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Medical student depression, anxiety and distress outside N orth A merica: a systematic review
Author(s) -
Hope Valerie,
Henderson Max
Publication year - 2014
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/medu.12512
Subject(s) - psycinfo , anxiety , context (archaeology) , distress , medline , depression (economics) , medicine , family medicine , psychiatry , psychology , clinical psychology , political science , macroeconomics , law , economics , paleontology , biology
Context N orth A merican medical students are more depressed and anxious than their peers. In the UK , the regulator now has responsibility for medical students, which may potentially increase scrutiny of their health. This may either help or hinder medical students in accessing appropriate care. The prevalences of anxiety, depression and psychological distress in medical students outside N orth A merica are not clear. A better understanding of the prevalence of, risk factors for and results of psychological distress will guide the configuration of support services, increasingly available for doctors, for medical students too. Objectives The aim of this study was to examine the prevalences of depression, anxiety and psychological distress in students in medical schools in the UK , E urope and elsewhere in the E nglish‐speaking world outside N orth A merica. Methods A systematic review was conducted using search terms encompassing psychological distress amongst medical students. Ovid SP was used to search the following databases: Ovid MEDLINE (R) from 1948 to October 2013; P syc INFO from 1806 to O ctober 2013, and EMBASE from 1980 to O ctober 2013. Results were restricted to medical schools in E urope and the E nglish‐speaking world outside N orth A merica, and were evaluated against a set of inclusion criteria including the use of validated assessment tools. Results The searches identified 29 eligible studies. Prevalences of 7.7–65.5% for anxiety, 6.0–66.5% for depression and 12.2–96.7% for psychological distress were recorded. The wide range of results reflects the variable quality of the studies. Almost all were cross‐sectional and many did not mention ethical approval. Better‐quality studies found lower prevalences. There was little information on the causes or consequences of depression or anxiety. Conclusions Prevalences of psychological distress amongst medical students outside N orth A merica are substantial. Future research should move on from simple cross‐sectional studies to better‐quality longitudinal work which can identify both predictors for and outcomes of poor mental health in medical students.