Medical Student Distress Research Articles

Emotional distress in medical students in the context of university teaching on mental disorders

Numerous studies have shown ahigh incidence and increase in stress-related symptoms and depression-like complaints among students. During teaching on mental disorders at our medical faculty, students repeatedly reported emotionally stressful situations and expressed adesire for support services. The aim of the present study was to objectify the level of stress and the need for such support services. Atotal of 118 students in the 9thsemester (winter semester 2022/2023) were surveyed using aquestionnaire on their emotional stress. The online questionnaire was conducted via LimeSurvey (LimeSurvey GmbH, Hamburg, Germany) and contained atotal of 18items formulated as statements as well as other items. The students rated the individual items on 11-point numerical scales with external anchor ratings. The respondents rated their own stress as increased compared to other modules, particularly for the subject of psychiatry (> 5out of10). Bedside teaching was estimated as being the most stressful, followed by seminars and lectures (all pairwise comparisons p < 0.001). The contents on depression predominantly caused the most stress. Approximately half of the students would like to be offered support services and most frequently aconsultation session (78.0%) and defined contact persons (70.7%). The emotional stress of students in the context of teaching on mental disorders is particularly high in psychiatry and higher with increasing patient contact; offers of support services are needed. Teachers should be sensitized to this and create offers such as open consultation sessions and the provision of defined contact persons.

Suicidal Ideation, Psychological Distress and Depression in Medical Students of Pakistan: Surviving or Thriving

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: In recent years, psychological stress has lead to increase in suicide cases readily among medical students of many countries. This study aims determine the prevalence of psychological stress, major depressive disorder, and suicidal ideation in Bachelor of Medicine and Bachelor of Surgery (MBBS) students of a government setup medical university in Pakistan. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: The data was gathered using a valid questionnaire containing 10 items Kessler psychological distress scale. The scale consists of the severity of the psychological distress from well, mild, moderate, and severe. Physical health questionnaire 2(PHQ2) was used for identifying the students with major depressive illness. Suicidal ideation was assessed using item no. 9 from PHQ9 questionnaire. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: The overall prevalence of suicidal ideation, distress and major depression among 353 students of MBBS was 22.9%, 63.1%, 27.8% respectively. The students with major depression and moderate/severe distress are more probable to think about suicide. Moreover, Students who choose medicine under the family influence are more likely to have suicidal ideation. Besides this, we found that particularly females experience higher psychological distress as compared to males. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: In the overall study, it is identified that suicidal ideation is strongly correlated to depression and distress. However, controlling these factors at an early stage can prevent the suicidal thoughts, which inevitably can reduce the suicide attempts not only in medical students but could also be valuable for students of different fields.

The relationship between social media dependency and psychological distress due to misunderstanding and fear of COVID-19 in medical students

Improper use of social media during the COVID-19 outbreak, leading to fear and misunderstanding, can contribute to psychological disorders in vulnerable populations. This descriptive and analytical cross-sectional study was conducted in 2023 on 511 medical students of Babol University of Medical Sciences. Data were collected using demographic, psychological distress, fear and misunderstanding questionnaires related to COVID-19 and social media dependency. A total of 511 medical students, with an average age of Mean and S.D; 23.57 ± 3.03 participated in the study. The average psychological distress score was 23.82 ± 7.73 (out of 54), the average score of social media dependency was 17.53 ± 3.09 (out of 30), for the fear of COVID-19 was12.63 ± 2.56 (out of 35), and for the misperception of COVID-19 was 0.53 ± 0.09 (out of 18). Path analysis results) showed that direct path from improper use of social media to psychological distress is significant (P < 0.001, B = 0.19) but this relationship is not significant through fear and misperception related to COVID-19. Improper use of social media, identified as the strongest predictor, can directly increase psychological distress in medical students, without mediation through fear and misperception related to COVID-19. These findings should be taken into consideration when designing and evaluating interventions aimed at promoting mental health and fostering appropriate use of social media among students during disease outbreaks.

Specific emotion regulation difficulties mediate the relationship between personal distress and depressive symptoms in medical students.

