Queen's Medical Center, Honolulu, Hawaii, USA.
Acad Med. 2010 Oct;85(10):1635-9. doi: 10.1097/ACM.0b013e3181f0b49c.
Although depressive symptoms and suicidal ideation are common in medical students, few programs address this serious problem. The authors developed, and then tested the effectiveness of, an intervention meant to reduce reported depressive symptoms and suicidal ideation.
To reduce the alarming reported rates of depression and suicidal ideation among medical students, the University of Hawaii John A. Burns School of Medicine implemented the following interventions: increased individual counseling for students, faculty education, and a specialized curriculum including lectures and a student handbook. Although counseling had always been available, a new emphasis was placed on facilitating an anonymous process and providing several options, including volunteer psychiatrists not involved in student education. In 2002 and 2003, the authors measured depressive symptoms and suicidal ideation in third-year medical students using, respectively, the Center for Epidemiologic Studies Depression Scale and a question about suicidal ideation from the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire.
Before the intervention, 26 medical students (59.1%) had reported depressive symptoms, and 13 (30.2%) reported suicidal ideation. After the intervention, 14 medical students (24.1%) reported depressive symptoms (χ² = 12.84, df = 2, P < .01), and 1 (3%) reported suicidal ideation (χ² = 13.05, df = 1, P < .001).
Programs that provide specific mental health support for medical students may significantly decrease the reported rates of depressive symptoms and suicidal ideation.
尽管抑郁症状和自杀意念在医学生中很常见,但很少有项目针对这一严重问题。作者开发了一种干预措施,旨在减少报告的抑郁症状和自杀意念,并对其效果进行了测试。
为了降低医学生报告的抑郁和自杀意念的惊人发生率,夏威夷大学约翰·A·伯恩斯医学院实施了以下干预措施:增加学生的个体咨询、教师教育,以及包括讲座和学生手册在内的专门课程。虽然咨询一直都有,但现在更加强调促进匿名流程,并提供多种选择,包括不参与学生教育的志愿精神科医生。在 2002 年和 2003 年,作者分别使用流行病学研究抑郁量表和初级保健评估精神障碍患者健康问卷中的自杀意念问题来衡量三年级医学生的抑郁症状和自杀意念。
在干预之前,有 26 名医学生(59.1%)报告有抑郁症状,13 名(30.2%)报告有自杀意念。干预后,14 名医学生(24.1%)报告有抑郁症状(χ²=12.84,df=2,P<.01),1 名(3%)报告有自杀意念(χ²=13.05,df=1,P<.001)。
为医学生提供特定心理健康支持的项目可能会显著降低报告的抑郁症状和自杀意念发生率。