Publicado

2024-10-07

Symptoms of anxiety and depression and reasons for seeking mental health services among medical students from São Paulo, Brazil

Síntomas de ansiedad y depresión y razones para buscar servicios en salud mental en estudiantes de medicina de São Paulo, Brasil

Palabras clave:

Medical Student, Depression, Anxiety, Emotional Support, Social Support (en)
Estudiante de medicina, Depresión, Ansiedad, Soporte emocional, Apoyo social (es)

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Autores/as

  • Vitor Miyashiro-Arias da Silva University of Sao Paulo - Escuela de Medicina - Oficina de Pregrado - Sao Paulo - Brasil. https://orcid.org/0000-0001-5218-7194
  • Vitor Silva-Mendonça University of Sao Paulo - Escuela de Medicina - Departamento de Medicina Interna - Sao Paulo - Brasil. | Universidad de Sao Paulo - Escuela de Medicina - Centro para el the Desarrollo de Educación Médica (CEDEM) - Sao Paulo - Brasil. https://orcid.org/0000-0001-9651-138X

Introduction: Medical students are at high risk of developing risk factors for mental disorders.

Objectives: To determine the prevalence of symptoms of anxiety and depression among second year medical students of a university in São Paulo, Brazil, and to identify their reasons for seeking mental health services.

Materials and methods: Cross-sectional mixed-methods study conducted in 74 second year medical students, who completed an online survey that included an ad hoc questionnaire, the validated versions for Brazilian population of the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI), and open-ended questions about the reasons for seeking and using the mental health services offered by the medical school and their motivation to continue with their medical training. A qualitative analysis of the responses to the open-ended questions was performed.

Results: Mean scores in the Trait-Anxiety and State-Anxiety scales were 47.52 and 48.17 (moderate anxiety), while the mean score in the BDI was 11.67 (mild depression). Transgender students and those who were beneficiary of a quota system or social and/or economic support program had higher scores in the State-Anxiety scale (53.00 and 49.32 points; high anxiety) and in the BDI (12.00 and 13.99). Furthermore, 36.48% of the students had used the mental health services offered by the school of medicine and 85.13% reported having sought emotional support from friends and the medical school. Answers to the open-ended questions revealed that the main reasons that led students to seek the school’s mental health service were anxiety, depression, stress, and attention deficit.

Conclusion: In the present study, second year medical students had mild depression symptoms, as well as moderate levels of State and Trait anxiety. In addition, the main reasons for seeking and using the mental health services offered by the medical school were anxiety, depression stress, and academic orientation (attention deficit).

Introducción. Los estudiantes de medicina tienen un alto riesgo de desarrollar factores de riesgo de trastornos mentales.

Objetivos. Determinar la prevalencia de síntomas tanto de ansiedad como de depresión en estudiantes de segundo año de medicina de una universidad de São Paulo, Brasil, e identificar sus razones para buscar servicios de salud mental.

Materiales y métodos. Estudio transversal de métodos mixtos realizado en 74 estudiantes de segundo año de medicina. Los estudiantes completaron una encuesta en línea que incluía un cuestionario ad hoc, las versiones validadas para población brasileña del Beck Depression Inventory (BDI) y el State-Trait Anxiety Inventory (STAI), y preguntas abiertas sobre las razones para buscar y utilizar los servicios de salud mental ofrecidos por la Facultad de Medicina y sobre su motivación para continuar su formación médica. Se realizó un análisis cualitativo de las respuestas a las preguntas abiertas.

