Mental health of medical students: a cross-sectional study in Tehran

Medical students are subject to stress from sources related to medical training in addition to personal problems, resulting in significant mental distress. This study evaluates the scope of the problem in Tehran medical schools and sheds light on some of its associations. Students (604) of medicine from four medical schools in the city of Tehran responded to the Persian version of 28-item General Health Questionnaire (GHQ-28) in conjunction with a data collection sheet asking about age, sex, marital status, current training level, living place, grade point average in previous semester, and perceptions of their financial status. Of 602 students, 40.7% had mental distress (45.7% of female and 36.7% of male students). Distress was associated with being a woman (female to male odds ratio: 1.55) and very poor financial status (OR: 18.0).     

Reactions to blindness: a four-year follow-up study

A previously studied group of newly blind adults was followed up after four years. There was only a slight increase in the acquisition of blind skills, while there was a surprising continuing pervasiveness of depression and poor health. A number of variables from the original study and from the follow-up data predicted outcome measures. Significant predictors of depression and distress were poor health, being married, being nonProtestant in this predominantly Protestant London population, and lacking ability to be more independent. Higher social class and an absence of a family history of blindness predicted greater distress. Earlier acceptance of blindness, early learning of blind skills, and better preillness adjustment predicted better coping and greater use of blind skills at follow-up. The extent of the depression and poor health are discussed, and recommendations are made for caregivers.     

Predictors of reading fluency in Italian orthography: Evidence from a cross-sectional study of primary school students

This study investigates the role of linguistic and visuospatial attentional processes in predicting reading fluency in typical Italian readers attending primary school. Tasks were administered to 651 children with reading fluency z scores > ?1.5 standard deviation to evaluate their phonological awareness, rapid automatized naming (RAN), verbal short-term memory, vocabulary, visual search skills, verbal-visual recall, and visual-spatial attention. Hybrid models combining confirmatory factor analysis and path analysis were used to evaluate the data obtained from younger (first and second grade) and older (third–fifth grade) children, respectively. The results showed that phonological awareness and RAN played a significant role among younger children, while also vocabulary, verbal short-term memory, and visuospatial attention were significant factors among older children.     

The prevalence and correlations of medical student burnout in the pre-clinical years: a cross-sectional study

Burnout is a psychological syndrome of emotional exhaustion, depersonalization, and impaired personal accomplishment induced by repeated workplace stressors. Current research suggests that physician burnout may have its origins in medical school. The consequences of medical student burnout include both personal and professional distress, loss of empathy, and poor health. We hypothesized that burnout occurs prior to the initiation of the clinical years of medical education. This was a cross-sectional survey administered to third-year medical students at the Mount Sinai School of Medicine (MSSM) in New York, New York (a traditional-style medical school with a marked division between pre-clinical and clinical training occurring at the beginning of the third year). Survey included an instrument used to measure job burnout, a sleep deprivation screen, and questions related to demographic information, current rotation, psychiatric history, time spent working/studying, participation in extracurricular activities, social support network, autonomy and isolation. Of the 86 medical students who participated, 71% met criteria for burnout. Burnt out students were significantly more likely to suffer from sleep deprivation (p?=?0.0359). They were also more likely to disagree with the following statements: "I have control over my daily schedule" (p?=?0.0286) and "I am confident that I will have the knowledge and skills necessary to become an intern when I graduate" (p?=?0.0263). Our findings show that burnout is present at the beginning of the third year of medical school, prior to the initiation of the clinical years of medical training. Medical student burnout is quite common, and early efforts should be made to empower medical students to both build the knowledge and skills necessary to become capable physicians, as well as withstand the emotional, mental, and physical challenges inherent to medical school.     

Attachment styles and close relationships: A four-year prospective study

A longitudinal study of 177 adults examined the stability of adult attachment styles and of romantic relationships over a 4-year period. Findings included the following: (a) attachment styles were highly stable over time; (b) Time 1 attachment style was a significant predictor of Time 2 relationship status, but (c) this effect was mediated by concurrent attachment style at Time 2; (d) secure respondents were less likely than insecure respondents to report one or more breakups during the 4-year interval, but (e) paradoxically, ambivalent respondents were just as likely as secure respondents to be in a relationship with the same partner they had identified 4 years earlier; and (f) attachment stability was moderated to some extent by the experience of breakup or initiation of new relationships during the interim. Respondents' ability to recall their previous attachment style was also examined. Methodological and theoretical implications are discussed, particularly with respect to the conceptualization of attachment styles as traits versus reflections of current relationship status.     

