title: Pre-existing mental health problems in medical students: a retrospective survey.
abstract: BACKGROUND
  The undergraduate medical course is demanding. Each year, a small number of students 'struggle', for academic or other reasons. Recent studies at Nottingham reported anecdotal evidence that those who struggle disclose a much higher incidence of psychological distress than those who do not struggle.
  
  
  OBJECTIVE
  The study aimed to assess whether a group of students with mental health problems were more likely to have a pre-admission history of similar problems.
  
  
  METHODS
  Three year-cohorts of medical students were classified as struggling or not on the course, and whether they disclosed mental health problems during their course. The Nottingham Occupational Health Service carried out a confidential review of pre-admission health questionnaires.
  
  
  RESULTS
  Students who struggled on the course and disclosed mental health problems were more likely to have a relevant pre-admission history. One third of those with a positive history disclosed a further significant episode.
  
  
  CONCLUSIONS
  Existing pastoral care mechanisms may need to be enhanced in order to identify and support potentially vulnerable students.
authors.affiliation: University of Nottingham Medical School, Nottingham, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Yates
authors.forename: David
authors.initials: D
authors.lastname: James
authors.forename: Ian
authors.initials: I
authors.lastname: Aston
mesh_terms: D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D012189:Retrospective Studies; D012570:School Admission Criteria; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology