Abstracts
Abstract
Introduction: Medical students experience high levels of stress due to their rigorous training, which can negatively affect their mental health. This study aimed to investigate substance use habits of medical students at Istanbul University-Cerrahpaşa and the association on their mental health and demographic factors.
Methods: This cross-sectional survey study was conducted in March-April 2022 among preclinical medical students (years 1-3 of a 6-year program). A confidential, anonymous online survey consisting of four sections on sociodemographic and educational characteristics, nicotine use and dependence [Fagerström Test for Nicotine Dependence (FTND)], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)], mental health status [12-item General Health Questionnaire (GHQ-12)], was distributed to 1131 students via WhatsApp and Telegram text messages. Mann-Whitney U and Kruskal Wallis tests compared variables’ distribution in the questionnaire categories. Spearman's correlation assessed associations between scales. Significance was p < 0.05.
Results: The study included 190 medical students. A total of 26.3% of the participants were smokers, with 8.4% showing moderate to high levels of nicotine dependence. An estimated 45.8% and 8.4% reported low-risk consumption and risky usage of alcohol, respectively. There were statistically significant associations between substance use and demographic factors such as sex, GPA, and religious belief. The study found a statistically significant correlation between FTND scores and GHQ-12 scores, and, between FTND scores and AUDIT scores.
Conclusion: The findings of this study will inform the development of interventions to improve the mental health and academic performance of medical students at Istanbul University-Cerrahpaşa. Furthermore, it will raise awareness about the importance of addressing substance use among medical students in Turkey.
Résumé
Introduction : Les étudiants en médecine sont assujettis à des niveaux élevés de stress en raison de leur formation rigoureuse, ce qui peut avoir un impact négatif sur leur santé mentale. Cette étude avait pour but d'étudier les habitudes de consommation de substances des étudiants en médecine de l'Université d'Istanbul-Cerrahpaşa et l'association avec leur santé mentale et les facteurs démographiques.
Méthodes : Cette étude transversale a été menée en mars-avril 2022 parmi les étudiants en médecine au pré-clinique (années 1 à 3 d'un programme de 6 ans). Un questionnaire en ligne confidentiel et anonyme comprenant quatre sections sur les caractéristiques sociodémographiques et éducatives, l'usage et la dépendance à la nicotine [Test de Fagerström pour la dépendance à la nicotine (FTND)], la consommation d'alcool [Test d'identification des troubles liés à la consommation d'alcool (AUDIT)], l'état de santé mentale [Questionnaire général sur la santé en 12 points (GHQ-12)], a été distribué à 1131 étudiants au moyen de messages texte WhatsApp et Telegram. Les tests de Mann-Whitney U et de Kruskal Wallis ont comparé la distribution des variables dans les catégories du questionnaire. La corrélation de Spearman a évalué les associations entre les échelles. Le niveau de signification statistique était p<0,05.
Résultats : L'étude a porté sur 190 étudiants en médecine. Au total, 26,3 % des participants étaient des fumeurs, dont 8,4 % présentaient des niveaux modérés à élevés de dépendance à la nicotine. On estime que 45,8 % et 8,4 % des participants ont déclaré une consommation d'alcool à faible risque et une consommation d’alcool à risque, respectivement. Des associations statistiquement significatives ont été observées entre la consommation de substances et des facteurs démographiques tels que le sexe, la moyenne générale et les croyances religieuses. L'étude a mis en évidence une corrélation statistiquement significative entre les scores FTND et les scores GHQ-12, ainsi qu'entre les scores FTND et les scores AUDIT.
Conclusion : Les résultats de cette étude permettront d'élaborer des interventions visant à améliorer la santé mentale et les résultats universitaires des étudiants en médecine de l'université d'Istanbul-Cerrahpaşa. En outre, elle sensibilisera à l'importance de la prise en charge de l’utilisation de substances chez les étudiants en médecine en Turquie.
Download the article in PDF to read it.