Gender differences in irritable bowel syndrome among medical students at Inner Mongolia Medical University,China: a cross-sectional study

There is little epidemiological research on Irritable bowel syndrome (IBS) in Inner Mongolia, China. Here we investigated the prevalence of IBS and factors associated with IBS in both males and females in Inner Mongolia Medical University by a cross-sectional study. We recruited Inner Mongolia Medical University students residing in campus and asked them to complete a self-administered questionnaire. The prevalence of IBS in each factor we chose in all, male, and female students was determined. We assessed IBS subtypes in male and female students. Multivariate logistic regression models were used to assess the factors associated with IBS in male and female students. The overall prevalence of IBS was 29.5%. The prevalence of IBS in female students was significantly higher than that in male students (31.3% vs. 24.8%, p < .001). Logistic regression results showed that attempting to lose weight and anxiety were both associated with increasing odds of IBS, while exercise was not associated with IBS in either male or female students. In female students, snack consumption and depression were also both associated with increasing odds of IBS. The predominant IBS subtype was the diarrhea-predominant type in both male and female students. Considering the high prevalence of IBS in students and the fact that the factors associated with IBS can be improved by individuals, students should be given adequate education and counseling to improve their mental health and lifestyle, especially female students in higher grades.     

Drivers' knowledge, attitudes, and behavior: a cross-sectional study

A cross-sectional survey was conducted by random duster sampling in the city of Tehran. Knowledge of the drivers was assessed with 6 questions about national traffic laws. Attitude was assessed on a 7-item scale of drivers' perceptions. Behavior was observed by a police officer on 13 areas of assessment. Correlations were low among these three scores. Drivers with advanced education had higher scores on behavior. Knowledge, attitude, and behavior of these drivers did not seem associated.     

Modeling relations between hassles and internalizing and externalizing symptoms in adolescents: a four-year prospective study

This study examined the relations between hassles and internalizing and externalizing symptoms across 4 years in adolescents who varied with regard to their risk for psychopathology. The sample comprised 240 adolescents assessed in 6th, 7th, 8th, and 9th grades regarding their level of peer and academic hassles and internalizing and externalizing symptoms. Structural equation modeling was used to construct latent variables of hassles and internalizing and externalizing syndromes. Results varied by informant about the teens' symptoms. For adolescent report, the stress exposure model fit the data best for internalizing syndromes; that is, higher levels of stressors predicted significantly higher levels of self-reported symptoms 1 year later. For mother report of adolescents' symptoms, the stress generation model fit the data best for both internalizing and externalizing syndromes; that is, higher levels of adolescents' internalizing and externalizing symptoms, as reported by their mothers, significantly predicted higher levels of hassles 1 year later.     

Depression and anxiety symptoms following cancer diagnosis: a cross-sectional study

Introduction: The aims of the present study were to assess demographic and clinical characteristics of patients after receiving a cancer diagnosis, and to determine possible risk factors for anxiety and depression. Methods: All consecutive patients aged 18 or above, were assessed before starting intravenous chemotherapy for the first time with the Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer, and a Visual Analog Scale for pain. Demographic and clinical data were also collected. Results: The patients assessed (n = 270) had a mean age of 59.4 (SD = 11.8) years, and 50.7% were women. Tumours were more frequently colorectal (27.2%), lung (18.8%) and breast (17.6%), and 68.9% were stages 3 or 4. A HADS Anxiety score ≥8 was present in 30% of the patients, a Depression score ≥8 in 24.1%, and a Distress score ≥4 in 44.4%. Independent risk factors for HADS Depression score ≥8 were being a woman (OR = 2.45; p = 0.004), being older (OR = 1.04; p = 0.005), and cancer stage 3–4 (OR = 2.24; p = 0.023) in the multivariable analysis; for Anxiety ≥8 they were being a woman (OR = 2.47; p = 0.002), having a past psychiatric consultation (OR = 2.83; p = 0.029), and cancer stage 3–4 (OR = 1.90; p = 0.047). Conclusion: These results suggest the need for greater awareness and a differentiated approach to patients at increased risk of anxiety and depression in the early stages of treatment and before starting chemotherapy.     

