BackgroundPrevious studies have indicated that suicidal ideation is prevalent in medical students. The factors related to school admission processes and medical school environments contribute to this high prevalence. The consequences of suicidal ideation include suicide attempts and completed suicide. This article reviewed the recent literature on suicidal ideation in medical students.Materials and methodsA systematic review of the literature was conducted to identify the articles published on the prevalence of suicidal ideation and associated factors in medical students. Original articles published from 2011 were included.ResultsSeventeen studies comprising a total of 13,244 medical students from 13 Western and non-Western countries were included. The prevalence of suicidal ideation ranged from 1.8% to 53.6%. The most frequent factors associated with suicidal ideation in medical students were depression and depressive symptoms, a previous diagnosis of a psychiatric disorder, lower socioeconomic status/financial difficulties, having a history of drug use, and feeling neglected by parents. We did not find studies on interventional studies on suicidal ideation in medical students published in recent years.ConclusionWe identified a number of non-Western studies published in recent years, overcoming the previous scarcity of research in this area. Findings confirmed that suicidal ideation in medical students remains a significant concern. Future studies should focus on preventive and treatment programs targeting the identified factors associated with suicidal ideation in medical students.
Literature on depression and obesity describes the relevance of the hypothalamic pituitary adrenal axis dysfunction, sympathetic nervous system (SNS) activation, and inflammatory processes as well as the interaction of genetic and environmental factors. Recent investigation in obesity highlights the involvement of several regulation systems, particularly in white adipose tissue. The hypothalamic pituitary adrenal axis, gonadal, growth hormone, leptin, sympathetic nervous system and adrenergic, dopaminergic, and serotoninergic central pathways, all seem interconnected and involved in obesity. From another perspective, the role of psychosocial chronic stressors, determining poor mental and physical health, is well documented. Empirical data can support biologically conceivable theories describing how perceptions of the external social environment are transduced into cellular inflammation and depression. Although in neurobiological models of depression, stress responses are associated with neuroendocrine and neuro-inflammatory processes, concerning similar pathways to those described in obesity, an integrating model is still lacking. The aim of this mini-review is to offer a reflexion on the interplay between the neuroendocrine dysfunctions related to chronic stress and the nature of the shared biologic mechanisms in the pathophysiology of both clinical entities, depression and obesity. We highlight dysfunctional answers of mind body systems that are usually activated to promote regulation and adaptation. Stress response, as a mediator between different level phenomena, may undertake the role of a plausible link between psychological and biological determinants of disease. Depression and obesity are major public health issues, urging for new insights and novel interventions and this discussion points to the need of a more in-depth approach.
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