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Depressed Med Students Seem to Fear Stigma More than Most

Posted Sep 14 2010 1:00pm
Second study finds burnt-out students report more unprofessional conduct in patient care

Tuesday, September 14, 2010
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TUESDAY, Sept. 14 (HealthDay News) -- A new study suggests that depressed medical students are more likely than their non-depressed counterparts to think that depression spells big trouble.

"They are much more likely to believe that mentally ill students like them will be isolated and stigmatized," said study author Dr. Thomas L. Schwenk, a professor at the University of Michigan. "They are not comfortable revealing their depression because they feel less worthy and less valuable."

Previous research has shown that a lot of medical students struggle with mental health issues: they suffer from more depression and burnout than the general population, and they commit suicide and consider killing themselves more often than other people of the same age.

"On the whole, though, they often do not seek treatment due to time constraints, fears around confidentiality, and worries that they will become stigmatized," said Dr. Laura Weiss Roberts, chair of the Department of Psychiatry and Behavioral Sciences at Stanford University, who wrote a commentary accompanying the study.

A second study in the same issue of the journal found that burnt-out medical students were more likely to report unprofessional conduct in patient care. In surveying students from seven U.S. medical schools, the Mayo Clinic researchers found 52.8 percent of the students surveyed had burnout.

Both studies are published in the Sept. 15 issue of the Journal of the American Medical Association.

In the first study, Schwenk and his colleagues surveyed 769 medical students at the University of Michigan Medical School and got responses back from 505.

The researchers found that, overall, about 14 percent of the students reported having moderate or severe depression; the rate was 18 percent in women, double the 9 percent rate reported in men.

Students with symptoms of moderate or severe depression were much more likely than other students to believe that alerting a counselor to their problems would be risky. More than 80 percent of students reporting symptoms of depression expressed the opinion that faculty members would lose faith in the abilities of depressed students; only 55 percent of non-depressed students agreed with that opinion.

Do the depressed students simply have a more accurate view of the stigma and problems that depressed medical students would face? Or are their views of reality blurred by their own depression? It's not entirely clear, Schwenk said.

However, medical school "causes students to feel like they have to be perfect," he said. "If they're not, they feel vulnerable and less worthy. They may project that and make students who are depressed feel like they're less valuable."

The study also looked at whether the participants thought medical students' depression posed a risk to patients. More than one-third of men thought depressed medical students could endanger patients, compared to 20 percent of women.

Overall, the study suggests that "there are significant barriers to effective mental care among physicians just like there are among patients," Schwenk said. "Some of the stigma that seems to exist among patients, and the stigma they feel in their daily lives, seems to carry over to physicians."

Roberts said the findings should inspire medical schools to support students and create new services to help them.

SOURCES: Thomas L. Schwenk, M.D., professor and chair, department of family medicine, University of Michigan, Ann Arbor; Laura Weiss Roberts, M.D., chair, department of psychiatry and behavioral sciences, Stanford University, Stanford, Calif.; Sept. 15, 2010, Journal of the American Medical Association


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