Network of burnout, depression, anxiety, and dropout intention in medical undergraduates

Abstract

Background: Burnout, depression, and anxiety are highly prevalent among medical students, which often leads to their attrition. We aim to assess the inter-relationships of depression, burnout, and anxiety symptoms with dropout intention among Chinese medical undergraduates using the network analysis. Method: A total of 3,648 Chinese medical undergraduates were recruited through snowball sampling. Learning burnout scale, 9-item Patient Health Questionnaire (PHQ-9), and General Anxiety Disorder Scale (GAD-7) was used to assess burnout, depression, and anxiety symptoms, respectively. We used the EBICglasso model to estimate the network. We compared the network based on gender, study phase, and clinical experience. Results: After removing repeated submissions and incorrect responses to the trap question, 3,536 participants were included in the final analysis. The prevalence of burnout, depression, anxiety, and dropout intention was 38, 62.7, 38.4, and 39% respectively, which is consistent with previous findings. Network analysis suggested that anxiety and depression items clustered together and displayed several strong bridge connections, while burnout items formed another cluster. All the strongest edges were within the respective distress. Cynicism symptoms ‘I am fed up with study’ and ‘I want to study but I feel that studying is boring’ were the most central symptoms, while ‘fatigue’ and ‘worthless’ were the bridge symptoms within the burnout-depression-anxiety network. Other central symptoms included ‘worthless’, ‘I can handle my courses’, ‘nervous’, and ‘uncontrollable worry’. Cynicism symptoms ‘I am interested in my major’ and ‘I feel that the knowledge I have learned is useless’ were mostly related to dropout intention. Gender, study phase, and clinical experience didn’t affect the global strength of the burnout-depression-anxiety network. Conclusion: Our results indicated the predominance of cynicism symptoms within the burnout-depression-anxiety network and its substantial impact on dropout intention, suggesting that early detection and intervention for cynicism symptoms in Chinese medical students are in urgent need. Other central and bridge symptoms might also serve as potential targets for the prevention and treatment of burnout, depression, and anxiety among medical students. For example, studies suggest cognitive-behavioral therapy could quickly improve ‘worthless’, which might be beneficial in treating burnout, depression, and anxiety in medical students.

Deserción en la educación superior y salud mental: Estudio bibliométrico

“…En el análisis bibliométrico, se observó que algunas palabras clave mantuvieron una relevancia constante a lo largo del tiempo, mientras que otras ganaron importancia. Por ejemplo, la palabra "ansiedad" ha sido utilizada en diversas investigaciones (Brumariu, et al, 2022;Jystad et al, 2021;Peng et al, 2023;Syvertsen et al, 2020).…”

A network analysis of the long-term quality of life and mental distress of COVID-19 survivors 1 year after hospital discharge

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“…To date, emerging studies have documented the network structure of mental distress (mainly depression and anxiety) in different populations such as the general population (16), adolescents (17), college students (18), and healthcare workers (19,20) during the COVID-19 pandemic. However, to our knowledge, only two studies assessed the network of mental distress in COVID-19 patients (21,22).…”

Direct and indirect effects of father-child attachment on academic burnout in college students

“…Academic burnout refers to a negative psychological and behavioral state in which students have low interest, lack of motivation, and tiredness in studying ( Lian et al, 2014 ). A recent survey conducted among 3,648 samples found that academic burnout is prevalent among Chinese college students, with a prevalence rate of 38% ( Peng et al, 2023 ). Academic burnout not only affects students’ academic performance ( Gao, 2014 ), but also has negative impacts on their mental health ( Shi et al, 2023 ).…”

“…Academic burnout not only affects students’ academic performance ( Gao, 2014 ), but also has negative impacts on their mental health ( Shi et al, 2023 ). College students experiencing academic burnout are more prone to suffer from depression, anxiety, and internet addiction ( Cheng and Lin, 2023 ; Nizam et al, 2023 ; Peng et al, 2023 ). Considering the total large number of Chinese college students in 2022, which has reached 46.55 million (data from the website of the Ministry of Education of the People’s Republic of China 1 ), as well as the increasing cost of higher education, it is crucial to identify the factors influencing academic burnout among Chinese college students and explore intervention strategies to reduce it for the sake of students’ psychological well-being.…”