Several studies indicate a link between personal distress and vulnerability to depression. The literature also suggests that personal distress is associated with emotion dysregulation and that emotion dysregulation plays a role in depression. However, which of the various emotion regulation difficulties mediates the relationship between personal distress and depression remains unexplored. This study therefore aims to investigate the mediating role of specific emotion regulation difficulties in the relationship between personal distress and depression. Of the 702 initially recruited participants, 635 completed a survey comprising the Interpersonal Reactivity Index, the Difficulties in Emotion Regulation Scale, and the Beck Depression Inventory. A mediation analysis was used to explore which emotion regulation difficulties mediate the relationship between personal distress and depression. Over a quarter (27%) of participants reported moderate-severe depression symptoms. Difficulties in accessing adaptive emotion regulation strategies and in having a clear understanding about one's own emotions partly mediated the relationship between personal distress and depression symptoms. Our results are the first to indicate that personal distress is linked to depression risk through specific emotion regulation difficulties in medical students. They also highlight possible modifiable skills that could be targeted by prevention intervention.

A Guiding Model for Undergraduate Medical Education Well-Being Programs.

Most medical schools have instituted undergraduate medical education (UME) well-being programs in recent years in response to high rates of medical student distress, but there is currently significant variability in the structure of UME well-being programs and limited guidance on how to best structure such programs to achieve success. In this article, the authors, all leaders of medical student well-being programs at their home institutions and members of the Association of American Medical Colleges Group on Student Affairs Committee on Student Affairs Working Group on Medical Student Well-Being between 2019 and 2023 offer guidance to the national community on how best to structure a UME well-being program. They use the current literature and their professional experiences leading well-being efforts at 7 different institutions to review the case for addressing medical student well-being, propose a guiding model, and make recommendations for strategies to implement this model.The proposed guiding model emphasizes the importance of the learning environment and efficiency of learning to medical student well-being, as well as personal resilience. Based on this model, the authors recommend specific and tangible well-being strategies to implement systemic interventions to improve the learning environment, efficiency of learning, and personal resilience, including formalizing the well-being program; hiring qualified, dedicated, and empowered well-being leadership with clear responsibilities; acting as a central hub for resources and as a liaison with mental health care; and establishing robust program evaluation methods.

Gender difference in emotional distress among nursing and health science college students: An online survey

This cross-sectional study investigates the self-reported emotional distress of medical, nursing, dental, pharmacy, and public health students and identifies gender-related differences through an online survey. The data of 364 students were analyzed using Pearson correlation coefficients and multiple logistic regression. Emotional distress was more prevalent among female respondents (11.7 %) than male (3.8 %) respondents. The stigma, isolation, and depression experienced by female respondents influenced their emotional distress, whereas only the depression of male respondents influenced their emotional distress. Our findings suggest that mental health professionals should consider gender-specific factors when developing interventions for the study population to minimize emotional distress.

Impact of COVID-19 on medical students well-being and psychological distress.

Mental well-being is important for medical students to perform effectively. The COVID-19 pandemic posed different stressors to medical students increasing their vulnerability to distress and impaired well-being. To assess the effect of the COVID-19 pandemic on the well-being of medical students and its relation with COVID-related psychological distress and fear as well as sleep quality. We planned a cross-sectional study on medical students with the help of an online Google Form including sociodemographic data, medical students well-being index (MSWBI), Psychological Distress Scale, fear of COVID-19 Scale (FCV-19S), and Pittsburgh Sleep Quality Index (PSQI). 48.13% of students reported higher distress and impaired mental well-being. Impaired well-being is correlated with COVID-related psychological distress, fear of COVID-19, and disturbed sleep quality. Regression analysis showed that joint family and sleep disturbances significantly predicted distress or poor well-being in medical students. Almost half of the medical students revealed impaired mental well-being underlining the role of COVID-related stressors in worsening the psychological health of students. In this situation, it is important to take prompt measures to identify vulnerable students and help them.

