Illness Anxiety Disorder and Distress among Female Medical and Nursing Students.

Background: Medical students’ syndrome (MSS) refers to health complaints resulting from medical expertise rather than genuine pathology. It is a hypochondriasis or illness anxiety disorder in medical students that occurs while studying a medical condition whena medical student repeatedly develops fears and symptoms of illness relating to the diseases that they are looking at at the time, and as a consequence, it affects their performance. Objective: To assess the prevalence of medical students’ syndrome and measure the impact of the syndrome on the GPA among medical students in Riyadh, Saudi Arabia. Method: The current cross-sectional study was conducted over six months on Riyadh’s medical students. Data was collected by using an online self-reported questionnaire. The questionnaire included two sections; the sociodemographic and mental health sections. MSD-5 and HAI-18 tools were used to assess mental health and the medical students’ syndrome. Results: Four hundred and thirteen (413) medical students completed the study questionnaire. About half (50.8 %) were female, and 96.6 % were single. According to the Medical Students’ Disease Distress scale (MSD-5), 88.9 % of the students had at least one mental health disorder. Anxiety was the major mental disorder found in 83.9 % of the medical students, followed by depression (73.6 %). According to the Health Anxiety Inventory tool (HAI-18) short-tool, the prevalence of medical students’ syndrome (MSS) among medical students was 22.3 %. Marital status is a significant factor affecting the prevalence of MSS; being married significantly increases MSS among medical students (53.8 % vs. 21.3 %, P=0.018). There is a significant negative correlation between the score of HAI-18 and the student’s Grade Point Average (GPA) (r=-0.111, P=0.024). Conclusion: Medical students are more vulnerable to mental conditions like medical students’ syndrome, which has negatively impacted their academic achievement. Since students face stress and pressure in their college life, medical students’ mental and psychological health should be the top priority to overcome and prevent the occurrence of MSS among students. Key words: medical student syndrome, Riyadh, Saudi Arabia

Health anxiety in medical students

BackgroundIt is often reported that medical students repeatedly develop health anxiety related to the diseases that they are studying. To the best of our knowledge, health anxiety has not been investigated in medical students in the United Arab Emirates (UAE). Therefore, we aimed to investigate the prevalence of health anxiety among a sample of medical students attending the United Arab Emirates University (UAEU). We conducted a cross-sectional study of 193 undergraduate medical students (68 males, 125 females) across the 6 years of the College of Medicine at the UAEU. Students were screened for health anxiety using the Short Health Anxiety Inventory (SHAI).ResultsEighteen students (9.3%) reached the threshold for clinically significant health anxiety on the SHAI (score ≥ 27). There was no statistically significant difference between those with and those without health anxiety in age, gender, place of origin, or year of study. There was a statistically significant difference (p < 0.05) between the two groups as regards a past history of medical or mental health conditions influencing their choice of college. No specific student demographic or background characteristics significantly predicted the occurrence of clinically significant health anxiety.ConclusionsHealth anxiety was prevalent in a significant proportion of subjects in our sample (almost one in every ten students). Individual experiences of medical and mental illness may play a role in the development of health anxiety and in the choice of studying medicine.

BackgroundHonesty and integrity are key attributes of an ethically competent physician. However, academic misconduct, which includes but is not limited to plagiarism, cheating, and falsifying documentation, is common in medical colleges across the world. The purpose of this study is to describe differences in the self-reported attitudes and behaviours of medical students regarding academic misconduct depending on gender, year of study and type of medical institution in Pakistan.MethodsA cross sectional study was conducted with medical students from one private and one public sector medical college. A pre-coded questionnaire about attitudes and behaviours regarding plagiarism, lying, cheating and falsifying documentation was completed anonymously by the students.ResultsA total of 465 medical students filled the questionnaire. 53% of private medical college students reported that they recognize copying an assignment verbatim and listing sources as references as wrong compared to 35% of public medical college students. 26% of private medical college students self-report this behaviour as compared to 42% of public medical college students. 22% of private versus 15% of public medical college students and 21% of students in clinical years compared to 17% in basic science years admit to submitting a fake medical certificate to justify an absence. 87% of students at a private medical college believe that cheating in an examination is wrong as compared to 66% of public medical college students and 24% self-report this behaviour in the former group as compared to 41% in the latter. 63% of clinical year students identify cheating as wrong compared to 89% of their junior colleagues. 71% of male versus 84% of female respondents believe that cheating is wrong and 42% of males compared to 23% of females admit to cheating.ConclusionsThere are significant differences in medical students’ attitudes and behaviours towards plagiarism, lying, cheating and stealing by gender, seniority status and type of institution. The ability to identify acts of academic misconduct does not deter students from engaging in the behaviour themselves, as evidenced by self-reporting.

