To assess the prevalence of psychological symptoms (depression, anxiety) among Chinese medical students and to find the possible relationships between psychological symptoms and social relationships.
Methods:
A sample of 10,140 medical students was investigated with a structured questionnaire, that included the Beck Depression Inventory, Beck Anxiety Inventory, Social Support Rating Scale, and Family APGAR Index (adaptability, partnership, growth, affection, resolve).
Results:
The present study revealed that 16.8% of the medical students suffered from depressive symptoms and 14.1% from anxiety symptoms. Female students were more likely to have anxiety, the second-year students had higher levels of psychological symptoms than the first-year students. Likewise, significant differences were found among college, satisfaction of specialty, and economic condition of the family in anxiety and depression symptoms. Social support, family function, and all dimensions were significantly negatively associated with depression and anxiety symptoms. Multivariable ordinal logistic regression showed that less social support, poor family function, the second-year students, and unsatisfactory specialty were associated with more psychological symptoms, after adjusting the effects of sex, age, and college.
Conclusions:
Medical students have a relatively high level of depression and anxiety symptoms. These findings support the hypothesis that if medical students are better supported and cared for, negative psychosocial consequences might be prevented or at least reduced.
SaslowG. Psychiatric problems of medical students. Journal of Medical Education1956; 31: 27–33.
2.
AdewuyaAOOlaBAAlobaOOMapayiBMOginniOO. Depression amongst Nigerian university students. Prevalence and sociodemographic correlates. Social Psychiatry and Psychiatric Epidemiology2006; 41: 674–678.
3.
ChanDW. Depressive symptoms and depressed mood among Chinese medical students in Hong Kong. Comprehensive Psychiatry1991; 32: 170–180.
4.
GuthrieEABlackDShawCMHamiltonJCreedGHTomensonB. Embarking upon a medical career: Psychological morbidity in first year medical students. Medical Education1995; 29: 337–341.
5.
MillerPMSurteesPG. Psychological symptoms and their course in first-year medical students as assessed by the Interval General Health Questionnaire (I-GHQ). The British Journal of Psychiatry1991; 159: 199–207.
6.
DahlinMJoneborgNRunesonB. Stress and depression among medical students: A cross-sectional study. Medical Education2005; 39: 594–604.
7.
JeongYKimJYRyuJSLeeKEHaEHParkH. The associations between social support, health-related behaviors, socioeconomic status and depression in medical students. Epidemiology and Health2010; 32: e2010009.
8.
LindemanSLääräEVuoriELönnqvistJ. Suicides among physicians, engineers, and teachers: The prevalence of reported depression, admissions to hospital and contributory causes of death. Acta Psychiatrica Scandinavica1997; 96: 68–71.
9.
CenterCDavisMDetreT. Confronting depression and suicide in physicians. The Journal of the American Medical Association2003; 289: 3161–3166.
10.
TjiaJGivensJLSheaJA. Factors associated with undertreatment of medical student depression. Journal of American College Health2005; 53: 219–224.
11.
BallSBaxA. Self-care in medical education: Effectiveness of health-habits interventions for first-year medical students. Academic Medicine2002; 77: 911–917.
12.
ZailinawatiAHTengCLChungYCTeowTLLeePNJamohniKS. Daytime sleepiness and sleep quality among Malaysian medical students. The Medical Journal of Malaysia2009; 64: 108–110.
13.
TamakiTKaneitaYOhidaT. Prevalence of and factors associated with smoking among Japanese medical students. Journal of Epidemiology2010; 20: 339–345.
14.
AkvardarYDemiralYErgörGErgörABiliciMOzerAkil O. Substance use in a sample of Turkish medical students. Drug and Alcohol Dependence2003; 72: 117–121.
15.
Newbury-BirchDWhiteMKamaliF. Factors influencing alcohol and illicit drug use amongst medical students. Drug and Alcohol Dependence2000; 59: 125–130.
16.
AktekinMKaramanTSenolYYErdemSErenginHAkaydinM. Anxiety, depression and stressful life events among medical students: A prospective study in Antalya, Turkey. Medical Education2001; 35: 12–17.
17.
CohenSHobermanHM. Positive events and social support as buffers of life change stress. Journal of Applied Social Psychology1983; 13: 99–125.
18.
KatzJMonnierJLibetJShawDBeachSR. Individual and crossover effects of stress on adjustment in medical student marriages. Journal of Marital and Family Therapy2000; 26: 341–351.
19.
KjeldstadliKTyssenRFinsetA. Life satisfaction and resilience in medical school—A six-year longitudinal, nationwide and comparative study. BMC Medical Education2006; 6: 48.
20.
BeckASteerRGarbinM. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review1988; 8: 77–100.
21.
ShekDT. Reliability and factorial structure of the Chinese version of the Beck Depression Inventory. Journal of Clinical Psychology1990; 46: 35–43.
22.
ZhengYPLinKM. Comparison of the Chinese Depression Inventory and the Chinese version of the Beck Depression Inventory. Acta Psychiatrica Scandinavica1991; 84: 531–536.
23.
ZhengYPWeiLAGoaLGZhangGCWongCG. Applicability of the Chinese Beck Depression Inventory. Comprehensive Psychiatry1988; 29: 484–489.
24.
BeckATSteerRA. Beck Anxiety Inventory Manual. San Antonio, TX: The Psychological Corporation Harcourt Brace Jovanovich, Inc., 1990.
25.
ChengSWongK-WWongC-WWongK-C. A study of psychometric properties, normative scores and factor structure of Beck Anxiety Inventory Chinese version. Chinese Journal of Clinic Psychology (in Chinese) 2002; 10: 4–6.
26.
XiaoSY. The social support rate scale. Chinese Journal of Psychology (in Chinese) 1993; 7(Suppl): 42–46.
27.
SmilksteinG. The family APGAR: A proposal for a family function test and its use by physicians. The Journal of Family Practice1978; 6: 1231–1239.
28.
SmilksteinGAshworthCMontanoD. Validity and reliability of the family APGAR as a test of family function. The Journal of Family Practice1982; 15: 303–311.
29.
LvFZengGLiuSNZhongTLZhanZQ. A study on validity and reliability of the family APGAR. Chinese Journal of Public Health (in Chinese) 1999; 15: 987–988.
30.
ToewsJALockyerJMDobsonDJ. Analysis of stress levels among medical students, residents, and graduate students at four Canadian schools of medicine. Academic Medicine1997; 72: 997–1002.
31.
StewartSMBetsonCMarshallIWongCMLeePWLamTH. Stress and vulnerability in medical students. Medical Education1995; 29: 119–127.
32.
VitalianoPPMaiuroRDRussoJMitchellES. Medical student distress. A longitudinal study. The Journal of Nervous and Mental Disease1989; 177: 70–76.
33.
BlazerDGKesslerRCMcGonagleKASwartzMS. The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. The American Journal of Psychiatry1994; 151: 979–986.
34.
KesslerRCBerglunPDemlerO. The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). The Journal of the American Medical Association2003; 289: 3095–3105.
35.
RegierDAFarmerMERaeDS. One-month prevalence of mental disorders in the United States and sociodemographic characteristics: The Epidemiologic Catchment Area study. Acta Psychiatrica Scandinavica1993; 88: 35–47.
36.
RegierDABoydJHBurkeJDJr. One-month prevalence of mental disorders in the United States. Based on five Epidemiologic Catchment Area sites. Archives of General Psychiatry1988; 45: 977–986.
37.
DyrbyeLNThomasMRShanafeltTD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Academic Medicine2006; 81: 354–373.
38.
SchwenkTLDavisLWimsattLA. Depression, stigma, and suicidal ideation in medical students. The Journal of the American Medical Association2010; 304: 1181–1190.
39.
DongZhangXiuyanLi. The correlation between coping style and anxiety of medical students. China Journal of Health Psychology (in Chinese) 2009; 17: 6–8.
40.
LiaoYKnoesenNPCastleDJ. Symptoms of disordered eating, body shape, and mood concerns in male and female Chinese medical students. Comprehensive Psychiatry2010; 51: 516–523.
41.
MoakZBAgrawalA. The association between perceived interpersonal social support and physical and mental health: Results from the National Epidemiological Survey on Alcohol and Related Conditions. Journal of Public Health (Oxf)2010; 32: 191–201.
42.
FranksPCampbellTLShieldsCG. Social relationships and health: The relative roles of family functioning and social support. Social Science & Medicine1992; 34: 779–788.
43.
BayramNBilgelN. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Social Psychiatry and Psychiatric Epidemiology2008; 43: 667–672.
44.
BostanciMOzdelOOguzhanogluNK. Depressive symptomatology among university students in Denizli, Turkey: Prevalence and sociodemographic correlates. Croatian Medical Journal2005; 46: 96–100.
45.
LorantVDeliègeDEatonWRobertAPhilippotPAnsseauM. Socioeconomic inequalities in depression: A meta-analysis. America Journal of Epidemiology2003; 157: 98–112.
46.
RohMSJeonHJKimHHanSKHahmBJ. The prevalence and impact of depression among medical students: A nationwide cross-sectional study in South Korea. Academic Medicine2010; 85: 1384–1390.
47.
LiYingSatoY. Relationship between socioeconomic factors, health behaviors, and mental health among university students of Heilongjiang province in China. School Health2008; 4: 9–15.
48.
MendelsonTKubzanskyLDDattaGDBukaSL. Relation of female gender and low socioeconomic status to internalizing symptoms among adolescents: A case of double jeopardy?Social Science & Medicine2008; 66: 1284–1296.
49.
LinHCTangTCYenJY. Depression and its association with self-esteem, family, peer and school factors in a population of 9586 adolescents in southern Taiwan. Psychiatry and Clinical Neurosciences2008; 62: 412–420.
50.
MonroeSMSteinerSC. Social support and psychopathology: Interrelations with preexisting disorder, stress, and personality. Journal of Abnormal Psychology1986; 95: 29–39.
