administered questionnaire was used to assess psychosocial factors, COVID-19 epidemic related factors and mental health problems. Acute stress, depressive and anxiety symptoms were measured by the Chinese versions of the impact of event scale-6, Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7, respectively. Univariate and hierarchical logistic regression analyses were performed to examine factors associated with mental health problems. RESULTS Among 821 218 students who participated in the survey, 746 217 (90.9%) were included for the analysis. In total, 414 604 (55.6%) of the students were female. About 45% of the participants had mental health problems. The prevalence rates of probable acute stress, depressive and anxiety symptoms were 34.9%, 21.1% and 11.0%, respectively. COVID-19 epidemic factors that were associated with increased risk of mental health problems were having relatives or friends being infected (adjusted odds ratio = 1.72-2.33). Students with exposure to media coverage of the COVID-19 ≥3 h/day were 2.13 times more likely than students with media exposure <1 h/day to have acute stress symptoms. Individuals with low perceived social support were 4.84-5.98 times more likely than individuals with high perceived social support to have anxiety and depressive symptoms. In addition, senior year and prior mental health problems were also significantly associated with anxiety or/and depressive symptoms. CONCLUSIONS In this large-scale survey of college students in China, acute stress, anxiety and depressive symptoms are prevalent during the COVID-19 pandemic. Multiple epidemic and psychosocial factors, such as family members being infected, massive media exposure, low social support, senior year and prior mental health problems were associated with increased risk of mental health problems. Psychosocial support and mental health services should be provided to those students at risk.
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Affiliation(s)
- Z. Ma
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - J. Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Y. Li
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - D. Chen
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - T. Wang
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - Z. Zhang
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - Z. Chen
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - Q. Yu
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - J. Jiang
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - F. Fan
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - X. Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
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Cheng S, Jia C, Wang Y. Only Children Were Associated with Anxiety and Depressive Symptoms among College Students in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114035. [PMID: 32517044 PMCID: PMC7313008 DOI: 10.3390/ijerph17114035] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/31/2020] [Accepted: 06/02/2020] [Indexed: 12/27/2022]
Abstract
This study explored the prevalence of anxiety and depressive symptoms among college students and analyzed the associations between only children and anxiety and depressive symptoms in college students in China. A total of 645 college students, from three universities in Jinan, Shandong, China, were investigated by questionnaire. The self-designed general information questionnaire was used to collect the demographic information such as gender, age, only children or not and so on. The Self-rating Anxiety Scale and Self-rating Depression Scale were used to reflect the psychological state of college students. Binary logistic regression analysis was applied to analyze associated factors of anxiety and depressive symptoms. We have found that there were 25.7% college students with anxiety symptom, 22.2% college students with depressive symptom, and 18.3% college students with a comorbidity of anxiety and depressive symptoms. The prevalence of anxiety symptom, depressive symptom, and comorbidity of anxiety and depressive symptoms in only children was higher than those among non-only children. There were no differences between males and females in anxiety symptom, depressive symptom, and comorbidity of anxiety and depressive symptoms among all college students, only child college students and non-only child college students. Only children were associated with anxiety symptom, depressive symptom, comorbidity of anxiety and depressive symptoms after adjusting potential important confounding factors, such as professional category, grade, parental relationship, parenting style, interpersonal relationship, activity participation enthusiasm, sleeping time, and eating habits. The prevalence of anxiety and depressive symptoms among college students was high. We should pay more attention to the mental health of college students, especially that of only child college students.
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Shawahna R, Hattab S, Al-Shafei R, Tab’ouni M. Prevalence and factors associated with depressive and anxiety symptoms among Palestinian medical students. BMC Psychiatry 2020; 20:244. [PMID: 32429889 PMCID: PMC7236464 DOI: 10.1186/s12888-020-02658-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/11/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Co-existence of depression and anxiety can be associated with severe detrimental consequences to the physical, mental and social wellbeing of the affected populations. This study was conducted to determine prevalence of depressive and anxiety symptoms among Palestinian medical students and to investigate associations between sociodemographic factors of the students with depressive and anxiety symptoms. METHODS This study was conducted in a cross-sectional observational design using a questionnaire in the period between September 2018 and April 2019 in a major university in the West Bank of Palestine. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II) and anxiety symptoms were assessed using the Beck Anxiety Inventory (BAI). The questionnaire also collected the sociodemographic characteristics of the students. Reliability of the questionnaire was tested using the test re-test method. A total of 425 medical students were invited to participate in the study. RESULTS Of those invited, 286 students completed the questionnaire, giving a response rate of 67.3%. More than half (56.6%) of the students had minimal depression, 20.3% had mild depression, 14.0% had moderate depression, 9.1% had severe depression, 23.4% had no anxiety, 29.7% had mild to moderate anxiety, 25.5% had moderate to severe anxiety, and 21.3% had severe anxiety. Multiple linear regression analysis showed that academic stage (p-value < 0.01), Grade Point Average (p-value < 0.01), mental health status (p-value < 0.001), ever attempted suicide (p-value < 0.05), and religious commitment (p-value < 0.01) were predictors of BDI-II scores. Multiple linear regression analysis showed that academic stage (p-value < 0.05) and mental health status (p-value < 0.001) were predictors of BAI scores. CONCLUSIONS Depressive and anxiety symptoms were prevalent among Palestinian medical students in a major university in the West Bank of Palestine. Interventions might be designed to improve self-rated mental health of medical students in their academic years, ameliorate study conditions, and provision of counseling services to improve spirituality might be effective in reducing symptoms of depression and anxiety among medical students in Palestine. Future studies are still needed to investigate if these interventions could be useful in reducing depressive and anxiety symptoms among Palestinian medical students.
