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Depressed medical students worried about stigma

Depression is common and students worry about being stigmatised

Louise Prime

Thursday, 16 September 2010

Medical students suffering from moderate to severe depression were more likely than students without depression to endorse statements that stigmatise sufferers, US research published in JAMA found. They also had a higher rate of suicidal thoughts.

Researchers sent a questionnaire to all 769 medical students at the University of Michigan Medical School to investigate the prevalence and severity of depression and the prevalence of suicidal ideation; almost two-thirds (505) replied. The survey, conducted in September-November 2009, also explored students’ perceptions of stigma associated with depression.

Moderate to severe depression was common among the medical students, and was twice as likely to be suffered by women (reported by 18.0%) as by men (9.0%). Suicidal ideation was reported less often by first- and second-year students (1.4%) than by third- and fourth-year students (7.9%).

Students with higher scores, indicating moderate to severe depression, said more frequently than students with no or minimal depression that: telling a counsellor about their illness would be risky; asking for help would mean they had inadequate coping skills; others would think them unable to handle their medical school responsibilities; fellow medical students would respect their opinions less; and also, they would be less likely to see treatment for depression.

First and second year students were more likely than those in their third and fourth years to say that asking for help with depression would leave them feeling less intelligent.

Researchers discovered widespread belief that depressed medical students could pose a danger to their patients; this was more common among men (36%) than among women (22.9%).

“Medical students experience depression, burnout, and mental illness at a higher rate than the general population, with mental health deteriorating over the course of medical training. Medical students have a higher risk of suicidal ideation and suicide, higher rates of burnout, and a lower quality of life than age-matched populations,” say the authors.

They say that medical students may be less likely than the general population to receive appropriate treatment because of the stigma associated with depression, and suggest measures to address this problem.

“The effective care of mental illness, the maintenance of mental health and effective emotional function, and the care of professional colleagues with mental illness could be taught as part of the ethical and professional responsibilities of the outstanding physician and become a critical component of the teaching, role modelling, and professional guidance that medical students receive as part of their curriculum in professionalism,” they write.

In her accompanying editorial, Laura Weiss Roberts of Stanford University, California, argues that these results and those from another paper in this week’s JAMA are actually encouraging regarding the formative experiences of medical school.

“Third- and fourth-year students expressed less stigmatised views of depression in peers. For example, advanced medical students in this study were less likely to see an ill student as potentially dangerous to patients and as depressed by choice. These data suggest that the iterative experiences of medical training may inspire more accurate and empathic understanding of the illness experience, whether in a patient or a colleague.”

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