中国医学生/住院医师心理健康，抑郁情况

目的：了解后疫情时代医学生产生抑郁的影响因素。方法：自编问卷调查医学生抑郁状态；运用SPSS 25.0、AMOS 24.0软件检验分析问卷信效度、构造影响因素结构方程。结果：自编问卷信效度良好，调查医学生抑郁检出率为19.18%。抑郁与身体功能(躯体机能、生理状态、睡眠质量)，心理认知(情感心境、心理弹性、认知功能)呈正向效应，与疫情背景(应激反应、学习影响、防控态度)呈负向效应。结论：医学专业属性可能减缓医学生抑郁情绪影响；结构方程模型结果可为大学生抑郁干预提供相关理论依据。

完美主义是一种追求高标准的稳定的人格特质，包括适应良好和适应不良两方面。本研究以603名医学大学生为研究对象，采用近乎完美主义量表修订版、自尊量表、流调中心抑郁量表对被试群体进行施测，以探讨自尊在完美主义与抑郁之间的中介作用。结果表明，自尊在完美主义高标准维度与抑郁之间、差异维度与抑郁之间都起到部分中介作用，说明提升完美主义者的自尊水平有助于减少抑郁。

目的：通过实证研究，探索音乐对高校医学生抑郁、焦虑情绪的干预效果。方法：通过抑郁自评量表(SDS)筛选出80名抑郁分值大于53的医学生，按照随机化原则分成实验组和对照组，每组40人。实验组学生参加由治疗师主导的音乐干预，每天1次，每次30分钟，持续4周；对照组学生不接受干预。音乐干预前后，通过抑郁自评量表(SDS)和焦虑自评量表(SAS)对两组学生的抑郁和焦虑水平进行测量，检验音乐对医学生抑郁、焦虑情绪的干预效果。结果：实验组学生在进行4周音乐干预后，抑郁、焦虑得分显著下降，而未进行干预的对照组前后差异不显著。结论：音乐干预能缓解医学生的抑郁、焦虑情绪。

目的：观察40天简易正念练习对医学生焦虑抑郁情绪以及情绪管理能力的影响。方法：2018年选取湖北医药学院某班级28名学生作为研究对象，观测一年后，于2020年进行40天正念练习，练习期间采用焦虑量表(SAS)、抑郁量表(SDS)和大学生情绪管理能力问卷(正式卷)进行前测和后测。结果：2020年SAS，SDS前测数据与2018年前测数据相比较，差异无统计学意义(P = 0.472, t = 0.195, P > 0.05)，40天干预后，2020年前测与后测数据相比，SAS，SDS评分显著降低，情绪量表中理智调控情绪能力与积极补救能力评分显著上升，差异具有统计学意义(P = 0.034, t = 2.337, P < 0.05)。结论：正念练习能有效减轻医学生焦虑抑郁等负性情绪，提高情绪管理能力。

本研究旨在研究医科类院校学生心理危机现况以获得其对心理危机干预真正需求，为校园心理健康工作提出指导意见。方法：本研究使用方便抽样方法，通过线上社交平台收集数据，共收集有效数据169份，获得心理危机现状，以分析医科类院校大学生对精神卫生服务的需求。结果：数据结果显示，通过EXCEL描述性分析人口学特征百分比、平均分、方差等结论，利用IBM SPSS 26软件求得心理健康量表的总均分为2.586 ± 0.877显著高于一般水平(t = 8.742, P χ2 = 5.287, P > 0.05)，大一新生、大四、大五毕业生心理危机检出率有显著差异(χ2 = 11.976, P < 0.05)。结论：某医科类院校心理危机现状情况不容乐观，相关部门应该引起重视，随着思想的进步，男女生对心理危机干预的需求无显著差异；新生、毕业生面对生活环境变化对心理危机干预的需求性更高，应该加强对于重点人群的关注；医学生所面临的心理危机主要源于人际交往和学习方面的压力，这些因素对其心理健康产生了负面影响。其中，人际关系压力是导致医学生心理危机最重要的因素。

目的：探究大学医学生复原力、社会支持和负性情绪情况。方法：对860名大一医学新生进行问卷调查，采用独立样本t检验、相关分析和Process中介分析。结果：复原力、社会支持和负性情绪在性别、近一年体力和脑力活动频率、此前是否素食以及父母受教育程度上均呈不同程度的差异，社会支持的中介效应显著。结论：男生复原力和负性情绪显著高于女生，社会支持显著低于女生。此前素食学生的社会支持较低且负性情绪较高。父母初中及以下学历学生的复原力和社会支持显著低于父母高中及以上学历的学生，父亲初中及以下学历学生的负性情绪显著高于父亲高中及以上学历的学生。社会支持在医学生心理复原过程中对负性情绪产生的中介效应占比为28.57%。

目的：探讨大学生的抑郁与五态人格、社会支持及生活事件的关系。方法：选取1600名大学生，采用贝克抑郁自评量表(BDI)、五态人格测验(FPPI)、社会支持评定量表(SSRS)和青少年生活事件量表(ASLEC)分别测量其抑郁、五态人格、社会支持及生活事件现状。结果：大学生的抑郁检出率为48.1%，重度抑郁检出率为3.5%，专科生的BDI总分高于本科生(P < 0.001)；FPPI中少阳、阴阳平和、太阴型人格维度上的得分显著低于全国高校同龄常模(P < 0.05)；SSRS上本科生、非独生子女得分显著高于专科生、独生子女(P < 0.01)；ASLEC上男大学生、专科生、非独生子女、农村生源大学生的得分显著高于女大学生、本科生、独生子女、城镇大学生(P < 0.05)；BDI总分与FPPI中太阳、少阳、阴阳平和分量表得分及SSRS得分呈负相关(r = −0.1~−0.33, P < 0.01)，与太阴分量表及ASLEC得分呈正相关(r = 0.52, r = 0.38, P < 0.01)；太阴、ASLEC总分及学历对BDI总分有正向预测作用，太阳和阴阳平和及SSRS总分对BDI总分有负向预测作用，其联合解释率为61.7%。结论：大学生抑郁受到太阴人格及生活事件的正向影响，受太阳、阴阳平和及社会支持的负向影响。

目的：调查新冠肺炎疫情下封闭管理医学生心理健康状况，研究分析其心理健康状况的影响因素，为高校心理教育及干预提供一定的借鉴。方法：使用一般情况调查表、抑郁–焦虑–压力自评量表(DASS-21)、自制在校日常活动调查表对连云港市某医学院校2685名学生网上问卷调查。结果：抑郁检出率为34.65%、焦虑检出率为46.72%、压力检出率为19.57%，其中护理专业抑郁、焦虑等情绪均高于其他专业。每周锻炼次数、每周与家人联系的次数、使用手机娱乐时间、是否参加疫情期间举办的活动、了解疫情相关的频率、每天饮食是否规律、每天的作息是否规律、戴口罩的频率等都具有统计学意义(P值 < 0.05)。有序多分类logistic回归分析结果表明，饮食规律(OR: 0.21, 95%CI: 0.10~0.44)、经常戴口罩(OR: 0.54, 95%CI: 0.42~0.69)的学生不容易感到抑郁。使用手机娱乐时间2小时以下(OR: 0.55, 95%CI: 0.41~0.92)、作息规律(OR: 0.43, 95%CI: 0.31~0.59)的学生更不容易感到焦虑。疫情期间有感冒发烧等症状或校外求医的学生焦虑症状的风险是没有疫情期间有感冒发烧等症状或校外求医的学生1.76倍。每天自主学习时间2至4小时的学生(OR: 0.68, 95%CI: 0.47~0.98)压力较小。没有寻求过心理咨询帮助的学生的压力症状的风险是寻求过心理咨询帮助的学生的3.94倍。结论：疫情封闭管理在校医学生心理健康状况不容乐观，高校及相关部门、心理健康工作者等需要采取积极的措施进行干预和疏导，高校应加强疫情防控卫生管理，加强对医学生的心理健康管理与对新冠肺炎的认知宣传，医学生自身应当加强自我调节能力。

目的：调查毕业综合演练期间武警医学生不良情绪、应对效能水平以及睡眠质量状况，探讨武警医学生睡眠质量的影响因素。方法：采用应对效能量表、睡眠质量量表和抑郁–焦虑–压力量表对300名武警医学生进行问卷调查，通过回归和中介效应检验，探讨毕业综合演练期间武警医学生不良情绪、应对效能水平与睡眠质量的关系。结果：武警医学生的睡眠质量总分的平均分为6.46 ± 3.39。睡眠质量与不良情绪、自信程度、胜任力和认知水平均存在显著相关关系，应对效能在不良情绪与睡眠间中介效应显著。结论：本研究武警医学生的整体睡眠质量良好，不良情绪水平偏低，应对效能水平较高，应对效能在不良情绪与睡眠质量间起中介作用，为下一步的心理干预工作提供了实证依据。

精神疾病是指在各种生物学、心理学以及社会环境因素影响下，大脑功能失调，导致认知、情感、意志和行为等精神活动出现不同程度障碍为临床表现的疾病。医学生作为中国未来医学行业的顶梁柱，精神医学学生又是医学生群体中直接接触精神心理专业知识的群体，他们的心理健康状况不容轻视。该研究通过问卷调查并运用知网、万方等数据库，检索国内外对于医学生尤其是精神医学学生心理健康问题的相关文献，对我国医学生尤其是精神医学学生心理健康问题的现状、影响因素、危害及应对措施四个方面进行探讨。运用量性研究探讨影响精神医学学生心理健康现状及影响因素，揭示精神医学专业知识的学习对医学生心理健康状况的作用机制。进而为推进精神医学学生的心理健康教育工作朝着系统化、科学化和规范化的方向迈进提供理论指导。

目的：了解昆明医科大学大学生心理健康状况，为心理健康教育提供参考借鉴。方法：于2024年3月7日至2024年3月10日采用问卷调查进行，通过网络问卷发放回收的方式进行数据收集，对我校52名学生进行调查，与全国常模比较心理健康水平，分析性别、居住地、生活费、生活习惯对心理健康水平的影响，运用多元回归模型预测各因素对心理健康水平的作用。结果：纳入研究的学生焦虑因子得分高于全国常模、大学生常模，抑郁因子得分无明显差异；拥有不同性别、居住地、生活费、生活习惯的学生焦虑与抑郁因子得分无明显差异，不同因素对学生心理健康水平的影响程度不同，结论：昆明医科大学学生群体中存在焦虑症状，生活习惯对于学生心理健康水平影响较明显，提示我们要根据情况制定有效的心理干预措施，开展对应的心理健康教育提高学生心理健康水平。

目的：通过实证干预的方法，探索正念认知疗法对医学生焦虑情绪的干预效果；方法：通过SAS焦虑自评量表筛选出40名焦虑分值大于50的医学生，按照随机化原则分成两组，分为实验组和对照组，一组20人。对照组学生不进行任何处理，实验组学生由专业老师指导，进行为期8周的正念认知训练，一周练习1次，每次练习45分钟，有具体的主题和内容。8周练习结束后，再次通过SAS量表对两组被试的焦虑水平进行测量，检验正念认知疗法对医学生焦虑情绪的干预效果如何。结果：实验组学生在进行8周正念认知训练后，实验组的焦虑得分显著下降。结论：正念认知疗法对医学生焦虑情绪的干预效果显著。

传染病流行一般分为5个阶段，分别为传入期、扩散期、暴发流行期、下降期、终止期。目的：调查新型冠状病毒肺炎(COVID-19)疫情下降期大学生心理健康状况。探索疫情应激情况下长期在家学习对大学生的心理健康所造成的影响。方法：采用SCL-90症状自评量表，对328名首都医科大学和天津医科大学本科生进行网络问卷调查。结果：所有因子均较大学生常模低，其中6项因子差异有统计学意义(P 0.05)，3项因子较非典时期医学生有升高，差异具有统计学意义(P < 0.05)。结论：COVID-19疫情下降期医学生心理情况与大学生常模相比有所改善，但仍比全国成人的心理情况差。与非典时期医学生相比差异不显著。

大量研究发现，医学生焦虑症状检出率高于全国青年常模水平，心理状况较全国大学生平均水平低，严重影响到医学生的学业绩效、人际交往、身心健康以及就业。正念作为一种简单的思维训练方式，强调将注意力集中于当下、有意识的觉察以及对一切观念不加评价，对个体的负面情绪具有调节作用。本文从正念疗法的内涵、模型、作用机制、正念疗法在医学生考试焦虑情绪的运用现状及研究展望等方面进行分析，以期为今后医学生的考试焦虑实施正念疗法提供依据。

伴随着医疗卫生体制改革的不断进步与深入落实，住院医师规范化培训制度的逐步健全，规范化培训是培养高层次临床医师，提高我国医疗质量的重要途径。然而由于各方面条件限制以及自身能力不足，住院医师规范化培训学员在能力提高的过程中易出现职业倦怠等情况。探讨国内外职业倦怠现状，分析其产生原因及影响，为有效预防职业倦怠提供有利依据。提出相应建议与对策，为延缓住院医师规范化培训学员职业倦怠提供参考意义。

医护人员特别是精神医学实习医师是出现职业倦怠的高频率群体，因为特殊的工作环境和封闭式条件，可能会出现对工作的厌恶疲倦感，所以需及时调整身心状态。因此了解精神医学实习医师的职业倦怠状况对其提高工作质量和生活质量具有重要的意义。最近几年的研究及临床实践中，关注较多的是精神科与其他各科室的职业倦怠的比较分析和医生总体之间的职业倦怠状况及各因素的影响，对于精神医学实习医师职业倦怠及其因素的分析最近几年的研究罕见报道。因此本文拟对精神科实习医师造成职业倦怠的自身、国家、社会与组织等方面进行探析，为今后了解造成精神医学实习医师职业出现倦怠感的各方面及促进未来社会对精神卫生服务的需求方面提供参考依据。