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Affiliation(s)
- Ramzi Shawahna
- grid.11942.3f0000 0004 0631 5695Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building 19, P.O. Box 7, Nablus, Palestine ,grid.11942.3f0000 0004 0631 5695An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine
| | - Suhaib Hattab
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building 19, P.O. Box 7, Nablus, Palestine.
| | - Rami Al-Shafei
- grid.11942.3f0000 0004 0631 5695Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mahmoud Tab’ouni
- grid.11942.3f0000 0004 0631 5695Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Dietz P, Reichel JL, Edelmann D, Werner AM, Tibubos AN, Schäfer M, Simon P, Letzel S, Pfirrmann D. A Systematic Umbrella Review on the Epidemiology of Modifiable Health Influencing Factors and on Health Promoting Interventions Among University Students. Front Public Health 2020; 8:137. [PMID: 32411645 PMCID: PMC7198755 DOI: 10.3389/fpubh.2020.00137] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/03/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Universities represent an important setting for health promotion. The unique collective of university students is of particular relevance since they are the leaders, decision-makers, and parents of tomorrow. In this context, modifiable health influencing factors as well as interventions to prevent these, play a crucial role. Therefore, the present umbrella review aims to (i) provide an overview of review articles addressing epidemiological issues (prevalence and determinants) of modifiable health influencing factors in university students and (ii) to provide an overview of review articles addressing the evidence of interventions to promote/enhance modifiable health influencing factors in university students. Methods: A systematic literature search was performed in the databases PubMed, Cochrane Reviews Library und Web of Science according to the PRISMA guidelines. Only systematic reviews and meta-analyses were included. The AMSTAR-2-Tool was used for the quality assessment. Result: The initial search resulted in 10,726 records of which 81 fulfilled the inclusion criteria, with a further distinction in articles with an epidemiological focus (n = 39) and in articles with interventional approaches (n = 42). Topics of the different review articles ranged from physical activity over mental health, substance use, sleep, diet and nutrition, and media consumption. Many review articles had a specific focus on medical and nursing students and originated from the U.S.A., U.K., or China. Discussion: This umbrella review provides an overview of review articles on the epidemiology of modifiable health influencing factors and on the evidence of interventions targeting these factors among university students. Thereby, experts as well as stakeholders in the field could gain insights into crucial target points for health promotion. It identifies research gaps in terms of study region and groups of students.
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Affiliation(s)
- Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Jennifer L. Reichel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Dennis Edelmann
- Department Sport Medicine, Rehabilitation and Disease Prevention, Institute of Sport Science, Johannes Gutenberg University, Mainz, Germany
| | - Antonia M. Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ana Nanette Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Markus Schäfer
- Department of Communication, Johannes Gutenberg University, Mainz, Germany
| | - Perikles Simon
- Department Sport Medicine, Rehabilitation and Disease Prevention, Institute of Sport Science, Johannes Gutenberg University, Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Daniel Pfirrmann
- Department Sport Medicine, Rehabilitation and Disease Prevention, Institute of Sport Science, Johannes Gutenberg University, Mainz, Germany
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Safaie N, Ketabi S, Kia N, Mirmohammadkhani M, Moonesan MR, Paknazar F. Exploration of mental health problems in association with health-promoting lifestyle profile in Iranian medical students: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:84. [PMID: 32509892 PMCID: PMC7271919 DOI: 10.4103/jehp.jehp_582_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/19/2019] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The aim was to explore the relationship between mental health problems (MHPs) and health-promoting lifestyle (HPL) in the medical students. METHODS This cross-sectional study was carried out on medical students in 2017 at Semnan University of Medical Sciences applying a stratified random sampling. The Symptom Checklist-25 and the HPL profile scales were used. Logistic regression models were used to analysis. RESULTS Of the participants, 84 were male and 148 were female. The mean age was 22.69 years (±2.42). Most students (95.3%) were single and 40.1% were in the preclinical stage. The mean MHP score was 44.14 (±13.99), and 3% were in the severe category. The mean HPL score was 104.88 (±16.84); 95.7% and 4.3% of them had average and satisfactory lifestyles, respectively. The MHP score of the female (P < 0.001), younger (P < 0.001), single (P = 0.045), preclinical (P < 0.001), and who were away from home (P = 0.009) were significantly higher. The HPL score of female (P < 0.001), older (P = 0.041), and married students (P = 0.028) were significantly higher. The female gender (odds ratio [OR] = 4.45, P < 0.001) and studying in the clinical level (OR = 0.30, P < 0.001) were the most important associated factors with MHP. Adjusting for them, there was a significant relationship between an increase in the HPL score and a decrease in the likelihood of MHP (OR = 0.96, P < 0.001). CONCLUSIONS The mental health of medical students was shown to be in association with lifestyle independent of other important determinants, including gender and academic level. It seems that modifying the lifestyle to a healthier way can improve students' mental health.
