Symptoms In Medical Students Research Articles

First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms?

Medical training is considered a significant stress factor. We sought to assess the prevalence and intensity of anxiety and depressive symptoms in medical students and compare samples of first-year and sixth-year students. This was a cross-sectional study of first- and sixth-year medical students who attended classes regularly. The study instruments were a sociodemographic questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). A total of 232 students (110 first-year, 122 sixth-year) completed the questionnaires, for a response rate of 67.4%. Overall 50.4% of respondents were male (56.4% of first-year and 45.1% of sixth-year students). Anxiety symptoms were reported by 30.8% of first-year students and 9.4% of sixth-year students (p < 0.001). Female students were more affected by anxiety. There were no significant between-group differences in depressive symptoms. A higher prevalence of anxiety symptoms was found in first-year medical students as compared with sixth-year students. Strategies should be developed to help medical students, particularly female students, manage these symptoms at the beginning of their medical training.

Depressive symptoms in medical students: prevalence and related factors.

This study was designed to estimate the prevalence of depression and the factors that influence it in Korean medical students. We evaluated depression in 122 first- and second-year medical students in December 2011 using the Korean Beck Depression Inventory (K-BDI). Sixteen potential factors were considered: gender, class year, grade point average, breakfast habits, residence type, leisure activity, sleep satisfaction, relationship status, a close friend or a significant other, finances, present health status, history of mood disorders, family history of mood disorders, religion, and self-esteem. The average BDI score was 8.9. There were 80 (65.6%), 16 (13.1%), 15 (12.3%), and 11 (9.0%) students with minimal, mild, moderate, and severe depression, respectively. The group with depressive symptoms comprised males with a total BDI score > or =24 and females with total BDI > or =25 and constituted 9.0% of students. Students in the depressive symptom group had lower self-esteem and lower grade point averages and were more frequently ill, less likely to be in a relationship, and more likely to have a history of mood disorders (p<0.05 for all). In particular, low self-esteem score was an independent factor. The BDI scores in our study were similar to those that have been reported in other countries but slightly higher than in other Korean medical and university students. Self-esteem, grade point average, health status, history of mood disorders, family history of mood disorders, and presence of a significant other correlated significantly with depression in medical students.

Looking Beyond Personal Stressors: An Examination of How Academic Stressors Contribute to Depression in Australian Graduate Medical Students

Background: Medical school is a challenging environment that requires students to deal effectively with stress borne out of the medical education environment, as well as their personal lives. Previous research has not systemically distinguished between academic and personal sources of stress, and in particular has not explored the independent contribution that academic stressors make to medical student depression. Purposes: This study aimed to investigate whether academic stressors make a unique contribution to the level of depressive symptoms in medical students, over and above the contribution made by personal stressors alone. Methods: Sixty-seven medical students completed an online questionnaire designed to measure the total number of recent life events (personal and academic), and their perceived impact, using a modified version of the Psychiatric Epidemiology Research Interview Life Events Scale. Depressive symptoms were measured using the Centre for Epidemiological Studies Depression Scale. Results: Both the total number of personal stressors, r(67) = .363, p = .003, and their perceived impact, r(67) = .412, p = .001, were found to be positively related to depressive symptoms. A positive relationship was also observed between depressive symptoms and the total number of academic stressors, r(67) = .321, p = .008, and their perceived impact, r(67) = .489, p < .001. In addition, it was found that the perceived impact of academic stressors was able to explain higher levels of depressive symptoms in medical students over and above the effect afforded by personal stressors alone. Conclusion: The findings of this study suggest that stress borne out of the medical school environment contributes to depressive symptoms in medical students over and above the contribution made by personal stressors alone. This indicates that although it is important to help students cope with stress borne out of their personal lives, interventions by medical schools aimed at reducing the impact of academic stressors on medical student depression may also be of great importance.

