JAMA:求关爱!医学生更容易抑郁和自杀!

2016-12-13 sunshine MedSci原创

医学生抑郁及自杀倾向的风险很高,然而不同研究之间研究结果各不相同。本研究旨在评估医学生抑郁、抑郁症状和自杀倾向的患病率。研究人员检索了2016年9月17日之前发表于EMBASE, ERIC, MEDLINE, psycARTICLES和psycINFO的关于医学生抑郁、抑郁症状或自杀倾向的研究,语言不限,同时也纳入发表在同行评审的文献中的研究以及使用有效评估方法的研究。对于研究的研究特征信息,抑郁

医学生抑郁及自杀倾向的风险很高,然而不同研究之间研究结果各不相同。本研究旨在评估医学生抑郁、抑郁症状和自杀倾向的患病率。

研究人员检索了2016年9月17日之前发表于EMBASE, ERIC, MEDLINE, psycARTICLES和psycINFO的关于医学生抑郁、抑郁症状或自杀倾向的研究,语言不限,同时也纳入发表在同行评审的文献中的研究以及使用有效评估方法的研究。


对于研究的研究特征信息,抑郁或抑郁症状和自杀倾向的患病率,以及抑郁学生是否积极寻求治疗方面的数据分别由三位研究者独立筛选。使用随机效应荟萃分析汇总估计值。使用分层荟萃分析和荟萃回归估计研究水平特征的差异。主要研究结果为,通过验证的问卷或结构化访谈评估抑郁,抑郁症状或自杀意念的点或周期患病率。

结果纳入的数据来自43个国家的167个横断面研究(n=116,628)和16个纵向研究(n=5728),除了1项研究外,其余研究使用自我报告的方式。汇总分析后,发现医学生存在抑郁或抑郁症状的整体患病率是27.2%(37,933/122,356; 95% CI, 24.7% - 29.9%, I2 = 98.9%)。不同评估方式之间患病率的不同,范围为9.3% - 55.9%。研究期间,医学生的抑郁症状患病率保持相对稳定(基线时间范围1982-2015年;斜率,每年增加0.2% [95% CI, −0.2% ~ 0.7%])。

在9项纵向研究中,学医前及进入医学院后学生(n = 2432)的抑郁症患病率的中位绝对增加值为13.5%(范围0.6% - 35.3%)。临床前和临床学生之间抑郁症状的患病率无显著差异(23.7% [95% CI, 19.5% - 28.5%] vs 22.4% [95% CI, 17.6% - 28.2%]; P = .72)。抑郁的学生寻求治疗的比例为15.7% (110/954; 95% CI, 10.2% - 23.4%, I2 = 70.1%)。

来自15个国家的24项(n = 21,002,除了1项研究外均采用自我评估形式)关于医学生自杀念头的横断面研究数据汇总发现,总的自杀念头存在率为11.1%(2043/21,002; 95% CI, 9.0% t- 13.7%, I2 = 95.8%),不同评估方式,自杀念头存在率不同,范围为7.4% - 24.2%。

总体而言,在此系统回顾分析中,医学生抑郁或抑郁症状的患病率为27.2%,自杀念头的存在率为11.1%。仍需进一步的研究以确定医学生中抑郁或抑郁症状及自杀倾向的预防及治疗。

原始出处:

