Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA.
Med Educ. 2019 Apr;53(4):345-354. doi: 10.1111/medu.13770. Epub 2018 Nov 25.
The prevalence of depressive symptoms among medical students has been found to be higher than among other students because of their longer studying time, higher workload and larger financial burden. Despite the availability of reviews examining this, some have focused solely on one country, whereas others used databases containing papers of solely one language; therefore, the results from reviews might not be comprehensive. Against this background, this overview aims to synthesise the results from all the published systematic reviews of depression among medical students, in order to provide a more accurate result.
A systematic search was conducted of online databases for published systematic reviews or meta-analyses examining the prevalence of depressive symptoms among medical students. The findings of individual studies included in these reviews were extracted and then combined with a random-effects model. Subgroup analysis was conducted by regions.
A total of 10 studies were selected in this overview, involving 249 primary studies and 162 450 medical students. MEDLINE was the most popular database used in these studies. The overlapping of primary studies in these reviews was appreciably high, except for three studies that focused on specific countries. The overall pooled prevalence was 27.0% (95% CI, 24.7-29.5%). Significant subgroup differences were detected (p < 0.001). The pooled prevalence among studies in the Western Pacific Region was the lowest, 18.9% (95% CI, 11.7-29.0%), whereas that in Africa (40.9%) was the highest (95% CI, 28.8-54.4%). The top five significant factors associated with depressive symptoms were: (i) year of study; (ii) gender; (iii) personal issues; (iv) family relations or issues, and (v) health status.
Depression affected around a quarter of medical students in general and 40.9% of students in Africa. It is suggested that medical schools and health authorities should introduce preventive measures to curb the high prevalence of depressive symptoms.
由于学习时间更长、工作量更大、经济负担更重，医学生的抑郁症状发生率高于其他学生。尽管已经有研究综述对此进行了检查，但有些综述仅关注一个国家，而其他综述则使用仅包含一种语言的论文数据库；因此，综述的结果可能并不全面。有鉴于此，本综述旨在综合所有已发表的医学生抑郁症状的系统综述结果，以提供更准确的结果。
对在线数据库中已发表的系统综述或荟萃分析进行了系统检索，以调查医学生抑郁症状的发生率。从这些综述中包含的各个研究中提取研究结果，然后采用随机效应模型进行合并。按地区进行亚组分析。
本综述共纳入 10 项研究，涉及 249 项原始研究和 162450 名医学生。MEDLINE 是这些研究中使用最广泛的数据库。这些综述中原始研究的重叠率相当高，除了 3 项专门针对特定国家的研究。总体合并患病率为 27.0%（95%CI，24.7-29.5%）。检测到显著的亚组差异（p<0.001）。在西太平洋地区研究中的合并患病率最低，为 18.9%（95%CI，11.7-29.0%），而非洲地区（40.9%）的患病率最高（95%CI，28.8-54.4%）。与抑郁症状相关的前 5 个重要因素是：（i）学习年限；（ii）性别；（iii）个人问题；（iv）家庭关系或问题，以及（v）健康状况。
一般来说，大约四分之一的医学生患有抑郁，其中非洲地区的学生患病率高达 40.9%。建议医学院校和卫生当局应采取预防措施来遏制抑郁症状的高发率。