Sex-based differences in subjective symptoms among medical students exposed to low-levels of formaldehyde in a gross anatomy dissection course

Background In our university, large-scale renovation for the installation of dissection tables equipped with local ventilation systems and the renewal of the general ventilation system was carried out in 2011 to reduce exposure of students to formaldehyde (FA) during a dissection course. These renovations caused the indoor FA levels to decrease dramatically. Not many reports are available on the health effects of a low FA level on medical students. We believe that there is a need to develop further strategies to reduce FA exposure in a low FA level environment. Women generally reported more health conditions than men. Therefore, we need to analyze the results according to sex. Aims To study the changes in subjective symptoms of medical students before, during, and 6 months after completion of the course according to sex. Methods We investigated the prevalence of 24 subjective symptoms in medical students before the start of a gross anatomy dissection course, during the course, and 6 months after completion of the course by using 2 self-administered questionnaires. Students completed the first survey at the end of the course, which focused on symptoms before and, during the course. The second survey was completed 6 months after the course ended. We investigated the difference in the pattern of subjective symptoms reported by men and women during 3?periods. Results The prevalence of most subjective symptoms was the lowest 6 months after completion of the course. Based on sex, the prevalence of most subjective symptoms was higher in women than in men during and 6 months after the course. The number of symptoms 6 months after the course was 17 in men and 5 in women, which indicated a significant decrease compared with the symptom prevalence during the course. Conclusions Our results indicate that the prevalence of subjective symptoms in women continued to be higher than in men 6 months after course completion. A countermeasure needs to be developed especially for women.

Inverted U shaped effect of nicotine on the severity of depressive symptoms: A population-based survey

ObjectivesTo investigate whether that nicotine concentration represented by the degree of smoking dependence variably influence the rate and severity of depressive symptoms. MethodsCross-sectional, analytical study, involving 300 medical students selected by random sampling techniques were asked to complete a questionnaire contains three parts: demographic information, Beck Depression Inventory with cutoff point for depression is 17 and the Fagerström Test for Nicotine dependence with cutoff point for severe dependence is five. ResultsA total of 233 medical students completed the questionnaire; their mean age was (21.38 ± 1.74). The rate of smoking was 22.7% while that of depression was 32.2%. Low dependent smokers in contrast to other groups of smokers and non-smokers display the lowest rate of depressive symptoms (15%), while the highest rate recorded among severely dependent smokers (71.4%, p = 0.0001). After adjustment of other risk factors, regression analysis reveal that severe dependent smokers associated with 12.5 odds of depressive symptoms than non-smokers (p = 0.0001, C.I. 4.10–38.29). ConclusionIn comparison with light and moderate smokers, heavy smokers demonstrate higher risk of depressive symptoms in medical students.

Depressive symptoms in medical students

Mental disorders represent a growing problem in the student population. There has been a recent increase in the prevalence of depressive symptoms among medical students. The objective of this study was to determine the frequency of depressive symptoms in medical students to provide insight into this problem in our country . In total, 131 fourth-year medical students were included in the study. To determine rates of depressive symptoms in the student population, we used the BDI IA. Symptoms of depression were found in 26.7% of students. The most common levels of depression were mild and moderate. The mean value of the BDI scores was 7.51±7.62. The high level of depressive symptoms found in medical students highlights the need for more comprehensive insight and follow up of this problem in the student population.

1320 – State anxiety, degree of autonomic symptoms in medical students in various situations during studying process in correspondence to gender

