Objective: The purpose of this study was to assess the prevalences and correlates of adverse affective states (burnout-, depression- and anxiety-related symptoms) among preclinical medical students.
Methods: Self-report questionnaires were sent to all preclinical medical students of Leiden University Medical Center (n=1311). Burnout-related symptoms were measured using the Maslach Burnout Inventory-General Survey (MBI-GS), depression and anxiety-related symptoms and vitality using the Symptom Questionnaire-48 (SQ-48). Furthermore, duration of sleep, quality of life (SF-36), need for recovery, happiness and dispositional optimism were assessed and analysed in relation to affective symptoms using regression analysis.
Results: Among the 433 responders (response rate=33.0%), prevalences of self-reported burnout-, depression- and anxiety-related symptoms were 46.0% (n=199), 27.0% (n=117) and 29.1% (n=126), respectively. Independent correlates for burnout-related symptoms were <6 h sleep per night (p=0.02), low happiness (p<0.001) and a high need for recovery (p<0.001). Independent correlates for both depression- and anxiety-related symptoms were low optimism (p<0.001; p<0.001, respectively), low happiness (p<0.001; p=0.001, respectively) and a high need for recovery (p=0.03; p<0.001, respectively).
Conclusion: Prevalences for adverse affective states were high among preclinical medical students and mainly associated with personality trait-related factors and need for recovery, rather than work-related factors. These findings suggest that being a medical student increases one’s risk to adverse affective states, and should inspire preventative initiatives.
Special thanks go to Prof. Dr. R. Reis for facilitating the contact between the researcher and Drs. P.C. Barnhoorn, which was crucial to the conception of this study. We thank Elmer Mackor (Directorate of Education, LUMC) for providing us with the information to calculate the response rate.
Conflict of interest statement: The authors declare no conflict of interest statement.
1. Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc 2005;80:1613–22. Search in Google Scholar
2. Ibrahim AK, Kelly SJ, Adams CE, Glazebrook, C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res 2013;47:391–400. Search in Google Scholar
3. Hope V, Henderson M. Medical student depression, anxiety and distress outside North America: a systematic review. Med Educ 2014;48:963–79. Search in Google Scholar
4. Ishak W, Nikravesh R, Lederer S, Perry R, Ogunyemi D, et al. Burnout in medical students: a systematic review. Clin Teach 2013;10:242–5. Search in Google Scholar
5. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med 2006;81:354–73. Search in Google Scholar
6. Dahlin ME, Runeson B. Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study. BMC Med Educ 2007;7:6. Search in Google Scholar
7. Dyrbye LN, Power DV, Massie FS, Eacker A, Harper W, et al. Factors associated with resilience to and recovery from burnout: a prospective, multi-institutional study of U.S. medical students. Med Educ 2010;44:1016–26. Search in Google Scholar
8. Jansen NW, Kant IJ, Van Den Brandt PA. Need for recovery in the working population: description and associations with fatigue and psychological distress. Int J Behav Med 2002;9:322–40. Search in Google Scholar
9. Giltay EJ, Zitman FG, Kromhout D. Dispositional optimism and the risk of depressive symptoms during 15 years of follow-up: the Zutphen Elderly Study. J Affect Disord 2006;91:45–52. Search in Google Scholar
10. Glaesmer H, Rief W, Martin A, Mewes R, Brahler E, et al. Psychometric properties and population-based norms of the Life Orientation Test Revised (LOT-R). Br J Health Psychol 2012;17:432–45. Search in Google Scholar
11. Kubzansky LD. Emotional vitality and incident coronary heart disease: benefits of healthy psychological functioning. Arch Gen Psychiatry 2007;64:1393–401. Search in Google Scholar