Resultados. Las puntuaciones promedio en las escalas de Ansiedad-Rasgo y Ansiedad-estado fueron de 47.52 y 48.17 (ansiedad moderada), mientras que la puntuación promedio en el BDI fue 11.67 (depresión leve). Los estudiantes transexuales y los que eran beneficiarios de un sistema de cuotas o de un programa de apoyo social y/o económico obtuvieron puntuaciones más altas en la escala Ansiedad-Estado (53.00 y 49.32 puntos; ansiedad alta) y en el BDI (12.00 y 13.99). Además, 36.48% de los estudiantes había utilizado los servicios de salud mental ofrecidos por la Facultad de Medicina y 85.13% declaró haber buscado apoyo emocional en amigos de la facultad. Las respuestas a las preguntas abiertas revelaron que las principales razones que llevaron a los estudiantes a buscar el servicio de salud mental de la facultad fueron la ansiedad, la depresión, el estrés y el déficit de atención.

Conclusiones. En el presente estudio, los estudiantes de segundo año de medicina presentaron síntomas leves de depresión y niveles moderados de ansiedad Estado y Riesgo. Además, las principales razones para buscar los servicios de salud mental ofrecidos por la facultad de medicina fueron la ansiedad, la depresión, el estrés y la orientación académica (déficit de atención).

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Citas

1. McKenna L, Robinson E, Penman J, Hills D. Factors impacting on psychological wellbeing of international students in the health professions: A scoping review. Inter J Nurs Stud. 2017;74:85-94. https://doi.org/gcnjb6.

2. King L, Yuan JH, Li H, Do V. Canadian Federation of Medical Students’ response to “The alarming situation of medical student mental health”. Can Med Educ J. 2021;12(3):182-3. https://doi.org/nd7w.

3. Brenneisen Mayer F, Souza Santos I, Silveira PS, Itaqui Lopes MH, de Souza AR, Campos EP, et al. Factors associated to depression and anxiety in medical students: a multicenter study. BMC Med Educ. 2016;16(1):282-90. https://doi.org/f88wrt.

4. Karp JF, Levine AS. Mental Health Services for Medical Students - Time to Act. N Engl J Med. 2018;379(13):1196-8. https://doi.org/gm55j9.

5. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81(4):354-73. https://doi.org/fq39xg.

6. Rotenstein LS, Ramos MA, Torre M, Segal B, Peluso MJ, Guille C, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016;316(21):2214-36. https://doi.org/gdsnfm.

7. Dyrbye LN, Thomas MR, Eacker A, Harper W, Massie FS., Power DV, et al. Race, ethnicity, and medical student well-being in the United States. Arch Intern Med. 2007;167(19):2103-9. https://doi.org/dsv3cg.

8. Haldorsen H, Bak NH, Dissing A, Petersson B. Stress and symptoms of depression among medical students at the University of Copenhagen. Scand J Public Health. 2014;42(1):89-95. https://doi.org/f5stjf.

9. Bassols AM, Okabayashi LS, Silva AB, Carneiro BB, Feijó F, Guimarães GC, et al. First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms? Braz J Psychiatry. 2014;36(3):233-40. https://doi.org/f6dshh.

10. Smith CK, Peterson DF, Degenhardt BF, Johnson JC. Depression, anxiety, and perceived hassles among entering medical students. Psychol Health Med. 2007;12(1):31-9. https://doi.org/bk3v68.

11. Ungar P, Schindler AK, Polujanski S, Rotthoff T. Online programs to strengthen the mental health of medical students: A systematic review of the literature. Med Educ Online. 2022;27(1):2082909. https://doi.org/nd7x.

12. Chew-Graham CA, Rogers A, Yassin N. ‘I wouldn’t want it on my CV or their records’: Medical students’ experiences of help-seeking for mental health problems. Med Educ. 2003;37(10):873-80. https://doi.org/bsgm37.

13. Storrie K, Ahern K, Tuckett A. A systematic review: Stu- dents with mental health problems-a growing problem. Int J Nurs Pract. 2010;16(1):1-6. https://doi.org/dkb7m6.

14. Zhang MWB, Lim RBC, Lee C, Ho RCM. Prevalence of Internet Addiction in Medical Students: a Meta-analysis. Acad Psychiatry. 2018;42(1):88-93. https://doi.org/gczmbd.