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Affiliation(s)
- Nilufar Safaie
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Sara Ketabi
- Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Naimossadat Kia
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Community Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Epidemiology and Biostatistics, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Fatemeh Paknazar
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Epidemiology and Biostatistics, Semnan University of Medical Sciences, Semnan, Iran
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Shao R, He P, Ling B, Tan L, Xu L, Hou Y, Kong L, Yang Y. Prevalence of depression and anxiety and correlations between depression, anxiety, family functioning, social support and coping styles among Chinese medical students. BMC Psychol 2020; 8:38. [PMID: 32321593 PMCID: PMC7178943 DOI: 10.1186/s40359-020-00402-8] [Citation(s) in RCA: 209] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 04/03/2020] [Indexed: 01/06/2023] Open
Abstract
Background Medical students experience depression and anxiety at a higher rate than the general population or students from other specialties. While there is a growing literature on the high prevalence of depression and anxiety symptoms and about potential risk factors to the prevalence of depression and anxiety symptoms among medical students, there is a paucity of evidence focused on the prevalence of depression and anxiety symptoms and associations with family function, social support and coping styles in Chinese vocational medicine students. This study aims to investigate the prevalence of depression and anxiety symptoms among Chinese medical students and assess the correlation between depression/anxiety symptoms and family function, social support and coping styles. Methods A sample of 2057 medical students from Chongqing Medical and Pharmaceutical College in China was investigated with a self-report questionnaire, which included demographic information, Zung self-rating depression scale, Zung Self-Rating Anxiety Scale, Family APGAR Index, Social Support Rating Scale and Trait Coping Style Questionnaire. Results The prevalence of depression and anxiety symptoms among the medical students was 57.5 and 30.8%, respectively. Older students(≥20 years) experienced higher levels of depression and anxiety. More depression and anxiety symptoms were exhibited among students with big financial burden, big study-induced stress and poor sleep quality. Students with large employment pressure showed more anxiety symptoms. Students who live alone or had bad relationship with their lovers or classmates or friends showed higher depression and anxiety scores. Depression and anxiety symptoms had highly significant correlations with family functioning, social support and coping style. Conclusions Academic staffs should take measures to reduce depression and anxiety among medical students and to provide educational counseling and psychological support for students to cope with these problems.
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Affiliation(s)
- Ruyue Shao
- School of Clinical Medicine, Chongqing Medical and Pharmaceutical College, No. 82, Daxuecheng Rd, Shapingba Dist, Chongqing, 401331, China.,Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing, 401331, China
| | - Ping He
- School of Clinical Medicine, Chongqing Medical and Pharmaceutical College, No. 82, Daxuecheng Rd, Shapingba Dist, Chongqing, 401331, China.,Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing, 401331, China
| | - Bin Ling
- School of Clinical Medicine, Chongqing Medical and Pharmaceutical College, No. 82, Daxuecheng Rd, Shapingba Dist, Chongqing, 401331, China.,Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing, 401331, China
| | - Li Tan
- School of Clinical Medicine, Chongqing Medical and Pharmaceutical College, No. 82, Daxuecheng Rd, Shapingba Dist, Chongqing, 401331, China.,Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing, 401331, China
| | - Lu Xu
- Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing, 401331, China.,Department of Pharmacology, Chongqing Medical and Pharmaceutical College, No. 82, Daxuecheng Rd, Shapingba Dist, Chongqing, 401331, China
| | - Yanhua Hou
- Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing, 401331, China.,School of Basic Medical Sciences, Chongqing Medical and Pharmaceutical College, No. 82, Daxuecheng Rd, Shapingba Dist, Chongqing, 401331, China
| | - Liangsheng Kong
- Key Laboratory of Clinical Laboratory Diagnostics (Ministry of Education), College of Laboratory Medicin, Chongqing Medical University, No.1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China
| | - Yongqiang Yang
- School of Basic Medical Sciences, Chongqing Medical University, No.1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
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Acharya Y, Merchant D, Manzoor A, Sathuluri J, Anoshina A, Arja SB. Understanding the health risks in basic science medical students: a cross sectional survey. MEDEDPUBLISH 2020; 9:67. [PMID: 38058872 PMCID: PMC10697508 DOI: 10.15694/mep.2020.000067.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
This article was migrated. The article was marked as recommended. Background Medical students are usually subjected to a high workload environment and stress is one of the most important health risks that medical students encounter. The negative impact of stress on the student's mental and general health in basic science has often been under reported. Methods and Materials A cross-sectional questionnaire survey was performed in Avalon University School of Medicine (AUSOM), Curacao, amongst the first to fourth semester basic science students with an objective to explore and understand their perspectives on different health risks. ResultsMore than ⅔ of the students (79.61%, n=82) were feeling stressed out during their basic sciences. The mean stress level among the basic science students was 7.42 ± 2.13 (scale:1-10). Common health issues encountered by the students were: sleep problems, impaired concentration, low mood, mood swings, difficulty in making decisions, emotional distress, anxiety, substance abuse, and abnormal weight gain. Conclusion Although lack of sleep and behavioral problems are the most common health issues encountered by the pre-clinical medical students. There is an urgent need to implement health promotion strategies in medical curriculum for mental and physical well-being of the students.