12. Sobowale K, Ning Zhou A, Fan J, Liu N, Sherer R. Depression and suicidal ideation in medical students in China: a call for wellness curricula. Int J Med Educ 2014;5:31–6. Search in Google Scholar
13. Gaspersz R, Frings-Dresen MWH, Sluiter JK. Prevalence of common mental disorders among Dutch medical students and related use and need of mental health care: a cross-sectional study. Int J Adolesc Med Health 2012;24:169–72. Search in Google Scholar
14. Van Holland BJ, Frings-Dresen MWH, Sluiter JK, editors. Risicofactoren, gezondheidsgedrag en gezondheidsklachten van medisch studenten: Rapportage basismeting Erasmus MC, 1st ed. Amsterdam: AMC/UvA, 2007 (in Dutch). Search in Google Scholar
15. Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory: third edition. In: Zalaquett CP, Woods RJ, editors. Evaluating stress: a book of resources. Lanham, MD: Scarecrow Education, 1997: 191–218. Search in Google Scholar
16. Schaufeli WB, van Dierendonck D, editors. Utrechtse Burnout Schaal-UBOS: Handleiding (Utrecht Burnout Scale- UBOS: Test-manual), 1st ed. Amsterdam: Harcourt Test Services, 2000 (in Dutch). Search in Google Scholar
17. Carlier I, Schulte-Van Maaren Y, Wardenaar K, Giltay E, Van Noorden M, et al. Development and validation of the 48-item Symptom Questionnaire (SQ-48) in patients with depressive, anxiety and somatoform disorders. Psychiatry Res 2012;200:904–10. Search in Google Scholar
18. Beurs E, editor. Paniekstoornis en agorafobie, 1st ed. Houten: Bohn Stafleu Van Loghum, 2004 (in Dutch). Search in Google Scholar
19. Schulte-Van Maaren YW, editor. NormQuest: reference Values for ROM Instruments and Questionnaires, 1st ed. Leiden: Department of Psychiatry (Leiden University Medical Center), 2014. Search in Google Scholar
20. Carver C. LOT- R (Life Orientation Test- Revised). Available at: http://www.psy.miami.edu/faculty/ccarver/sclLOT-R.html. Search in Google Scholar
21. Van de Rest O, de Goede J, Sytsma F, Oude Griep LM, Geleijnse JM, et al. Association of n-3 long-chain PUFA and fish intake with depressive symptoms and low dispositional optimism in older subjects with a history of myocardial infarction. Br J Nutr 2010;103:1381–7. Search in Google Scholar
22. Motmans R. Need for recovery – herstelbehoefteschaal. Available at: http://www.ergonomiesite.be/arbeid/need_for_recovery.htm (in Dutch). Search in Google Scholar
23. Van Veldhoven M, Broersen S, Fortuin R, editors. Handleiding VBBA (Questionnaire on Perception and Assesment of Labor), 2nd ed. Amsterdam: SKB Vragenlijst Services, 2002 (in Dutch). Search in Google Scholar
24. Schulte-Van Maaren YW, Carlier IV, Giltay EJ, van Noorden MS, de Waal MW, et al. Reference values for mental health assessment instruments: objectives and methods of the Leiden Routine Outcome Monitoring Study. J Eval Clin Pract 2013;19:342–50. Search in Google Scholar
25. Dyrbye LN, Thomas MR, Harper W, Massie Jr FS, Power DV, et al. The learning environment and medical student burnout: a multicentre study. Med Educ 2009;43:274–82. Search in Google Scholar
26. Slavin SJ, Schindler DL, Chibnall JT. Medical student mental health 3.0: improving student wellness through curricular changes. Acad Med 2014;89:573–77. Search in Google Scholar
27. Hojat M, Vergare M, Isenberg G, Cohen M, Spandorfer J. Underlying construct of empathy, optimism, and burnout in medical students. Int J Med Educ 2015;6:12–6. Search in Google Scholar
28. Cook C, Heath F, Thompson RL. A meta-analysis of response rates in web- or internet- based surveys. Educ and Psychol Meas 2000;60:821–36. Search in Google Scholar
29. Tijdink JK, Vergouwen AC, Smulders YM. Emotional exhaustion and burnout among medical professors; a nationwide survey. BMC Med Educ 2014;14:183. Search in Google Scholar
©2017 Walter de Gruyter GmbH, Berlin/Boston