为探究学生学习满意度、成就动机、抑郁程度三者间的关系，本研究运用衡量学习满意度、成就动机、抑郁程度的量表收集了中国314名学生的有效数据，并基于SPSS软件和Mplus软件通过构建结构方程模型分析学习满意度、成就动机与抑郁程度间的关系。结果显示：(1) 学生学习满意度对学生的抑郁程度产生负向影响(β = −0.481, P β = 0.954, P β = −0.528, P < 0.001)；(4) 成就动机在学习满意度对抑郁程度的影响中具有中介作用。研究发现，学生学习满意度和成就动机是导致学生群体抑郁的重要因素，为此要关注学生学习满意度和成就动机的变化，重视学生的心理健康问题。

本研究旨在探讨大学生父母心理控制和考试焦虑的关系，并探讨核心自我评价和负面评价恐惧在这条路径上的直接中介作用以及链式中介作用，对于预防和干预大学生的考试焦虑具有参考意义。本研究选用父母心理控制量表、考试焦虑量表、核心自我评价量表和负面评价恐惧量表，对534名大学生进行测量。结果显示：(1) 大学生的父母心理控制和核心自我评价、负面评价恐惧等主要变量两两之间呈显著相关；(2) 大学生父母心理控制对考试焦虑的直接效应显著；(3) 在三条中介路径中，由核心自我评价单独作为中介变量的中介效应显著；由负面评价恐惧作为单独中介变量的中介效应显著；由核心自我评价和负面评价恐惧共同作用的的链式中介路径显著。研究表明，父母心理控制会通过大学生的核心自我评价和负面评价恐惧这些认知评价机制影响考试的焦虑程度。

目的：探讨以宽恕为主题的舞动团体干预对降低贫困医学生愤怒水平和提高愤怒控制能力的效果。方法：招募28名贫困医学生并随机分配到干预组和对照组。干预组进行连续8周的，每周2小时的舞动团体干预，对照组只进行心理健康教育。8周后，干预组和对照组均接受生物反馈仪进行愤怒唤醒及控制的实验。两组在实验前后均使用状态–特质愤怒表达问卷(STAXI-2)量表进行测量。结果：干预组除愤怒表达中的外向怒因子结果为不显著外，其余因子得分均高于干预前(P 0.05)；生物反馈仪结果显示，干预组在使用舞动方法干预后的皮电水平明显低于诱发后的皮电水平(P = 0.043, t = 2.245, P 0.05)。结论：宽恕主题的舞动团体能有效减轻贫困医学生的愤怒水平，提高愤怒控制能力。

为考察领悟社会支持量表在医学生和非医学生之间的测量等值性，检验两群体在领悟社会支持的差异，采用领悟社会支持问卷对384名大学生展开问卷调查。结果发现，领悟社会支持问卷的三因子结构能良好地拟合数据，且在医学生组和非医学生组之间达到严格等值，具有良好的信效度和测量等值性。t检验显示，医学生的领悟社会支持总分显著高于非医学生，t (2, 382) = 2.277，p = 0.023。意味着该量表适合在我国大学生、医学生与非医学生群体中使用，且医学生比非医学生的领悟社会支持水平更高。

目的：本研究试图对医学生的躺平程度、自我同情水平、乐观程度三者之间的相互关系及乐观是否在躺平与自我同情之间起中介作用进行探讨。方法：采用躺平量表、自我同情量表、生活定向测验量表对295名医学生进行调查。结果显示：(1) 躺平、自我同情和乐观在部分人口学变量上存在显著差异。(2) 躺平、自我同情、乐观彼此之间存在显著相关。(3) 自我同情对乐观水平具有正向预测的作用，且对躺平有负向预测的作用。乐观水平与躺平程度呈显著负相关关系。(4) 乐观水平在自我同情与躺平之间起着中介效应。结论：自我同情和乐观能对医学生的躺平产生影响，自我同情水平越高的医学生更易保持乐观心态，进而减少躺平行为倾向。

目的：了解临床医学专业大学生的心理健康状况，为后期的心理健康工作提供良好的依据。方法：采用症状自评量表(SCL-90)对354名临床医学专业大学生进行调查，通过使用SPSS软件对数据进行统计学分析。结果：1) 临床医学专业大学生的心理健康状况在恐怖和精神病性因子上得分高于国内成人常模(P P P P < 0.05)。结论：本次调查的学生状况整体较好，但性别、是否为独生子女对大学生的心理健康水平存在一定的影响。建议院校有针对性地建立有效的预警及干预机制，提高学生的心理健康水平，促进学生心理健康发展。

目的：研究本科医学生同伴关系、核心自我评价、心理耐挫力的现状及相关性。方法：采用多中心分层随机抽样法选取4所本科医学院校的794名学生，应用同伴关系量表、核心自我评价量表、心理耐挫力问卷对研究对象施测。结果：本科医学生同伴接纳水平、同伴恐惧自卑水平、核心自我评价、心理耐挫力得分分别为(61.25 ± 8.79)、(22.59 ± 5.71)、(35.39 ± 6.33)、(18.30 ± 4.54)；性别不同、是否为学生干部、籍贯不同的本科医学生心理耐挫力差异有统计学意义(p p p p p < 0.01)；核心自我评价在同伴关系与心理耐挫力之间存在中介效应。结论：同伴接纳和良好的核心自我评价对本科医学生心理耐挫力具有正向作用，可以通过建立和谐的同伴关系、树立积极的核心自我评价来提高本科医学生心理耐挫力。

目的：探讨医学生特质焦虑与学业拖延之间的中介机制。方法：选取重庆市某高校545名医学生为研究对象，采用特质焦虑量表(TAI)、学业拖延量表(PASS)和学业自我效能感量表对其进行问卷调查。结果：(1) 54.31%的医学生存在不同程度的学业拖延，学业拖延在成绩、生源地方面存在显著差异。(2) 学业拖延与特质焦虑呈显著正相关，与学业自我效能感呈显著负相关。(3) 特质焦虑不仅能直接影响医学生学业拖延，还能通过学业自我效能感对学业拖延产生间接影响，间接效应占总效应的18.33%。结论：特质焦虑和学业自我效能感是学业拖延的重要影响因素。医学生学业自我效能感在特质焦虑与学业拖延之间起部分中介作用。

目的：探讨医学生父母心理控制与社会适应的关系及其自尊在其中的中介作用。方法：采用父母心理控制量表、社会适应量表和自尊量表对甘肃某医学院校415名医学生进行测量。结果：父母心理控制与医学生社会适应显著相关，然后自尊在父母心理控制与医学生社会适应之间起部分中介作用。结论：通过提高自尊水平，有利于提升医学生的社会适应能力以及有利于降低父母心理控制的影响。对策：首先多方协作构建社会支持网络系统。其次学校可以通过各种活动创建特色校园文化环境，最后，医学生需提高个人心理韧性，从而达到通过提高自尊水平，降低父母心理控制，增加社会适应的目的。

目的：运用积极心理学对高职医学生进行心理干预，提高医学生心理弹性、缓解压力知觉。方法：将140名高职医学生随机分为对照组70名和干预组70名。对照组不施加任何心理干预措施，干预组运用积极心理学的方式实施心理干预。对照组和干预组在实施干预前后，分别进行心理弹性、压力知觉的评价。结果：通过实施积极心理干预，干预组的心理弹性、压力知觉水平好于对照组(P < 0.01)。结论：积极心理干预可提高高职医学生心理弹性，改善压力知觉。

目的：了解本科护生的急性应激反应及与抑郁、焦虑的相关性，为采取应对措施提供依据。方法：对昆明医科大学护理学院本科护生，采用一般资料问卷、斯坦福急性应激反应问卷(SASRQ)、DASS-21量表进行调查。结果：153名本科护生的SASRQ的得分(20.57 ± 19.71)分，抑郁评分为(8.69 ± 6.35)分，焦虑评分为(6.17 ± 5.10)分。性别、年龄以及焦虑和抑郁进入回归方程，本科护生焦虑、抑郁阳性症状者在SASRQ总分及各个维度评分均大于焦虑、抑郁阴性症状者，差异有统计学意义(P < 0.05)。结论：焦虑和抑郁是本科护生发生急性应激障碍的主要影响因素，应该引起重视。

目的：了解常态化疫情背景下大学生心理健康状况。方法：选取深圳地区院校在校本科大学生为研究对象，采用焦虑自评量表、抑郁自评量表、事件影响量表和人口学基本信息资料进行调查，运用相关性、多元线性回归方法进行统计分析。结果：大学生群体中受疫情影响存在不同程度的焦虑、抑郁情绪和创伤后应激障碍症状，其中非医学生比例高于医学生，男生比例高于女生；不同专业、年级和生源地与焦虑具有统计学意义，不同专业和年级与抑郁具有统计学意义，不同专业、年级和生源地与创伤后应激障碍具有统计学意义。结论：学校可针对学生的不同特点开展心理干预以降低突发公共卫生事件造成的心理危害。

目的：探索心理健康水平、自尊对心理健康服务求助态度的影响。方法：用自测健康评定量表、心理健康服务求助态度量表以及自尊量表对430名大学生进行调查，调查结果采用SPSS17.0进行t检验、方差分析、皮尔逊相关法、多元回归分析。结果：① 自尊(t = −3.081, p < 0.01)、自测生理健康(t = −4.252, p < 0.001)、日常生活功能(t = −3.618, p < 0.001)对心理开放程度因子具有负向预测作用。② 自测心理健康(t = 3.293, p < 0.01)、心理症状与负向情绪因子(t = 2.428, p < 0.05)对心理开放程度因子具有正向预测作用。③ 自测社会健康(t = 8.512, p < 0.001)、角色活动与社会适应因子(t = 4.309, p < 0.001)、社会支持因子(t = 3.981, p < 0.001)、社会资源与社会接触因子(t = 4.924, p < 0.001)、自尊(t = 2.813, p < 0.01)对心理求助倾向因子具有正向预测作用。结论：大学生的心理健康和自尊影响心理健康服务求助态度，具有预测作用。

Introduction Mobile phone addiction (MPA) is an escalating issue, particularly among high-pressure medical students prone to over-reliance on mobile phones, and it is closely associated with lower achievement motivation. This study aimed to explore the associations between Chinese medical students' achievement motivation, anxiety, depression, and MPA. Methods Single-site cluster sampling was used to recruit 2,977 undergraduate medical students (Years 1–3) from a large medical university in Shandong Province. Data were collected via the Achievement Motivation Scale (AMS), Generalized Anxiety Disorder Scale-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Mobile Phone Addiction Index (MPAI), with 2,679 valid questionnaires retained. Results Of the participants, 26.58% had MPA, with an average MPAI score of 42.97 ± 12.12. The average AMS score was 1.87 ± 0.35. Multiple linear regression showed that gender, liking one's major, MPAI, 7, and PHQ-9 scores significantly influenced achievement motivation (all p < 0.05). Mediation analysis indicated that anxiety and depression played a chain mediating role in the relationship between MPA achievement motivation: the total indirect effect was −0.114 (95%CI = [−0.133, −0.095]), including three paths: MPAI → GAD7 → AMS (effect = −0.027, 95%CI = [−0.047, −0.008]), MPAI → PHQ9 → AMS (effect = 95%CI = [−0.042, −0.023]), and MPAI → GAD7 → PHQ9 → AMS (effect = −0.055, 95% CI = [−0.070, −0.041]). Discussion MPA correlates with lower achievement motivation in Chinese medical students, with anxiety and depression acting as mediators. Universities should take targeted measures to address MPA, in anxiety and depression, and improve medical students' achievement motivation.

Objective To investigate the associations between meeting the new Canadian 24‐h movement guidelines and symptoms of depression, anxiety, and stress among Chinese medical students, thus providing empirical and theoretical support for targeted mental health interventions. Methods A total of 3679 medical students were recruited through multicenter convenience sampling in November 2022. A self‐administered standardized questionnaire assessed three 24‐h movement behaviors—moderate‐to‐vigorous physical activity (MVPA), sedentary time, and sleep—as well as symptoms of depression, anxiety, and stress. Logistic regression models were applied to analyze the association between meeting new 24‐h movement guidelines and symptoms of depression, anxiety, and stress. Results A total of 3228 valid responses were obtained. The proportions of students who met all 24‐h movement behavior recommendations were low, at 4.01% among clinical students and 7.14% among nursing students. The overall prevalence of negative emotional symptoms was 60.9% in clinical students and 46.7% in nursing students. A clear dose–response relationship was evident between the number of recommendations met and a lower risk of depression, anxiety, and stress. Medical students who fully met all recommendations had a significantly lower risk of negative emotional symptoms compared with those who met none (stress odds ratio [OR] = 0.239, 95% confidence interval [CI]: 0.101–0.568, p = 0.001; anxiety OR = 0.601, 95% CI: 0.407–0.889, p = 0.011; depression OR = 0.450, 95% CI: 0.290–0.700, p  < 0.001). Similar protective associations were found in both clinical and nursing subgroups. All associations remained generally consistent after false discovery rate (FDR) correction, supporting the robustness of the results. A significant three‐way interaction among MVPA, sedentary behavior, and sleep was observed for stress. Conclusion Adherence to the 24‐h movement behavior recommendations was suboptimal among Chinese medical students. However, greater adherence was associated with a lower risk of symptoms of depression, anxiety, and stress, highlighting the need for integrated lifestyle interventions targeting physical activity, sedentary time, and sleep balance.

Background Current assessment of depression primarily relies on psychological scales. Although the use of machine learning in depression has grown, limited reports are available on multiple neurophysiological measurements. We employed machine learning algorithms incorporating eye tracking, visual evoked potentials (VEPs), and auditory P300 to classify depression among Chinese medical students. Methods A total of 66 students with depression and 72 matched controls were recruited; eye tracking, VEPs, and auditory P300 data were collected. Descriptive analyses and group comparisons were performed between the depression and control groups. Then, multivariate logistic regression (LR) analysis was conducted to evaluate the relationship between eye tracking, VEPs, and auditory P300 features and Patient Health Questionnaire-9 (PHQ-9) scores. Furthermore, the study employed six classifiers to differentiate between depression and nondepression. Five-fold cross-validation was employed. Model performance was assessed using receiver operating characteristic (ROC) curves, area under the curve (AUC), precision, accuracy, recall, and F1 score. We applied SHapley Additive exPlanations (SHAP) values to explain the model. Results Depression group was characterized by lower response search scores, higher D values, and prolonged P100 latencies in both eyes. No significant differences were observed in auditory P300 features. Random forest (RF) classifier demonstrated superior classification performance relative to the other five machine learning algorithms. Models utilizing combined features showed enhanced performance compared with those based solely on eye tracking or VEP features. Utilizing the SHAP method, we identified that P100 latency in the right eye was the most significant feature across all machine learning models. Conclusions Chinese medical students with depression exhibited reduced responsive search scores and extended P100 latencies, suggesting impairments in attention and visual information processing associated with depression. The combined eye tracking and VEPs proved to be more effective than single features for distinguishing depression and nondepression. P100 latency in the right eye may be the most significant predictor of depression.

