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Depressed Medical Students More Likely To Associate Stigma With Depression

Discussion in 'Medical Students Cafe' started by Egyptian Doctor, Oct 20, 2011.

  1. Egyptian Doctor

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    Medical students with moderate to severe depression more frequently endorsed several
    depression stigma attitudes than nondepressed students and had a higher rate of
    suicidal thoughts, according to a study in the September 15 issue of JAMA, a theme
    issue on medical education.


    "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," the authors write. They add that medical students are less likely
    than the general population to receive appropriate treatment, perhaps because of
    the stigma associated with depression. "Students may worry that revealing their
    depression will make them less competitive for residency training positions or
    compromise their education, and physicians may be reluctant to disclose their
    diagnosis on licensure and medical staff applications."

    Thomas L. Schwenk, M.D., of the University of Michigan, Ann Arbor, and colleagues
    conducted a study to assess the prevalence of self-reported depression and
    suicidal ideation among medical students and to assess the perceptions of
    depression stigma by both depressed and nondepressed students. In
    September-November 2009, the researchers surveyed all students enrolled at the
    University of Michigan Medical School (n = 769). The survey response rate was
    65.7 percent (505 of 769).

    The authors found that the prevalence of moderate to severe depression was 14.3 percent.
    A significantly greater percentage of women than men scored in the moderate to severe range (18.0
    percent vs. 9.0 percent). Twenty-two students (4.4 percent) reported suicidal
    ideation at some point during medical school, with the proportion of moderate to
    severely depressed participants varying significantly by level of suicidal
    ideation. First- and second-year students less frequently reported suicidal
    ideation than did third- and fourth-year students (1.4 percent vs. 7.9 percent).


    Stigma perceptions varied by depression score. "Students with higher
    depression scores felt more strongly than did those with no to minimal
    depression that telling a counselor would be risky and that asking for help
    would mean the student's coping skills were inadequate. Those with moderate to
    severe depression scores also agreed more strongly that, if depressed, others
    would find them unable to handle medical school responsibilities (83.1 percent
    vs. 55.1). Medical students with moderate to severe depression scores more
    frequently reported feeling that, if depressed, fellow medical students would
    respect their opinions less than did those with no to minimal depression (56.0
    percent vs. 23.7 percent)," the authors write.

    Also, men agreed more commonly than women that depressed students could endanger patients (36.3
    percent vs. 20.1 percent). First- and second-year students more frequently
    agreed than third- and fourth-year students that seeking help for depression
    would make them feel less intelligent (34.1 percent vs. 22.9 percent). Students
    with high depression scores would also be less likely to seek treatment if
    depressed.

    "These results suggest that new approaches may be needed to
    reduce the stigma of depression and to enhance its prevention, detection, and
    treatment. The characteristics of medical education emphasizing professional
    competence and outstanding performance might be explored as reinforcing, rather
    than potentially sabotaging, factors in the creation of a culture that promotes
    professional mental health. 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 modeling, and professional
    guidance that medical students receive as part of their curriculum in
    professionalism," the authors write.


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