Viral diseases have been a severe problem at the global level, gaining more or less publicity from time to time. At the end of 2019, the world witnessed alarming news about the spread of the coronavirus disease (COVID-19) across the globe. The speed of spread and severity of complications from COVID-19 have made it a global threat. Researchers indicate that the COVID-19 pandemic may cause mental trauma globally .
That is why the mental health of doctors and medical students is becoming increasingly important. At the same time, it becomes clear that this area needs further research and interventions. In 1948, WHO defined health as complete physical, mental, and social well-being. And if, for physical well-being, society can get help by turning to somatic profile doctors, then seeking help, in case of mental illness, is still considered a stigma in society. Mental illness is highly stigmatized, and it is becoming increasingly clear that this stigma is widespread within the general population and among medical professionals and students [3,4].
Previous literature dating back to 2019 suggests that the process and conditions of medical university education represent a set of stressors that may contribute to the development of mental illness[5,6,7]. Despite the increased interest of the scientific community in this topic, unified protocols of prevention and care to overcome these problems still need to be developed. With the beginning of the pandemic, the question of the mental health of medical students arose repeatedly and urgently. Thus, further research on the mental health of medical students and the systematization of knowledge gained before and during the pandemic is needed.
This review article aims to systematize information on the mental health of medical students to outline the next steps in solving this issue. We have analyzed the literature on the topic published during the last five years. For a literature search, such databases as PubMed, APA PsychNet, Google Scholar, Scopus, and Web of Science were used.
The number of publications on students' mental health increased, and with the beginning of the pandemic, it peaked (Fig. 1), indicating the extreme relevance of this topic.
Full-text of the article is available for this locale: Українська.
- Henderson, C., Noblett, J., Parke, H., Clement, S., Caffrey, A., Gale-Grant, O., Schulze, B., Druss, B., & Thornicroft, G. (2014). Mental health-related stigma in health care and mental health-care settings. The Lancet. Psychiatry, 1(6), 467–482. https://doi.org/10.1016/S2215-0366(14)00023-6
- Thornicroft G, Mehta N, Clement S, et al. Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet. 2016;387(10023):1123-1132. doi:10.1016/S0140-6736(15)00298-6
- Dyrbye LN, Thomas MR, Shanafelt TD. A systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81(4):354-373. doi:10.1097/00001888-200604000-00009
- Dyrbye LN, Thomas MR, Huntington JL, et al. Personal life events and medical student burnout: a multicenter study. Acad Med. 2006;81(4):374-384. doi:10.1097/00001888-200604000-00010
- Slavin SJ. Medical Student Mental Health: Culture, Environment, and the Need for Change. JAMA. 2016;316(21):2195-2196. doi:10.1001/jama.2016.16396
- Raj SR, Simpson CS, Hopman WM, Singer MA. Health-related quality of life among final-year medical students. CMAJ. 2000;162(4):509-510.
- Edwards D, Burnard P, Bennett K, Hebden U. A longitudinal study of stress and self-esteem in student nurses. Nurse Educ Today. 2010;30(1):78-84. doi:10.1016/j.nedt.2009.06.008
- Gazzaz ZJ, Baig M, Al Alhendi BSM, et al. Perceived stress, reasons for and sources of stress among medical students at Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia. BMC Med Educ. 2018;18(1):29. Published 2018 Feb 23. doi:10.1186/s12909-018-1133-2
- Hill MR, Goicochea S, Merlo LJ. In their own words: stressors facing medical students in the millennial generation. Med Educ Online. 2018;23(1):1530558. doi:10.1080/10872981.2018.1530558
- Chang E, Eddins-Folensbee F, Coverdale J. Survey of the prevalence of burnout, stress, depression, and the use of support by medical students at one school. Acad Psychiatry. 2012;36(3):177-182. doi:10.1176/appi.ap.11040079
- Santen SA, Holt DB, Kemp JD, Hemphill RR. Burnout in medical students: examining the prevalence and associated factors. South Med J. 2010;103(8):758-763. doi:10.1097/SMJ.0b013e3181e6d6d4
