Tyssen R, Vaglum P, Grønvold N T, Ekeberg O
Department of Behavioural Sciences in Medicine, Faculty of Medicine, University of Oslo, Norway.
Med Educ. 2001 Feb;35(2):110-20. doi: 10.1046/j.1365-2923.2001.00770.x.
Physicians show an increased prevalence of mental health problems, the first postgraduate years being particularly stressful.
To study the prevalence of mental health problems during the fourth postgraduate year, and to investigate whether it is already possible to predict such problems at medical school.
A cohort of medical students (n=396) from all Norwegian universities, who were approached in their graduating semester (baseline) and in their fourth postgraduate year.
A nationwide and longitudinal postal questionnaire survey, including measures of perceived mental health problems in need of treatment, personality, perceived stress and skills, and ways of coping. Data were analysed using logistic regression.
Mental health problems in need of treatment during the fourth postgraduate year were reported by 17.2% (n=66), with no gender difference, possibly because of a higher prevalence among the men compared with the general population. A majority had not sought help. Univariate medical school predictors of mental health problems included: previous mental health problems; not being married/cohabitant; the personality traits 'vulnerability' (or neuroticism) and 'reality weakness'; perceived medical school stress, and lack of perceived diagnostic skills. In addition, the coping variables avoidance, blamed self and wishful thinking were univariate predictors. Multivariate analysis identified the following adjusted predictors: previous mental health problems; 'intensity' (extraversion); perceived medical school stress, and wishful thinking. Medical school variables were inadequate for predicting which individual students would experience postgraduate mental health deterioration. However, the perceived medical school stress instrument may be used for selecting a subgroup of students suitable for group-oriented interventions.
医生心理健康问题的患病率有所上升，研究生学习的头几年压力尤其大。
研究研究生四年级时心理健康问题的患病率，并调查在医学院阶段是否已经有可能预测这类问题。
来自挪威所有大学的一批医学生（n = 396），在他们毕业学期（基线）和研究生四年级时接受调查。
一项全国性的纵向邮寄问卷调查，包括对需要治疗的感知心理健康问题、个性、感知压力和技能以及应对方式的测量。数据采用逻辑回归分析。
17.2%（n = 66）的人报告在研究生四年级时存在需要治疗的心理健康问题，无性别差异，这可能是因为男性患病率高于一般人群。大多数人未寻求帮助。医学院阶段心理健康问题的单因素预测指标包括：既往心理健康问题；未婚/非同居；个性特质“易感性”（或神经质）和“现实弱点”；感知到的医学院压力以及缺乏感知诊断技能。此外，应对变量回避、自责和一厢情愿思维是单因素预测指标。多因素分析确定了以下校正预测指标：既往心理健康问题；“外向性”（外向性）；感知到的医学院压力以及一厢情愿思维。医学院阶段的变量不足以预测哪些个体学生在研究生阶段会出现心理健康恶化。然而，感知到的医学院压力工具可用于挑选适合进行团体干预的学生亚组。
