Abstract

To compare health-related quality of life (QoL) of medical students in initial and final phases of the program, and to evaluate the association between ego defense mechanisms and specific health-related QoL domains within each group. This was an observational, cross-sectional study. Quality of life was assessed according to the World Health Organization Quality of Life instrument - Abbreviated Version (WHOQOL-Bref); anxiety and depression symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS); defense mechanisms were assessed using the Defense Style Questionnaire (DSQ-40). A total of 139 medical students were evaluated. Students in the initial semesters of the program (1st and 3rd) presented more depressive symptoms and worse quality of life in the psychological domain of WHOQOL-Bref when compared to those in the final semesters (8th and 12th). In a later analysis, conducted to identify the variables associated with the psychological domain of the WHOQOL-Bref for each group, both depressive symptoms and defense mechanisms were independently associated with the outcome for medical students in the beginning and in the end of the graduation program. Students in the initial phases of medical school may need more specific attention from educational managers. Understanding the role of ego defense mechanisms in the quality of life of medical students may help identify effective psychopedagogical interventions for this population. In addition, the results reinforce the impact of depressive symptoms on quality of life, an association already well evidenced in the literature.

Highlights

  • Quality of life (QoL) is an important outcome in health

  • A systematic review on the prevalence of depressive symptoms and suicidal ideation in medical students observed that the prevalence of depressive symptoms in this population was higher than that reported for the general population.[4]

  • Whereas for the initial phases the immature factor had an independent association with a poorer QoL in this domain, for the final phases the neurotic factor of the DSQ-40 was the variable associated with the same outcome after the multiple linear regression

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Summary

Introduction

Quality of life (QoL) is an important outcome in health. It is defined as the “individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.”[1] QoL incorporates, in a complex way, the subject’s physical and psychological state, their level of independence, social relations, personal beliefs and their relations with the environment.[1,2] Among the several factors associated with QoL, depression is one of the most frequently found in the literature.[3]. Medical school is described as a stressor that can negatively affect the academic performance, health, and psychological

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