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Measuring Health: A Guide to Rating Scales and Questionnaires

Importance Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies. Objective To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students. Data Sources and Study Selection Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included. Data Extraction and Synthesis Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. Main Outcomes and Measures Point or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview. Results Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n = 116 628) and 16 longitudinal studies (n = 5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37 933/122 356 individuals; 95% CI, 24.7% to 29.9%, I2  = 98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982-2015; slope, 0.2% increase per year [95% CI, −0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during medical school (n = 2432), the median absolute increase in symptoms was 13.5% (range, 0.6% to 35.3%). Prevalence estimates did not significantly differ between studies of only preclinical students and studies of only clinical students (23.7% [95% CI, 19.5% to 28.5%] vs 22.4% [95% CI, 17.6% to 28.2%]; P  = .72). The percentage of medical students screening positive for depression who sought psychiatric treatment was 15.7% (110/954 individuals; 95% CI, 10.2% to 23.4%, I2  = 70.1%). Suicidal ideation prevalence data were extracted from 24 cross-sectional studies (n = 21 002) from 15 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of suicidal ideation was 11.1% (2043/21 002 individuals; 95% CI, 9.0% to 13.7%, I2  = 95.8%). Summary prevalence estimates ranged across assessment modalities from 7.4% to 24.2%. Conclusions and Relevance In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%. Further research is needed to identify strategies for preventing and treating these disorders in this population.

https://jamanetwork.com/journals/jama/articlepdf/2589340/joi160133.pdf

Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis.

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Learning To Teach In Higher Education

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)00648-6.pdf

Global burden of diseases, injuries, and risk factors for young people's health during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: Being in medical school has always been regarded as highly
stressful. Excessive stress causes physical and mental health problems.
Persistent stress can impair students’ academic achievement and
personal or professional development. The aim of this study is to
explore the nature of stress among medical students by determining the
prevalence, sources and pattern of stress and the factors affecting it.
Methods: We chose a cross-sectional study design utilizing validated
questionnaires, the 12 items General Health Questionnaire (GHQ-12) and
Medical Student Stressor Questionnaire (MSSQ), to evaluate stress
levels and stressors. School and ethical committee clearance were
obtained prior to the study. Data were analysed using SPSS version 12.
Results: Of the medical students who were administered the
questionnaire, 761 (72%) respondents participated in this study. The
prevalence of stress among the medical students was 29.6%. The top 10
stressors were academic-related. Prevalence of stress for the first,
second, third, fourth and fifth year students was 26.3%, 36.5 %, 31.4%,
35.3% and 21.9%, respectively. Year of study was the only significant
factor affecting stress among medical students (P-value < 0.05).
Conclusions: The prevalence of stress among medical students in USM is
high. Academic related problems were the major stressor among medical
students. Year of study was the factor most significantly associated
with medical students’ stress. There was a bimodal pattern of the
stress level throughout the year of study.

Prevalence and Sources of Stress among Universiti Sains Malaysia Medical Students.

Prevalence and associated factors of stress, anxiety and depression among prospective medical students

Many studies have shown that the prevalence of psychological distress among medical students during medical training is higher than that in general population. A few studies have shown that the prevalence of psychological distress among medical students before the onset of medical training was similar to general population. This study aimed to investigate psychological health of medical students before and during medical training. A one-year prospective study was done on successful applicants who undergo the first year of medical training for 2010/2011 academic session. The stress, anxiety and depression were measured by the DASS-21 at five intervals; during interview (Time 0), two months (Time 1), four months (Time 2), six months (Time 3) and final examination (Time 4) of the first year medical training. The prevalence of unfavourable stress, anxiety and depression before the onset of medical training was 4.1%, 55.6% and 1.8%, respectively. The prevalence of unfavourable stress during medical training ra...

The impact of medical education on psychological health of students: A cohort study

Introduction: The milieu of tertiary education has always been regarded as a highly stressful environment for students especially for medical students. The study aims to explore the stress level, stressors, and coping strategies among first year medical students in Malaysian public universities and factors contributed to the stress at the end of year. Methodology: A multicenter cross-sectional study involving four Malaysian public universities. The 12-item General Health Questionnaire (GHQ-12), Medical Student Stressor Questionnaire (MSSQ) and Brief COPE inventory were self-administered to measure stress level, sources of stress and coping strategies respectively among the participants. Calculated sample size was 387. Results: Out of 387 selected participants, 359 (92.7%) responded to this survey. This study found that the prevalence (at the end of the year) of distressed first year medical students was 50%. The major stressors across the universities were academic-related issues. The top five coping strategies were religion, active coping, positive re- interpretation, acceptance and planning. University, parent income, academic activities, group activities, and desire related stressors were significant factors contributing to the students' stress (p-value < 0.05). Conclusion: This study found that there was a high prevalence of distressed among first year medical students at the end of year, the major stressors were related to academic and contributing factors of stress were related to university, coping strategy, types of stressor and parent income status. Training first year medical students on adaptive coping strategies, managing stressors, and improving peer-group supports to the students will help to improve this condition.

A study on stress, stressors and coping strategies among Malaysian medical students

The COVID-19 pandemic has precipitated a shift to emergency remote teaching (ERT) for educational institutions worldwide, including medical schools. To help faculty design online assessments, guidelines available in the internet were compiled and nine common themes were identified. These nine guidelines for online assessment were discussed in the light of ERT as well as relevance to health professions education. The guidelines include: Evaluate prerequisites for implementing online assessment; ensure alignment of assessment activities with stated learning objectives; address the diversity of students’ situations; maintain a good balance of formative and summative assessments; stimulate student learning with online assessment; consider format; scheduling and timing of tests; establish clear communication to students regarding assessment matters; ensure high-quality feedback; and address assessment validity threats.

/pdf/guidelines-for-online-assessment-in-emergency-remote-108fl7pqyl.pdf

Ahmad Fuad Abdul Rahim

Papers

Prevalence and Sources of Stress among Universiti Sains Malaysia Medical Students.

Prevalence and associated factors of stress, anxiety and depression among prospective medical students

The impact of medical education on psychological health of students: A cohort study

A study on stress, stressors and coping strategies among Malaysian medical students

Guidelines for Online Assessment in Emergency Remote Teaching during the COVID-19 Pandemic