Effects of the mental health promotion seminar ‘Coping with stress’ in the undergraduate medical curriculum of the Medical University of Vienna

BackgroundHigh prevalence rates of distress and burnout in medical students are well-documented in mental health literature. Different types of interventions have been developed in the past in order to reduce stress in medical undergraduate students and promote better coping skills. There is, however, a paucity of studies that have tested the effectiveness of these interventions. This study aimed to examine the effect of different versions of the seminar ‘Coping with stress’, which was implemented in the first year of the undergraduate curriculum of the Medical University of Vienna in the summer semester of 2018, on students’ mental health.MethodsInvitations to participate in the study were sent via email to six cohorts of students from the Medical University of Vienna. Two cohorts participated in the onsite version of the seminar ‘Coping with stress’, whereas two cohorts participated in the online version of the seminar, and two cohorts received no intervention (control group). Data on burnout risk, life satisfaction, stress, and knowledge about available help resources were collected via online questionnaires from n = 137 students before and after the curriculum module that contained the seminar.ResultsMedical students who participated in the onsite seminar reported a reduction of some aspects of burnout, a decrease in stress, and an increase in knowledge about available help resources. No such effect was seen in the control group. Participants of the online seminar experienced a similar increase in knowledge about available help resources, but no changes in other outcomes.ConclusionsThe findings support the notion that the onsite seminar of ‘Coping with stress’ had a positive impact on medical students’ mental health and is a useful addition to the medical curriculum by promoting mental health literacy.Trial registrationThis research has been registered in the German Clinical Trial Registry with the registration number DRKS00018981 and the registration date 14/11/2019.

Psychological distress of medical students in western Saudi Arabia: A mixed-methods study

Background: Psychological distress such as anxiety and depression can negatively affect medical students’ academic performance and future careers. Aim: This study examined the prevalence and impact of psychological distress on medical students’ academic achievement, their associated learner characteristics, and how students handle stress in western Saudi Arabia. Setting and Design: This cross-sectional study incorporated a mixed-methods design, including quantitative and qualitative components for Phase 2 medical students. Methods: A self-administered questionnaire was used for quantitative components to examine the prevalence of psychological distress among medical students. In addition, a qualitative study component was conducted with students with severe psychological distress using structured interviews with a predetermined list of responses to which to select and assess factors that lead to severe psychological distress and how students handle stress. This study began on January 15, 2018, at the medical college Taif University and lasted 3 months. Statistical Analysis Used: The quantitative and qualitative data were coded, verified, and analyzed by a statistician using the Statistical Package for the Social Sciences software (SPSS version 22.0). Chi-squared tests were used to examine differences between proportions. Results: This study (n = 289) revealed that more than 69% of medical students experienced some form of psychological distress, 52% suffered from mild and moderate psychological distress, and 17% with severe psychological distress. There were no statistically significant differences between genders and years of study regarding psychological distress. Overall, there was no statistically significant association between grade point average and psychological distress scores. Conclusions: This study revealed a high prevalence of psychological distress among medical students. This study recommends establishing a psychological counseling unit at medical schools in western Saudi Arabia to detect psychological distress in medical students and timely referrals of those who need medical advice.

Tōku Oranga: the subjective wellbeing and psychological functioning of postgraduate and medical students in Ōtautahi Christchurch.

Postgraduate and medical students are at risk of psychological distress and burnout, which can cause significant functional and occupational impairment. We aimed to report subjective wellbeing, psychological distress and burnout in postgraduate and medical students in Ōtautahi Christchurch, Aotearoa (New Zealand), and identify any associations between participant and course information and outcome measures including exposure to major earthquakes in 2010/2011 and the 2019 terrorist attack. A self-report online survey was completed by 140 students between November 2019 and March 2020. Life satisfaction, psychological distress and burnout were primary outcomes. Data were analysed using univariate and multivariable analysis. High levels of psychological distress were present in both student groups. Burnout was reported by 78% of respondents. There were no significant associations found between exposure to the Christchurch earthquakes or terrorist attack with primary outcomes. Personality factors, resilience and perceived support and success were weakly associated with wellbeing, distress and burnout. Postgraduates and medical students reported high levels of psychological distress and burnout. The earthquakes and terrorist attack do not appear to be associated with negative effects in these cohorts. Personality and resilience characteristics may assist in predicting students at risk of morbidity and evaluating potentially relevant interventions.

Psychosomatic symptoms associated with traumatic events experienced in medical students.