High rates of anxiety symptoms among medical students have been observed in many studies. Autonomic symptoms are indications of anxiety somatization. Reports about gender variations in anxiety and autonomic lability are contradictory and require further researches. To investigate changes of state anxiety, autonomic symptoms among medical students in various study periods and role of gender variations. 54 medical students (28 female and 26 male) of I.M. Sechenov Moscow State Medical University were recruited in this study. Participants were assigned unique identification codes. We used State and Trait Anxiety Inventory (STAI) and Vein’s Autonomic Symptoms Questionnaire (VASQ). State anxiety and autonomic symptoms were defined three times: 2 weeks, one day before the exam and after examination. ANOVA, correlation and t-statistics methods were used to analyze data. Changing of study situation influenced lability of state anxiety (ANOVA, F= 3,23; p= 0,04). We found gender differences in autonomic symptoms’ penetration in 1 st (p= 0.05), 2 nd (p< 0.05) and 3 rd (p< 0.01) periods; state anxiety varied in 2 nd period (p< 0,05) only. Correlation between autonomic symptoms and gender was found in 1 st (r= 0,46; p= 0,003) and 2 nd (r= 0,901; p< 0.001) periods; correlation between state anxiety and gender was moderate in 2 nd period (r= 0,55; p< 0.001). Statistical significance was achieved between a level of anxiety and various studying situations. Correlation between gender and both state anxiety and rate of autonomic symptoms was found. State anxiety and degree of autonomic symptoms was significantly higher in female.

Effects of Electroacupuncture on Stress-Related Symptoms in Medical Students: A Randomised Controlled Pilot Study

To assess the effects of electroacupuncture on stress-related symptoms-sleep disorders, anxiety, depression and burnout-in medical students, and provide data to inform a power analysis to determinate numbers for future trials. Twenty-five students were randomly assigned to an electroacupuncture (n=12) group or control group (n=13) that did not receive treatment. Electroacupuncture was applied at a continuous frequency 2 Hz for 20 min once a week for 8 weeks at sites on the extremities, face, ear and scalp. The outcomes of the students treated with electroacupuncture were compared with those of the control group at the endpoint, controlling the influence of baseline scores. The instruments used were self-administered questionnaires that comprised the validated Portuguese version of the mini-sleep questionnaire (MSQ), the Pittsburgh sleep quality index (PSQI), the Epworth sleepiness scale (ESS), the Beck depression inventory (BDI), the Beck anxiety inventory, the Maslach burnout inventory-student survey (MBI-SS), and World Health Organization quality of life assessment - abbreviated version (WHOQOL-bref). The medical students treated with electroacupuncture showed a significant decrease compared with the control group for MSQ scores (p=0.04) and PSQI (p=0.006). After treatment, 75% students in the electroacupuncture group presented a good sleep quality, compared with 23.1% of the students in the control group. No significant difference on daytime sleepiness was shown by the ESS. The electroacupuncture group showed significant improvement on depressive symptoms (BDI), the emotional exhaustion and cynicism dimensions of burnout (MBI-SS) and physical health (WHOQOL-bref). Electroacupuncture was associated with a significant reduction of stress-related symptoms, but because of the study design the authors cannot say what proportion of the reduction was due to needle stimulation.

Severity of Symptoms and Quality of Life in Medical Students With ADHD

Objective: In this study, the authors examined the severity of ADHD symptoms and related quality of life in 1st and 2nd year medical students diagnosed with ADHD. Method: The sample consists of 33 preclinical medical students previously diagnosed with ADHD. The Adult ADHD Quality of Life Scale (AAQoL) and Adult ADHD Self-Reported Checklist were administered. Results: Participants’ ADHD-related quality of life and life productivity were negatively correlated with the severity of their ADHD symptoms. Students receiving academic accommodations reported significantly higher ADHD symptoms. The presence of a comorbid condition contributed to significantly lower psychological health scores. Unexpectedly, women had significantly lower quality of life (AAQoL total score) and significantly lower psychological health scores than men. Conclusion: Since the majority of the sample reported severe ADHD symptoms while receiving medication treatment, the authors have concluded that it is important to develop psychosocial treatments to manage the associated distress from residual symptoms in medical students with ADHD.

Does ragging play a role in medical student depression — Cause or effect?