The COVID-19 pandemic has negatively impacted mental health worldwide, especially among healthcare professionals, including medical students, who were more exposed to pandemic-related stressors. However, health anxiety within this vulnerable group remains understudied. This study aimed to assess and compare health anxiety and COVID-19 anxiety between medical and non-medical students during the COVID-19 pandemic and to identify factors associated with these forms of anxiety. This cross-sectional study recruited Iranian medical and non-medical students studying in Mashhad via convenience sampling using messaging apps. Participants completed a self-reported questionnaire on demographic and social factors, along with the Health Anxiety Inventory (HAI) and the Corona Disease Anxiety Scale (CDAS), with higher scores reflecting greater symptom severity. Statistical analyses evaluated group differences, correlations between HAI and CDAS scores, and the influence of confounding variables. A total of 305 students participated, with 176 medical students (57.7%) and 129 non-medical students (42.3%). The majority (92.7%) reported mild COVID-19 anxiety, while 3.2% reported moderate and 0.98% reported severe COVID-19 anxiety. COVID-19 anxiety did not significantly differ between medical and non-medical students (P = 0.439). However, medical students reported significantly higher fear of illness consequences than non-medical students (P = 0.037), while no significant differences were found in susceptibility to disease (P = 0.299) or general health concern (P = 0.156). HAI and CDAS scores were significantly correlated (r = 0.30, P < 0.001). Based on logistic regression, Female gender (OR = 4.55, P = 0.002) was associated with susceptibility to health anxiety, while studying a non-medical major was associated with lower health anxiety (OR = 0.01, P < 0.001) and lower COVID-19 anxiety (OR = 0.05, P < 0.001). Mild COVID-19 anxiety was prevalent among both medical and non-medical students, with comparable levels of health anxiety across the groups. These findings suggest the need for targeted mental health support among students during pandemic conditions.

Objectives:To estimate and assess the prevalence and predictors of illness anxiety disorder among Saudi medical students in western Saudi Arabia.Methods:A cross-sectional study was conducted from November 2017 to March 2018 at King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. A self-administered questionnaire was applied. The questionnaire is composed of demographic data, the short version of the Health Anxiety Inventory (SHAI), the Medical Student’s Disease (MSD) perception and distress scale and history of a visit to a physician in the past 6 months.Results:Two hundred and seventy-one Saudi medical students participated; 71% were males and 53% were less than 22 years old. The participants represented all academic years, with 54% in their 4th, 5th, and 6th years. Illness anxiety disorder was identified in 17% of the participants. Younger students and those with a history of a physician’s visit within the past 6 months were more likely to have illness anxiety disorder (OR=2.31, 95% CI= 1.16, 4.60; OR=2.46, 95% CI=1.25, 4.84).Conclusions:The prevalence of illness anxiety disorder among Saudi medical students is comparable to similar recent studies. Student counseling programs highlighting coping techniques, especially during the early study years, should be implemented.

Background: Medical school is commonly perceived as a demanding environment that can negatively affect a student’s academic performance, physical fitness, and mental well-being. According to a study, 23 percent of undergraduate clinical college students in the United States had clinical depression, and 57 percent were under mental stress. Our main aim of this study is to assess the mental health of medical students in different levels of training to see if a certain level plays a higher role in developing mental health issues. Methodology: This quantitative study is a descriptive cross-sectional study conducted among medical students in different universities in Riyadh region. The study depended on a self-reported questionnaire that included validated GHQ-12 for the Arab population that was used for assessing psychological distress. Results: In the current study, we collected data from 617 medical students from four universities in Riyadh region, Saudi Arabia. Among the students, 56.7 % of the participants were males, and 42.1 % were aged between 20-21 years old, and 91.6 % of them were single. According to the GHQ-12, 368 students were classified as GHQ- cases having symptoms of depression and psychiatric disorders (59.6 %). The prevalence of psychological distress among female students was significantly higher than among males (68.9 % vs. 52.6 %, P=0.000). Furthermore, we found that the prevalence of distress was the lowest among students who reported higher than 30000 SR monthly income (P=0.015). Concerning educational level, the results of the current study did not show any significant difference in the prevalence of distress among students of different levels (P=0.096); however, students of the first level showed the highest level of distress (72.2 %). Conclusion: The current study confirmed the previous studies on the high prevalence of psychological distress among medical students, which was significantly higher among females, students of low income, and students with lower GPAs. Moreover, the study showed that first-level students were the most affected by psychological distress. Keywords: Mental health, psychological distress, medical students, medical education, Saudi Arabia