OBJECTIVES This study aimed to explore the characteristics, overall anxiety and depression status, and influencing factors of only-child and non-only-child students by examining a medical student population in the post-COVID-19 era. STUDY DESIGN This study was a cross-sectional design. METHODS An online questionnaire survey was administered among medical students. The psychological problems related to depression and anxiety were measured using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), respectively, which were scored via a Likert-4 scale. Statistical analysis was employed to explore the characteristics and overall differences between only-child and non-only-child students, along with the factors affecting their anxiety and depression. RESULTS A total of 1688 participants were enrolled. No significant differences were observed in the prevalence of anxiety (χ2 = 1.154, P = 0.283) and depression (χ2 = 0.313, P = 0.576) between only-child and non-only-child students. School level, single status, and desire for only child status are associated with anxiety and depression in the two groups. Region and loneliness are merely related to anxiety and depression among only-child students, while gender, willingness to apply for medical school, and equal treatment are associated with anxiety and depression among non-only-child students. CONCLUSION Our study found the factors that are associated with depression or anxiety inthe only-child and non-only-child medical students jointly and separately, which could provide a new theoretical basis for the psychological intervention of medical students, that is, to identify the high risk factors of depression and anxiety from the perspective of only child and non-only child.

Medical students experience depression and anxiety at a higher rate than the general population or students from other specialties. While there is a growing literature on the high prevalence of depression and anxiety symptoms and about potential risk factors to the prevalence of depression and anxiety symptoms among medical students, there is a paucity of evidence focused on the prevalence of depression and anxiety symptoms and associations with family function, social support and coping styles in Chinese vocational medicine students. This study aims to investigate the prevalence of depression and anxiety symptoms among Chinese medical students and assess the correlation between depression/anxiety symptoms and family function, social support and coping styles. A sample of 2057 medical students from Chongqing Medical and Pharmaceutical College in China was investigated with a self-report questionnaire, which included demographic information, Zung self-rating depression scale, Zung Self-Rating Anxiety Scale, Family APGAR Index, Social Support Rating Scale and Trait Coping Style Questionnaire. The prevalence of depression and anxiety symptoms among the medical students was 57.5 and 30.8%, respectively. Older students(≥20 years) experienced higher levels of depression and anxiety. More depression and anxiety symptoms were exhibited among students with big financial burden, big study-induced stress and poor sleep quality. Students with large employment pressure showed more anxiety symptoms. Students who live alone or had bad relationship with their lovers or classmates or friends showed higher depression and anxiety scores. Depression and anxiety symptoms had highly significant correlations with family functioning, social support and coping style. Academic staffs should take measures to reduce depression and anxiety among medical students and to provide educational counseling and psychological support for students to cope with these problems.

OBJECTIVE Aggressive behaviour is a significant public health concern because of its high prevalence and the challenges it poses for management. This study investigated the role of anxiety and depression as mediators in the association between mobile phone addiction and aggressive behaviours among medical students. METHODS A cross-sectional survey was conducted among 1759 medical students in Anhui Province, China, from February to May 2023. Participants completed the Mobile Phone Addiction Tendency Scale, the Generalized Anxiety Disorder-2 (GAD-2) scale, the Patient Health Questionnaire-2 (PHQ-2), and the Buss-Perry Aggression Questionnaire. Data were analysed using SPSS 26.0 and the PROCESS Macro to examine the chained mediation effects of anxiety and depression. RESULTS The findings supported the hypothesis that mobile phone addiction influences aggression through three distinct pathways: independent mediation by anxiety (13.3 % of the total effect), independent mediation by depression (1.7 %), and sequential mediation through anxiety to depression (4.4 %). The total mediation effect accounted for 19.4 % of the variance in aggression. CONCLUSION This research identifies anxiety and depression as critical mediators in the technology-behaviour relationship among medical students. The chained mediation mechanism offers healthcare educators a dual intervention framework: addressing smartphone overuse patterns while implementing emotion-regulation strategies. These findings provide empirical evidence for developing institutional mental health protocols that simultaneously target digital well-being and mitigate psychological distress.

Network analysis provides a novel approach to discovering associations between mental disorders at the symptom level. This study aimed to examine the characteristics of the network of depression and anxiety symptoms and their associations with mobile phone addiction (MPA) among Chinese medical students during the late stage of the COVID-19 pandemic. A total of 553 medical students were included. Depression and anxiety symptoms and MPA were measured by the nine-item Patient Health Questionnaire (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (GAD-7), and the Mobile Phone Addiction Index (MPAI), respectively. Central and bridge symptoms were identified with centrality indices and bridge centrality indices. Network stability was examined using the case-dropping procedure. “Uncontrollable worry”, “restlessness” and “nervousness” were the central symptoms in the depression and anxiety network. “Restlessness” and “motor” were the most central bridge symptoms linking depression and anxiety. “Concentration”, “anhedonia” and “sleep” were most strongly associated with MPA. “Uncontrollable worry”, “restlessness”, “nervousness,” and “motor” may be the symptoms for interventions to target in medical students with comorbid depression and anxiety. From a network perspective, depressive symptoms may be more important than anxiety symptoms in medical students with MPA.

The literature has shown that mobile phone addiction is an important risk factor for depression. However, the internal mechanisms of mobile phone addiction leading to depression are still not clear. This study examined the mediating role of sleep quality and moderating role of peer relationships in the association between mobile phone addiction and depression. A sample of 450 Chinese medical students were recruited to complete measures of mobile phone addiction, depression, sleep quality and peer relationships. In this study, SPSS 25.0 and macro PROCESS were used to conduct statistical analysis on the collected data. The results showed that sleep quality partially mediated the association between mobile phone addiction and depression. Moreover, the effect of sleep quality on depression was moderated by peer relationships. The present study can advance our understanding of how and when mobile phone addiction leads to depression. Limitations and implications of this study are discussed.

The use of social network sites (SNSs) is inevitable in daily life. Everyone is likely to be addicted to SNSs, especially medical students. This study is aimed to assess the degree of SNS addiction and its relation to psychosocial factors such as depression, loneliness and unmet interpersonal needs among Chinese medical students. The cross-section survey was conducted from March to May in 2018 in Shanghai Jiao Tong University School of Medicine. Of the total 1067 participants, 33.18% had an SNS addiction, 87.7% of the participants used SNSs every day during last month and 53.42% of the participants used SNSs for at least an hour per day during the last week. SNS addiction is positively related with depression both directly and indirectly. The mediating roles of loneliness and unmet interpersonal needs on the relationship between SNS addiction and depression are significant. For the well-being of medical students, efforts should be taken to prevent them from becoming addicted to SNSs.

Background This study aims to investigate the mediating role of emotional regulation in the relationship between physical exercise and suicidal ideation among Chinese medical students. The study specifically examined how exercise-induced enhancement of emotional regulatory capacity may mitigate suicide risk through neurobiological and psychological pathways. Methods A cross-sectional study assessed 852 medical students using the Physical Activity Rating Scale-3 (PARS-3) to categorize exercise intensity (low: 51.9%; moderate: 25.9%; high: 22.2%). Suicidal ideation was measured with the Positive and Negative Suicide Ideation Scale (PANSI), emotional regulation capacity with the Emotion Regulation Questionnaire (ERQ), and psychological symptoms with the Symptom Checklist-90 (SCL-90). Independent t-tests, ANOVA tests, and mediation modeling were used for analysis. Results The prevalence of suicidal ideation was 8.10% (69/852), consistent with national epidemiological data. Males exhibited significantly lower depression (Δ = −1.24, p < 0.05) and anxiety (Δ = −0.87, p < 0.05) scores than females. Students engaging in high/moderate-intensity exercise demonstrated lower rates of depression and psychosis compared to low-intensity exercisers (p < 0.05). Emotional regulation mediated 38.1% of the protective effect of exercise against suicidal ideation (p < 0.01), aligning with established neurobiological pathways linking physical activity to mood regulation. Conclusion The physical exercise habits of medical students are intricately linked to their mental and emotional well-being. It is recommended that medical institutions intensify efforts to promote physical exercise and encourage greater participation among medical students. This proactive approach can contribute to reducing suicidal ideation among medical students and enhancing their overall mental health.

ABSTRACT The prevalence of depression continues to increase among medical students in China, and higher than that of other majors, which is a potential risk for medical students and their patients. This study aimed to observe the prevalence of depression in Chinese medical students and also the correlation between them. All cross-sectional studies on the prevalence of depression in Chinese medical students were retrieved from PubMed, Embase, the Cochrane Database of Systematic Reviews, CNKI, and Wanfang. An 11-item checklist recommended by the Agency for Healthcare Research and Quality was adopted to evaluate the methodological quality of the included studies. Software Stata 12.0 was used to analyze the data. Registration: PROSPERO, CRD42020169681. The prevalence of depression among medical students in China was 27%. The subgroup analysis showed significant differences in the prevalence of depression in different regions. The sleep quality was a significant heterogeneous source of depression. Medical students with sleep disorders were more than three times as likely to report depression. The prevalence of depression in Chinese medical students is relatively high, and medical students with sleep disorders are more likely to have depression problems. Regular screening and appropriate intervention are recommended for these mental health problems.

ABSTRACT The present study explored whether the two psychosocial resources including resilience and social support serve as moderating factors in the process between academic burnout and depression among medical students, and investigated factors that associated with depression. We applied Learning Burnout Scale of Undergraduates, Beck Depression Inventory-II, Connor-Davidson Resilience Scale, and Social Support Rating Scale as tools for an investigation with 1722 Chinese medical students. Academic burnout positively correlated with depression while resilience and social support negatively related to depression. Hierarchical regression implied that resilience moderated burnout and depression while social support did not show a buffer effect between the same variables. Building resilience and enhancing their social support are essential for preventing depression in their college life. It is also worth noting that resilience can still work against depression even when academic burnout emerged.

No abstract available

Mental health problems are frequent obstacles in medical students’ careers as doctors. Given that previous studies overlook the mediation of stress perception, the current study expanded previous goal orientation researches by addressing an unexplored mechanism. This study aims to examine the mediational roles of stress perception (perceived stressors and stress-related cognition) on the relationship between achievement goal orientation and depression in medical students. A total of 1,015 Chinese 2-year medical students completed a multi-section questionnaire. Hypotheses were examined by structural equation modeling. The findings suggest that performance-avoidance goal orientation and perceived stressors both demonstrated direct facilitative effects on depression, whereas stress-related cognition demonstrated direct obstructive effects on depression. Both perceived stressors and stress-related cognition mediated the relationship between achievement goal orientation and depression. The findings spark a new perspective on motivational intervention that assist students in adopting mastery-approaching strategy as well as ways of coping with stressful academic situations. Identifying students with achievement goal orientation and providing them with the appropriate supportive services may help them to manage stress and mitigate or prevent depression.

Introduction Professional psychological qualities are crucial for individuals’ career development and overall well-being, especially in clinical medical professions. Medical students often face significant work, academic, and doctor-patient communication pressures, which can challenge their mental and emotional health. Measuring and understanding the relationship between medical students’ professional psychological qualities and their mental health is of significant practical importance. Methods This study developed a comprehensive professional psychological qualities scale through a series of qualitative and quantitative studies, consisting of three main components and thirteen secondary dimensions. The scale’s reliability was assessed using Cronbach’s α coefficients. In Study 2, the scale was administered to 972 medical students to explore their anxiety and depression levels. A simple mediation analysis was conducted to investigate the relationship between professional psychological qualities, anxiety, and depression. Results The professional psychological qualities scale demonstrated satisfactory reliability, with a total scale α coefficient of 0.947 and subscale α coefficients ranging from 0.895 to 0.933. The mediation analysis revealed that medical students’ professional psychological qualities directly negatively impact depression levels and indirectly positively influence them via their effects on anxiety levels, exhibiting an overall masking effect unrelated to depression levels. Discussion This study addresses the gap in research on the professional psychological qualities of medical students by providing a reliable measurement tool. The findings shed light on the complex mechanisms through which these qualities impact the mental health process. The scale can be used by other researchers to assess medical students’ professional psychological qualities and further investigate their relationship with mental health outcomes.

Emotional intelligence (EI) is increasingly recognized as an essential competency in medical education, yet evidence on its determinants and its relationship with mental health among Chinese medical students remains limited. This study examined factors associated with EI, explored its associations with stress, anxiety, and depression, and assessed whether EI mediates gender differences in psychological outcomes. The study involved undergraduate medical students from the 1st, 3rd, 5th, 7th, and 9th semesters at the Norman Bethune Health Science Center of Jilin University. An online questionnaire was administered, including sociodemographic questions and validated scales to assess perceived stress, anxiety, depression, and EI. Additional data on factors such as leadership experience and participation in competitive activities were also collected. Descriptive statistics, t-tests, ANOVA, Pearson correlations, and multivariate logistic regression analyses were used to evaluate associations. Mediation analyses tested whether EI mediated the relationship between gender and mental health indicators. A total of 1,376 medical students were included (mean EI = 4.86 ± 0.81). EI differed significantly by gender, academic semester, leadership experience, and competition participation (all p < 0.05). Students reporting stress (53%), anxiety (9%), or depression (18%) had markedly lower EI scores (all p < 0.001). Higher EI was independently associated with lower odds of stress (OR 0.20), anxiety (OR 0.14), and depression (OR 0.12) in adjusted models (all p < 0.001). Mediation analysis indicated that EI partially accounted for gender differences in psychological outcomes, explaining 36.4% of the total effect on anxiety and 38.3% on depression. These findings highlight the protective role of EI in medical students’ mental health and its contribution to gender-related differences in psychological well-being. EI plays a protective role in the mental health of medical students and partially explains gender disparities in anxiety and depression. As EI is a modifiable competency, incorporating EI-focused training, leadership development, and experiential learning into medical curricula may strengthen students’ emotional skills and psychological resilience. Future longitudinal and multi-institutional studies are needed to evaluate the long-term impact of EI-enhancing strategies within medical education.

