title: The characteristics of depressive symptoms in medical students during medical education and training: a cross-sectional study.
abstract: BACKGROUND
  Medical education and training can contribute to the development of depressive symptoms that might lead to possible academic and professional consequences. We aimed to investigate the characteristics of depressive symptoms among 481 medical students (79.8% of the total who matriculated).
  
  
  METHODS
  The Beck Depression Inventory (BDI) and cluster analyses were used in order to better describe the characteristics of depressive symptoms. Medical education and training in Brazil is divided into basic (1st and 2nd years), intermediate (3rd and 4th years), and internship (5th and 6th years) periods. The study organized each item from the BDI into the following three clusters: affective, cognitive, and somatic. Statistical analyses were performed using analysis of variance (ANOVA) with post-hoc Tukey corrected for multiple comparisons.
  
  
  RESULTS
  There were 184 (38.2%) students with depressive symptoms (BDI > 9). The internship period resulted in the highest BDI scores in comparison to both the basic (p < .001) and intermediate (p < .001) periods. Affective, cognitive, and somatic clusters were significantly higher in the internship period. An exploratory analysis of possible risk factors showed that females (p = .020) not having a parent who practiced medicine (p = .016), and the internship period (p = .001) were factors for the development of depressive symptoms.
  
  
  CONCLUSIONS
  There is a high prevalence towards depressive symptoms among medical students, particularly females, in the internship level, mainly involving the somatic and affective clusters, and not having a parent who practiced medicine. The active assessment of these students in evaluating their depressive symptoms is important in order to prevent the development of co-morbidities and suicide risk.
authors.affiliation: Psychiatry and Medical Psychology Disciplines, ABC Regional Medical School, Santo André, Brazil. spbaldassin@uol.com.br.
authors.forename: Sergio
authors.initials: S
authors.lastname: Baldassin
authors.forename: Tânia Correa de Toledo Ferraz
authors.initials: TC
authors.lastname: Alves
authors.forename: Arthur Guerra
authors.initials: AG
authors.lastname: de Andrade
authors.forename: Luiz Antonio
authors.initials: LA
authors.lastname: Nogueira Martins
mesh_terms: D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D004504:Education, Medical, Undergraduate; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010555:Personality Inventory; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013337:Students, Medical / Q000523:psychology*; D055815:Young Adult