Many facts indicate the important role of psychosomatic symptoms that occur due to traumatic events. This study is an analysis of the coexistence of psychosomatic symptoms and traumatic events. Though not every person taking part in these events develops a fully symptomatic post-traumatic stress disorder (PTSD), psychosomatic symptoms with a strong psychological component are observed in many. This study focuses on a comparison of the intensity of somatization, anxiety, depression, and distress of medical university students, who encountered a traumatic event and those who have not experienced trauma. The data was collected from 594 students of different academic majors at the Poznan University of Medical Sciences, Poland. The participants were asked if they had experienced situations that caused psychological trauma as well as about the intensity of their psychosomatic symptoms. The data was collected with 2 questionnaires: Post-traumatic Stress Diagnostic Scale and Four-Dimensional Symptom Questionnaire. The study reveals that 78% of students experienced a traumatic event, in 15% moderate and severe symptoms of PTSD are observed, 45% presents average and high stress levels, 23% experiences symptoms of depression, whereas 30% has anxiety and 26% somatic symptoms. Studies show that experiencing traumatic events in life is linked to the higher intensity of an/the entire range of psychosomatic symptoms. Int J Occup Med Environ Health. 2023;36(5):606-17.

Determinants of Poor Mental Health of Medical Students in Portugal-A Nationwide Study.

Medical students are a population that is vulnerable to the development of anxiety, depression, and burnout. This observational cross-sectional study sought to assess the levels of distress and identify precipitating factors in all students enrolled in a Portuguese medical school during the academic year of 2022/23. Students (n = 768) were surveyed via validated instruments to measure anxiety, depression, and burnout. Sociodemographic information was also collected through a questionnaire. The study indicated that almost half of this population had depressive symptoms. No differences were found in distress levels between medical schools, and when comparing curricular years, higher levels of distress were found in the pre-clinical years in comparison to the clinical ones. Burnout, being a woman, the existence of physical health problems, homo- and bisexual orientations, affective family problems, problems with relationships in the academic community, difficulties in academic performance, and daily organization were identified as predictors of distress. On the other hand, satisfaction with the social support received and with academic ratings were identified as protective factors. In conclusion, there is a high prevalence of distress in medical students, which is associated with personal, physical, social, economic, and academic factors. The identification of predictive factors of distress may allow for the early identification of vulnerable students and for intervention and prevention strategies to be defined.

MMPI-2 Domain and Psychological Distress in Clinical Medical Students

Introduction: The clinical rotation is a stage of medical education that provides a stressful environment for medical students. Psychological distress in medical students affects the learning output and achievement of clinical competencies. MMPI-2 is a screening tool for mental disorders in clinical medical student admission protocols. Nevertheless, the domain for predicting psychological distress during clinical rotation has not been considered before. The aim of the study is to determine the MMPI-2 domain as a predictor of future psychological distress in clinical rotation students.&#x0D; Methods: This study used a cross-sectional and retrospective design using the MMPI-2 data derived from admission protocols and the SRQ (self-reporting questionnaire-29) questionnaire measuring the psychological distress in first-year clinical rotation students. &#x0D; Results: 87 data showed that not all MMPI-2 domains were statistically associated with psychological distress in clinical medical students. Domains of psychasthenia (Pt), psychopathic deviated (Pd), neurotic personality (NEGE), introverted personality (Intr), and lower stress resistance (ES) were the best predictors of psychological distress during the clinical process.&#x0D; Conclusion: The psychological distress of clinical medical students can be predicted by Pd, Pt, Nege, Intr, and Es scores of MMPI-2 with cut-off points 40T and 50T.

Pattern of access, early predictors of use, and treatment effectiveness of a psychological counselling service for medical students: an Italian longitudinal study

ABSTRACT Psychological counselling represents sensitive frontline services for the detection and treatment of early signs of distress in students. This study aims to assess psychological distress in medical students at the beginning of their academic career and the access rate to a counselling service during medical school. Predictors of access to the service and the effectiveness of the service were also explored. Distress and emotional dysregulation were measured in three consecutive cohorts of first-year students (n = 385, 53% female). Students accessing the counselling service at any time during the 6 years of medical school all completed the same baseline measurements and a pre/post assessment of the intervention. Nearly one-third of first-year students reported levels of distress above the clinical cutoff. The access rate to the counselling service was 13.9%. Only 21% of the students with clinical levels of distress contacted the counselling service. Living alone and having high distress at the beginning of the medical course were the main predictors of access to the service. Students reported a significant reduction of distress and dysregulation after counselling interventions. More efforts are needed to develop effective tools for identifying and tracking medical students in psychological hardship and to increase their willingness to attend the counselling services.