No abstract available

Abstract Purpose Here we aimed to define the prevalence of imposter syndrome (IS) and identify associated characteristics in Chinese medical students and residents enrolled at Peking Union Medical College Hospital (PUMCH). Methods This was a single-center, cross-sectional study of medical students and residents enrolled at PUMCH conducted in September and October 2022. Participants were recruited to complete a 37-question survey on demographics, a Chinese version of the Clance Imposter Phenomenon Scale (CIPS), and self-assessments of anxiety, depression, burnout, sleep quality, challenges of clinical learning, and time allocation. IS prevalence and its associated factors were analyzed. Results One hundred and forty-eight medical students and 89 residents completed the survey. IS was significant or severe in 62.8% of medical students and 57.2% of residents. Students enrolled in the eight-year program had significantly higher CIPS scores than those enrolled in the 4 + 4 program (66.4 vs. 60.7, p = .005). There were no gender differences in IS prevalence and severity. Participants with severe IS had significantly higher self-rated anxiety, depression, insomnia, and burnout than participants with mild/moderate IS. Participants significantly challenged by clinical learning had significantly higher CIPS scores. Conclusions IS is both prevalent and severe in Chinese medical students and residents. Classroom learning, an eight-year program, and being challenged by clinical learning are potentially associated with IS.

Medical students are at high risk of psychological subhealth under heavy stress with increasing screen time. This study aimed to explore the association between screen time and depressive symptoms and determine empathy as a mediating factor. In this cross-sectional study, a total of 945 medical students were surveyed, and 924 medical students were ultimately included after standard exclusion criteria. They reported their daily screen time and completed the Chinese version of the Jefferson Scale of Empathy-Student Version (JSE-S) and the Self-Rating Depression Scale (SDS). t tests and analysis of variance showed a significant difference in empathy and depressive symptoms by sex, stage, and screen time. The correlation analysis revealed that both affective and cognitive empathy have inverse associations with depressive symptoms. The mediation model confirmed that cognitive empathy played a positive mediating role between screen time and depressive symptoms, reducing the impact of screen time on depressive symptoms. Our study may add empirical evidence to prevent and intervene in depressive symptoms. These findings call for considering controlling screen time and enhancing cognitive empathy as interventions for medical students' depressive symptoms.

Background The efficacy of Traditional Chinese Medicine (TCM) Five Elements Music in intervening anxiety and depression has been extensively validated by trials. This study employed three different instruments to perform TCM Five Elements Music interventions on medical students’ anxiety and depression, aiming to evaluate the differences in therapeutic effects and provide empirical evidence for optimizing treatment protocols. Methods A total of 148 medical students screened via the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were randomly divided into an Erhu group, Guzheng group, Bamboo flute group, and a Control group (37 participants each). The three intervention groups listened to TCM Five Elements Music for 15 min daily over 2 weeks, while the Control group received no intervention. Pre- and post-intervention assessments were conducted using the SAS and SDS. Results Except for the Control group, all three intervention groups showed significantly lower SDS and SAS scores post-intervention compared to pre-intervention (p < 0.01). Statistically significant differences in SDS and SAS scores were observed among the three intervention groups post-intervention (p < 0.01), with the Guzheng group demonstrating the most pronounced intervention effect. Conclusion TCM Five Elements Music effectively alleviates anxiety and depression in medical students. The therapeutic effects vary significantly across different instruments, with the Guzheng yielding the most remarkable outcomes. Clinical trial registration This study has been registered with the International Traditional Medicine Clinical Trial Registry (Registration No.: ITMCTR2025000818).

Mental health problems among medical students have been widely acknowledged and research shows that problems such as depression may occur from the outset of medical education. However, there are few studies focusing on the correlations between personality traits and depression among preclinical medical students. The purpose of this study was to examine the relationship between big five personality traits and depression and to explore the mediating role of self-compassion in this relationship among preclinical medical students. This is a multicenter cross-sectional study. First-year and second-year undergraduate preclinical medical students (N = 730) from three medical universities in China participated in this study and completed questionnaires including NEO-Five Factor Inventory (NFFI), Self-Compassion Scale (SCS), Center for Epidemiologic Studies Depression Scale (CES-D) and demographic information. Statistical analyses included scale reliability analysis, descriptive statistics analysis, the Student’s t-test, one-way ANOVA, Pearson’s correlation analysis, hierarchical linear regression analysis and bootstrap mediation analysis. Almost one third of preclinical medical students (30.3%) were found to be depressed and males were more likely to suffer from depression compared with females (p < 0.05). After the adjustment of age and gender, big five personality traits and self-compassion combined accounted for a large proportion (47.4%) in the variance of depression. Self-compassion played a partial mediating role in the relationship between extraversion, conscientiousness, neuroticism and depression and a full mediating role in the association of agreeableness with depression. This study found a high prevalence of depression among preclinical medical students and self-compassion had a significant mediating effect on the relationship between extraversion, agreeableness, conscientiousness, neuroticism and depression. Medical institutions and related authorities need to consider implementing effective interventions to cultivate preclinical medical students’ self-compassion to protect them against depression and make them better prepared for the succeeding clinical study.

OBJECTIVE This study aimed to investigate the suboptimal health status or subhealth status and their relationship with mental health and smartphone addiction among Chinese medical students. METHODS A cross-sectional survey was conducted at Wannan Medical College of China in Wuhu. RESULTS A total of 2,741 students were surveyed in October 2020. Of 2,741 Chinese medical students who completed the survey, 904 (33%) participants reported to have had subhealth status. Anxiety status (p<0.001), depression status (p<0.001), and smartphone addiction status (p<0.001) have strong association with subhealth status. CONCLUSION This survey shows that the detection rate of subhealth status in Chinese medical students was 33%. Anxiety, depression, and smartphone addiction students had a higher detection rate of subhealth status. The anxiety, depression, and smartphone addiction of Chinese medical students are associated with subhealth status.

Background Medical students in China who face the dual pressure of study and employment tend to experience subclinical depressive symptoms. Parental care plays an important direct and indirect role in the psychological development of medical students, and the extent and mechanism of this role urgently need to be studied and discussed. Methods After simple random sampling and screening of valid questionnaires, data from a total of 924 people were used. The participants completed the parental bonding instrument, self-rating depression scale, Chinese version of the Jefferson empathy scale-medical student edition and self-rating anxiety scale to evaluate parental care, empathy, depressive symptoms and anxiety. The data were statistically processed using a descriptive analysis, correlation analysis and test of moderated mediation. Results Maternal care had a significant negative predictive effect on depressive symptoms among medical students. Strong maternal care can reduce the occurrence of depressive symptoms in medical students. Empathy played a positive mediating role such that both types of empathy could alleviate the effect of weak maternal care on the depressive symptoms of medical students. However, neither cognitive empathy nor affective empathy played a mediating role in the relationship between paternal care and depressive symptoms. Nevertheless, the relationship between maternal care and empathy was moderated by the medical students’ gender. Conclusions The effect of this relationship on female medical students deserves special attention. The results of this study provide a reference and basis for the adjustment of medical education. This study could also help in the design of effective psychological intervention measures to reduce the degree of depressive symptoms and enhance personal empathy.

We entitled “Prevalence of subhealth status and its effects on mental health and smartphone addiction: a cross-sectional study among Chinese medical students” by et al. 1 . The findings of this study suggest that anxiety, depression, and smartphone addiction among Chinese medical students are associated with subhealth status. This study is of great significance in the prevention and treatment of the physical and mental health of medical students. However, in our opinion, there are some ques-tions that are still unanswered and worth discussing.

Backgrounds Medical students are prone to experience alexithymia due to academic work overload, which could increase the prevalence of mental illness such as anxiety and depression. The purpose of our study was to estimate the levels of alexithymia and to explore the relationships between alexithymia, self-control, and mindfulness among medical students. Materials and methods From March 18th, 2021 to April 9th, 2021, a cross-sectional study with stratified sampling was carried out in China Medical University, Liaoning Province, China. A total of 1,013 medical students participated in this study. The questionnaires pertaining to the Toronto Alexithymia Scale (TAS-26), the Five Facet Mindfulness Questionnaire (FFMQ), and the Self-control Scale (SCS) were used to assess the levels of alexithymia, mindfulness and self-control. We used Hierarchical Multiple Regression (HMR) and structural equation modeling to explore the mediating role of mindfulness between self-control and alexithymia. Results The mean score of alexithymia in medical students was 69.39 ± 9.9. After controlling for confounders, males were more likely to experience alexithymia. Self-control, acting with awareness, describing, and observing in mindfulness were negatively associated with alexithymia (P < 0.01). Mindfulness mediated the relationship between self-control and alexithymia (a*b = −0.06, BCa 95% CI: −0.09 to −0.031, Percentile 95% CI: −0.089 to −0.031). Conclusion Chinese medical students experienced high levels of alexithymia. Self-control could directly attenuate alexithymia for medical students and indirectly affect alexithymia through the mediating path of mindfulness. Initiatives for self-control ability enhancement should be provided to medical students to combat alexithymia. And interventions on mindfulness training should be developed to prevent from alexithymia and promote their mental health.

INTRODUCTION Students from Shantou University Medical College were subject to domicile quarantine during the early phase of the COVID-19 outbreak. METHODOLOGY We investigated their experience during March-April 2020 using a cross-sectional, self-administered, anonymous online survey. RESULTS Out of 531 respondents, 75.7% became aware of the outbreak via the Internet (61.7%), WeChat (57.8%), and Weibo (49%). Nearly all students knew COVID-19 manifestations, incubation period, and transmission modes; about half considered wearing facemask and hand hygiene as effective epidemic interventions. They experienced various emotional reactions that changed significantly in response to the outbreak, lockdown, and quarantine (ps < 0.001), with depression in 23.3%. Most students (83.4%-99.4%) had positive attitudes and good compliance towards domicile quarantine and preventive measures. Females were significantly better than males in hand hygiene compliance (p = 0.04). More students with positive attitudes and good compliance than those without educated their families (ps < 0.05 - ps < 0.001). Multiple logistic regression showed negative relationships between anger and hand hygiene attitude (OR = 0.06, 95% CI = 0.01-0.87); confusion and quarantine compliance (0.30, 0.12-0.76); and anger and compliance with quarantine (0.32, 0.11-0.93), facemask (0.12, 0.03-0.50), and hand hygiene (0.27, 0.08-0.88). CONCLUSIONS This study revealed how multichannel risk communication, early awareness, positive attitudes, and conformity of medical college students might have contributed to the favorable outcome from the COVID-19 epidemic in China. Clear, accurate, consistent, early risk communication by the local, national, and international public health authorities seems critical to promote public understanding, correct risk perception, and rational emotions and attitudes, leading to optimal conformity.

Objective To explore the potential effects of demographic variables and three factors of psychological resilience, tenacity, strength, and optimism on the stress, anxiety, and depression of medical students, and to provide data support for the refinement of mental health interventions. Method A total of 1,099 junior medical students were selected from a certain medical college and surveyed using the Depression Anxiety Stress Scale (DASS-21 Chinese version) and the Connor–Davidson Resilience Scale(CD-RISC Chinese version), as well as a self-designed demographic questionnaire. Data processing was conducted using latent category analysis, contingency table analysis, logistic regression, and other methods. Result Three subgroups for stress and depression, and two subgroups for anxiety were obtained. Contingency table analysis results showed that the correlation coefficients between the subgroups and severity were all greater than 0.6. In normal and mild symptomatic populations, latent category analysis fitted the low stress subgroup and the depression subgroup with insufficient motivation. The logistic regression results showed that psychological resilience factors had different effects on the latent categories of stress, anxiety, and depression. Optimism only had a significant predictive effect on the latent category of stress, while for the latent category of anxiety, only strength had a significant predictive effect. The disharmonious or average family atmosphere were common high-risk factors for high stress, high anxiety and high depression subgroups. The experience of living on campus in high school was a unique influencing factor of anxiety among medical students. Male gender and low subjective socio-economic status were unique influencing factors for the high depression group, while left-behind experience was a unique influencing factor for the depression group with insufficient motivation. Limitations The explanatory power of cross-sectional studies and non-random sampling is limited, and the universality and misrepresentations of the results need further verification. Conclusion There was significant group heterogeneity in the manifestations of stress, anxiety, and depression among medical students, and the behavioral response patterns of subgroups with latent categories exhibited cross group characteristics when grouped by the norm. The impact of tenacity, strength, and optimism on subgroups of stress, anxiety, and depression varied. Future research should integrate different research paradigms, deepen understanding, and provide more targeted evidence support for psychological education and intervention programs for medical students.

Background Suicidal ideation (SI) is intricately linked with insomnia and trait depression, yet the directional relationships and the role of trait depression remain unclear. This study sought to investigate the dynamic interplay between insomnia symptoms, SI, and trait depression (including trait anhedonia (TAN) and trait dysthymia (TDY)), aiming to clarify the role of trait depression in the relationship between insomnia and SI. Methods A longitudinal design was employed to assess 566 undergraduate students (aged 18-25) recruited from a medical university in China. Participants underwent comprehensive assessments with a one-month interval between baseline and follow-up, applying the Athens Insomnia Scale (AIS), the Self-rating Idea of Suicide Scale (SIOSS), and the Trait Depression Scale (TDS). Cross-lagged panel network (CLPN) models were implemented to examine temporal associations, centrality metrics, and network differences between high/low TAN and TDY subgroups. Network stability was evaluated using bootstrap methods. Results Insomnia symptoms, particularly AIS6 (sense of well-being during the day) and AIS7 (functioning), emerged as pivotal nodes significantly predicting SI factors, including despair (DSP) and suicide (SUI), with bidirectional feedback observed. TAN emerged as a central node, strongly influenced by insomnia and SI. TDY primarily influenced TAN and optimism (OPT). In the high-TAN group, OPT was a mediator among the nodes, OPT, AIS2 (awakening during the night), and AIS7 were key bridging nodes, whereas AIS3 (final awakening earlier than desired), AIS8 (sleepiness during the day), and DSP bridged in the low-TAN group. High/low TDY networks exhibited structural congruence but significant differences in bridge centrality rankings. Conclusion Insomnia symptoms exacerbate SI by impairing daytime functioning and emotional regulation, with trait anhedonia serving as a critical node. Personalized interventions targeting specific insomnia symptoms (e.g., AIS6, AIS7 or AIS8) and suicidal emotional factors (e.g., OPT or DSP) are crucial disrupting feedback loops or critical connections to reduce suicide risk, particularly in individuals with varying levels of trait anhedonia. Although medical undergraduates represent a population commonly affected by mental health problems, the specialized nature of our sample may limit the generalizability of our findings. Future research and validation should be conducted in more diverse populations.