Cognitive researchers assume that learning strategies are related to three types of learning processes: 'surface learning,' 'strategy learning,' and 'deep learning.' A 'deep learning' approach is widely accepted to be associated with long-term success in medical school, contributing to the development of doctors who take desirable approaches to self-directed learning and studying in medical practice. Therefore, this study measured how medical students learn and determined whether the use of learning strategies differs between high and low academic performers. In addition, we compared medical college students with graduate medical school students with regard to the use of learning strategies. To explore the learning strategies of students and their relation to academic achievement, we performed LIST (Learning Strategies in Higher Education Inventory) in a sample of 111 Year 1 medical students. Medical students with high academic performance scored higher in most learning strategies than low performers. Additionally, learning strategies were used more frequently by graduate medical school students than medical students, specifically with regard to organization, elaboration, critical thinking, and time management. We conclude that learning strategy instruments provide information that enables medical students to optimize their study. To foster deep learning and intrinsic motivation in students, it might also be necessary to adopt more changes in teaching and assessment in medical schools.

ABSTRACTPhenomenon: Transient health-related anxiety/hypochondriacal concerns in medical students are well documented. The literature suggests that after studying a particular disease, medical students are likely to consider any symptoms earlier regarded as normal to be signs of the disease they are studying. The aim of this study was to investigate the prevalence of these phenomena and their cognitive and distress aspects among medicals students in Karachi, Pakistan. Approach: This was an analytical, cross-sectional study. Self-administered questionnaires comprising demographic details, the Short Health Anxiety Inventory, Medical Students’ Disease (MSD) Perception Scale, and MSD Distress Scale were distributed to 1st- through 5th-year medical students. Findings: In total, 513 medical students (66% female) participated. Their mean age was 21 ± 1.6 years. Three hundred seventy-five students (73%) reported having visited a doctor at least once in the past 6 months. Fifty students (9.9%) admitted to having addictions. The overall prevalence of significant hypochondriacal concerns was 11.9% (61 students). The presence of addiction was associated with a greater likelihood of developing significant health-related anxiety (odds ratio = 3.82, p = .003), 95% confidence interval [1.51, 7.11]. Age, gender, medical school, year of medical school, and visits to the doctor in the previous 6 months were not associated with greater likelihood of developing significant health-related anxiety. Second-year medical students experienced a significantly greater degree of worry (MSD–Distress scale) than 5th-year students (M score = 12.6 ± 4.6 vs. 10.7 ± 4.4, p = .04). Insights: The prevalence of substantial hypochondriacal concerns in medical students in Pakistan was low in comparison to similar studies published in literature. Student health physicians should be aware of the true prevalence of hypochondriacal concerns and behavior and not dismiss legitimate complaints. Educational sessions to counteract this phenomenon can be incorporated into the curriculum of undergraduate medicine. By defining heightened awareness of symptoms as a normal process, different coping techniques can be discussed to help medical students reduce their level of stress.