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Mohammed S, Tharayil H, Gopakumar S, George C. Pattern and Correlates of Depression among Medical Students: An 18.Month Follow-Up Study. Indian J Psychol Med 2020; 42:116-121. [PMID: 32346251 PMCID: PMC7173653 DOI: 10.4103/ijpsym.ijpsym_28_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 01/24/2019] [Accepted: 06/28/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Medical students are subjected to various challenges, which are possibly etiological in the onset and persistence of depression. There is inadequate research on the longitudinal pattern and correlates of the emotional health of medical students in India. We aim to delineate the longitudinal pattern of depression among medical students and the factors predictive of depression. METHODS An 18-month follow-up design with 350 students (2012 intake) from two medical colleges in Kerala, India, was employed. A semistructured questionnaire and the Patient Health Questionnaire 9 were administered 2, 8, and 18 months into the course. RESULTS Depression was present in 42.80%, 36.20%, and 42.50% of the students at the three assessments. Variables significantly associated with depression on univariate analysis were the course not being of the student's choice at the first assessment; having an unemployed parent (mother) at the second assessment; alcohol use and male gender at the third assessment. On multivariate analysis, male gender (OR = 1.95[1.11-3.41]) and the presence of depression at 2 months (OR = 2.30[1.31-4.05]) and 8 months (OR = 2.48[1.39-4.44]) were predictive of depression at 18 months. CONCLUSIONS The high rates of depression and the pattern of high rates early in the course among the medical students contrasts with that reported from other countries. Early depression and male gender were predictive of depression later in the course. The implications of this are to be taken into consideration when undergraduate intervention programs are planned.
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Affiliation(s)
- Shabna Mohammed
- Department of Psychiatry, Dr. SMCSI Medical College, Karakonam, Kerala, India
| | - Harish Tharayil
- Department of Psychiatry, Govt Medical College, Kozhikode, Kerala, India
| | - Soumya Gopakumar
- Department of Community Medicine, Dr. SMCSI Medical College, Karakonam, Kerala, India
| | - Christina George
- Department of Psychiatry, Dr. SMCSI Medical College, Karakonam, Kerala, India
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Janatolmakan M, Andaieshgar B, Aryan A, Jafari F, Khatony A. Comparison of Depression Rate Between the First- and Final-Year Nursing Students in Kermanshah, Iran. Psychol Res Behav Manag 2020; 12:1147-1153. [PMID: 31920411 PMCID: PMC6935301 DOI: 10.2147/prbm.s238873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 12/16/2019] [Indexed: 11/23/2022] Open
Abstract
Background Depression can affect nursing students' quality of life, academic performance, and clinical self-efficacy and may interfere with their relationship with patients. The purpose of this study was to compare of depression rate between the first- and final-year nursing students in Kermanshah, Iran. Methods In this descriptive-analytical study, 60 first-year and 42 last-year nursing students were enrolled. The participants were chosen using the census sampling method. The data collection tool was Beck's Depression Inventory. Data were analyzed using descriptive and inferential statistics. Results In our study, 61.7% (n = 37) of the first year and 38.1% (n = 16) of the last year students had varying degrees of depression. The rate of depression was significantly higher in first-year students than last-year students (p = 0.013). Discussion Given the relatively high rate of depression among nursing students, the need for targeted planning to control their mental health, especially in the first year of study, is of importance.
