Comparing mental distress and help-seeking among first-year medical students in Norway: results of two cross-sectional surveys 20 years apart

ObjectiveTo investigate any changes in mental distress levels over 20 years among medical students, as well as the clinical importance of these changes.DesignTwo cross-sectional surveys 20 years apart.SettingThe surveys were performed at two Norwegian medical faculties in 1993 and 2015.ParticipantsO...

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Bibliographic Details
Published in:	BMJ open Vol. 10; no. 8; p. e036968
Main Authors:	Ruud, Nora, Løvseth, Lise Tevik, Isaksson Ro, Karin, Tyssen, Reidar
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group LTD 16-08-2020 BMJ Publishing Group
Series:	Original research
Subjects:	Academic achievement Anxiety Anxiety disorders Cross-Sectional Studies Curricula Epidemiology Female Gender Help seeking behavior Higher education Humans Learning Longitudinal Studies Male Medical Education and Training Medical schools Medical students Mental depression Mental disorders Mental Disorders - epidemiology Mental health Norway - epidemiology Self esteem Social support Stress Stress, Psychological - epidemiology Students, Medical - psychology Suicides & suicide attempts Surveys and Questionnaires Young Adult Young adults Norway epidemiology anxiety disorders depression & mood disorders mental health medical education & training
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Summary:	ObjectiveTo investigate any changes in mental distress levels over 20 years among medical students, as well as the clinical importance of these changes.DesignTwo cross-sectional surveys 20 years apart.SettingThe surveys were performed at two Norwegian medical faculties in 1993 and 2015.ParticipantsOne hundred and seventy-four first-year medical students in 1993 were compared with 169 students in 2015.Main outcome measuresMental distress (Hopkins Symptom Checklist 5) and Mental Health Problems in Need of Treatment.ResultsMental distress increased from 1993 to 2015 (p<0.001) due to a larger increase among female students, which seemed to be of clinical importance (Cohen’s d=0.63). There was a significant gender difference in mental distress in 2015 (p=0.007), but not in 1993. Independent factors associated with mental distress in 2015 were female sex (p<0.001), low perceived social support from parents (p=0.023) and low perceived social support from other friends (p=0.048). Additional analyses showed that social support from friends was more important for female students than for their male peers. From 1993 to 2015, there was no significant increase in the proportion of female students reporting previous mental health problems in need of treatment (21.3% vs 27.8%), but we found a significant increase in help-seeking among those in need of treatment over these years from 30.0% (6/20) to 74.3% (26/35; p=0.003).ConclusionsWe found a significant increase in mental distress among female medical students over the past 20 years, but also a promising increase in help-seeking among those in need of treatment. The strong and important association between low social support and mental distress should urge both universities and students to maintain students’ social life after entering medical school.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2020-036968