Trait emotional intelligence as predictor of psychological health in undergraduate medical students: A hierarchical multiple regression approach

Objectives: Trait emotional intelligence (TEI) is a key personality construct by which an individual recognizes, understands, expresses and regulates emotions in self and others to adapt to environments or achieve one’s goals. TEI skills are modifiable and have a potential to significantly influence psychological health (PH) of a person. The aims of current work were to evaluate relationship between TEI and PH of medical students and to explore the incremental validity of TEI to predict psychological distress beyond sociodemographic and educational factors in them. Materials and Methods: One hundred and thirty-two medical students (mean age 18.02 years) participated in this cross-sectional study. TEI and PH were assessed using TEI questionnaire short form (TEIQue-sf) and depression, anxiety and stress scale (DASS-21), respectively. Hierarchical multiple regression analysis was carried out to determine if scores on TEIQue-sf added significantly to the prediction of psychological symptoms in medical students. Results: There was a significant negative association (r = −0.57, P &lt; 0.001) between TEIQue-sf and DASS-21 scores. Hierarchical regression analyses revealed that after controlling for sociodemographic and educational variables, TEIQue-sf scores explained a statistically significant increment of variance (P &lt; 0.001) in DASS-21 scores. TEI emerged as best predictor of psychological distress of medical students followed by educational factors. However, sociodemographic profile as an attribute failed to demonstrate significant capacity to predict PH of our participants. Conclusion: Our results indicate that TEI is a robust and unique predictor of better PH and plays a positive role in promoting psychological well-being.

Study of test anxiety amongst undergraduate medical students from the state of Gujarat.

Test anxiety is physiological and behavioral response that accompanies concerns about possible negative consequences of failure on an exam. Undergraduate medical students had their academics disrupted during COVID-19 pandemic. This study was done to assess levels of test anxiety among undergraduate medical students, its variance in relation to demography, COVID-19 pandemic, learning experiences, and individual factors. Online questionnaire-based survey was done among undergraduate medical students from medical schools of Gujarat. Students from 1st, 2nd, and 3rd years who were about to appear in final exams from March to June 2021 and were asked to enroll on the survey. Apart from demography, COVID-19-related factors, learning experiences during lockdown, 10-item Westside test anxiety (WTA) scale was used to assess test anxiety levels and Kessler Psychological distress (K10) scale was used to assess level of psychological distress. Total of 370 students participated. Mean WTA Score was 3.15 ± 1; 60.2% of the respondents had moderate or higher levels of test anxiety. On bivariate analysis, WTA score was found significantly associated with year of study, coming from vernacular medium, various lockdown-related issues (poor internet connection, family financial problem, lack of information, worry about future), various learning experiences (self-rated proficiency with computers, feeling ill prepared for exams, feeling ill prepared for practical), and K10 score. Of these associations with K10 score, coming from vernacular medium and feeling ill-prepared for exams were maintained on multiple-linear regression. Vernacular medium of study during high school was found associated with test anxiety among medical students and can be a potential area of intervention. There may be merit in using WTA scale as a surrogate marker for distress in medical students.

The Prevalence of Internet Gaming Disorder Among Medical Students at Umm Al-Qura University (UQU), Saudi Arabia: A cross-sectional study

Background and Aims: Internet gaming disorder (IGD) is a worldwide psychological illness that can cause substantial suffering and impairment of gamers’ mental and physical health. Our study aimed to investigate the prevalence of IGD as well as the correlations between this disorder and gender, age and GPA among medical students at Umm Al-Qura University (UQU), Saudi Arabia. Methods: This was a comparative cross-sectional study conducted through an online survey between August 2022 and December 2022. The questionnaire was administered to male and female students across all years attending the Faculty of Medicine at Umm Al-Qura University, Saudi Arabia. Results: The sample included 351 responses from medical students, more than half of them male (58.1%). In our study, 14.5% of the participants had IGD, while 44% of people were at risk of getting this illness. There was a significant association between IGD and gender, with the male participants having twice as high a risk of developing it as the females. Conclusions: This study’s findings show that medical students have a high rate of IGD, which has a significant relationship with gender, four times higher in males than in females. However, IGD did not significantly correlate with GPA or age. It is necessary to conduct more research on the topic of psychological distress of medical students with IGD.

