Depressed Medical Students More Likely To Associate Stigma With Depression

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.




Source : Depressed Medical Students More Likely To Associate Stigma With Depression