GLOOMY FACES BEHIND THE WHITE COATS: DEPRESSION IN MEDICAL STUDENTS CALLS FOR ACTION

IntroductionIt is well-established that medical students often experience health-related anxiety, a phenomenon commonly referred to as “medical student syndrome” in the literature. This condition is believed to arise from exposure to life-threatening diseases during medical training.Health anxiety is characterized by excessive worry about having a serious illness, often leading to heightened distress and maladaptive health-related behaviors.ObjectivesThe aim of this study was to explore and compare health anxiety levels between preclinical and clinical medical students.MethodsA cross-sectional, descriptive, and analytical study was conducted at the Sfax Medical School from March to June 2024. Medical students were invited to voluntarily complete a self-administered questionnaire, which collected socio-demographic data, lifestyle-related factors (such as substance use, physical activity, and medical history), and the Short Health Anxiety Inventory (HAI-18). The HAI-18 assesses the frequency and intensity of health-related worries and behaviors experienced over the past six months. The total score ranges from 0 to 54 and includes two subscales: the Health Anxiety subscale (items 1–14, range 0–42) and the Negative Consequences of Illness subscale (items 15–18, range 0–12). A score of 18 or higher on the Health Anxiety subscale indicates significant health anxiety.ResultsA total of 285 students participated in the study, with a predominance of females (73.7%).The mean age was 21.96 ± 2.05 years. Preclinical students constituted 31.9% of the sample, while clinical students comprised 68.1%. Most participants (91.9%) resided in urban areas, and 82.1% reported a moderate socioeconomic status. Additionally, 69.5% of participants were living with their families. A medical history was reported by 21.8% of the participants, while 17.2% had a history of psychiatric difficulties. Among these students, 5% had been hospitalized for a serious illness, for a prolonged duration or on multiple occasions.Health-related anxiety was observed in 24.6% of participants. It was significantly associated with female gender (p = 0.045), a history of psychiatric difficulties (p = 0.004), and being a clinical medical student (p = 0.04). These factors were identified as key predictors of increased health-related anxiety levels.ConclusionsFemale gender, a history of psychiatric difficulties, and clinical medical training were identified as significant risk factors for health-related anxiety among medical students. These findings suggest the need for targeted interventions to address and alleviate anxiety in these high-risk groups, potentially improving both mental health and academic performance within medical training environments.Disclosure of InterestNone Declared

Objectives Students are the spiritual assets of each country. Anxiety and mental health problems negatively affect their performance. This study aims to assess the effect of online group metacognitive training on the medical students’ health anxiety and general health during the COVID-19 pandemic. Methods This a randomized clinical trial. Participants were 56 students of Mashhad University of Medical Sciences aged 18-30 years who were selected by a convenience sampling method and were randomly divided into two groups of intervention and control. The intervention group received online metacognitive training at 8 sessions, each for one hour, while the control group did not receive any intervention. At three stages of pre-test, post-test, and one-month follow-up, they completed Salkovskis and Warwick’s short health anxiety inventory and the 28-item general health questionnaire. Data were analyzed in SPSS software, version 23. Using the repeated measures analysis of variance (ANOVA) test. Results Metacognitive training was effective in reducing health anxiety and improving general health of students (P&lt;0.05). The results remained significant one month after the intervention. Conclusion Metacognitive training online can reduce health anxiety and improve general health of medical students during the COVID-19 pandemic.

BackgroundAn imbalance of physician supply by medical specialty has been observed in most countries. In Korea, there is a greater tendency to avoid surgical specialties and specialty choices in nonclinical medicine, such as the basic science of medicine. In this study, we identified factors affecting the specialty choice of physicians in order to provide a basis for policies to address this problem.MethodsWe used the results of a 2013 nationwide survey of 12 709 medical students (82.7 % responded) to analyze the data of 9499 students after excluding missing data. Descriptive analyses of all students’ specialty choice were performed. Logistic regression was performed by selecting gender, age, grade level, type of medical school, hometown, and the location of the medical school as the independent variables. Medical specialty was the dependent variable. The dependent variable, or specialty of medicine, was categorized into three groups: nonclinical/clinical medicine, surgical-medical specialty, and controllable lifestyle specialty.ResultsThe order of preferred medical specialties was internal medicine, psychiatry, and pediatrics; for surgical specialties, the order was orthopedic surgery, general surgery, and ophthalmology. Medical specialties were most favored by women and students in the third (men) and second (women) year of the medical program, whereas surgical specialties were most preferred by men and students in the first year of the program. Students in the third year mostly favored nonclinical medicine. Medical college students had a stronger preference for nonclinical medicine (odds ratio [OR] 1.625, 95 % confidence interval [CI] 1.139–2.318) than graduate medical school students. Surgical specialties were more favored by men (OR 2.537, 95 % CI 2.296–2.804) than by women. However, they were favored less by medical college students (OR 0.885, 95 % CI 0.790–0.991) than by graduate medical school students and by medical students in metropolitan areas (OR 0.892, 95 % CI 0.806–0.988) than by medical students in nonmetropolitan areas. A controllable lifestyle specialty was less favored by men (OR 0.802, 95 % CI 0.730–0.881) than by women.ConclusionsBased on these results, we can evaluate the effectiveness of the government’s educational policies for solving the imbalance of physician supply and provide empirical evidence to understand and solve this problem.