Background Anxiety and depression have been increasing among Chinese medical students. The psychological well-being of Chinese medical students has become a critical focus of attention for the medical education community. Increasing evidence shows that positive psychology interventions can be effective in the enhancement of psychological well-being, and may help to prevent depressive symptoms in university students. In the present study, we aimed to explore the potential effect of positive psychology education on improving the mental health of Chinese medical students. Methods An 8-week classroom-based positive psychology intervention workshop, which was established as an elective course embedded in the regular school curriculum, was conducted at the School of Medicine, South China University of Technology (SCUT), China. Undergraduate medical students of the institute in year-2 or year-3 of academic study participated in this training course voluntarily. The participants’ self-reported data on the hope scale, life satisfaction scale, subjective happiness scale, and depression and anxiety scale were collected and analyzed at pre-course ( n  = 61) and post-course ( n  = 49) times. The investigation was also validated with an independent cohort of students who enrolled in the course in the year following the preliminary study. Results The analyses showed that the psychological well-being of the participants were improved after the intervention. Their mean scores on the hope scale, life satisfaction scale and subjective happiness scale were significantly improved ( P  < 0.05), while their symptom levels of depression and anxiety were significantly reduced ( P  < 0.01). A similar trend was observed in the validation cohort. Conclusions These preliminary findings suggest that positive psychology education holds promise for improving psychological well-being among Chinese medical students. Further investigations with larger and well-controlled sample cohorts may yield more convincing and reliable results.

Background Depression is the main risk factor leading to suicidal ideation among college students. This study focused on observing and assessing how the combination of Five-Element Music and Eight-Section Brocade affected depression levels among medical students attending higher vocational colleges. Methods From a total of 1,030 medical students studying in higher vocational colleges, we selected 160 students who showed depressive symptoms and met the specific criteria for the study. We used the SDS scale to identify these students and made them the participants of our experiment. Participants were randomly divided into four groups: the music intervention group (listening to traditional Chinese Five-Element Music for 15 min daily), the Eight-Section Brocade intervention group (practicing the Eight-Section Brocade exercises once daily, approximately 15 min), the combined intervention group (first practicing the Eight-Section Brocade exercises once, then listening to music for 15 min), and the control group (no intervention). Each group consisted of 40 participants. The three intervention groups (excluding the control group) underwent continuous intervention for 4 weeks. The SDS, SAS, and PSQI scales were used for evaluation before and after the intervention. Results Except for the control group, the SDS, SAS, and PSQI scores of the other three groups were lower after the intervention than before the intervention (p < 0.01). After the treatment, the scores on SDS, SAS, and PSQI tests did not vary much between the students who listened to music and those who practiced Eight-Section Brocade (the difference was not statistically significant, p > 0.05). However, the students who did both music and Eight-Section Brocade showed significantly lower scores than those who did only one activity (both p < 0.01). Conclusion Five-Element Music and Eight-Section Brocade can improve depression, anxiety, and sleep status among medical students in higher vocational colleges. The combined intervention of the two is more effective than a single method, and it is worth promoting and applying in higher vocational colleges. Clinical Trial Registration https://www.chictr.org.cn/showproj.html?proj=210705.

Background Previous studies have established a strong association between depression and suicidal behaviors, yet the relationship between anxiety and suicidal behaviors remains unclear. This study examines whether anxiety and depression are independent risk factors for suicidal behaviors in medical college students, and further, whether anxiety may increase the greater risk of suicidal behaviors (SB) in participants with depression. Methods This cross-sectional study was conducted among 4,882 medical students. Demographic information, anxiety, and depression data were collected using online questionnaires or through a widely used social media app named WeChat. Results Anxiety and depression were independent risk factors for suicidal behaviors, and levels of risk correlated positively with the severity of both anxiety and depressive symptoms. A dose–response relationship was identified between the severity of anxiety and the risk of SB, as well as the severity of depression and SB. Furthermore, anxiety increased the risk of suicidal behaviors in participants with depression, with a dose–response relationship between the severity of anxiety symptoms and the risk of SB. Conclusion The findings highlight the importance of screening for anxiety and depressive symptoms in medical college students, as well as reducing anxiety in addition to depressive symptoms in treatment. This study provides valuable data as a reference for clinicians for suicide risk assessments.

Background: The 2019 coronavirus disease (COVID-19) pandemic is a public health emergency of international concern. This study aimed to assess the psychological outcomes and their influencing factors among medical and non-medical University students during the COVID-19 pandemic in China. Methods: A cross-sectional online survey using structured questionnaires was conducted from February 20 to March 20, 2020. Psychological outcomes were assessed according to the Depression, Anxiety, and Stress Scale (DASS-21). Influencing factors were assessed by COVID-19 knowledge, mindful coping scale, and sense of control scale. Results: Our sample is comprised of 563 University students (male = 172, mean age = 21.52). Among them, 382 are medical students. Among the participants, 12.26, 18.47, and 8.53% have moderate to severe levels of depression, anxiety, and stress symptoms, respectively. Compared with the non-medical students, the medical students had a higher knowledge level of COVID-19, a higher sense of awareness, and fewer mental health symptoms. After controlling the covariance, perceived constraints of sense of control were negatively associated with depression, anxiety, and stress among both medical and non-medical students. Prevention of negative emotions by mindful coping was negatively associated with depression and anxiety among non-medical students. Knowledge of COVID-19 is not associated with mental distress among medical and non-medical students. Conclusions: During the COVID-19 pandemic in China, the mental health of University students was affected. Our findings suggested that a sense of control is a protective factor for both medical and non-medical students, while mindful coping is a protective factor for only non-medical students.

Background Perfectionism is a pivotal factor in the etiology and prognosis of major depression. Nevertheless, there is a scarcity of longitudinal research examining the association between perfectionism and major depressive disorder (MDD). The objective of this study was to explore the impact of perfectionism on MDD among a cohort of first-year Chinese university students. Methods This study employed a longitudinal design to investigate the relationship between perfectionism and MDD in a sample of first-year Chinese university students (n=8079). Socially prescribed perfectionism and almost perfectionism were measured using the Multidimensional Perfectionism Scale (MPS) and the Almost Perfect Scale-Revised (APS-R), while MDD was assessed using the Composite International Diagnostic Interview (CIDI-3.0). Random effects logistic regression modeling was utilized to estimate the associations between the variables. Results The findings revealed that the incidence of MDD was 0.6%. Lifetime exposure to severe traumatic events (≥10) (OR=2.619, 95% CI: 1.502–4.565) and almost perfectionism (OR=1.015, 95% CI: 1.004–1.026) were identified as significant risk factors for MDD. Conclusion It is evident that perfectionism is linked to an increased susceptibility to MDD. However, additional longitudinal studies focusing on university students are imperative to delve deeper into the influence of perfectionism on the initial manifestation of MDD.

BackgroundKnowledge about the prevalence of depressive symptoms among Chinese medical students and its related factors is rather limited. Understanding the correlates of depressive symptoms and the roles that positive psychological variables play in depressive symptoms is of vital importance for future interventions. The main objectives of this study were to investigate the prevalence of depressive symptoms and the integrated effects of resilience, hope and optimism on depressive symptoms among Chinese medical students.MethodsThis multi-center cross-sectional study was conducted in June 2014. The questionnaires that consisted of the Center for Epidemiologic Studies Depression Scale (CES-D), Wagnild and Young Resilience Scale-14 (RS-14), Adult Dispositional Hope Scale (ADHS), Life Orientation Test-Revised (LOT-R), and socio-demographic characteristics, were distributed to students at four medical colleges or universities in Liaoning province, China. A total of 2925 medical students became the final subjects. Hierarchical linear regression analyses were used to explore the integrated effects of resilience, hope and optimism on depressive symptoms.ResultsThe prevalence of depressive symptoms among Chinese medical students was 66.8 % (CES-D ≥ 16). Resilience, hope and optimism were all negatively correlated with depressive symptoms and they accounted for 26.1 % of the variance in depressive symptoms.ConclusionsThe high prevalence of depressive symptoms among Chinese medical students calls for special attention from all stakeholders, especially university authorities. Intervention strategies that focus on enhancing the positive psychological variables of resilience, hope and optimism can be integrated into depression prevention and treatment programs.

BackgroundEstablishing an evidence-based method of improving knowledge and attitudes concerning depression has been identified as a priority in Chinese medical education. The purpose of this study was to determine whether a self-directed learning strategy as a part of student-centred education improved knowledge of and attitudes towards depression among Chinese medical students.MethodsA controlled trial in which 205 medical students were allocated to one of two groups: didactic teaching (DT) group or a combined didactic teaching and self-directed learning (DT/SDL) group. The DT/SDL group continued having a series of learning activities after both groups had a lecture on depression together. Student's knowledge and attitudes were assessed immediately after the activities, one month and six months later.ResultsThe intervention (DT/SDL) group showed substantially greater improvements in recognition of depression as a major health issue and identifying helpful treatments than the DT group. Only the DT/SDL group demonstrated any improvement in attitudes. This improvement was sustained over six months.ConclusionsSelf-directed learning is an effective education strategy in improving medical students' knowledge of and attitudes towards depression.

Background Anxiety is one of the most common psychiatric disorder and imposes a great burden on both the individual and the society. Previous studies indicate a high comorbidity of anxiety disorders and Attention Deficit Hyperactivity Disorder (ADHD). However, few studies have examined the comorbidity of anxiety and ADHD among medical college students in mainland China. This study aimed to examine the prevalence of anxiety and the associated risk factor of anxiety disorder as well as to explore the association between ADHD symptoms, depression, suicidal behaviors and anxiety. Methods A cross-sectional design was employed among 4882 medical college students who were recruited and enrolled with convenience sampling. Self-reported demographic information and clinical characteristics were collected online on a computer or through a social media app named Wechat. Results The prevalence of anxiety in this study was 19.9%. Students with anxiety were more likely to have a poor relationship with parents, be of Han nationality, have smoking or drinking habits, have an extensive physical disorder history and have engaged in suicidal behaviors. The independent risk factors for anxiety were: smoking, physical disorder history, suicidal ideations, suicide attempts, inattention and hyperactivity. Significant associations were observed between anxiety and depression, inattention, hyperactivity, suicide plans and suicide attempts. Conclusions Nearly one in five medical students suffered from anxiety. The findings of this study indicate the importance of addressing both anxiety and ADHD symptoms in order to better promote mental health and the well-being of medical students as well as reduce suicidal behaviors.

No abstract available

Objective To investigate the effect of changes in campus living conditions related to the Corona Virus Disease 2019 (COVID-19) pandemic on medical school students’ mental health status, to explore the mediating role of emotion regulation strategies, and to provide effective suggestions for promoting medical school students’ mental health. Methods A self-report questionnaire, an emotion regulation questionnaire (ERQ), and psychological questionnaires for emergent events of public health (PQEEPH) were used to interview 998 medical school students who experienced campus lockdowns during the COVID-19 pandemic. Results The mean total PQEEPH score was 3.66 ± 3.06. The degrees of inconvenience in daily life and change in routine and expression suppression as an emotion regulation strategy were significantly positively correlated with all PQEEPH dimensions. Cognitive reappraisal was significantly negatively associated with depression, neurosis, obsessive–compulsive anxiety, and hypochondriasis (ps < 0.05). Cognitive reappraisal and expression suppression demonstrated a chain mediating role between the degree of inconvenience in life and mental health and between the degree of change in routine and mental health (F = 32.883, 41.051, ps < 0.05). Conclusion Campus lockdown management significantly impacts medical school students’ mental health. Extensive use of cognitive reappraisal and expression suppression can reduce students’ adverse psychological reactions during campus lockdowns to an extent.

Purpose This study examined whether depression and anxiety mediate the relationship between family functioning and academic burnout in first-year Traditional Chinese Medicine (TCM) students. Methods A cross-sectional survey was conducted among 319 first-year TCM students at a medical college in Shandong Province. Participants completed validated questionnaires assessing family functioning, academic burnout, depression, and anxiety. Correlational and regression analyses were conducted, and mediation effects were tested using bootstrap resampling (5,000 iterations). Results Poor family functioning was significantly associated with higher levels of academic burnout, depression, and anxiety. Mediation analysis showed that depression significantly mediated the relationship between family functioning and academic burnout. Anxiety demonstrated a non-significant indirect effect. Conclusion Deficient family functioning indirectly influences academic burnout in first-year TCM students, primarily through depression. Interventions addressing family dynamics and mental health may help reduce the risk of academic burnout in this population.

No abstract available

Background The outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, Hubei province, has led to the quarantine of many residents in their homes, in order to mitigate its spread. Some of these people developed mental health problems, and many solutions have been put in place to address the mental health issues of patients and health professionals affected by the disease. However, not much attention has been given to students, particularly those from medical school. The present study aims to conduct an online survey to investigate the mental health status of students from a medical college in Hubei province. Materials and Methods The WeChat-based survey program Questionnaire Star, which contained questions from Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), was utilized for the present study. Results A total of 217 students participated in the survey. Among these students, 127 were female and 90 were male. Furthermore, 77 students (35.5%) who participated in the survey were in a state of depression, and 48 (22.1%) were in a state of anxiety. The majority of students who were in depressed (n=75) or anxiety (n=46) states had mild or moderate states. There were no significant differences in students in terms of gender, geographical location, and grade, for the prevalence of depression and anxiety. Conclusion The present study implies that universities need to take measures to prevent, identify, and deal with mental health problems among students during large-scale stressors.