Download
Appendices
Bibliography
- Haykal KA, Pereira L, Power A, Fournier K. Medical student wellness assessment beyond anxiety and depression: a scoping review. PLoS One. 2022;17(10):e0276894. https://doi.org/10.1371/journal.pone.0276894
- Moir F, Yielder J, Sanson J, Chen Y. Depression in medical students: current insights. Adv Med Educ Pract. 2018;9:323-333. https://doi.org/10.2147/AMEP.S137384
- Fares J, Al Tabosh H, Saadeddin Z, El Mouhayyar C, Aridi H. Stress, burnout and coping strategies in preclinical medical students. North Am J Med Sci. 2016;8(2):75. https://doi.org/10.4103/1947-2714.177299
- Hope V, Henderson M. Medical student depression, anxiety and distress outside North America: a systematic review. Med Educ. 2014;48(10):963-979. https://doi.org/10.1111/medu.12512
- Dyrbye LN, Thomas MR, Shanafelt TD. systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81(4):354-373. https://doi.org/10.1097/00001888-200604000-00009
- Farrell SM, Moir F, Molodynski A, Bhugra D. Psychological wellbeing, burnout and substance use amongst medical students in New Zealand. Int Rev Psychiatry. 2019;31(7-8):630-636. https://doi.org/10.1080/09540261.2019.1681204
- Flaherty JA, Richman JA. Substance use and addiction among medical students, residents, and physicians. Psychiatric Clinics. 1993;16(1):189-197. https://doi.org/10.1016/S0193-953X(18)30201-6
- Dyrbye LN, Satele D, West CP. Association of characteristics of the learning environment and US medical student burnout, empathy, and career regret. JAMA Netw Open. 2021;4(8):e2119110. https://doi.org/10.1001/jamanetworkopen.2021.19110
- Arora A, Kannan S, Gowri S, Choudhary S, Sudarasanan S, Khosla PP. Substance abuse amongst the medical graduate students in a developing country. Indian J Med Res. 2016;143(1):101-103. https://doi.org/10.4103/0971-5916.178617
- Bryl N, Czrnecka-Iwańczuk M, Romanowska M, Stanisić M, Michalak M, Posadzy-Małaczyńska A. Drinking alcohol as a way of coping with stress in students of medical faculties. Psychiatr Pol. 2020;54(2):265-277. https://doi.org/10.12740/PP/99029
- Freire BR, Castro PASV de, Petroianu A. Alcohol consumption by medical students. Rev Assoc Med Bras. 2020;66:943-947. https://doi.org/10.1590/1806-9282.66.7.943
- Bahji A, Danilewitz M, Guerin E, Maser B, Frank E. Prevalence of and factors associated with substance use among Canadian medical students. JAMA Netw Open. 2021;4(11):e2133994. https://doi.org/10.1001/jamanetworkopen.2021.33994
- Baldwin DC Jr, Hughes PH, Conard SE, Storr CL, Sheehan DV. Substance use among senior medical students: a survey of 23 medical schools. JAMA. 1991;265(16):2074-2078. https://doi.org/10.1001/jama.1991.03460160052028
- Akvardar Y, Demiral Y, Ergor G, Ergor A. Substance use among medical students and physicians in a medical school in Turkey. Soc Psychiatry Psychiatr Epidemiol. 2004;39(6):502-506. https://doi.org/10.1007/s00127-004-0765-1
- Frank E, Elon L, Naimi T, Brewer R. Alcohol consumption and alcohol counselling behaviour among US medical students: cohort study. BMJ. 2008;337:a2155. https://doi.org/10.1136/bmj.a2155
- Smith D, Leggat P. An international review of tobacco smoking among medical students. J Postgrad Med. 2007;53(1):55. https://doi.org/10.4103/0022-3859.30333
- Al-Haqwi AI. Perception among medical students in Riyadh, Saudi Arabia, regarding alcohol and substance abuse in the community: a cross-sectional survey. Subst Abuse: Treat Prev Policy. 2010;5(1):2. https://doi.org/10.1186/1747-597X-5-2
- Ayala EE, Roseman D, Winseman JS, Mason HRC. Prevalence, perceptions, and consequences of substance use in medical students. Med Ed Online. 2017;22(1):1392824. https://doi.org/10.1080/10872981.2017.1392824
- Babaei Heydarabadi A, Ramezankhani A, Barekati H, et al. Prevalence of substance abuse among dormitory students of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Int J High Risk Behav Addict. 2015;4(2). https://doi.org/10.5812/ijhrba.22350v2
- Candido FJ, Souza R, Stumpf MA, et al. The use of drugs and medical students: a literature review. Rev Assoc Med Bras. 2018;64:462-468. https://doi.org/10.1590/1806-9282.64.05.462
- Kabbash IA, Sarsik SM, Kabbash MI, et al. Perception and practices of tobacco smoking among medical students in the Nile Delta, Egypt. Environ Sci Pollut Res. 2018;25(31):30839-30846. https://doi.org/10.1007/s11356-017-9443-1
- Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. Addiction. 1991;86(9):1119-1127. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x
- Etter JF, Le Houezec J, Perneger TV. A self-administered questionnaire to measure dependence on cigarettes: the cigarette dependence scale. Neuropsychopharmacol. 2003;28(2):359-370. https://doi.org/10.1038/sj.npp.1300030
- Reinert DF, Allen JP. The Alcohol Use Disorders Identification Test: an update of research findings. Alcoholism Clin Exp Res. 2007;31(2):185-199. https://doi.org/10.1111/j.1530-0277.2006.00295.x
- Saunders JB, Aasland OG, Babor TF, De La Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88(6):791-804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x
- Lundin A, Hallgren M, Theobald H, Hellgren C, Torgén M. Validity of the 12-item version of the general health questionnaire in detecting depression in the general population. Public Health. 2016;136:66-74. https://doi.org/10.1016/j.puhe.2016.03.005
- Goldberg DP, Gater R, Sartorius N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27(1):191-197. https://doi.org/10.1017/S0033291796004242
- Guthrie EA, Black D, Shaw CM, Hamilton J, Creed FH, Tomenson B. Embarking upon a medical career: psychological morbidity in first year medical students. Medical Education. 1995;29(5):337-341. https://doi.org/10.1111/j.1365-2923.1995.tb00022.x
- RStudio Team. RStudio: integrated development for R. RStudio, PBC, Boston, MA. Published online 2020. http://www.rstudio.com/
- Garnett C, Oldham M, Shahab L, Tattan-Birch H, Cox S. Characterising smoking and smoking cessation attempts by risk of alcohol dependence: a representative, cross-sectional study of adults in England between 2014-2021. The Lancet Regional Health - Europe. 2022;18:100418. https://doi.org/10.1016/j.lanepe.2022.100418
- Cherkil S, Gardens SJ, Soman DK. Coping styles and its association with sources of stress in undergraduate medical students. Ind J Psychol Med. 2013;35(4):389-393. https://doi.org/10.4103/0253-7176.122235