Anxiety, although as common and arguably as debilitating as depression, has garnered less attention, and is often undetected and undertreated in the general population. Similarly, anxiety among medical students warrants greater attention due to its significant implications. We aimed to study the global prevalence of anxiety among medical students and the associated factors predisposing medical students to anxiety. In February 2019, we carried out a systematic search for cross-sectional studies that examined the prevalence of anxiety among medical students. We computed the aggregate prevalence and pooled odds ratio (OR) using the random-effects model and used meta-regression analyses to explore the sources of heterogeneity. We pooled and analyzed data from sixty-nine studies comprising 40,348 medical students. The global prevalence rate of anxiety among medical students was 33.8% (95% Confidence Interval: 29.2–38.7%). Anxiety was most prevalent among medical students from the Middle East and Asia. Subgroup analyses by gender and year of study found no statistically significant differences in the prevalence of anxiety. About one in three medical students globally have anxiety—a prevalence rate which is substantially higher than the general population. Administrators and leaders of medical schools should take the lead in destigmatizing mental illnesses and promoting help-seeking behaviors when students are stressed and anxious. Further research is needed to identify risk factors of anxiety unique to medical students.

https://www.mdpi.com/1660-4601/16/15/2735/pdf

The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis

Objective
To perform a meta-analysis on studies reporting prevalence of Toxoplasma gondii (T. gondii) infection in any psychiatric disorder compared with healthy controls. Our secondary objective was to analyze factors possibly moderating heterogeneity.

Method
A systematic search was performed to identify studies into T. gondii infection for all major psychiatric disorders versus healthy controls. Methodological quality, publication bias, and possible moderators were assessed.

Results
A total of 2866 citations were retrieved and 50 studies finally included. Significant odds ratios (ORs) with IgG antibodies were found in schizophrenia (OR 1.81, P < 0.00001), bipolar disorder (OR 1.52, P = 0.02), obsessive–compulsive disorder (OR 3.4, P < 0.001), and addiction (OR 1.91, P < 0.00001), but not for major depression (OR 1.21, P = 0.28). Exploration of the association between T. gondii and schizophrenia yielded a significant effect of seropositivity before onset and serointensity, but not IgM antibodies or gender. The amplitude of the OR was influenced by region and general seroprevalence. Moderators together accounted for 56% of the observed variance in study effects. After controlling for publication bias, the adjusted OR (1.43) in schizophrenia remained significant.

Conclusion
These findings suggest that T. gondii infection is associated with several psychiatric disorders and that in schizophrenia reactivation of latent T. gondii infection may occur.

Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta‐analysis

To explore contemporary (from 1990) utilization and practice of electroconvulsive therapy (ECT) worldwide. Systematic search (limited to studies published 1990 and after) was undertaken in the databases Medline, Embase, PsycINFO, SveMed, and EBSCO/Cinahl. Primary data-based studies/surveys with reported ECT utilization and practice in psychiatric institutions internationally, nationally, and regionally; city were included. Two reviewers independently checked study titles and abstracts according to inclusion criteria, and extracted ECT utilization and practice data from those retrieved in full text. Seventy studies were included, seven from Australia and New Zealand, three Africa, 12 North and Latin America, 33 Europe, and 15 Asia. Worldwide ECT differences and trends were evident, average number ECTs administered per patient were eight; unmodified (without anesthesia) was used in Asia (over 90%), Africa, Latin America, Russia, Turkey, Spain. Worldwide preferred electrode placement was bilateral, except unilateral at some places (Europe and Australia/New Zealand). Although mainstream was brief-pulse wave, sine-wave devices were still used. Majority ECT treated were older women with depression in Western countries, versus younger men with schizophrenia in Asian countries. ECT under involuntary conditions (admissions), use of ambulatory-ECT, acute first line of treatment, as well as administered by other professions (geriatricians, nurses) were noted by some sites. General trends were only some institutions within the same country providing ECT, training inadequate, and guidelines not followed. Mandatory reporting and overall country ECT register data were sparse. Many patients are still treated with unmodified ECT today. Large global variation in ECT utilization, administration, and practice advocates a need for worldwide sharing of knowledge about ECT, reflection, and learning from each other's experiences.