Background Long working hours are common among medical residents and may increase the risk of mental disorders. We aimed to investigate the association between experienced long working hours and depression, anxiety, and suicidal ideation among Chinese medical residents during the COVID-19 pandemic. Methods This study was conducted in September 2022; 1343 residents from three center in Northeastern China were included in the final analysis (effective response rate: 87.61%). The data were collected from participants via online self-administered questionnaires. Depression and anxiety were measured by the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale, respectively. Adjusted odds ratios and 95% confidence intervals were determined after adjusting for potential confounders by binary unconditional logistic regression. Results The effective response rate was 87.61%. Among the 1343 participants, 12.88% (173), 9.90% (133), and 9.68% (130) had experienced major depression, major anxiety, and suicidal ideation, respectively. We found that longer weekly worktime increased the risk of major depression, particularly in those who worked for more than 60 hours per week (≥ 61 hours vs ≤ 40 hours, OR=1.87, P for trend = 0.003). However, this trend was not observed for either major anxiety or suicidal ideation (P for trend > 0.05 for both). Conclusion This study revealed that there was a considerable incidence of poor mental health among medical residents; furthermore, the longer weekly worktime was associated with a higher risk of major depression, especially for those who worked more than 60 hours per week, but this association was not observed in either major anxiety or suicidal ideation. This may help policymakers to develop targeted interventions.

Background COVID-19 has presented a challenge for dental settings and dental schools: how to continue providing dental care and maintain education during the pandemic while remaining healthy. We highlight the necessity of infection containment control training for dental residents and rethink the tasks of safeguarding trainees' health and cultivating their abilities to deal with public health crises in the future. This paper may also serve as a health policy reference for policy makers. Objective The study aimed to compare the formats, frequency, contents, emphasis, and test scores of infection containment control training pre- and post-pandemic. Besides, after the COVID-19 outbreak, we assessed the increased anxiety level, communication difficulties, and confidence of dental residents impacted by the pandemic. Methods A total of 251 dental residents in Stomatological Hospital of Chongqing Medical University were recruited to complete a questionnaire of their routine involvement in infection control training before and after the COVID-19 outbreak. A self-designed 10-point Likert scale was used to assess the increased anxiety level, communication difficulties, and confidence in facing with the future public health crisis impacted by the pandemic. Results After the outbreak, although more trainees chose online assessment than offline assessment, most of them (74.90%) still preferred in-person training rather than online training. Contents that trainees had been focusing on were affected by the COVID-19 outbreak. Thereafter, they were more inclined to learn crisis management. Over half of the participants (56.17%) participated in training more frequently after the outbreak. However, postgraduate students participated in training less frequently than others after the outbreak (p < 0.01). First-year trainees accounted for the majority in the population who emphasized considerably on infection control training and whose test scores had increased after the outbreak. In addition, the percentage of women scoring increasingly in post-pandemic assessment was significantly higher than that of men. In this study, the average increased anxiety level caused by COVID-19 was 5.51 ± 2.984, which was positively related to communication difficulties with patients caused by the pandemic. The trainees whose homes were located in Hubei Province showed higher increased anxiety levels (8.29 ± 2.93) impacted by the pandemic than the trainees from other provinces (p < 0.05). However, the former's confidence in coping with future public health crises was not significantly different from that of others (p > 0.05). Conclusions Owing to the impact of COVID-19, the contents that the trainees focused on, frequency, emphasis, and test scores of infection containment control training were changed. Some recommendations have been provided for policy makers to attach importance to crisis-based training to cultivate dental residents in the post-pandemic era.

Purpose Pediatric residents are a high-risk group, prone to negative emotions such as anxiety and depression. Previous studies have explored a variety of factors affecting the mental health of medical staff, but few have utilized machine learning methods for early warning prediction of psychological problems. This study aimed to investigate the mental health status of pediatric residents in two Chinese cities, Chongqing and Hangzhou, and develop a predictive model for identifying anxiety and depression. Methods The model was validated using data from both cities and found to be robust. The best predictor variables included sociodemographic information, emotion self-rating, social support rating, and psychological resilience. The study utilized 18 mainstream machine learning methods and screened the best early warning prediction model using the cross-validated LASSO method. Results The Linear Discriminant Analysis (LDA) model had the best discriminatory performance in distinguishing the presence or absence of anxiety and depression in pediatric residents. The tuned LDA model exhibits excellent discriminatory performance (AUC = 0.923) on the test set. Stress and psychological resilience, particularly commiseration, were found to be strong predictors of anxiety and depression. Conclusion The study provides a new perspective on early warning prediction and intervention for negative emotions in pediatric residents and medical staff, which may be a new direction for interventions to address mental health issues in this group.

Abstract Background During the COVID-19 lockdown, it was difficult for residency training programs to conduct on-site, hands-on training. Distance learning, as an alternative to in-person training, could serve as a viable option during this challenging period, but few studies have assessed its role. Objective This study aims to investigate the impact of distance learning during the lockdown on residents’ self-assessed competency development and to explore the moderating effect of poor mental health on the associations. It is hypothesized that radiology residents who were trained through distance learning during the lockdown were more likely to report higher self-assessed competency compared to those who did not receive organized, formal training. Methods A cross-sectional survey was conducted in 2021 among all of the radiology residents in 407 radiology residency programs across 31 provinces of China. To estimate the long-term outcomes of radiology residents’ training after the initial COVID-19 outbreak, this study measured 6 core competencies developed by the US Accreditation Council for Graduate Medical Education reported by radiology residents. Multiple linear regression and moderating effect analysis were conducted to examine the associations between distance learning, mental health status, and self-assessed competencies. Mental health status moderated the association between distance learning and self-assessed competency of radiology residents. Results A total of 2381 radiology residents (29.7% of the 8,008 nationwide) met the inclusion criteria and were included in the analysis. Among them, 71.4% (n=1699) received distance learning during the COVID-19 lockdown, and 73.2% (n=1742) reported mental health struggles ranging in severity from slight to extremely severe. Radiology residents who were trained through distance learning (β=0.35, 90% CI 0.24‐0.45) were more likely to report higher self-assessed competencies. This was particularly true for the competency of “interpersonal and communication skills” (β=0.55, 90% CI 0.39‐0.70). Whereas, the competency of “patient care and technical skills” (β=0.14, 90% CI 0.01‐0.26) benefited the least from distance learning. Poor mental health significantly moderated the relationship between distance learning and competency (β=−0.15, 90% CI −0.27 to −0.02). Conclusions Distance learning, a means of promoting enabling environments during the COVID-19 lockdown, serves its purpose and helps generally improve residents’ self-assessed competencies, though different competency domains benefit unequally. The impact of mental health status calls for special attention so that distance learning can fulfill its potential.

Burnout affects the physical and mental health of residents. This study aims to investigate the association between burnout and health across biological, psychological, and social domains among Chinese residents. A cross-sectional study was conducted from July 2022 to June 2024 at Peking Union Medical College Hospital in China. A total of 274 resident physicians were recruited, with 207 providing valid responses. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), while general health was measured using the Union Physio-Psycho-Social Assessment Questionnaire (UPPSAQ-70). Self-efficacy and subjective incompetence were also evaluated. Network analysis was applied to identify the centrality of various health factors in relation to burnout. The overall prevalence of burnout was 74.4% (95% CI: 68.5-79.9%). Emotional exhaustion and depersonalization were significantly higher in male physicians compared to females, while younger physicians (aged ≤ 30 years) reported higher burnout in personal achievement. Network analysis identified strong connections between burnout dimensions (emotional exhaustion and depersonalization) and mental health symptoms such as anxiety, fatigue, and depression. Sleep, anxiety, and self-efficacy were found to be central nodes in the network, indicating their crucial role in resident physicians’ well-being. This study found a high prevalence of burnout among resident physicians, with significant links between burnout and mental health conditions. Anxiety and fatigue emerge as core symptoms in the burnout network, suggesting that interventions should address these factors. Additionally, self-efficacy plays a crucial role in burnout.

The workforce shortage in child and adolescent psychiatry (CAP) in China greatly restricts patients’ access to child and adolescent mental health services (CAMHS). Implementing CAP training within general or adult psychiatry programs may offer a viable solution; however, such programs are underdeveloped in China. The aim of this study was to gather empirical evidence regarding CAP training needs within Chinese psychiatry residency programs. An exploratory survey was administered online to psychiatry residents and their mentors to assess the application of CAP in clinical practice, satisfaction with existing CAP training, and attitudes towards the expansion of such training. The data were analysed using descriptive statistics, the Mann‒Whitney U test, the t-test, and the χ2 test to explore demographic differences and responses. A total of 230 residents (response rate = 54.76%) and 241 mentors (response rate = 53.79%) provided effective responses. A significant majority of both residents (201, 87.39%) and mentors (216, 89.63%) reported frequent engagements with pediatric mental health patients. Additionally, a considerable portion in both groups (70.43% of the residents and 59.34% of the mentors) indicated experiencing moderate to high stress levels in their work with these patients, primarily due to inadequate training in CAP. Only 37.39% of the residents and 21.99% of the mentors expressed satisfaction with current training offerings. Notably, substantial support exists among both residents (77.82%) and mentors (85.89%) for expanding CAP training programs. This study highlights a critical gap in CAP expertise among psychiatry professionals in China, mirrored by general dissatisfaction with existing training frameworks. There is strong, evidence-based support for the expansion of CAP training within residency programs, which is imperative to bolster the competence of CAMHS providers. Not applicable.

Abstract To evaluate job burnout and its impacts on mental health among clinical residents in a 3-year standardized residency training program in China. This cross-sectional study was conducted among all residents in the Department of Internal Medicine of the Peking Union Medical College Hospital in August 2017. Job burnout and depressive symptoms were assessed using the Maslach Burnout Inventory-General Survey and the Center for Epidemiological Survey, Depression, respectively. Among the 159 residents who completed the survey, comprising 69 who had graduated from 8-year medical schools and 90 from 5-year schools, the rate of job burnout was 62.2% (100/159) and the rate of depression was 28.3% (45/159). Rates of job burnout and depression in residents completed different years of training showed no significant difference. Rate of job burnout was significantly higher among graduates of 5-year medical schools (76.7%) than among those of 8-year schools (44.9%, P < .001). Pearson chi-squared test revealed a significant correlation between depression and job burnout (P < .001). Multiple logistic regression revealed a significant correlation between job burnout and attendance at 5- or 8-year medical schools (P = .044). Job burnout may be more frequent among graduates from 5-year medical schools than among those from 8-year schools.

Background Although life satisfaction is a predictor of depressive and anxiety symptoms, the mechanisms underlying this association are poorly understood. This study examined how psychological capital (PsyCap), a positive psychological state, mediated the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic. Methods A cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 583 students. Depressive symptoms, anxiety symptoms, life satisfaction, and PsyCap were measured anonymously. A hierarchical linear regression analysis was performed to explore the effects of life satisfaction on depressive and anxiety symptoms. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between life satisfaction and depressive and anxiety symptoms. Results Life satisfaction was positively associated with PsyCap and its four components. There were significant negative associations between life satisfaction, psychological capital, resilience, optimism, and depressive and anxiety symptoms among medical students. Self-efficacy was negatively associated with depressive and anxiety symptoms. Psychological capital (a×b = -0.3201, BCa 95% CI: -0.3899, -0.2446; a×b = -0.2749, BCa 95% CI: -0.3817, -0.1996), resilience (a×b = -0.2103, BCa 95% CI: -0.2727, -0.1580; a×b = -0.1871, BCa 95% CI: -0.2520, -0.1414), optimism (a×b = -0.2100, BCa 95% CI: -0.3388, -0.1150; a×b = -0.1998, BCa 95% CI: -0.3307, -0.0980), and self-efficacy (a×b = -0.0916, BCa 95% CI: 0.0048, 0.11629; a×b = 0.1352, BCa 95% CI: 0.0336, 0.2117) significantly mediated the association between life satisfaction and depressive and anxiety symptoms. Limitations This was a cross-sectional study, and causal relationships between the variables could not be ascertained. Self-reported questionnaire instruments were used for data collection, which may have recall bias. Conclusions Life satisfaction and PsyCap can be used as positive resources to reduce depressive and anxiety symptoms among third-year Chinese medical students during the COVID-19 pandemic. Psychological capital and its components (self-efficacy, resilience, and optimism) partially mediated the relationship between life satisfaction and depressive symptoms, and completely mediated the relationship between life satisfaction and anxiety symptoms. Therefore, improving life satisfaction and investing in psychological capital (especially self-efficacy, resilience, and optimism) should be included in the prevention and treatment of depressive and anxiety symptoms among third-year Chinese medical students. Additional attention is needed to pay for self-efficacy in such disadvantageous contexts.

Background The consumption of takeaways is becoming increasingly prevalent. Despite this, the relationship between takeaway food consumption and depressive symptoms in Chinese populations has not been clarified. Furthermore, the factors that mediate the association between takeaway frequency and depressive symptoms are unknown. Methods Questionnaires were employed to collect data from 6,417 new students at Chongqing Medical University in the autumn of 2023, including sociodemographic information, takeaway frequency, physical activity levels (measured by the International Physical Activity Questionnaire Short Form), and depressive symptoms (measured by the Patient Health Questionnaire-9). Multiple linear regression and mediation analysis were performed. Multiple imputations were used to fill in missing data through sensitivity analyses. Results Among 6417 participants, 2,606 (40.6%) students ordered takeaway at least once a week, with 235 (3.7%) of them ordering takeaway food every day. Takeaway frequency was significantly associated with depressive symptoms (β=0.034, P=0.006), and physical activity partially mediated this relationship (95% bootstrap confidence interval=0.0024, 0.0371). Conclusions The study highlights the negative relationship between takeaway frequency and emotional well-being, emphasizing the need to focus on the emotional health of frequent takeaway food consumers. Moreover, our study suggests that increased physical activity may alleviate takeaway-induced mood-related outcomes.