15. Puthran R, Zhang MW, Tam WW, Ho RC. Prevalence of depression amongst medical students: a meta-analysis. Med Educ. 2016;50(4):456-68. https://doi.org/gdsnfq.

16. Center C, Davis M, Detre T, Ford DE, Hansbrough W, Hendin H, et al. Confronting depression and suicide in physicians: A consensus statement. JAMA. 2003;289(23):3161-6. https://doi.org/dbc3nh.

17. Royal College of Psychiatrists. Mental health of students in higher education - College report CR166. London: Royal College of Psychiatrists; 2011.

18. Biaggio AMB, Natalicio L. Manual para o Inventário de Ansiedade Traço-Estado (IDATE). Rio de Janeiro: Centro Editor de Psicologia Aplicada-CEPA; 1979.

19. Gorenstein C, Andrade L. Validation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Braz J Med Biol Res. 1996;29(4):453-7.

20. Denzin NK, Lincoln YS (eds.). The Landscape of Qualitative Research. 4th ed. Thousand Oaks, CA: SAGE Publications, Inc; 2013.

21. Giorgi A, Sousa D. Método fenomenológico de investigação em psicologia. Lisbon: Fim de Século; 2010.

22. World Medical Association (WMA). WMA Declaration of Helsinki - Ethical principles for medical research involving human subjects. Fortaleza: 64th WMA General Assembly; 2013 [cited 2022 Mar 21]. Available from: https://bit.ly/3sCX2Ji.

23. Shao R, He P, Ling B, Tan L, Xu L, Hou Y, et al. Prevalence of depression and anxiety and correlations between depression, anxiety, family functioning, social support and coping styles among Chinese medical students. BMC Psychol. 2020;8(1):38. https://doi.org/gjv8wx.

24. Quek TT, Tam WW, Tran BX, Zhang M, Zhang Z, Ho CS, et al. The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis. Int J Environ Res Public Health. 2019;16(15):2735. https://doi.org/ggrdd4.

25. Dyrbye LN, Sciolla AF, Dekhtyar M, Rajasekaran S, Allgood JA, Rea M, et al. Medical School Strategies to Address Student Well-Being: A National Survey. Acad Med. 2019;94(6):861-8. https://doi.org/gf89rh.

26. Fernandes CM, Silva VMA, Siqueira MAM, Tempski PZ, Mendonca VS, Martins MA. Factors influencing mental health and academic performance of medical students: a descriptive study. J Under Med Res. 2022;4(2):11-9.

27. Marta OFD, Kuo SY, Bloomfield J, Lee HC, Ruhyanuddin F, Poynor MY, et al. Gender differences in the relationships between sleep disturbances and academic performance among nursing students: A cross-sectional study. Nurse Educ Today. 2020;85:104270. https://doi.org/ggzc22.

28. Fenaughty J, Lucassen MFG, Clark T, Denny S. Factors Associated with Academic Achievement for Sexual and Gender Minority and Heterosexual Cisgender Students: Implications from a Nationally Representative Study. J Youth Adolesc. 2019;48(10):1883-98. https://doi.org/njmn.

29. Baldassin S, Alves TC, de Andrade AG, Nogueira Martins LA. The characteristics of depressive symptoms in medical students during medical education and training: a cross-sectional study. BMC Med Educ. 2008;8:60. https://doi.org/bfbqmm.

30. Stubbing EA, Helmich E, Cleland J. Medical student views of and responses to expectations of professionalism . Med Educ. 2019;53(10):1025-36. https://doi.org/ggjpgs.

31. Weurlander M, Lonn A, Seeberger A, Brobeger E, Hult H, Wernerson A. How do medical and nursing students experience emotional challenges during clinical placements? Int J Med Educ. 2018;9:74-82. https://doi.org/gc8bkn.

32. Wasson LT, Cusmano A, Meli L, Louh I, Falzon L, Hampsey M, et al. Association Between Learning Environment Interventions and Medical Student Well-Being: A Systematic Review. JAMA. 2016;316(21):2237-52. https://doi.org/gjwcc7.

