A deeper understanding of depression and suicidality among medical students

Abstract

Prevalence rates for depression among medical students are three times higher than the prevalence rates of depression in the general population. In order to understand these high prevalence rates, the authors discuss the underlying psychodynamics of a subset of medical students who seek therapy for depression and suicidality during their medical school years. Does medical school screen for people who are more prone to depression or does medical school cause high depression rates? The authors describe students with the combination of harsh/critical aspects from their early family life coupled with emotional misattunement of caregivers. The authors then discuss how the medical school environment may lead to reeexperiencing of these dynamics, triggering depression and suicidal ideation. The article provides recommendations for identifying these students and referring them to mental health services.

Dysfunctional Parenting Styles Are Associated with Mental Disorders and Low Self-Efficacy Beliefs in Brazilian Undergraduate Medical Students

“…Individuals who are better prepared psychologically should be emotionally protected when dealing with these challenges. A hostile family environment in childhood and adolescence, with adverse parental bonding styles, is relived in a segment of these students at medical school, an environment in which demands and expectations are high, with a clear and often emotionally cold hierarchy [37]. In the present study, following adjustment for sociodemographic data, variables related to student life, and events in the students' lives, an important association was found between distinct patterns of parental bonding styles and psychological issues in these medical students.…”

Depressive disorders in Thai medical students: an exploratory study of institutional, cultural, and individual factors

“…Perceptions of prestige in medicine, family's expectations and the pressure and competence-oriented medical school culture are seen elsewhere too. 19 But in the Asian context, medical students seem to be much more compiled with the family's rules, values and expectations, including those from the institutional community. Problems tend to become amplified in the strict hierarchical Thai society, where seniority issues may prevent students from seeking support from faculty staff, adding to further stressors.…”

Preditores de idealização suicida entre estudantes de medicina: uma revisão sistemática

“…A idealização suicida, caracterizada pela presença de pensamentos ou vontade de cometer suicídio, infelizmente está em ascendência no mundo contemporâneo, afetando cada vez mais jovens 1 . Os estudantes de medicina, por conta de diversos fatores, intrínsecos e extrínsecos, fazem parte de um grupo que possui índices consideravelmente mais altos de idealização suicida se comparado a população em geral da mesma faixa etária 5,21,22 . Geralmente, por trás desta condição, é possível encontrar diversos problemas de cunho psicológico e emocional, além de doenças psiquiátricas, que deterioram a saúde mental e acabam por predispor a seu aparecimento 1,5 .…”

“…A associação entre doenças psiquiátricas e a presença de idealização suicida também é um fato bem documentado na comunidade científica, sendo o primeiro considerado um fator desencadeante ou agravante do último 22,24 . Nos artigos analisados por este trabalho, Coentre et al, Pinzon-Amado et al e Torres et al indicaram uma importante associação entre os sintomas depressivos e idealização suicida 4,13,14 .…”

“…Provavelmente o perfil do estudante de medicina -competitivo e perfeccionista -associado ao rigor do curso poderia explicar a susceptibilidade deste grupo à depressão. Geralmente, eles são muito focados no sucesso acadêmico e, quando recebem notas ruins, acabam tendo sentimentos de culpa, remorso e desvalia, sendo estes muito prejudiciais para sua saúde mental 22,26 .…”