The correlates of stress, coping styles and psychiatric morbidity in the first year of medical education at a Nigerian University.

Abstract

Objectives: This study was prompted by the heightened concerns about the stress inherent in medical education evident from the incessant requests for suspension of studies due to psychological problems. The objectives of the study were to: (i) survey the students for possible psychological problems at admission, and follow them up till exit for possible changes in morbidity, and (ii) ascertain possible risk factors, and coping strategies.

Method: This is a preliminary 2-stage cross-sectional report, which is part of a longitudinal survey. It involves first year medical students of the College of Health Sciences of University of Ilorin between March and April, 2011. Questionnaires used included socio demographic, sources of stress, the general health questionnaire-12 (GHQ-12), Maslach's burnout inventory (MBI), and Brief COPE. Data were analysed using SPSS version 15 at 5% significance level. Chi-square, frequency distributions, Pearson's correlation, Odd ratios, and Confidence Intervals were calculated to determine the levels of risk.

Results: 79 students returned completed questionnaires. 12 (15.2%) were ghq-12 cases (i.e., scored ≥ 3). Students who had morbidity were 9 times at risk of being stressed consequent upon 'competing with their peers' and 4 times at risk due to 'inadequate learning materials'. Morbidity was significantly more likely to engender use of 'religion', 4 times less likely to engender use of 'positive reframing' with a trend in the use of 'self blame' as coping strategies.

Conclusion: Aside from psychosocial/personal issues in this cohort, academic demand was an additional source of psychological problems thereby causing those who had morbidity to utilize 'religion' and 'positive reframing' to cope. There is therefore an apparent need to incorporate the principle of mental health promotion in medical education.