Medical student depression and its correlates across three international medical schools

查看全文 作　　者：Jessica A [1]Gold;Xinran [2]Hu;Gan [3]Huang;Wan-Zhen [3]Li;Yi-Fan [3]Wu;Shan [3]Gao;Zhe-Ning [3]Liu;Mickey [4]Trockel;Wan-Zhen [5]Li;Yi-Fan [5]Wu;Shan [5]Gao;Zhe-Ning [5]Liu;Robert M [2]Rohrbaugh;Kirsten M [2]Wilkins

机构地区：[1]Department of Psychiatry, Washington University in St Louis;[2]Department of Psychiatry, Yale University;[3]Central South University Xiangya School of Medicine;[4]Department of Psychiatry, Stanford University;[5]不详

出　　处：《World Journal of Psychiatry》索引2019年第9卷第4期,共13页

摘　　要：BACKGROUND Medical students have high rates of depression, anxiety, and burnout that have been found to affect their empathy, professional behaviors, and performance as a physician. While studies have examined predictors for burnout and depression in the United States (US), no study, to our knowledge, has compared depression in medical students cross-culturally, or has attempted to examine the effect of factors influencing rates including burnout, exercise, stress, unmet mental health needs, and region. AIM To examine rates of depression in three international cohorts of medical students, and determine variables that may explain these differences. METHODS Convenience samples of medical students from three countries (US, China, and a Middle Eastern country whose name remains anonymous per request from the school) were surveyed in this observational study. Using the Patient Health Questionnaire-2 (PHQ-2) and a modified Maslach Burnout Inventory, depression and burnout were examined among medical students from the three cohorts (n = 473). Chi-square test and analysis of variance were used to examine differences in demographics, behavioral, and psychological variables across these three schools to identify potentially confounding descriptive characteristics. Analysis of covariance compared depression and the emotional exhaustion component of burnout identified through Principal Component Analysis across countries. Multiple linear regression was used to analyze the impact of demographic, behavioral, and psychological variables on screening positive for depression. RESULTS Medical students from the Middle Eastern country had the highest rates of positive depression screens (41.1%), defined as a PHQ-2 score of ≥ 3, followed by China (14.1 %), and then the US (3.8%). More students in the Middle Eastern school had unmet mental health needs (50.8%) than at the medical school in China (34.8%) or the school in the US (32.8%)(Pearson chi-square significance < 0.05). Thus, PHQ-2 scores were adjusted for unmet mental health needs;however, the Middle Eastern country continued to have the highest depression. Adjusting for PHQ-2 score, medical students from the US scored the highest on emotional exhaustion (a measure of burnout). Demographic variables did not significantly predict medical student depression;however, lack of exercise, unmet mental health needs, stress, and emotional exhaustion predicted nearly half of depression in these cohorts. In comparison to the US, coming from the Middle Eastern country and China predicted higher levels of depression. CONCLUSION Depression rates differ in three international cohorts of medical students. Measured factors contributed to some observed differences. Identifying sitespecific prevention and intervention strategies in medical student mental health is warranted. 关键词：Medical students WELLNESS BURNOUT DEPRESSION INTERNATIONAL

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Medical student depression and its correlates across three international medical schools

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