Avaliação dos principais fatores de estresse e seus impactos na saúde mental dos estudantes de medicina: estudo longitudinal

Abstract

Introduction: Despite the growing concern about the mental health of medical students, long-term monitoring and identification of the factors that lead to this outcome are still lacking. The present study aims to longitudinally evaluate the main stress factors and their impact on the mental health of medical students followed for two years. Methods: This is a longitudinal, observational, and quantitative study, with data collected over two years, 2016 and 2018, involving students from the UFJF School of Medicine enrolled during this period. These students were assessed using the following scales: DASS21, to measure symptoms of depression, anxiety, and stress, and the Medical Student Stress Factor Scale (MSSF) to identify the main stress factors faced by medical students. In the statistical analysis, structural equation models (SEM) were used to identify the stress factors associated with the students' mental health. Results: A total of 231 medical students participated in the study. Significant levels of depression (increasing from 45.9% in 2016 to 48.9% in 2018), anxiety (decreasing from 52.8% to 48.9%), and stress (increasing from 56.7% to 59.7%) were observed, affecting the majority of students. The most prevalent stressors were related to lack of time and learning environment/academic performance. Our SEM revealed that learning environment, baseline depression, and relationship problems were associated with depression at follow-up; learning problems, health stressors, and baseline anxiety were associated with anxiety at follow-up; and learning environment, learning problems, health stressors, and baseline stress were associated with stress at follow-up. Conclusion: There is a high prevalence of mental health symptoms over time, and specific stressors associated with symptoms of depression, anxiety, and stress were identified. It is important that medical schools prioritize addressing medical students’ mental health, along with implementing targeted policies and interventions to improve the mental well-being of students and future physicians.