Medical students experience a lot of stress what may contribute to symptoms of depression. In this study we set out to look at the environmental factors which may be contributing in one medical school in Brazil. We assessed depressive symptoms using Beck's Depression Inventory in 465 and 267 medical students in 2001 and 2006 respectively. We explored possible social and environmental causes using qualitative data. Nearly 15% scored above the cut off for depression in both the samples. Males in the pre-clinical stage in 2006 showed an increase in depressive symptoms than males in the same cycle in 2001 (aOR=7.36 [95% CI=0.85-63.5] p=0.07). Qualitative data confirmed that factors such as ragging and low social involvement were correlated with depressive symptoms in pre-clinical stage males. The sample size was small both for quantitative and qualitative aspects of the study. It appears that ragging plays an important role in the genesis of depressive symptoms in medical students.

Effect of Large-Scale Repair Work on Indoor Formaldehyde Levels and Subjective Symptoms in Medical Students during Gross Anatomy Dissection Course

To examine the effect of large-scale repair work on indoor formaldehyde (FA) levels and subjective symptoms in medical students during a gross anatomy dissection course. We measured the indoor FA levels, room air temperature, and room humidity during a gross anatomy dissection course. In addition, the prevalence of subjective symptoms, keeping allergy state, and wearing personal protective equipment were surveyed in two groups of students using a self-administered questionnaire. The mean indoor FA levels before and after repair work were 1.22 ppm and 0.14 ppm, respectively. The mean indoor FA level significantly decreased after repair work. The prevalences of most subjective symptoms before the anatomy practice were similar before and after the repair work. However, the prevalences of most subjective symptoms during the anatomy practice were lower after the repair work. The mean indoor FA levels and prevalences of subjective symptoms decreased after the repair work. We have to continuously monitor indoor FA levels, carry out private countermeasures to minimize exposure to FA, and maintain equipment for ventilation to be able to conduct practice in a comfortable environment.

Belastet in den Beruf – Empathie und Burnout bei Medizinstudierenden am Ende des Praktischen Jahres

Empathy is a central element in daily patient care. The burnout syndrome seems to be a potential factor influencing physicians' empathic behavior negatively. In Germany up to 20 % of practicing physicians experience burnout. So far, there have been no studies measuring empathy and the degree of burnout among final-year medical students in Germany. The aim of the current study was to investigate final-year students' self-reported empathy, burnout and the association of job satisfaction and occupational self-efficacy with regard to potential gender differences. 127 medical students at the end of their final year (82 f, 45 m; 26.8 years of age) were surveyed using the Jefferson Scale of Physician Empathy (JSPE), the Maslach Burnout Inventory (MBI) and items addressing job satisfaction and occupational self-efficacy. The mean JSPE score of all final-year students was 113.25 ± 10.21 (20=lowest possible empathy score, 140=highest possible empathy score). Based on the three dimensions of burnout, the students fell in the moderate burnout category in all subscales of the MBI. There was an association between a lower empathy score and a higher burnout score. Also, the MBI correlated negatively with final-year students' job satisfaction and occupational self-efficacy. Despite high self-rated empathy scores, the experience of burnout symptoms in medical students may begin as early as their final year of studies, where higher levels of burnout are associated with lower self-rated empathy scores. The number of final-year medical students affected by clinically significant burnout (up to 20 %) was just as high as among practicing physicians. Female students were found to be particularly affected. Given the rising numbers of female graduates, this shows that urgent action is required.

Sexual Function and Depressive Symptoms among Male North American Medical Students