Background: Communication skills (CS) learning is a core skill in medical and dental education. The comparison of attitudes towards CS between dental and medical students based on the taught curriculum (problem-based learning vs. traditional teaching) in Saudi Arabia awaits investigation. Aims: (1) To assess the attitudes of both undergraduate dental and medical students towards communication skills (CS) learning and (2) to compare the attitudes towards CS between Medical and Dental students in relation to sociodemographic and education-related characteristics. Methods and Materials: A cross-sectional study, using an online survey, invited 260 conveniently sampled Taibah university medical and dental undergraduate students. The survey collected data on sociodemographic characteristics, education-related factors, and CS using Communication Skills Attitude Scale (CSAS) that assess positive and negative attitudes (PAS, NAS). Data analysis included descriptive statistics and the Mann–Whitney U test. Results: Of the distributed questionnaire 91% responded (145 dental and 91 medical students). There were, overall, non-significant scores’ differences between medical and dental students on PAS (Medicine Median 51 vs. Dentistry Median 50, p = 0.059) and NAS (Medicine Median 32 vs. Dentistry Median 32, p = 0.596). Older medical students, those at clinical levels and those who reported they need to improve their communication skills and student whose parents were not doctors, tended to score statistically significantly (p = 0.032, 0.017, 0.034, and 0.004, respectively) on PAS compared with dental students; on the other hand, medical students with doctor parents scored significantly high in NAS compared to dental students (p = 0.015). Conclusion: Demographic and education-related characteristics underpinned medical student positive attitude towards CS compared to dental students. Although medical and dental students showed no differences in self-rating their attitudes towards (CS). Different factors influence medical and dental students’ attitudes towards CS learning.

Byline: R. Murthy, S. Khandelwal Historical Development of Mental Health Services During the last three centuries, there has been major shifts in the way mentally ill are viewed and cared for all over the world. The changes during the last 50 years are most significant. From a situation of considering the "mad" as "bad" and incarceration in jails and asylums, there is now recognition of the human rights of the mentally ill. From jails and asylums, the care of the mentally ill persons has moved to the community. Another important development is the care providers. Current approach to care in the community includes, besides psychiatrists, other mental-health professionals, primary-care doctors, family members, volunteers and the ill persons. The driving forces towards these changes have been many: the recognition of the wide range of mental disorders, the high prevalence of mental disorders in the community, the availability of a variety of interventions (pharmacological and nonpharmacological), the demonstration of the effectiveness. Human Resources for Health Care There is an international focus on human resources for health care. The theme of the World Health Report 2006 (WHR 2006) was Working Together for Health. The WHR 2006 begins with the following observation: "In this decade of the 21[sup] st century, immense advances in human well-being coexist with extreme deprivation. In global health we are witnessing the benefits of new medicines and technologies. But there are unprecedented reversals. Life expectancies have collapsed in some of the poorest countries to half the level of the richest - attributable to the ravages of HIV/AIDS in parts of sub-Saharan Africa and to more than a dozen "failed states". These setbacks have been accompanied by growing fears, in rich and poor countries alike, of new infectious threats such as SARS and avian influenza and "hidden" behavioural conditions such as mental disorders (emphasis added) and domestic violence ."(xv) (emphasis added). Further, the report states The ultimate goal of health workforce strategies is a delivery system that can guarantee universal access to health care and social protection to all citizens in every country. There is no global blueprint that describes how to get there - each nation must devise its own plan. Effective workforce strategies must be matched to a country's unique situation and based on social consensus (emphasis added). (p.119) The human resources for mental health care are grossly inadequate in the developing countries, as presented by the WHO Atlas document in 2005. In the Indian context, the development of appropriate human resources for health in general is receiving serious attention. For example, the setting up of the Public Health Foundation of India in 2006 is a good example of this concern. Both authors come from a background of community mental health and experience of training and working with primary health-care doctors. The effort is to present the "world" perspective (from the World Health Report, the World Psychiatric Association (WPA) guidelines, experiences of different countries) and identify some issues relevant to undergraduate education in India. World Health Report 2001 The World Health Report 2001 makes 10 overall recommendations. The first of this is "Provide treatment in primary care." The management and treatment of mental disorders in primary care is a fundamental step which enables the largest number of people to get easier and faster access to services. It is to be recognized that many are already seeking help at this level. This not only gives better care but also cuts wastage resulting from unnecessary investigations and inappropriate and nonspecific treatments. For this to happen, however, general health personnel need to be trained in the essential skills of mental health care. Such training ensures the best use of the available knowledge for the largest number of people and makes possible the immediate application of interventions. …