Comparing the Psychological Distress Among the Medical Students at Different Levels of Training

Background: Psychological distress is a global health issue which impact the medical students learning and professional development. Varied factors impact the psychological distress of the medical students. The study evaluates the role of year of study on the psychological distress of medical students. Material and Methods: The study was conducted on 318 medical students in different years of medical training. The items from DASS-21 was validated and used for the data collection. The data was collected by stratified random sampling method. Descriptive and inferential statistical analysis was performed using Statistical package for social science version 26. Result: Year three students had significantly higher psychological distress compared to all other years of study. The stress and depression is significantly higher in year three students who have progressed from preclinical years to clinical year. Conclusion: The year three students requires support from the educators to adapt to the more complex learning environment in the clinical years. This would facilitate their leaning and professional development

"Every day that I stay at home, it's another day blaming myself for not being at #Frontline"-Understanding medical students' sacrifices during COVID-19 Pandemic.

COVID-19 struck the world and stretched the healthcare system and professionals. Medical students engaged in the pandemic effort, making personal and professional sacrifices. However, the impact of these sacrifices on students` professional development is still unknown. We applied constructivist grounded theory to individual audio diaries (total time = 5h38min) and interviews (total time = 11h57min) performed with 18 last-year medical students during the first wave of COVID-19 pandemic in Brazil. The perspective of making sacrifices caused initial emotional distress in medical students, followed by a negotiation process revolving around three themes: predisposition to sacrifice, sense of competence, and sense of belonging. This negotiation process led to three response patterns: Pattern A: "No sense of duty"-the sacrifice was perceived as meaningless, and students showed intense anger and a desire to flee; Pattern B: "Sense of duty with hesitation to act"-the sacrifice was acknowledged as legitime, but students felt unprepared to contribute, leading to feelings of frustration and shame; and, Pattern C: "Sense of duty with readiness to act"-the engagement with the sacrifice was perceived as an opportunity to grow as a doctor, leading to fulfillment and proudness. Students ready to engage with the COVID-19 effort experienced identity consonance, reinforcing their professional identities. Students who felt incompetent or found the sacrifice meaningless experienced identity dissonance, which led to emotional suffering and the consideration of abandoning the course. Monitoring students' emotional reactions when facing professional challenges creates opportunities to problematize the role of sacrifice in the medical profession and scaffold professional identity development.

The association between academic achievement, psychological distress, and smartphone addiction: A cross-sectional study among medical students

ABSTRACT This study investigates the relationship between academic achievement, psychological distress, and smartphone addiction in medical students. In total, 513 medical students voluntarily completed a survey that included the Personal Information Questionnaire, the Smartphone Addiction Scale-Short Version (SAS-SV), the Depression, Anxiety and Stress Scale (DASS-21), and the Interaction Anxiousness Scale (IAS). Results showed that 321 participants were screened positive for smartphone addiction and the prevalence of smartphone addiction was 62.6%. We found that the prevalence of smartphone addiction was higher among male rather than female students (67.1% vs 58.2%; p = 0.039). There were significant differences between the smartphone addiction group and the smartphone non-addiction group as per the DASS-21 scores and the IAS scores. In addition, multiple regression indicated that psychological distress including anxiety, stress, depression, and social anxiety might be the predictors of smartphone addiction. However, smartphone addiction was found to have no significant correlation with academic performance in 274 undergraduate medical students. In conclusion, the study revealed the high prevalence of smartphone addiction in medical students. Smartphone addiction was associated with states of depression, anxiety, stress, and social anxiety, and there was no significant relationship between academic performance and smartphone addiction in undergraduate medical students. Further longitudinal research is needed to clarify the causal relationship between smartphone addiction and psychological distress.