- Dyrbye LN, Harper W, Durning SJ, et al. Patterns of distress in US medical students. Med Teach. 2011;33(10):834-839. doi:10.3109/0142159X.2010.531158
- Evans W, Kelly B. Pre-registration diploma student nurse stress and coping measures. Nurse Educ Today. 2004;24(6):473-482. doi:10.1016/j.nedt.2004.05.004
- Azad MC, Fraser K, Rumana N, et al. Sleep disturbances among medical students: a global perspective. J Clin Sleep Med. 2015;11(1):69-74. Published 2015 Jan 15. doi:10.5664/jcsm.4370
- Belingheri M, Pellegrini A, Facchetti R, De Vito G, Cesana G, Riva MA. Self-reported prevalence of sleep disorders among medical and nursing students. Occup Med (Lond). 2020;70(2):127-130. doi:10.1093/occurred/kqaa011
- Fares J, Al Tabosh H, Saadeddin Z, El Mouhayyar C, Aridi H. Stress, Burnout and Coping Strategies in Preclinical Medical Students. N Am J Med Sci. 2016;8(2):75-81. doi:10.4103/1947-2714.177299
- Foster K, Fethney J, Kozlowski D, Fois R, Reza F, McCloughen A. Emotional intelligence and perceived stress of Australian pre-registration healthcare students: A multi-disciplinary cross-sectional study. Nurse Educ Today. 2018;66:51-56. doi:10.1016/j.nedt.2018.04.001
- Heinen I, Bullinger M, Kocalevent RD. Perceived stress in first-year medical students - associations with personal resources and emotional distress. BMC Med Educ. 2017;17(1):4. Published 2017 Jan 6. doi:10.1186/s12909-016-0841-8
- Jacob T, Itzchak EB, Raz O. Stress among healthcare students--a cross-disciplinary perspective. Physiother Theory Pract. 2013;29(5):401-412. doi:10.3109/09593985.2012.734011
- Wilks S, Spivey C. Resilience in undergraduate social work students: social support and adjustment to academic stress. Social Work Education 2010;29(3):276-88. doi:10.1080/02615470902912243
- Cecil J, McHale C, Hart J, Laidlaw A. Behaviour and burnout in medical students. Med Educ Online. 2014;19:25209. Published 2014 Aug 25. doi:10.3402/meo.v19.25209
- Dyrbye LN, Thomas MR, Harper W, et al. The learning environment and medical student burnout: a multicentre study. Med Educ. 2009;43(3):274-282. doi:10.1111/j.1365-2923.2008.03282.x
- Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ. 2016;50(1):132-149. doi:10.1111/medu.12927
- Bunevicius A, Katkute A, Bunevicius R. Symptoms of anxiety and depression in medical and humanities students: relationship with big-five personality dimensions and vulnerability to stress. Int J Soc Psychiatry. 2008;54(6):494-501. doi:10.1177/0020764008090843
- Compton MT, Carrera J, Frank E. Stress and depressive symptoms/dysphoria among US medical students: results from a large, nationally representative survey. J Nerv Ment Dis. 2008;196(12):891-897. doi:10.1097/NMD.0b013e3181924d03
- Mao Y, Zhang N, Liu J, Zhu B, He R, Wang X. A systematic review of depression and anxiety in medical students in China. BMC Med Educ. 2019;19(1):327. Published 2019 Sep 2. doi:10.1186/s12909-019-1744-2
- Tung YJ, Lo KKH, Ho RCM, Tam WSW. Prevalence of depression among nursing students: A systematic review and meta-analysis. Nurse Educ Today. 2018;63:119-129. doi:10.1016/j.nedt.2018.01.009
- Kötter T, Wagner J, Brüheim L, Voltmer E. Perceived Medical School stress of undergraduate medical students predicts academic performance: an observational study. BMC Med Educ. 2017;17(1):256. Published 2017 Dec 16. doi:10.1186/s12909-017-1091-0
- Neumann M, Edelhäuser F, Tauschel D, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med. 2011;86(8):996-1009. doi:10.1097/ACM.0b013e318221e615
- 30.Yamada Y, Klugar M, Ivanova K, Oborna I. Psychological distress and academic self-perception among international medical students: the role of peer social support. BMC Med Educ. 2014;14:256. Published 2014 Nov 28. doi:10.1186/s12909-014-0256-3
- Ye Y, Hu R, Ni Z, Jiang N, Jiang X. Effects of perceived stress and professional values on clinical performance in practice nursing students: A structural equation modeling approach. Nurse Educ Today. 2018;71:157-162. doi:10.1016/j.nedt.2018.09.036
- Hamshire C, Jack K, Forsyth R, Langan AM, Harris WE. The wicked problem of healthcare student attrition. Nurs Inq. 2019;26(3):e12294. doi:10.1111/nin.12294
- Lu J, Fang GE, Shen SJ, Wang Y, Sun Q. A Questionnaire survey on sleeping in class phenomenon among Chinese medical undergraduates. Med Teach. 2011;33(6):508.