ABSTRACT High workloads and heavy academic pressure can have significant implications for the risk for depression and poor quality of life (QoL). This study aimed to investigate QoL and depressive symptoms in medical students undergoing postgraduate neurology specialty training in China. The survey covered demographic characteristics, the 8-itemMedical Outcomes Study Short-Formquestionnaire (SF-8), and the 2-itemPrimary Care Evaluation of Mental Disorders depression screening tool. Logistic regression analysis was used to investigate the determinants of QoL and depressive symptoms. Participants were 1,814 postgraduates from 249 hospitals in 27 Chinese provinces. The mean SF-8 physical and mental component summary scores were 78.17 (standard deviation [SD] 15.20) and 68.33 (SD 17.15), respectively. One-third of respondents had depressive symptoms, and those without depressive symptoms had significantly higher QoL scores. The multivariate regression analysis showed that factors independently associated with depressive symptoms were being in the second year of study, a lower household income, and less sleep time. Although QoL among our sample of Chinese medical students undergoing postgraduate neurology specialty training was favorable relative to other comparable populations, one-third of respondents had depressive symptoms. Accurate measures should be taken to change this situation.

BACKGROUND AND AIMS Although previous studies have considered rumination a possible mediator of the relationship between mental health and problematic smartphone use (PSU), few prospective studies have been conducted, limiting the ability to draw causal inferences. Therefore, the current study aimed to examine the mediating role of rumination on the depression-PSU relationship using three-wave cross-lagged panel models (CLPMs) with longitudinal data. METHODS A sample of 321 medical students from China Medical University completed three waves of online measures of depressive symptoms, rumination, and PSU. The three-wave CLPMs were constructed to examine the mediating role of rumination. RESULTS Our results demonstrated that depressive symptoms were bidirectionally related to rumination, and that rumination was bidirectionally related to PSU. The reciprocal CLPM suggested that depressive symptoms at Time 1 positively affected PSU at Time 3 via rumination at Time 2. The indirect effect was significant, with a path coefficient of 0.023 (95% CI: 0.004 to 0.042). Conversely, PSU at Time 1 positively affected depressive symptoms at Time 3 via rumination at Time 2, with a path coefficient of 0.015 (95% CI: 0.001 to 0.029). DISCUSSION and Conclusions: This prospective study provided empirical evidence of the influence of depression on PSU and vice versa among Chinese university students. It also highlighted the importance of rumination in the depression-PSU relationship, revealing a bidirectional mediating role of rumination. Additional large-scale multi-wave longitudinal studies are needed to verify our results.

Introduction: Major depressive disorder is highly prevalent among medical students and strongly associated with cognitive dysfunctions. Objective: To compare neuropsychological and electrophysiological profiles (P300 parameters) of medical students with and without depressive symptoms. Methods: A cross-sectional and comparative study was conducted with 140 second-year medical students. Depressive symptoms were assessed with the Patient Health Questionnaire-9. Cognitive performance was evaluated with the Montreal Cognitive Assessment (MoCA) and CogniFit (CogniFit Inc., San Francisco, CA, USA) computerized tests. Event-related potentials were recorded through a standard auditory oddball paradigm, analyzing N100, N200, and P300 latency and amplitude. Statistical analyses included independent sample t-tests and analysis of variance, with significance set at p < 0.05. Effect sizes (Cohen’s d) were reported for all group comparisons, and appropriate corrections for multiple comparisons were applied to control type I error. Results: Students with depressive symptoms exhibited slower response time (p < 0.01), processing speed (p = 0.01), impaired contextual memory (p =.01), short-term memory (p = 0.01), working memory (p = 0.01), focused attention (p = 0.01) and perception domain( p = 0.03). On the MoCA, lower in abstraction (p = 0.03), delayed memory recall (p < 0.01), and total MoCA score (p = 0.008). Event-related potentials analysis revealed significantly prolonged latencies for N100, N200, and P300 (all, p < 0.01), and decreased amplitudes in N100, N200, and P300 (p < 0.05). Prolonged event-related potentials latencies (particularly P300) correlated negatively with performance on processing speed (r = -0.39, p < 0.001), focused attention (r = -0.32, p < 0.001), and delayed recall (r = -0.31, p < 0.001). Conclusions: Medical students with depressive symptoms demonstrate specific cognitive impairments and altered event-related potential markers, reflecting reduced attentional efficiency and information processing. Combining computerized neuropsychological testing with electrophysiological measures may provide a feasible screening pathway for cognitive vulnerability among medical trainees and guide the development of preventive and educational interventions within medical curricula.

Objective This study aims to explore the independent and combined effects of sleep duration and sleep quality on depressive symptoms in the medical graduate student population, utilizing causal inference methods, in order to provide more informative evidence to support mental health interventions in this group. Methods A cross-sectional study was conducted among 2591 medical graduate students from Sun Yat-sen University in Guangdong, China. Participants completed self-administered questionnaires, including the Center for Epidemiological Survey Depression Scale (CES-D) for depressive symptoms and the Pittsburgh Sleep Quality Index (PSQI) scale for sleep quality. Sleep duration was categorized based on hours of sleep per night. A causal inference approach using inverse probability weighting (IPW) was employed to evaluate the relationship between sleep factors and depression risk. Results Individuals sleeping less than 7 hours had a 1.65-fold higher depression risk (95% CI: 1.26–2.14), while those sleeping ≥9 hours had a 0.67-fold lower risk (95% CI: 0.47–0.95). High sleep quality reduced depression risk. In the low sleep quality group, short sleep increased depression risk by 1.40-fold (95% CI: 1.02–1.94), while long sleep decreased it by 0.66-fold (95% CI: 0.45–0.97). In the high sleep quality group, sleeping 8–9 hours increased depression risk by 1.80-fold (95% CI: 1.10–2.95) compared to 7–8 hours. Sensitivity analyses confirmed the robustness of these findings across different IPW models. Conclusion Both sleep duration and quality are significantly associated with depressive symptoms among medical graduate students. These findings may support targeted interventions that improving sleep hygiene, particularly for those with low sleep quality, while also emphasizing the importance of maintaining an optimal sleep duration of 7–8 hours for those with high-quality sleep.

Objective In this study, we aimed to disentangle the mediating effect of sleep disorder between mental health literacy (MHL) and depressive symptoms in Chinese medical students, especially focusing on the impact of gender and grade. Methods Pooled longitudinal data of 5,504 medical students was collected between November 2019 and June 2020 to assess the MHL, sleep disorder and mental health of medical students in Anhui province, China. Mediation analyses were tested by using bootstrapping procedures. Results Sleep disorder were negatively correlated with adequate MHL, but positively correlated with depressive symptoms. The relationships between MHL and depressive symptoms were mediated by sleep disorder in total samples and the indirect effect accounted for 13.59% of the total effect. However, the ratio was 20.82% in female students, whereas no mediating effect was found in the male students. Moreover, the ratio was found higher in freshmen (15.11%) than that in sophomores (11.56%). Conclusion Improving the sleep disorder by enhancing MHL is an effective way to reduce depressive symptoms in Chinese medical students. Further investigations elaborately considered by using more gender-balanced population with higher grade and lower level of education.

BACKGROUND Depressive symptoms typically exhibit sex differences among medical students and are associated with bedtime procrastination (BP) and self-control. However, it remains unclear whether sex differences exist in the relationship between these variables. METHODS A cross-sectional observational study was conducted among 402 medical students from a public university in China. Students' depressive symptoms, BP, and trait self-control were assessed using the Chinese version of the Beck Depression Inventory (BDI)-II, the Bedtime Procrastination Scale, and the Self-control Scale, respectively. Applying a BDI cutoff value of 14, 364 valid participants were divided into non-depressed (<14) and depressed (≥14) groups. RESULTS Binary logistic regression revealed that BP was an independent predictor of the prevalence of depressive symptoms in women only. Hierarchical regression showed that high BP levels were independently positively correlated to more depressive symptoms only in non-depressed women. In contrast, low self-control levels were independently negatively correlated to more depressive symptoms in non-depressed and depressed female students. Furthermore, structural equation modeling reflected the mediating role of BP between self-control and depressive symptoms in the non-depressed female group only. CONCLUSIONS Sex differences exist in the effect of BP on depressive symptoms as well as the relationship between self-control and depressive symptoms among Chinese medical students. As a moderator, sex regulates the mediating effect of BP on the relationship between self-control and depressive symptoms in the non-depressed group. These findings provide a sex-specific perspective for targeted prevention and intervention of depressive symptoms among high-risk medical students, especially during the non-depressed period.

Background Job burnout, career choice regret, and depressive symptoms among medical students have received widespread attention. However, little is known about the role of gender in these areas for dental postgraduates. This study aimed to explore gender differences in job burnout, career choice regret, and depressive symptoms among Chinese dental postgraduates. Methods The data were collected from an epidemiological survey conducted by our group from February 2021 to March 2021. We used a self-administered questionnaire covering demographic characteristics, the Maslach Burnout Inventory, the Primary Care Evaluation of Mental Disorders scale, and the Career Choice Regret scale. Univariate and multivariable analyses were performed to explore influencing factors. Results A total of 558 valid dental postgraduate questionnaires were included in this study. The prevalence of job burnout, career choice regret, and depressive symptoms exceeded 30% in males and females. The prevalence of job burnout was 4.7% higher in females than in males; career choice regret was 12.2% higher in females than in males (P < 0.05), and depressive symptoms were 4.9% higher in females than in males. The multivariable analysis showed that factors associated with job burnout for males were sleep time and career choice regret for females. The influencing factors on career choice regret for females were postgraduate entrance examination score, sleep time, and job burnout. Depressive symptoms were a common influencing factor for job burnout and career choice regret in male and female dental postgraduates. Also, job burnout and depressive symptoms had the highest odds ratio for influencing factors on each other. Conclusion Over 30% of dental postgraduates suffered from job burnout, career choice regret, and depressive symptoms, and incidences were higher in females. A discrepancy of influencing factors existed between male and female dental postgraduates. Targeted measures should be taken to change this situation.

This study examines depressive symptoms faced by non-native international medical students studying in China during the COVID-19 pandemic. The targeted population for this cross-sectional study included non-native medical students studying in Chinese universities. This study used convenience sampling. An online, self-administered questionnaire was distributed to international medical students studying in Chinese universities from February 2020 to June 2021. The questionnaire collected demographic data, information regarding struggles faced, and used the CES-D-10 Likert scale to assess both the challenges and depression symptoms, respectively. By analyzing the 1,207 students’ responses, the study found that students with poor Chinese language were two times more likely to suffer from depressive symptoms (OR = 2.67; value of p 0.00). Moreover, female students were found more prone (76.35%) than their male counterparts (44.96%). The study found that food adaptability, health issues, accommodation issues, and financial issues were related factors contributing to depressive symptoms among non-native international medical students during the COVID-19 pandemic. The study tried to highlight the factors that resulted in depressive symptoms among non-native international medical students, and the findings may help diplomatic representatives take necessary actions to help their citizens during this difficult time.

Background The two most prevalent mental health conditions are anxiety and depression and they often coexist (comorbidity) in an individual aggravating the person’s psychological or medical conditions. College students suffered from anxiety and depressive symptoms during the COVID-19 pandemic, according to numerous studies. The lack of information on the comorbidity of anxiety and depression (CAD) among international medical students, however, makes it difficult to develop effective policies or strategies to support these students. Objective The present research seeks to investigate the incidence of CAD among international medical students in China and to identify the variables that may be useful in predicting CAD. Method A cross-sectional study was conducted at China Medical University in Shenyang, China, for international medical students during November 2020. A total of 519 international students provided information on their demographics, stress related to the COVID-19 pandemic, generalized anxiety disorder assessment (GAD-7), patient health questionnaire-9 (PHQ-9), simplified coping style questionnaire (SCSQ), perceived stress scale (PSS-10), the multidimensional scale of perceived social support (MSPSS), revised life orientation test (LOT-R), and resilience scale-14 (RS-14). To investigate the potential predictors of CAD, a chi-square test, a nonparametric test, and multinomial logistic regression analyses were carried out as appropriate. Results The incidence of anxiety, depression, and CAD in the current study was 5.8%, 8.9%, and 22.7%, respectively. The predictors for students having symptoms of anxiety were observed to be the negative coping style (β = 0.662, OR = 1.938, CI:1.07–3.694) and perceived stress (β = 0.167, OR = 1.181, CI:1.076–1.297); the predictors for students having symptoms of depression were observed to be the COVID-19 pandemic-related stress (β = 0.323,OR = 1.382,CI:1.211–1.577), negative coping style (β = 0.693,OR = 2.000, CI:1.21–3.568), and perceived stress (β = 0.135,OR = 1.145,CI:1.050–1.248); whereas the predictors for students with CAD were observed to be staying up late (Yes VS No) (β = 1.028,OR = 2.794,CI:1.227–6.364), current place of residence (Other continents VS China) (β = -1.413, OR = 0.243,CI:0.065–0.910), COVID-19 pandemic-related stress (β = 0.371,OR = 1.450,CI:1.284–1.636), negative coping style (β = 1.092,OR = 2.979,CI:1.706–5.203), and perceived stress (β = 0.339,OR = 1.403,CI:1.289–1.527). Conclusion Single anxiety and depressive symptoms were moderately prevalent among international medical students in China. However, CAD turned out to be the most prevalent mental health issue due to its relatively higher incidence. Negative coping style and perceived stress were the communal predictors of the three categories, whereas stress related to the COVID-19 pandemic was linked to both depression and CAD, and staying up late and in residential places were specific predictors for CAD. Study results suggest that COVID-19 pandemic-related stress was related to students’ CAD and depressive symptoms, and specific intervention measures with stress reduction, proper coping strategy, and a good lifestyle might be useful in improving the international students’ mental health status.