33. Slavin SJ. Medical Student Mental Health: Culture, Environment, and the Need for Change. JAMA. 2016;316(21):2195-6. https://doi.org/nd8k.

34. de Vibe M, Solhaug I, Rosenvinge JH, Tyssen R, Hanley A, Garland E. Six-year positive effects of a mindfulness-based intervention on mindfulness, coping and well-being in medical and psychology students: results from a randomized controlled trial. PLoS One. 2018;13(4):e0196053. https://doi.org/gdfhd3.

35. Peleias M, Tempski P, Paro HB, Perotta B, Mayer FB, Enns SC, et al. Leisure time physical activity and quality of life in medical students: results from a multicentre study. BMJ Open Sport Exerc Med. 2017;3(1):e000213.

36. Mammen G, Faulkner G. Physical activity and the prevention of depression: a systematic review of prospective studies. Amer J Preven Med. 2013;45:649-57. https://doi.org/gbqq39.

37. Jacka FN, Berk M. Depression, diet and exercise. Med J Aust. 2013;199:S21-3. https://doi.org/nd8n.

38. Lobelo F, Duperly J, Frank E. Physical activity habits of doctors and medical students influence their counselling practices. Br J Sports Med. 2009;43(2):89-92. https://doi.org/b4bz5p.

39. Stanford FC, Durkin MW, Stallworth JR, Powell CK, Poston MB, Blair SN. Factors that influence physicians’ and medical students’ confidence in counseling patients about physical activity. J Prim Prev. 2014;35(3):193-201. https://doi.org/f5zt2j.

40. Patel RS, Tarrant C, Bonas S, Shaw RL. Medical students’ personal experience of high-stakes failure: case studies using interpretative phenomenological analysis. BMC Med Educ. 2015;15:86. https://doi.org/f7trsk.

41. Tawanwongsri W, Phenwan T. Reflective and feedback performances on Thai medical students’ patient history-taking skills. BMC Med Educ. 2019;19(1):141. https://doi.org/jdzc.

42. Siqueira MAM, Gonçalves JP, Mendonça VS, Kobayasi R, Costa FA, Tempski P, et al. Relationship between metacognitive awareness and motivation to learn in medical students. BMC Med Educ. 2020;20(1):393. https://doi.org/gp2m5n.

43. Goel S, Angeli F, Dhirar N, Singla N, Ruwaard D. What motivates medical students to select medical studies: a systematic literature review. BMC Med Educ. 2018;18(1):16. https://doi.org/gcwfvg.

44. Walkiewicz M, Guziak M. Availability of psychological support for medical students in Poland. Int J Occup Med Envirom Health. 2021;34(1):87-99. https://doi.org/gkgjwv.

45. Shapiro J, Galowitz P. Peer Support for Clinicians: A Programmatic Approach. Acad Med. 2016;91(9):1200-4. https://doi.org/f89n92.

46. Guckian J, Utukuri M, Asif A, Burton O, Adeyoju J, Oumeziane A, et al. Social media in undergraduate medical education: A systematic review. Med Educ. 2021;55(11):1227-41. https://doi.org/gj2xr9.

47. Plackett R, Blyth A, Schartau P. The Impact of Social Media Use Interventions on Mental Well-Being: Systematic Review. J Med Internet Res. 2023;25:e44922. https://doi.org/gtt434.

48. Moir F, Henning M, Hassed C, Moyes SA, Elley R. A Peer-Support and Mindfulness Program to Improve the Mental Health of Medical Students. Teach Learn Med. 2016;28(3):293-302. https://doi.org/gfzqt3.

49. Fröjd S, Marttunen M, Pelkonen M, von der Pahlen B, Kaltiala-Heino R. Adult and peer involvement in help- seeking for depression in adolescent population: A two-year follow-up in Finland. Soc Psychiatry Psychiatr Epidemiol. 2007;42(12):945-52. https://doi.org/cwc427.

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