The role of sexuality as an association of medical student well-being has not been extensively studied. We explored the relationship between depressive symptoms, sexuality, and sexual dysfunction in male North American medical students. North American medical students were invited to participate in an Internet-based survey. The Center for Epidemiological Studies Depression Scale (CES-D) was utilized to screen for depressive symptoms. Subjects completed an ethnodemographic survey, a sexuality survey, and instruments for the quantification of anxiety, sexuality, and psychosocial function. Descriptive statistics, odds ratios (ORs), and logistic regression were used to analyze our data. There were 844 male subjects with complete data on the CES-D and the Spielberger State-Trait Anxiety Index. Depressive symptoms (CES-D ≥ 16) were present in 37% of respondents and were more common in subjects with greater levels of anxiety. Subjects who were in sexual relationships and/or had frequent sexual activity were less likely to be depressed compared to other subjects. Erectile dysfunction (ED) was associated with significantly greater likelihood of depressive symptoms (OR 2.90 and 9.27 for depressive symptoms in men with mild or moderate/severe ED relative to men without ED, P < 0.01). After adjusting for ethnodemographic and sexual history factors, ED remained significantly positively associated with depressive symptoms (OR 2.87 and 6.59 for depressive symptoms in men with mild or moderate/severe ED relative to men without ED after adjustment, P ≤ 0.01). Inclusion of data related to psychosocial/relationship factors in the multivariate model eliminated the significant association between ED and depressive symptoms (OR 1.59 and 2.29 for depressive symptoms in men with mild or moderate/severe ED relative to men without ED after adjustment with the Self-Esteem and Relationship quality instrument, P > 0.05), suggesting that psychosocial factors were more strongly associated with depressive symptoms than erectile function. Healthy sexuality and relationships may be protective against depressive symptoms in medical students. Attention to these factors may enhance medical student well-being.

Depression in Medical Students: Gene-Environment Interactions

This study investigated the interaction of genetic, environmental, and psychological factors in predicting depression and anxiety symptoms in medical students. First-year medical students (n = 141) completed measures of anxiety, depression, hope, and spiritual meaning at three time points during the first year. Buccal samples were utilized to genotype each individual at the s/l variant in the promoter region of the serotonin transporter gene (5-HTTLPR). A subset (n = 91) completed a measure of recent stressors. Mean levels of depression increased during year one of medical school. Presence of the s/s genotype in the promoter region of the 5-HTT gene was associated with greater increases in depression, but only in association with higher numbers of recent stressors. Spiritual meaning and hope were found to counteract genetic susceptibility to stress-related depressive symptoms in the more vulnerable s/s group.

Factors associated with depressive symptoms in a sample of Brazilian medical students

OBJECTIVES: 1 - Verify the prevalence of depressive symptoms in first to fourth-year medical students using the Beck Depression Inventory (BDI). 2 - Establish correlations between target factors and higher or lower BDI scores. 3 - Investigate the relationship between the prevalence of depressive symptoms and the demand for psychological care offered by the Centro Universitário Lusíada. METHOD: Cross-sectional study of 290 first to fourth-year medical students; implementation of the BDI, socio-demographic survey, and evaluation of satisfaction with progress. RESULTS: The study sample was 59% female and 41% male. Mean BDI was 6.3 (SD 5.8). Overall prevalence of depressive symptoms was 23.1%. The following associations were statistically significant (p&lt;0.05): among students for whom the course failed to meet original expectations, who were dissatisfied with the course, or who came from the interior of the State (20.5%, 12.5%, and 24.4% of the total sample, respectively), for 40%, 36.1% and 36.4%, respectively, the BDI was consistent with some degree of depression. CONCLUSION: The study showed that there is higher prevalence of depressive symptoms in medical students than in the general population

Depressive Symptoms in Medical Students and Residents: A Multischool Study

This multisite, anonymous study assessed depressive symptoms and suicidal ideation in medical trainees (medical students and residents). In 2003-2004, the authors surveyed medical trainees at six sites. Surveys included content from the Center for Epidemiologic Studies-Depression scale (CES-D) and the Primary Care Evaluation of Mental Disorders (PRIME-MD) (measures for depression), as well as demographic content. Rates of reported major and minor depression and of suicidal ideation were calculated. Responses were compared by level of training, gender, and ethnicity. More than 2,000 medical students and residents responded, for an overall response rate of 89%. Based on categorical levels from the CES-D, 12% had probable major depression and 9.2% had probable mild/moderate depression. There were significant differences in depression by trainee level, with a higher rate among medical students; and gender, with higher rates among women (chi2 = 10.42, df = 2, and P = .005 and chi2 = 22.1, df = 2, and P < .001, respectively). Nearly 6% reported suicidal ideation, with differences by trainee level, with a higher rate among medical students; and ethnicity, with the highest rate among black/African American respondents and the lowest among Caucasian respondents (chi2 = 5.19, df = 1, and P = .023 and chi2 = 10.42, df = 3, and P = .015, respectively). Depression remains a significant issue for medical trainees. This study highlights the importance of ongoing mental health assessment, treatment, and education for medical trainees.