- Kim EJ, Dimsdale JE. The effect of psychosocial stress on sleep: a review of polysomnographic evidence. Behav Sleep Med. 2007;5(4):256-278. doi:10.1080/15402000701557383
- Giri P, Baviskar M, Phalke D. Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western maharashtra, India. Ann Med Health Sci Res. 2013;3(1):51-54. doi:10.4103/2141-9248.109488
- Gomes AA, Tavares J, de Azevedo MH. Sleep and academic performance in undergraduates: a multi-measure, multi-predictor approach. Chronobiol Int. 2011;28(9):786-801. doi:10.3109/07420528.2011.606518
- Lund HG, Reider BD, Whiting AB, Prichard JR. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health. 2010;46(2):124-132. doi:10.1016/j.jadohealth.2009.06.016
- Lichstein KL, Rosenthal TL. Insomniacs' perceptions of cognitive versus somatic determinants of sleep disturbance. J Abnorm Psychol. 1980;89(1):105-107. doi:10.1037//0021-843x.89.1.105
- Sateia MJ. Update on sleep and psychiatric disorders. Chest. 2009;135(5):1370-1379. doi:10.1378/chest.08-1834
- Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?. JAMA. 1989;262(11):1479-1484. doi:10.1001/jama.262.11.1479
- Chang PP, Ford DE, Mead LA, Cooper-Patrick L, Klag MJ. Insomnia in young men and subsequent depression. The Johns Hopkins Precursors Study. Am J Epidemiol. 1997;146(2):105-114. doi:10.1093/oxfordjournals.aje.a009241
- 42.Dolsen EA, Prather AA, Lamers F, Penninx BWJH. Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation. Psychological Medicine. 2021;51(12):2094-2103. doi:10.1017/S0033291720000860
- Drennan MD, Klauber MR, Kripke DF, Goyette LM. The effects of depression and age on the Horne-Ostberg morningness-eveningness score. J Affect Disord. 1991;23(2):93-98. doi:10.1016/0165-0327(91)90096-b
- Eller T, Aluoja A, Vasar V, Veldi M. Symptoms of anxiety and depression in Estonian medical students with sleep problems. Depress Anxiety. 2006;23(4):250-256. doi:10.1002/da.20166
- Tafoya SA, Jurado MM, Yépez NJ, Fouilloux M, Lara MC. Dificultades del sueño y síntomas psicológicos en estudiantes de medicina de la ciudad de México [Sleep difficulties and psychological symptoms in medicine students in Mexico]. Medicina (B Aires). 2013;73(3):247-251.
- Romero-Blanco C, Rodríguez-Almagro J, Onieva-Zafra MD, Parra-Fernández ML, Prado-Laguna MDC, Hernández-Martínez A. Sleep Pattern Changes in Nursing Students during the COVID-19 Lockdown. Int J Environ Res Public Health. 2020;17(14):5222. Published 2020 Jul 20. doi:10.3390/ijerph17145222
- Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA. 2010;304:1181-1190. doi:10.1001/jama.2010.1300
- Molodynski A, Lewis T, Kadhum M, et al. Cultural variations in wellbeing, burnout and substance use amongst medical students in twelve countries [published online ahead of print March 18, 2020]. Int Rev Psychiatry. doi:10.1080/09 540261.2020.1738064
- Liu J, Zhu Q, Fan W, Makamure J, Zheng C, Wang J. Corrigendum: Online Mental Health Survey in a Medical College in China During the COVID-19 Outbreak. Front Psychiatry. 2020;11:845. Published 2020 Aug 14. doi:10.3389/fpsyt.2020.00845