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Affiliation(s)
- Maryam Janatolmakan
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bahare Andaieshgar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Aryan
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Faranak Jafari
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Khatony
- Health Institute, Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Liu X, Ping S, Gao W. Changes in Undergraduate Students' Psychological Well-Being as They Experience University Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:2864. [PMID: 31405114 PMCID: PMC6719208 DOI: 10.3390/ijerph16162864] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 12/14/2022]
Abstract
The onset of most lifetime mental disorders occurs during adolescence, and the years in college, as the final stage of adolescence in a broad sense, deserve attention in this respect. The psychological well-being of undergraduate students can influence not only their academic and professional success, but also the development of society as a whole. Although previous studies suggested psychiatric disorders are common in the adult population, there was little consistent information available about undergraduate students' mental health problems. This research aimed to describe the changes in depression, anxiety, and stress of Chinese full-time undergraduate students as they experienced university life using the Depression Anxiety Stress Scales-21 (DASS-21). The main conclusions of our study were as follows: (1) on average, students' severity scores of depression during the four academic years varied between 7.22 and 7.79, while stress scores ranged from 9.53 to 11.68. However, the anxiety scores of college students in the first three years turned out to be 7.40, 7.24 and 7.10, respectively, slightly overtaking the normal threshold of 7. These results indicated that Chinese college students, in general, were mentally healthy with regard to depression and stress, but their average anxiety levels were beyond normal in the first three years. (2) As for the proportions of students with different degrees of severity, approximately 38% to 43% of college students were above the normal level of anxiety, about 35% above the normal level of depression, and around 20% to 30% above the normal level of stress. (3) There were significant differences in the psychological health states of students of different years, especially among the sophomores, juniors, and seniors; the highest score of depression, anxiety, and stress all appeared in the first or second year on average, but some improvements were achieved in the third and last years. The findings suggested that colleges and universities need to pay special attention to psychologically unhealthy students, and with concerted efforts by the government, formulate mental health policies in the prevention, detection, and treatment of students' psychiatric disorders, rather than just focusing on their average levels of mental health.
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Affiliation(s)
- Xinqiao Liu
- Graduate School of Education, Peking University, Beijing 100871, China
- China Institute for Educational Finance Research, Peking University, Beijing 100871, China
| | - Siqing Ping
- Department of Public Policy & Management, Guangzhou Administration School, Guangzhou 510070, China
| | - Wenjuan Gao
- Graduate School of Education, Peking University, Beijing 100871, China.
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Gold JA, Hu X, Huang G, Li WZ, Wu YF, Gao S, Liu ZN, Trockel M, Li WZ, Wu YF, Gao S, Liu ZN, Rohrbaugh RM, Wilkins KM. Medical student depression and its correlates across three international medical schools. World J Psychiatry 2019; 9:65-77. [PMID: 31799151 PMCID: PMC6885454 DOI: 10.5498/wjp.v9.i4.65] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/26/2019] [Accepted: 05/23/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Medical students have high rates of depression, anxiety, and burnout that have been found to affect their empathy, professional behaviors, and performance as a physician. While studies have examined predictors for burnout and depression in the United States (US), no study, to our knowledge, has compared depression in medical students cross-culturally, or has attempted to examine the effect of factors influencing rates including burnout, exercise, stress, unmet mental health needs, and region.
AIM To examine rates of depression in three international cohorts of medical students, and determine variables that may explain these differences.
METHODS Convenience samples of medical students from three countries (US, China, and a Middle Eastern country whose name remains anonymous per request from the school) were surveyed in this observational study. Using the Patient Health Questionnaire-2 (PHQ-2) and a modified Maslach Burnout Inventory, depression and burnout were examined among medical students from the three cohorts (n = 473). Chi-square test and analysis of variance were used to examine differences in demographics, behavioral, and psychological variables across these three schools to identify potentially confounding descriptive characteristics. Analysis of covariance compared depression and the emotional exhaustion component of burnout identified through Principal Component Analysis across countries. Multiple linear regression was used to analyze the impact of demographic, behavioral, and psychological variables on screening positive for depression.
RESULTS Medical students from the Middle Eastern country had the highest rates of positive depression screens (41.1%), defined as a PHQ-2 score of ≥ 3, followed by China (14.1 %), and then the US (3.8%). More students in the Middle Eastern school had unmet mental health needs (50.8%) than at the medical school in China (34.8%) or the school in the US (32.8%) (Pearson chi-square significance < 0.05). Thus, PHQ-2 scores were adjusted for unmet mental health needs; however, the Middle Eastern country continued to have the highest depression. Adjusting for PHQ-2 score, medical students from the US scored the highest on emotional exhaustion (a measure of burnout). Demographic variables did not significantly predict medical student depression; however, lack of exercise, unmet mental health needs, stress, and emotional exhaustion predicted nearly half of depression in these cohorts. In comparison to the US, coming from the Middle Eastern country and China predicted higher levels of depression.
CONCLUSION Depression rates differ in three international cohorts of medical students. Measured factors contributed to some observed differences. Identifying site-specific prevention and intervention strategies in medical student mental health is warranted.