Lisa S. Rotenstein, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical StudentsA Systematic Review and Meta-Analysis. JAMA.December 6, 2016.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1770843, encodeId=5a991e708430a, content=<a href='/topic/show?id=3a5b300654c' target=_blank style='color:#2F92EE;'>#关爱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30065, encryptionId=3a5b300654c, topicName=关爱)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a0a38187382, createdName=jklm22, createdTime=Wed Oct 18 00:25:00 CST 2017, time=2017-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=164879, encodeId=468e1648e90d, content=唉!可怜!, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160616/IMG5762A3665DC7B3997.jpg, createdBy=df0a1649089, createdName=ys2323, createdTime=Thu Dec 22 14:06:30 CST 2016, time=2016-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162780, encodeId=c19d162e80a8, content=高风险行业,留下的都是好样的, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLv9NticiaOcQPiaUCcaQu4KaJyKHVPB46MpRExqnMl4RfvS3glIE7QYnQGRSnPJxymtNIP6kADF4mpg/132, createdBy=0b131930103, createdName=Ljm1998, createdTime=Wed Dec 14 15:25:19 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162757, encodeId=8c52162e57b1, content=选了路就走下去!不怕,实在不行,就换专业,路,到处都是!不虚, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160911/IMG57D51CE461BD24798.jpg, createdBy=91d61672802, createdName=西风染林, createdTime=Wed Dec 14 13:24:05 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162587, encodeId=ffc916258e92, content=那已经学了呢。怎么办, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Wed Dec 14 00:10:21 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162543, encodeId=b0dc16254315, content=不要轻易学医, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62d381629, createdName=yafeiliutjh, createdTime=Tue Dec 13 20:40:41 CST 2016, time=2016-12-13, status=1, ipAttribution=)]
    2017-10-18 jklm22
  2. [GetPortalCommentsPageByObjectIdResponse(id=1770843, encodeId=5a991e708430a, content=<a href='/topic/show?id=3a5b300654c' target=_blank style='color:#2F92EE;'>#关爱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30065, encryptionId=3a5b300654c, topicName=关爱)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a0a38187382, createdName=jklm22, createdTime=Wed Oct 18 00:25:00 CST 2017, time=2017-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=164879, encodeId=468e1648e90d, content=唉!可怜!, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160616/IMG5762A3665DC7B3997.jpg, createdBy=df0a1649089, createdName=ys2323, createdTime=Thu Dec 22 14:06:30 CST 2016, time=2016-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162780, encodeId=c19d162e80a8, content=高风险行业,留下的都是好样的, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLv9NticiaOcQPiaUCcaQu4KaJyKHVPB46MpRExqnMl4RfvS3glIE7QYnQGRSnPJxymtNIP6kADF4mpg/132, createdBy=0b131930103, createdName=Ljm1998, createdTime=Wed Dec 14 15:25:19 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162757, encodeId=8c52162e57b1, content=选了路就走下去!不怕,实在不行,就换专业,路,到处都是!不虚, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160911/IMG57D51CE461BD24798.jpg, createdBy=91d61672802, createdName=西风染林, createdTime=Wed Dec 14 13:24:05 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162587, encodeId=ffc916258e92, content=那已经学了呢。怎么办, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Wed Dec 14 00:10:21 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162543, encodeId=b0dc16254315, content=不要轻易学医, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62d381629, createdName=yafeiliutjh, createdTime=Tue Dec 13 20:40:41 CST 2016, time=2016-12-13, status=1, ipAttribution=)]
    2016-12-22 ys2323

    唉!可怜!

    0

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    2016-12-14 Ljm1998

    高风险行业,留下的都是好样的

    0

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    2016-12-14 西风染林

    选了路就走下去!不怕,实在不行,就换专业,路,到处都是!不虚

    0

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    2016-12-14 xiaotaiyang1

    那已经学了呢。怎么办

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1770843, encodeId=5a991e708430a, content=<a href='/topic/show?id=3a5b300654c' target=_blank style='color:#2F92EE;'>#关爱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30065, encryptionId=3a5b300654c, topicName=关爱)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a0a38187382, createdName=jklm22, createdTime=Wed Oct 18 00:25:00 CST 2017, time=2017-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=164879, encodeId=468e1648e90d, content=唉!可怜!, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160616/IMG5762A3665DC7B3997.jpg, createdBy=df0a1649089, createdName=ys2323, createdTime=Thu Dec 22 14:06:30 CST 2016, time=2016-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162780, encodeId=c19d162e80a8, content=高风险行业,留下的都是好样的, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLv9NticiaOcQPiaUCcaQu4KaJyKHVPB46MpRExqnMl4RfvS3glIE7QYnQGRSnPJxymtNIP6kADF4mpg/132, createdBy=0b131930103, createdName=Ljm1998, createdTime=Wed Dec 14 15:25:19 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162757, encodeId=8c52162e57b1, content=选了路就走下去!不怕,实在不行,就换专业,路,到处都是!不虚, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160911/IMG57D51CE461BD24798.jpg, createdBy=91d61672802, createdName=西风染林, createdTime=Wed Dec 14 13:24:05 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162587, encodeId=ffc916258e92, content=那已经学了呢。怎么办, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Wed Dec 14 00:10:21 CST 2016, time=2016-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=162543, encodeId=b0dc16254315, content=不要轻易学医, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62d381629, createdName=yafeiliutjh, createdTime=Tue Dec 13 20:40:41 CST 2016, time=2016-12-13, status=1, ipAttribution=)]
    2016-12-13 yafeiliutjh

    不要轻易学医

    0

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