Students' self-ratings of stress in medical school: a replication across 20 months

We replicated the essential results of a prior study on the capacity of the BAROMAS scales to reflect stress in medical school as perceived by students. As before, subjective stress was high at the start of medical school, and when facing the exams prerequisite to entry into clinical clerkships. On most measures, stress was lowest when the second year began (i.e. after having passed the first). Once again, most test-retest reliabilities (significant rs ranged from 0.24 to 0.66 for confidence ratings at 12- and 20-months after entry) were moderate.     

Behaviorally treated irritable bowel syndrome patients: a four-year follow-up

Nineteen of 27 patients suffering from Irritable Bowel Syndrome (IBS) who had completed a multicomponent treatment involving progressive muscle relaxation, thermal biofeedback, cognitive therapy and IBS education were located and evaluated 4 yr posttreatment. Seventeen of 19 (89.5, or 63% of the total original sample) rated themselves as more than 50% improved. Six of the 12 patients (50%) who submitted symptom monitoring diaries met our criteria for clinical improvement, i.e. achieving at least a 50% reduction in primary IBS symptom scores. The means on all measures at long-term follow-up were lower than those obtained prior to treatment. When follow-up symptom means were compared with pretreatment means, significant (P less than 0.05) reductions were obtained on abdominal pain/tenderness, diarrhea, nausea, and flatulence.     

Relationship between annual household income and suicidal ideation: a cross-sectional study

Previous studies have shown that high income was associated with low risk of death by suicide; however, the extent to which household income reduces suicidal ideation remains unclear. We performed a survey to examine the relationship between annual household income and suicidal ideation and determine the level of annual household income at which suicidal ideation no longer decreased as income increased. In total, 94,131 members of Internet survey panels were recruited as participants by a major Japanese Internet survey company in 2016. The participants completed a self-administered questionnaire consisting of items pertaining to demographics, annual household income, and suicidal ideation. We performed logistic regression analysis with suicidal ideation as the dependent variable and income level as the independent variable. The results showed that odds ratios for suicidal ideation decreased as annual household incomes increased, with sex, age, educational level, marital status, and parenthood adjusted for; however, once annual household incomes exceeded 8 million JPY (approximately 77,700 USD), the risk of suicidal ideation no longer decreased. We conclude that suicidal ideation was negatively associated with annual household income and 8 million JPY (approximately 77,700 USD) is a threshold beyond which further increases in income no longer reduce individuals’ suicidal ideation.     

The role of goal orientation during expatriation: a cross-sectional and longitudinal investigation

Using cross-sectional and longitudinal data from expatriates in China, the authors investigated the roles of general, work, and interaction adjustment, as well as work stress, as mediators between the antecedents (learning, proving, and avoiding goal orientations, and perceived organizational support) and expatriate outcome (job performance and premature return intention) relationships. Results indicated that goal orientations toward overseas assignments had differential relationships with expatriate job performance and premature return intention. In addition, it was found that these relationships were partially mediated by expatriate adjustment facets. Implications for expatriate adjustment research and practice are discussed.     

The association between ill-health and abuse: a cross-sectional population based study

The lifetime prevalence of physical, sexual and psychological abuse was studied cross-sectionally in a representative sample of Swedish women. The association between the three kinds of abuse and ill-health, and the relation between magnitude of abuse and various health problems were also investigated. The Abuse Screening Inventory (ASI), measuring experiences of physical, sexual and psychological abuse and including questions on health and social situation, was sent by mail to 6,000 women, randomly selected from the population register. The questionnaire was completed and returned by 4,150 (70%) of 5,896 eligible women. Various kinds of abuse were reported by 1,142 women (27.5%). The prevalence rates were 19.4% for physical abuse, 9.2% for sexual abuse and 18.2% for psychological abuse. Abused women reported more ill-health and a less advantageous social situation than non-abused women. There was an association between magnitude of abuse and health problems. Also a low magnitude of abuse was substantially associated with ill-health.