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Affiliation(s)
- Jessica A Gold
- Department of Psychiatry, Washington University in St Louis, St Louis, MO 63110, United States
| | - Xinran Hu
- Department of Psychiatry, Yale University, New Haven, CT 06511, United States
| | - Gan Huang
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Wan-Zhen Li
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Yi-Fan Wu
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Shan Gao
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Zhe-Ning Liu
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Mickey Trockel
- Department of Psychiatry, Stanford University, Stanford, CA 94305, United States
| | | | | | | | | | - Robert M Rohrbaugh
- Department of Psychiatry, Yale University, New Haven, CT 06511, United States
| | - Kirsten M Wilkins
- Department of Psychiatry, Yale University, New Haven, CT 06511, United States
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Jiang F, Zhou H, Hu L, Rakofsky J, Liu T, Wu S, Liu H, Liu Y, Tang YL. Psychiatry Residents in China: Socio-Demographic Characteristics, Career Satisfaction, and Related Factors. Front Psychiatry 2019; 10:177. [PMID: 31001154 PMCID: PMC6454050 DOI: 10.3389/fpsyt.2019.00177] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/11/2019] [Indexed: 11/25/2022] Open
Abstract
Objective: To study the socio-demographic characteristics, the working environment, and the level of career satisfaction among psychiatry residents in China. Method: This was a part of a large-scale, nation-wide online survey of hospitals, healthcare professionals, and patients. Data, including socio-demographics, work hours, income, job satisfaction, and intention to quit were collected anonymously. Respondents also completed the Minnesota Satisfaction Questionnaire (MSQ). Results: One thousand sixty residents nested in 32 psychiatric hospitals in 29 provinces in China completed the survey. Respondents were predominantly female (69.0%), worked an average of 47.8 ± 11.6 h per week, and 28.97% had experienced medical disputes in the previous year. The top three reported reasons for dissatisfaction were low pay (50.1%), contentious doctor-patient relationships (17.6%), and high workload (10.8%). An intention to quit their current job was reported by 18.7% of residents. The overall mean MSQ score was 73.8 ± 13.8, with significant differences across post-graduate training years and regions. A multilevel regression analysis found that a higher MSQ score was significantly associated with fewer years in residency, shorter work hours, higher monthly pay, having medical liability insurance, and feeling satisfied with the level of doctor-nurse cooperation, their hospitals' medical disputes prevention/management, and the healthcare workers' social environment. Conclusion: Psychiatry residents in China are predominantly female and well-educated. They are only moderately satisfied with their career. Poor salaries, contentious doctor-patient relationships and high workload are among their top complaints and may explain why a considerable proportion are intending to leave their current residency. More support from the government regarding residents' salaries, workload and working environment may help improve their job satisfaction and retention, ensuring that China will have a pool of well-trained and engaged psychiatrists for the future.
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Affiliation(s)
- Feng Jiang
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Huixuan Zhou
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Linlin Hu
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jeffrey Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Shichao Wu
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yuanli Liu
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Atlanta VA Medical Center, Decatur, GA, United States
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Gebreegziabher Y, Girma E, Tesfaye M. Help-seeking behavior of Jimma university students with common mental disorders: A cross-sectional study. PLoS One 2019; 14:e0212657. [PMID: 30794639 PMCID: PMC6386312 DOI: 10.1371/journal.pone.0212657] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/08/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Globally, the mental health help-seeking behavior of university students is reported to be poor; less than one-third of university students with common mental disorders (CMDs) report having sought help from formal sources. Failure to seek treatment is associated with prolonged disability and poor mental health outcomes, including suicide. In Ethiopia, little is known about the help-seeking behavior of university students for CMDs. OBJECTIVE This study aimed to assess the prevalence and determinants of help seeking, and sources of help sought by Jimma University undergraduate students with CMDs. METHOD Seven hundred and sixty students were selected to participate in this cross-sectional study using multi-stage sampling. Sources of help were identified using the Actual Help-Seeking Questionnaire. CMDs were assessed using the 10-item Kessler Psychological Distress Scale. Binary logistic regression analysis was used for both univariate and multivariable analysis. RESULTS Of the sampled students, 58.4% were found to have current CMDs. Of those with current CMDs, 78.4% had sought help for their problems. The majority (83.8%) of participants who sought help did so from informal sources. Compared to students who had 'very good' overall levels of satisfaction with life, those who had 'good', 'fair', and 'poor or very poor' overall level of satisfaction with life were less likely to seek help (p-value = 0.021, 0.014, and 0.011, respectively). Lastly, having no previous history of help-seeking was significantly associated with seeking help for CMDs (p-value<0.001). CONCLUSION More than half of Jimma University students were found to have a high risk of CMDs and the majority of those with CMDs sought help from informal sources. Future studies are needed to explore the barriers of seeking help from formal resources, and the effects of not receiving help from formal sources for CMDs symptoms.
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Affiliation(s)
| | - Eshetu Girma
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Markos Tesfaye
- Department of Psychiatry, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Francis B, Gill JS, Yit Han N, Petrus CF, Azhar FL, Ahmad Sabki Z, Said MA, Ong Hui K, Chong Guan N, Sulaiman AH. Religious Coping, Religiosity, Depression and Anxiety among Medical Students in a Multi-Religious Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E259. [PMID: 30658450 PMCID: PMC6352239 DOI: 10.3390/ijerph16020259] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/30/2018] [Accepted: 01/15/2019] [Indexed: 12/20/2022]
Abstract
Medical students are vulnerable to depression and anxiety due to the nature of their academic life. This study aimed to determine the prevalence of depressive and anxiety symptoms among medical students and the association between religious coping, religiosity and socio-demographic factors with anxiety and depressive symptoms. A cross sectional design was used for this study. Scales used were the Malay version of the Duke Religious Index (DUREL-M), the Malay version of the Brief Religious Coping Scale (Brief RCOPE) and the Malay version Hospital and Anxiety Depression Scale (HADS-M). 622 students participated in this study. They scored moderately on the organized (mean: 3.51) and non-organized religious (mean: 3.85) subscales of the DUREL, but had high intrinsic religiosity (mean: 12.18). The prevalence of anxiety and depressive symptoms were 4.7% and 17.4% respectively, which is lower than local as well as international data. Islam, negative religious coping and the presence of depressive symptoms were significantly associated with anxiety symptoms. Only the presence of anxiety symptoms was significantly associated with depressive symptoms. Negative religious coping, rather than positive religious coping, has significant association with depressive and anxiety symptoms. Redirecting focus towards negative religious coping is imperative to boost mental health outcomes among medical students.
