Common mental disorders in medical students: prevalence and associated factors

This study aimed to estimate the prevalence of Common Mental Disorders (CMD) among medical students and identify the factors associated with this disorder.

Methods:

A cross-sectional study was conducted with all medical students, enrolled from the 1^st to the 8^th semesters in a public university, in the state of Bahia, Brazil. We used a self-administered questionnaire that included SRQ-20 (Self-Reporting Questionnaire), IPAQ (International Physical Activity Questionnaire - long form) and sociodemographic, school, occupational and health variables. The multivariate analysis was performed using COX Regression for cross-sectional studies.

Results:

We evaluated 556 students (289 women and 267 men), representing 90.2% of the target population. The overall prevalence of CMD found was 53.3%, 78.8% of students reported feeling nervous, 56.8% experienced poor sleep quality, and 6.5% had suicidal thoughts. After the multivariate analysis, the following factors maintained their association with a higher prevalence of CMD: having no previous undergraduate degree (PR=1.49), having an unfavorable self-perception of health (PR=1.53), not having failed disciplines (PR=1.20), and being a smoker (PR=1.19). Physical activity did not have a protective effect on CMD in this study.

Conclusions:

The prevalence of CMD among medical students was high and mainly associated with an unfavorable self-perception of health. The results highlight the need for strengthening institutional policies aimed at preventing psychological distress among students.

Keywords:
Mental disorders; medical students; mental health; physical exercise; cross-sectional studies

Questions	Positive answers
Questions	n	(%)	% Women	% Men
Depressive-anxious mood
Do you feel nervous, tense or worried?	438	78.8	83.7	73.4
Are you easily startled?	159	28.6	38.8	17.6
Have you cried more than usual?	130	23.4	32.5	13.5
Have you felt sad lately?	250	45.0	49.5	40.1
Somatic symptoms
Do you have frequent headaches?	180	32.4	40.5	23.6
Lack of appetite?	83	14.9	17.3	12.4
Do you sleep poorly?	316	56.8	57.1	56.6
Do you have hand tremors?	104	18.7	17.0	20.0
Do you have poor digestion?	160	28.8	33.6	23.6
Do you have unpleasant sensations in your stomach?	211	37.9	43.9	31.5
Decrease of vital energy
Do you have difficulty thinking clearly?	187	33.6	36.7	30.3
Do you find it difficult to carry out your daily activities with satisfaction?	310	55.8	56.4	55.1
Do you have difficulties to make decisions?	267	48.0	52.9	42.7
Do you feel tired all the time?	343	61.7	69.9	52.8
Do you get tired easily?	313	56.3	64.7	47.2
Do you have difficulties at work?	188	33.8	34.9	32.6
Depressive thoughts
Are you unable to play a useful role in your life?	74	13.3	13.5	13.1
Have you lost interest in things?	201	36.2	37.4	34.8
Do you feel like a useless, worthless person?	94	16.9	18.0	15.7
Have you had thoughts of ending your life?	36	6.5	7.3	5.6

			Common Mental Disorder (present)
Variables	n	%	(%)	Raw RP	Adjusted RP
Gender
Female	289	51.8	54.0	1.03	1.12
Male	267	48.1	52.4	1	1
Age
≤23 years	288	52.5	53.1	1.01	0.90
>23 years	261	47.5	52.5	1	1
Ethnicity/Skin Color
Black/Indigenous	77	13.8	57.1	1.06	1.15
Brown	292	52.7	51.7	0.96	1.05
White/yellow	185	33.4	54.1	1	1
Previous Degree
No	381	69.3	56.4	1.24	1.49
Yes	169	30.7	45.6	1	1
Semester
1^st to 5^th	335	60.3	53.1	1.07	1.12
7^th	75	13.5	60.8	1.23	1.17
6^th and 8^th	144	25.9	49.3	1	1
Failing grades
Yes	42	7.6	52.4	1	1
No	513	92.4	53.4	1.02	1.20
Self-reported health
Favorable	424	76.3	46.0	1	1
Unfavorable	132	23.7	76.5	1.66	1.53
Physical activity by domain
At work
Active	102	19.5	63.7	1	1
Irregularly active	422	80.5	51.9	0.81	0.83
Going to work
Active	170	33.4	54.7	1	1
Irregularly active	339	66.6	53.1	0.97	1.02
Household chores
Active	144	28.0	57.6	1	1
Irregularly active	371	72.0	52.3	0.90	0.89
Leisure time
Active	267	50.8	52.8	1	1
Irregularly active	259	49.2	54.1	1.02	1.02
Tobacco Use
Yes	27	4.9	66.7	1.27	1.19
No	527	95.1	52.3	1	1

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