/pdf/contemporary-use-and-practice-of-electroconvulsive-therapy-1c4z9hxlsb.pdf

Contemporary use and practice of electroconvulsive therapy worldwide

https://onlinelibrary.wiley.com/doi/pdf/10.1002/j.2051-5545.2010.tb00296.x

WPA guidance on how to combat stigmatization of psychiatry and psychiatrists.

https://pure.rug.nl/ws/files/48343991/International_trends_in_antipsychotic_use.pdf

International trends in antipsychotic use: A study in 16 countries, 2005-2014

Objective : This study aimed to determine the prevalence and factors associated with poor sleep quality among medical students at a Nigerian university. Materials and Methods : In a cross sectional survey, the sleep quality of students (n=255) was assessed using the Pittsburgh Sleep Quality Index (PSQI). In addition to obtaining sociodemographic data, history of adverse childhood experiences and drug use, measures assessing daytime sleepiness, fatigue and psychiatric morbidity were also administered. Results : Almost a third (32.5%) of medical students reported poor quality sleep. The presence of a chronic illness (OR: 5.10, 95% CI: 1.53-17.11, P P P Conclusion: Poor quality of sleep is common among medical students, and is associated with predisposing and several modifiable factors. Strategies to improve sleep quality are suggested.

Prevalence and correlates of poor sleep quality among medical students at a Nigerian university

Objectives : Women with infertility experience higher rates of psychological distress compared with their fertile counterparts. In developing countries, socio-cultural factors may aggravate this distress. We aimed to determine the prevalence of psychological distress as well as its associated socio-cultural characteristics among women attending the infertility clinic of a tertiary hospital in Nigeria. Materials and Methods : Women (n = 100) attending an infertility clinic were consecutively recruited over a two-month period and compared with a similar number of pregnant women attending the antenatal clinic at the same hospital. A semi-structured questionnaire was designed to record socio-demographic and clinical variables. The 30-item General Health Questionnaire was used to screen for psychological distress. Results : The prevalence of probable psychological distress was significantly higher among the infertile group compared with their fertile counterparts ( P P P P P P Conclusion : Infertile women are more vulnerable to psychological distress and require psychological support. There is a need to incorporate mental health screening and treatment in the routine care of infertile women in Nigeria.

/pdf/psychosocial-characteristics-of-female-infertility-in-a-ah381p4tyn.pdf

Psychosocial characteristics of female infertility in a tertiary health institution in Nigeria.

Background: Schizophrenia is a devastating mental disorder which places immense burden on family members. There are few studies that have explored the enormity of burden experienced by caregivers i...

Burden of care among relatives of patients with schizophrenia in midwestern Nigeria

Stigmatising attitudes towards persons with mental illness are commonly reported among health professionals. Familiarity with mental illness has been reported to improve these attitudes. Very few studies have compared future medical doctors’ attitudes toward types of mental illness, substance use disorders and physical illness. A cross-sectional survey of 5th and 6th year medical students as well as recently graduated medical doctors was conducted in April 2011. The 12-item level of contact report and the Attitude towards Mental Illness Questionnaire were administered. Participants endorsed stigmatising attitudes towards mental illness; with attitudes more adverse for schizophrenia compared to depression. Stigmatising attitudes were similarly endorsed for substance use disorders. Paradoxically, attitudes towards HIV/AIDS were positive and similar to diabetes mellitus. Increasing familiarity with mental illness was weakly associated with better attitudes towards depression and schizophrenia. Stigmatising attitudes towards depression and schizophrenia are common among future doctors. Efforts to combat stigma are urgently needed and should be promoted among medical students and recent medical graduates.

Stigmatising Attitudes Towards Persons with Mental Illness: A Survey of Medical Students and Interns from Southern Nigeria

Objectives. Depression is associated with diabetes mellitus and affects treatment goals negatively. We aimed to determine the prevalence of depression and identify its socio-demographic or clinical correlates among patients with diabetes mellitus attending an out-patient clinic in Nigeria. Methods. Two hundred consecutively recruited diabetes patients (index group) were compared with a similar number of apparently healthy controls in a cross-sectional survey. In both groups, in addition to obtaining socio-demographic details, depression was diagnosed using the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN), while the Beck Depression Inventory (BDI) was used to assess depression symptom severity. Results. Sixty (30%) diabetes patients met a SCAN diagnosis for clinical depression, compared with 19 (9.5%) in the control group. Having a smaller income and more children were significantly correlated with higher depression symptoms on the BDI. Conclusion. Depression is highly co-morbid with diabetes mellitus. The care of individuals with diabetes mellitus should include the screening and possible treatment for depression in order to achieve and sustain treatment goals.

/pdf/depression-among-patients-with-diabetes-mellitus-in-a-511uiwa6c2.pdf

Joyce O Omoaregba

Papers

Prevalence and correlates of poor sleep quality among medical students at a Nigerian university

Psychosocial characteristics of female infertility in a tertiary health institution in Nigeria.

Burden of care among relatives of patients with schizophrenia in midwestern Nigeria

Stigmatising Attitudes Towards Persons with Mental Illness: A Survey of Medical Students and Interns from Southern Nigeria

Depression among patients with diabetes mellitus in a Nigerian teaching hospital