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Affiliation(s)
- Benedict Francis
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Jesjeet Singh Gill
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Ng Yit Han
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | | | - Fatin Liyana Azhar
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Zuraida Ahmad Sabki
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Mas Ayu Said
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
- Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
- University of Malaya Centre of Addiction Sciences, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Koh Ong Hui
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Ng Chong Guan
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
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Nguyen Ngoc A, Le Thi Thanh X, Le Thi H, Vu Tuan A, Nguyen Van T. Occupational Stress Among Health Worker in a National Dermatology Hospital in Vietnam, 2018. Front Psychiatry 2019; 10:950. [PMID: 32038316 PMCID: PMC6992594 DOI: 10.3389/fpsyt.2019.00950] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/02/2019] [Indexed: 12/18/2022] Open
Abstract
A cross-sectional study was conducted among 171 doctors and nurses in a National Dermatology hospital using the Karasek's Job Content Questionnaire which has been validated in Vietnamese (JCQ-V), to assess the prevalence of occupational stress and to explore the association with some associated factors among them. The result showed that doctors and nurses with occupational stress accounted for 6.4%. This proportion was higher among nurse compared to doctor (8.0% vs. 2.2%); among those with diploma literacy compared to bachelor and above (10.6% and 2.3%). This rate was also higher in health workers under 30 years old (12.9%), health workers under 5 years at work (12.1%), working night shift from 3-4 nights (33.3%), temporary employment (12.8%), heavy workload occasionally (12.5%), and working hard occasionally (17.2%) compared to those in the comparison groups with p value <0,05. This prevalence concentrated in some departments such as surgery (11.9%), internal medicine (6.7%), dermatology, and others (1.5%). The study has not found the significant association between the prevalence of occupational stress and heavy workload and skill level. Therefore, it is essential for hospital should conduct screening all doctors, nurses, and medical staffs to identify subjects having occupational stress and give appropriate intervention.
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Affiliation(s)
- Anh Nguyen Ngoc
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Xuan Le Thi Thanh
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hue Le Thi
- General Examination Department, Quy Hoa National Dermatology Hospital, Binh Dinh, Vietnam
| | - Anh Vu Tuan
- General Examination Department, Quy Hoa National Dermatology Hospital, Binh Dinh, Vietnam
| | - Thanh Nguyen Van
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
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Zhang MWB, Lim RBC, Lee C, Ho RCM. Prevalence of Internet Addiction in Medical Students: a Meta-analysis. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:88-93. [PMID: 28849574 DOI: 10.1007/s40596-017-0794-1] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/25/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE With the development of online learning, communication, and entertainment, the Internet has become an indispensable tool for university students. Internet addiction (IA) has emerged as a health problem and the prevalence of IA varies from country to country. To date, the global prevalence of IA in medical students remains unknown. The objective of this meta-analysis was to establish precise estimates of the prevalence of IA among medical students in different countries. METHODS The pooled prevalence of IA among medical students was determined by the random-effects model. Meta-regression and subgroup analysis were performed to identify potential factors that could contribute to heterogeneity. RESULTS The pooled prevalence of IA among 3651 medical students is 30.1% (95% confidence interval (CI) 28.5-31.8%, Z = -20.66, df = 9, τ 2 = 0.90) with significant heterogeneity (I 2 = 98.12). Subgroup analysis shows the pooled prevalence of IA diagnosed by the Chen's Internet Addiction Scale (CIAS) (5.2, 95% CI 3.4-8.0%) is significantly lower than Young's Internet Addiction Test (YIAT) (32.2, 95% CI 20.9-45.9%) (p < 0.0001). Meta-regression analyses show that the mean age of medical students, gender proportion and the severity of IA are not significant moderators. CONCLUSIONS In conclusion, this meta-analysis identified the pooled prevalence of IA among medical students is approximately five times than that of the general population. Age, gender, and severity of IA did not account for high heterogeneity in prevalence, but IA assessment questionnaire was a potential source of heterogeneity. Given the high prevalence of IA, medical teachers and medical school administrators should identify medical students who suffer from IA and refer them for intervention.
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Affiliation(s)
- Melvyn W B Zhang
- National Addictions Management Service, Institute of Mental Health, Singapore, Singapore.
