Abstract
BackgroundHigh prevalence rates of psychological distress in medical training and later professional life indicate a need for prevention. Different types of intervention were shown to have good effects, but little is known about the relative efficacy of different types of stress management interventions, and methodological limitations have been reported. In order to overcome some of these limitations, the present study aimed at evaluating the effect of a specifically developed mindfulness-based stress prevention training for medical students (MediMind) on measures of distress, coping and psychological morbidity.MethodsWe report on a prospective randomized controlled trial with three study conditions: experimental treatment (MediMind), standard treatment (Autogenic Training) and a control group without treatment. The sample consisted of medical or dental students in the second or eighth semester. They completed self-report questionnaires at baseline, after the training and at one year follow-up. Distress (Trier Inventory for the Assessment of Chronic Stress, TICS) was assessed as the primary outcome and coping (Brief COPE) as a co-primary outcome. Effects on the psychological morbidity (Brief Symptom Inventory, BSI) as a secondary outcome were expected one year after the trainings.ResultsInitially, N = 183 students were randomly allocated to the study groups. At one year follow-up N = 80 could be included into the per-protocol analysis: MediMind (n =31), Autogenic Training (n = 32) and control group (n = 17). A selective drop-out for students who suffered more often from psychological symptoms was detected (p = .020). MANCOVA’s on TICS and Brief COPE revealed no significant interaction effects. On the BSI, a significant overall interaction effect became apparent (p = .002, η2partial = .382), but post hoc analyses were not significant. Means of the Global Severity Index (BSI) indicated that MediMind may contribute to a decrease in psychological morbidity.ConclusionDue to the high and selective dropout rates, the results cannot be generalized and further research is necessary. Since the participation rate of the trainings was high, a need for further prevention programs is indicated. The study gives important suggestions on further implementation and evaluation of stress prevention in medical schools.Trial registrationThis trial is recorded at German Clinical Trials Register under the number DRKS00005354 (08.11.2013).
Highlights
High prevalence rates of psychological distress in medical training and later professional life indicate a need for prevention
In accordance with former studies [2, 3, 7], our data confirm the high experience of stress and the vulnerability for psychological disorders in students of German medical schools
Since this is still evident in later professional life [5, 56], appropriate preventive interventions should already be provided during the time of studies to decrease the risk of suffering from mental disorders and to guarantee a stable performance of future doctors in patient care
Summary
High prevalence rates of psychological distress in medical training and later professional life indicate a need for prevention. To verify the assumption that medical training contributes to the deterioration of mental health, Brazeau et al [10] compared matriculating medical students with age-matched college graduates from the general population. They found that medical students at the beginning of their studies were of better mental health compared to the controls, suggesting that the training process may contribute to an increase in psychological morbidity. Aktekin et al [13] showed a higher psychological distress in medical students compared to students studying economics and physical education
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