Psychiatric and psychological follow-up of undergraduate and postgraduate medical students: Prevalence and associated factors. Results from the national BOURBON study

Abstract

BackgroundPhysicians are at risk of burnout, anxiety and depression. Prevention is needed from the beginning of the medical studies to detect early poor mental health outcomes. ObjectiveTo determine the prevalence and associated of psychiatric or psychological follow-up in a national sample of undergraduate and postgraduate medical students (UPMS). MethodsUPMS of the 35 French Medicine faculties were recruited through mailing lists and social networks between December 2016 and May 2017 and fulfilled Internet anonymised questionnaires. ResultsOverall, 10,985 UPMS were included in the present study (2165 (19.7%) postgraduate, 31.6% males, mean aged 21.8 years). Overall, 1345 (12.2%) were followed-up by a psychiatrist and/or a psychologist, 20.5% of them were regular anxiolytic consumers and 17.2% of them were regular antidepressant consumers. In multivariate analyses, being followed-up by a psychiatrist and/or psychologist was associated with older age (aOR = 1.2[1.2–1.2], p < 0.0001), female gender (aOR = 0.5[0.5–0.7], p < 0.0001), current alcohol use disorder (aOR = 1.3[1.3–1.5], p < 0.0001), higher anxiolytic (aOR = 3.1[2.5–3.7],p < 0.0001) and antidepressant (aOR = 11.7[7.6–18.0],p < 0.0001) consumption, and with lower self-reported general health, social functioning and mental health quality of life (all aORs = 0.9, all p < 0.05). The UPMS followed-up by psychiatrist and/or psychologist reported to have been more frequently exposed to sexual assault (5.1% vs. 0.9%, aOR = 2.5[1.3–4.7], p < 0.0001), domestic violence (3.3% vs. 0.8% aOR = 2.1[1.2–4.0], p = 0.01) and parents divorce (11% vs. 6.4%, aOR = 1.5[1.2–1.9], p = 0.001). Students followed-up by a psychiatrist and/or psychologist reported more frequently to seek alleviating anxiety (aOR 1.9[1.6–2.3], p < 0.0001), depression (aOR 1.7[1.3–2.1],p < 0.0001), coping with studies difficulties (aOR 1.5[1.2–1.8],p < 0.0001), experiencing more stress at hospital (aOR = 2.3[1.6–3.5],p < 0.001) and more burnout syndrome (aOR = 1.4[1.1–1.8], p = 0.03). ConclusionsAround 12% of UPMS are followed-up by a psychiatrist and/or a psychologist. These students reported higher antidepressant and anxiolytic consumption, psychic suffering and altered quality of life, associated with professional pressure and personal issues. Public health programs should be developed to help these students through their studies to prevent later mental /addictive issues and professional suffering. Improving UPMS mental health may also improve the later quality of care of their patients and global stress at hospital.