- National University of Singapore, Singapore, Singapore.
| | - Russell B C Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheng Lee
- National Addictions Management Service, Institute of Mental Health, Singapore, Singapore
| | - Roger C M Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Monrouxe LV, Bullock A, Tseng HM, Wells SE. Association of professional identity, gender, team understanding, anxiety and workplace learning alignment with burnout in junior doctors: a longitudinal cohort study. BMJ Open 2017; 7:e017942. [PMID: 29284717 PMCID: PMC5770913 DOI: 10.1136/bmjopen-2017-017942] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To examine how burnout across medical student to junior doctor transition relates to: measures of professional identity, team understanding, anxiety, gender, age and workplace learning (assistantship) alignment to first post. DESIGN A longitudinal 1-year cohort design. Two groups of final-year medical students: (1) those undertaking end-of-year assistantships aligned in location and specialty with their first post and (2) those undertaking assistantships non-aligned. An online questionnaire included: Professional Identity Scale, Team Understanding Scale, modified Hamilton Anxiety Rating Scale and modified Copenhagen Burnout Inventory. Data were collected on four occasions: (T1) prior to graduation; (T2) 1 month post-transition; (T3) 6 months post-transition and (T4) 10 months post-transition. Questionnaires were analysed individually and using linear mixed-effect models. SETTING Medical schools and postgraduate training in one UK country. PARTICIPANTS All aligned assistantship (n=182) and non-aligned assistantship students (n=319) were contacted; n=281 (56%) responded: 68% (n=183) females, 73% (n=206) 22-30 years, 46% aligned (n=129). Completion rates: aligned 72% (93/129) and non-aligned 64% (98/152). RESULTS Analyses of individual scales revealed that self-reported anxiety, professional identity and patient-related burnout were stable, while team understanding, personal and work-related burnout increased, all irrespective of alignment. Three linear mixed-effect models (personal, patient-related and work-related burnout as outcome measures; age and gender as confounding variables) found that males self-reported significantly lower personal, but higher patient-related burnout, than females. Age and team understanding had no effect. Anxiety was significantly positively related and professional identity was significantly negatively related to burnout. Participants experiencing non-aligned assistantships reported higher personal and work-related burnout over time. CONCLUSIONS Implications for practice include medical schools' consideration of an end-of-year workplace alignment with first-post before graduation or an extended shadowing period immediately postgraduation. How best to support undergraduate students' early professional identity development should be examined. Support systems should be in place across the transition for individuals with a predisposition for anxiety.
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Affiliation(s)
- Lynn V Monrouxe
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital Linkou Branch, Linkou, Taiwan
- School of Medicine, Chang Gung University, Linkou, Taiwan
| | | | - Hsu-Min Tseng
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital Linkou Branch, Linkou, Taiwan
- Healthcare Management Department, Chang Gung University, Linkou, Taiwan
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Pacheco JP, Giacomin HT, Tam WW, Ribeiro TB, Arab C, Bezerra IM, Pinasco GC. Mental health problems among medical students in Brazil: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2017; 39:369-378. [PMID: 28876408 PMCID: PMC7111407 DOI: 10.1590/1516-4446-2017-2223] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/25/2017] [Indexed: 12/30/2022]
Abstract
Objective: To provide a comprehensive picture of mental health problems (MHPs) in Brazilian medical students by documenting their prevalence and association with co-factors. Methods: We systematically searched the MEDLINE/PubMed, SciELO, LILACS, and PsycINFO databases for cross-sectional studies on the prevalence of MHPs among medical students in Brazil published before September 29, 2016. We pooled prevalences using a random-effects meta-analysis, and summarized factors associated with MHP. Results: We included 59 studies in the analysis. For meta-analyses, we identified the summary prevalence of different MHPs, including depression (25 studies, prevalence 30.6%), common mental disorders (13 studies, prevalence 31.5%), burnout (three studies, prevalence 13.1%), problematic alcohol use (three studies, prevalence 32.9%), stress (six studies, prevalence 49.9%), low sleep quality (four studies, prevalence 51.5%), excessive daytime sleepiness (four studies, prevalence 46.1%), and anxiety (six studies, prevalence 32.9%). Signs of lack of motivation, emotional support, and academic overload correlated with MHPs. Conclusion: Several MHPs are highly prevalent among future physicians in Brazil. Evidence-based interventions and psychosocial support are needed to promote mental health among Brazilian medical students.
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Affiliation(s)
- João P Pacheco
- Faculdade de Medicina, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitória, ES, Brazil
| | - Henrique T Giacomin
- Faculdade de Medicina, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitória, ES, Brazil
| | - Wilson W Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tássia B Ribeiro
- Faculdade de Medicina, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitória, ES, Brazil
| | - Claudia Arab
- Departamento de Cardiologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Italla M Bezerra
- Faculdade de Medicina, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitória, ES, Brazil
| | - Gustavo C Pinasco
- Faculdade de Medicina, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitória, ES, Brazil
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