Objectives The COVID-19 outbreak has caused enormous strain on healthcare systems, and healthcare trainees, which comprise the future healthcare workforce, may be a vulnerable group. It is essential to assess the psychological distress experienced by healthcare trainees during the COVID-19 outbreak. Design, setting and participants A cross-sectional study with 4184 healthcare trainees at Sichuan University in China was implemented during 7–13 February 2020. Participants were grouped by training programmes (medicine, medical technology and nursing) and training stages (undergraduate, postgraduate and residency). Main outcomes COVID-19–related psychological distress and acute stress reaction (ASR) were assessed using the Kessler 6-item Psychological Distress Scale and the Impact of Event Scale–Revised, respectively. We estimated the ORs of distress by comparing trainees across programmes and training stages using multivariable logistic regression. Results Significant psychological distress was found in 1150 (30.90%) participants and probable ASR in 403 (10.74%). Compared with the nursing trainees, the medical trainees (OR 1.54, 95% CI 1.22 to 1.95) reported a higher burden of psychological distress during the outbreak, while the medical technology trainees (OR 1.25, 95% CI 0.97 to 1.62) reported similar symptom scores. Postgraduates (OR 1.55, 95% CI 1.16 to 2.08) in medicine had higher levels of distress than their undergraduate counterparts did, whereas the nursing residents (OR 0.38, 95% CI 0.20 to 0.71) reported a lower burden than did nursing undergraduates. A positive association was found between having active clinical duties during the outbreak and distress (OR 1.17, 95% CI 0.98 to 1.39), particularly among the medical trainees (OR 1.85, 95% CI 1.47 to 2.33) and undergraduates (OR 4.20, 95% CI 1.61 to 11.70). No clear risk patterns of ASR symptoms were observed. Conclusions Medical trainees, particularly postgraduates and those with active clinical duties, were at risk for psychological distress during the COVID-19 outbreak. Stress management may be considered for high-risk healthcare trainees.

Background/Objectives: College and undergraduate students around the world struggle with stress, anxiety, and depression, which have a significant negative influence on their academic performance, social interactions, and general well-being. Creating successful preventative and intervention plans requires an understanding of the many, multi-level factors that contribute to psychological discomfort. The objective of this scoping review was to use the Socio-Ecological Model (SEM) to map the determinants of psychological distress among college students in a comprehensive manner. Methods: A total of 15 review publications published between 2015 and 2024, including narrative reviews, systematic reviews, meta-analyses, and umbrella reviews, were analyzed under the guidance of PRISMA ScR. These studies synthesized evidence across various countries, including China, Iran, India, Canada, Egypt, Nigeria, Saudi Arabia, and the United States. Results: Academic pressure, financial stress, poor sleep, unhealthy coping mechanisms, and pre-existing mental health issues were all individual-level concerns, with female and minority students being more vulnerable. Strong familial ties and friendships served as protective interpersonal support. Heavy academic workloads, strict grading guidelines, a lack of mental health resources, and unwelcoming campus environments were among the institutional factors. Stigma and socioeconomic disparities are examples of community-level variables that make mental health issues worse. Conclusions: Student mental health is shaped by interrelated factors across all SEM levels. Integrated, multi-level strategies are essential to fostering supportive campuses, strengthening community networks, and implementing inclusive policies that promote mental health equity.

Objectives The current study examines the mediating roles of resilience and self-efficacy and the moderating role of gender in the association between neuroticism and psychological distress in Chinese freshman nursing students (FNSs). Methods A total of 1220 FNSs were enrolled from the Be Resilient to Nursing Career (ChiCTR2000038693) Programme and the following instruments were administered to them: NEO Five-Factor Inventory, General Self-Efficacy Scale, Connor-Davidson Resilience Scale and Kessler Psychological Distress Scale. A moderated mediation analysis and a generalised additive model analysis were performed. Results The direct and indirect effects of neuroticism on psychological distress were significantly mediated by self-efficacy (B = 0.200, 95% CI 0.001 to 0.039), resilience (B = 0.021, 95% CI 0.007 to 0.038) and the interaction between self-efficacy and resilience (B = 0.016, 95% CI 0.005 to 0.028). The interactions between neuroticism and gender (β = 0.102, 95% CI 0.001 to 0.203, p<0.05) and between resilience and gender were significant (β = 0.160, 95% CI 0.045 to 0.275, p<0.01). A non-linear and positive association was confirmed between neuroticism and psychological distress. Conclusions Self-efficacy and resilience significantly mediate the relationship between neuroticism and psychological distress. Gender moderates the relationships between neuroticism and resilience and between resilience and psychological distress.

Background: The COVID-19 pandemic has had impact that may contribute to a rise in mental health problems. The present study was aimed to better understand psychological status among medical staff and medical students during the early epidemic and to explore the influence factors of psychological distress. Methods: A cross-sectional survey was conducted online from February 2–14, 2020. We collected general information related to the COVID-19 outbreak. Respondents were assessed using the Kessler-6 Psychological Distress Scale (K6), Social Support Rating Scale (SSRS), Perceived Stress Scale (PSS) and Simplified Coping Style Questionnaire (SCSQ). Stepwise multiple linear regression was performed to identify factors influencing psychological distress. Results: Five hundred and twenty-eight respondents returned valid questionnaires. Medical staff and Medical students scored averages of 6.77 ± 5.04, 15.48 ± 8.66 on the K6, 37.22 ± 11.39, 22.62 ± 11.25 on the SSRS and 18.52 ± 7.54, 28.49 ± 11.17 on the PSS, respectively. Most medical staff (279, 91.77%) and 148 medical students (66.07%) showed a positive coping style. Social support, perceived stress, hours spent watching epidemic-related information per day and frequency of epidemic-related dreams were identified as factors influencing psychological distress among medical staff and medical students. Coping style emerged as a determinant of psychological distress among medical staff. Conclusions: In the early stages of the COVID-19 epidemic in China, medical staff and medical students were at moderate to high risk of psychological distress. Our results suggest that psychological interventions designed to strengthen social support, reduce perceived stress and adopt a positive coping style may be effective at improving the mental health of medical staff and medical students.

Chinese people experienced a nationwide coronavirus disease 2019 (COVID-19) pandemic after the adjustment of epidemic response policies from December 2022 to January 2023. This study aims to explore the prevalence of mental and cognitive symptoms and their associated factors among medical students after the COVID-19 pandemic. A cross-sectional study was conducted between February 27th and March 8th, 2023. The symptoms of anxiety, depression, insomnia, post-traumatic stress disorder (PTSD), and cognitive function among medical students were examined using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Athens Insomnia Scale (AIS), the Impact of Event Scale-6 (IES-6), and the Perceived Deficits Questionnaire-Depression-5 (PDQ-D-5). Data on demographic information was also collected. Statistical analyses were conducted to describe the prevalence and explore the associated factors of mental and cognitive symptoms. Among 947 participants, the proportion of students experiencing anxiety, depression, insomnia, and PTSD symptoms was 37.8, 39.3, 28.3, and 29.5%, respectively. The self-reported COVID-19 infection rate was 72.2%. Higher grades, childhood, and current rural residence were identified as potential risk factors for mental and cognitive symptoms. Gender, age, average monthly household income, and COVID-19 diagnosis were not associated with mental and cognitive symptoms among medical students. Our findings revealed a high prevalence of mental and cognitive symptoms among Chinese medical students after the COVID-19 pandemic. Special attention should be paid to the mental health of higher-grade students and those residing in rural areas.

During the COVID-19 pandemic Chinese international students were reported to experience racism, food security issues and social isolation. However, no study has investigated the prevalence of these issues and the potential for worsening mental health in this population group during the pandemic. Therefore, this study aimed to examine the effect of this pandemic on the mental health of Chinese international students living in Australia and China, and the protective effect of social support. Data were extracted from a survey of Australian university students (April-June 2019) and follow-up during the pandemic (Sept-Oct 2020). The prevalence of anxiety, major depression and pandemic-related stressors was reported. Multivariable logistic regression was used to assess the association between country of residence, social support (baseline/follow-up), and follow-up self-reported mental health. With the pandemic, there was a substantial increase in the prevalence of anxiety (24.7 % vs 45.7 %) and major depression (22.1 % vs 43.8 %). Major depression was less likely to be reported by international students in China (34.8 %) than in Australia (46.3 %). Students with high social support during the pandemic were less likely to report major depression (Adjusted OR:0.15 [95 % CI 0.06,0.34]), although this effect was not observed longitudinally (Adjusted OR:1.03 [95 % CI 0.58,1.83]). Post pandemic improvement in mental health cannot be assessed. The pandemic appeared to have had a strong negative effect on Chinese international university students' mental health. Those living in Australia were more likely to experience poorer mental health, highlighting the need for increased support to this group.

Stigma towards people with mental illness is a worldwide concern. A five-nation survey of medical student attitudes towards people with mental illness recently reported far lower levels of social acceptance among Chinese medical students compared to those from the US, Brazil, Ghana, and Nigeria. This qualitative study presented recent Chinese medical school graduates with probes based on questions used in the aforementioned cross-national study to elicit their views of factors underlying the negative attitudes towards social acceptance of people with mental illness. One-hour interviews were conducted with twenty psychiatry residents in June, 2016. Of 241 coded responses concerning negative attitudes, 51.5% were coded as reflecting fear of violent behavior, 22.8% as loss of face (i.e. shame from interpersonal associations), 17.0% lowered social status, 4.98% nonconforming social behavior, and 3.73% the heritability of mental illness. Low levels of social acceptance of individuals with mental illness among medical students in China are largely related to fears of violence of and loss of face. Understanding the attitudes of medical students may inform efforts to reduce stigma through educational initiatives targeted at both medical students and the general public.

Standardized residency training is a crucial component of medical education. However, residents commonly face heavy clinical workloads, occupational stress, and insufficient social support, contributing to a high prevalence of negative emotions such as depression, anxiety, and stress. These psychological issues significantly threaten personal well-being and the quality of medical care. International studies have documented prominent mental health challenges among medical residents; yet, empirical research within the Chinese context remains limited, particularly regarding the mechanisms involving social support, workload, and institutional design. This study aimed to evaluate the prevalence of negative emotions among residents undergoing standardized residency training, identify key influencing factors, and to provide a basis for developing targeted intervention strategies in the future. A cross-sectional study was conducted involving 514 residents from 3 general hospitals in Hunan Province. Data were collected using a general information questionnaire, the Depression Anxiety Stress Scales-21, and a residency training-specific questionnaire. Data analysis was performed using SPSS version 26.0 to assess the residents' mental health status and identify associated influencing factors. The prevalence rates for depression, anxiety, and stress among residents were 86.4%, 92.2%, and 90.7%, respectively. Moderate-to-severe cases accounted for 19.8% (depression), 29.6% (anxiety), and 13.0% (stress). Factors significantly associated with negative emotions included interpersonal stress (odds ratios [OR] = 2.20-2.87), emotional stress (OR = 3.89), frequent extra shifts (OR = 4.85-5.42), duration of training (OR = 1.36), and low satisfaction with residency training (OR = 2.17-3.11). Conversely, positive perceptions regarding the value of residency training were protective factors (OR = 0.21-0.54). Negative emotions are prevalent among medical residents and influenced by multiple factors. Our findings indicate that interventions should prioritize mitigating interpersonal and emotional stressors, reducing non-rostered workloads, and fundamentally enhancing trainees' satisfaction and sense of value within the training program to safeguard their mental well-being and, by extension, patient care quality.

The psychological well-being of students in higher education has become an increasingly important concern in the context of the COVID-19 pandemic. The majority of prior studies were cross-sectional and thereby failed to capture the individual changes in mental health over time. Moreover, few studies have explored whether and how socioeconomic and education backgrounds could be related to college students' mental health changes. This study aimed to fill these gaps. Data were from a nationwide, two-wave panel survey of college students in China. Baseline information was collected in November 2019, i.e., before the outbreak of the COVID-19 epidemic in China. A follow-up survey was conducted in November and December 2020, when the epidemic was effectively contained in mainland China. In both waves, mental health was assessed with the 10-item Kessler Psychological Distress Scale (K10). The between-wave changes in psychological distress were measured and categorized. Overall, 13.5% of students experienced at least a one-standard-deviation increase in psychological distress over the one-year follow-up. Results from both bivariate and multivariable analysis showed that this marked distress increase was more pronounced among vocational college students (vs. academic undergraduate and postgraduate students) and those with lower levels of academic performance. In contrast, family socioeconomic status (as measured by parental education, family economic condition, and current residence) was not associated with distress changes over time. These findings highlight the importance of the educational disparities within the higher education system in understanding the mental health dynamics of college students in the context of the COVID-19 pandemic.

With the COVID-19 outbreak in China, the Chinese government took measures to prevent and control the spread of the virus. In-person teaching was replaced by distance learning, which was an unknown challenge for students. In this context, little is known about the perceived distress of nursing students and the relationship between psychological capital, perceived distress, and psychological stress. This study examined the relationship between psychological capital, psychological distress, and perceived stress, and the mediating role of psychological capital in the relationship between perceived stress and psychological distress among nursing students. This cross-sectional survey was conducted between January and December 2020 using a convenience sampling method involving 359 undergraduate and specialist nursing students at a tertiary hospital in Shandong Province. Standardised instruments were used to measure psychological capital, psychological stress, and perceived stress. We used SPSS 24.0 and PROCESS macro to analyse the data. There was a statistically significant difference in perceived stress among students based on whether they liked the nursing profession (P < 0.01). Relative to nursing college students, undergraduates experienced significantly higher levels of perceived stress (P < 0.01). Nevertheless, there were no significant differences in perceived stress according to gender, place of residence, and being an only child. Psychological distress was positively correlated (r = 0.632, p < 0.001) with perceived stress (r =-0.662, p < 0.001), whereas it was negatively correlated with psychological capital. Psychological capital played a potential mediating role in the relationship between psychological distress and perceived stress. Psychological distress was negatively correlated with psychological capital, and positively correlated with perceived stress. Mediation analyses indicated that psychological capital partially mediated the relationship between perceived stress and psychological distress. Educators should therefore heed students' perceived stress and develop appropriate mental health counselling programmes for students in the curriculum that could help them reduce their psychological distress. In clinical practice, nursing managers must take effective measures, such as skills training, to improve the psychological capital of nursing students and reduce the negative impact of their psychological distress.