Psychological Morbidities and Coping Styles: A Rural Institution-Based Cross-Sectional Comparative Study between Undergraduate Medical Students Undergoing Different Phases of Training

S. Garg, A. Chauhan
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Abstract

Background Psychological morbidities are high among undergraduate medical students. They experience the transition between pre-/para-clinical and clinical training as a stressful period, and cope differently. Research studies from India in this regard are lacking. Aims The aim of this study is to assess and compare the prevalence of psychological morbidities and their respective associated factors and coping styles between pre-/para-clinical and clinical undergraduate medical students. Materials and Methods This institution-based cross-sectional observational design study was conducted among undergraduate medical students (a total of 382) in pre-/para-clinical and clinical years by using a questionnaire in the period between April and June 2019. A stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like General Health Questionnaire-28 (GHQ-28) and Lin–Chen's coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities and coping styles between two groups were compared using the Chi-square test, independent t-test, and binary logistic regression analysis. Results Out of the 382 responders, psychological morbidities (GHQ-28 score > 23) were found in 61% participants. Both groups reported high levels of psychological morbidities; a slightly higher preponderance in clinical (61.5%) than in pre-/para-clinical students (60.6%) with a nonsignificant difference. Compared with the pre-/para-clinical group, the clinical group was found to have more substance consumption behavior (p < 0.001), dissatisfaction with academic performance (p < 0.001), sought psychiatric consultation (p < 0.004), and at that time on psychiatric treatment (p < 0.04). Active problem coping behavior was more significantly used by the pre-/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in the clinical group. Conclusion This study suggests a significant correlation between psychological morbidities and passive coping styles in the clinical group. These students need interventions to encourage the use of more active coping styles during training to provide advances in future career. A strong correlation between psychological morbidities and dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.
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心理发病率与应对方式:基于农村机构的不同培养阶段医大学生的横断面比较研究
背景心理疾病在本科医学生中发病率较高。他们经历了从临床前/准临床训练到临床训练之间的过渡,这是一个充满压力的时期,他们的应对方式也有所不同。印度缺乏这方面的研究。目的评估和比较临床预科/准临床与临床医学本科学生的心理患病率及其相关因素和应对方式。材料与方法本研究基于机构的横断面观察性设计,于2019年4月至6月期间通过问卷调查对临床前/临床中和临床年的医科本科生(共382人)进行了调查。采用分层随机抽样方法选择研究对象。本研究采用一般健康问卷-28 (GHQ-28)和Lin-Chen应对量表等标准自填问卷,分别评估心理发病率和应对方式。采用卡方检验、独立t检验和二元logistic回归分析比较两组心理发病率和应对方式的相关因素。结果在382名应答者中,61%的参与者存在心理疾病(GHQ-28评分为bbb23)。两组都报告了高水平的心理疾病;临床学生(61.5%)略高于临床预科/准临床学生(60.6%),差异不显著。与临床前/准临床组比较,临床组的物质消费行为(p < 0.001)、学业表现不满意(p < 0.001)、心理咨询(p < 0.004)和当时的心理治疗(p < 0.04)均有所增加。临床前/准临床组更倾向于使用主动问题应对行为,而临床组更倾向于使用被动问题应对和被动情绪应对行为与心理发病率呈正相关。结论临床组患者心理发病率与被动应对方式有显著相关性。这些学生需要干预,以鼓励他们在培训期间使用更积极的应对方式,从而在未来的职业生涯中取得进步。心理疾病和不满意的学习成绩之间的强烈联系可能是对高效和更有利于学生的课程的呼吁。
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