The characteristics of depressive symptoms in medical students during medical education and training: a cross-sectional study

BackgroundMedical education and training can contribute to the development of depressive symptoms that might lead to possible academic and professional consequences. We aimed to investigate the characteristics of depressive symptoms among 481 medical students (79.8% of the total who matriculated).MethodsThe Beck Depression Inventory (BDI) and cluster analyses were used in order to better describe the characteristics of depressive symptoms. Medical education and training in Brazil is divided into basic (1st and 2nd years), intermediate (3rd and 4th years), and internship (5th and 6th years) periods. The study organized each item from the BDI into the following three clusters: affective, cognitive, and somatic. Statistical analyses were performed using analysis of variance (ANOVA) with post-hoc Tukey corrected for multiple comparisons.ResultsThere were 184 (38.2%) students with depressive symptoms (BDI > 9). The internship period resulted in the highest BDI scores in comparison to both the basic (p < .001) and intermediate (p < .001) periods. Affective, cognitive, and somatic clusters were significantly higher in the internship period. An exploratory analysis of possible risk factors showed that females (p = .020) not having a parent who practiced medicine (p = .016), and the internship period (p = .001) were factors for the development of depressive symptoms.ConclusionThere is a high prevalence towards depressive symptoms among medical students, particularly females, in the internship level, mainly involving the somatic and affective clusters, and not having a parent who practiced medicine. The active assessment of these students in evaluating their depressive symptoms is important in order to prevent the development of co-morbidities and suicide risk.

Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study

BackgroundMental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year.MethodsQuestionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i) and Performance-based self-esteem (PBSE-scale) were assessed at first year, Study conditions (HESI), Burnout (OLBI), Depression (MDI) at 1st and 3rd years. Diagnostic interviews (MINI) were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender.Results98 (77%) responded on both occasions, 80 (63%) of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27%) had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis.ConclusionPsychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students should be encouraged to seek help and adequate facilities should be available.

Anxiety symptoms and perceived performance in medical students

Medical students represent a highly educated population under significant pressures. During the transition to clinical settings in the third year, they may experience a loss of external control and may counter this with an increase in obsessionality and/or other anxiety symptoms. Our study examines the phenomenology of obsessive-compulsive and other anxiety symptoms in medical students at two U.S. medical schools and relates these symptoms to self-perception of performance. Subjects anonymously completed a battery of questionnaires regarding obsessive-compulsive symptoms, attentional problems, anxiety symptoms, depressive symptoms, and perceived performance in medical school. A factor analysis of obsessional symptoms showed four primary factors: checking/doubts, contamination, long time/detail, and unpleasant thoughts/worries. These four factors were similar to those found among college students and other nonclinical populations. Anxiety, attentional, and depressive symptoms were highest in the third-year medical students. In contrast, obsessional symptoms were highest in the first-year students and lower for subsequent years. Perceived performance was not significantly correlated with obsessionality, although lower perceived performance was associated with higher levels of anxiety and depressive symptoms. Students with lower perceived performance in medical school were significantly more likely to be female, depressed, or older. The progressive decrease in number of obsessional symptoms across years and the lack of correlation with perceived performance suggest that these symptoms may be developmentally appropriate, and perhaps adaptive. In contrast, other anxiety symptoms appear to be maladaptive responses to external stressors.

Depressive symptoms in medical students and physicians

Depression is one of the most commom and disabliding mental disorders with 15-25% life time prevalence.