Sinclair School of Nursing, University of Missouri, Columbia, MO, USA.
College of Osteopathic Medicine of the Pacific-Northwest, Western University of Health Sciences, Lebanon, OR, USA.
Ann Med. 2023;55(2):2242781. doi: 10.1080/07853890.2023.2242781.
Somatic symptoms related to mental health in medical students are under-researched, with nothing on the topic being published in the United States in over three decades. This scoping review is the first of its kind to explore the prevalence, type and severity of somatic symptoms induced by stress, anxiety, depression and burnout amongst medical students, with the objective of describing the significance and breadth of this issue.
PRISMA-ScR guidelines were used to guide this review. A comprehensive search was performed of 22 databases, followed by bibliographic and hand searching. Inclusion criteria were published, peer-reviewed articles with a sample of medical students and at least one measure of somatic symptoms related to mental health, in English or with an English-language translation. Excluded were review, companion and editorial articles. Coding was done by an experienced coder trained in systematic review techniques. Two authors reviewed each article.
Twenty-nine articles met inclusion criteria, representing 16 countries, 31 schools/teaching hospitals and 9,887 medical students. The prevalence of somatic symptoms ranged from 5.7 to 80.1%, and somatic symptoms were overwhelmingly found to be significantly correlated with mental ill-health. Somatic symptoms included back pain, neck pain, headaches, sleep disturbances and functional gastrointestinal disorders. Eleven different outcome measures were used, with varying degrees of validity and reliability, which were compared and assessed.
Somatic symptoms appear strongly correlated with mental ill-health in medical students, and are likely highly prevalent. This review highlights the need for further research on somatic symptoms of mental ill-health in medical students, particularly in the United States, and the addition of larger, multi-institutional cohorts to expand our understanding of prevalence, incidence and inciting factors of somatic symptoms. Longitudinal studies tracking somatic symptoms' effect on career trajectory and professional burnout levels are also needed. Finally, future research should explore interventions for reducing physical symptom burden in medical students.
医学生的心理健康相关躯体症状研究不足，三十多年来美国尚无相关研究发表。本研究旨在探索医学生因压力、焦虑、抑郁和倦怠而产生的躯体症状的发生率、类型和严重程度，为该问题的重要性和广泛性提供描述，是此类研究中的首例。
本研究遵循 PRISMA-ScR 指南进行。我们对 22 个数据库进行了全面检索，随后进行了文献追溯和手工检索。纳入标准为：发表的、同行评议的、以医学生为样本的研究，且至少有一项与心理健康相关的躯体症状测量，语言为英语或有英文翻译。排除综述、相关和社论文章。由接受过系统综述技术培训的经验丰富的编码员进行编码。两位作者对每篇文章进行了评估。
29 篇文章符合纳入标准，代表了 16 个国家、31 所学校/教学医院和 9887 名医学生。躯体症状的发生率从 5.7%到 80.1%不等，且躯体症状与精神健康不良显著相关。躯体症状包括背痛、颈痛、头痛、睡眠障碍和功能性胃肠疾病。使用了 11 种不同的结果测量方法，其有效性和可靠性各不相同，并对其进行了比较和评估。
躯体症状似乎与医学生的精神健康不良密切相关，且可能高度普遍存在。本综述强调了进一步研究医学生精神健康不良的躯体症状的必要性，特别是在美国，以及增加更大规模的、多机构队列研究来扩展我们对躯体症状的发生率、发病率和诱发因素的理解。还需要进行追踪躯体症状对职业轨迹和职业倦怠水平影响的纵向研究。最后，未来的研究应探索减少医学生躯体症状负担的干预措施。
