title: Perceived sources of stress in fifth year dental students--a comparative study.
abstract: BACKGROUND
  The term "stress" refers to the effect of certain external factors (physical or mental) on the individual's physical and psychological health. Stress is very high in dental medicine. It may well be generated by the process of training in dentistry. During their training dental students express high levels of stress and considerable stress-related symptoms such as physical problems, depression, obsessive-compulsive and personality disorders. The perceived stress can be dependent on socio-cultural factors. The type of personality, gender, emotional intelligence and other individual characteristics may also influence the stress effects.
  
  
  OBJECTIVE
  To determine the main sources of stress in students during their dental training and compare the level of stress fifth-year dental students experience in the Faculty of Dental Medicine, Plovdiv, Bulgaria and the Faculty of Dentistry in Montpellier, France.
  
  
  METHODS
  We recruited in the study fifth-year students from the Faculty of Dental Medicine in Plovdiv, Bulgaria and the Faculty of Dentistry in Montpellier, France. The modified Dental Environment Stress (DES) questionnaire was used to assess the effect of the various stressors. The questionnaire survey was conducted between February and March 2008.
  
  
  RESULTS
  The living arrangements domain indicates higher levels of stress in Bulgarian students compared to their French counterparts with significant statistical difference for all factors. In personal factors the highest levels of stress were found with respect to the reduced holidays during school year and financial problems. Exams were the highest stressor in academic work domain and for the survey as a whole. In educational environment factors the stressors with the highest significance were the interactions with patients, academic environment (for French students) and risk of cross transmitted infections (for Bulgarian students). The high stress during clinical work is related to completing the assigned clinical workload quota and the shortage of time for clinical work.
  
  
  CONCLUSIONS
  The students from both faculties report the highest mean levels of stress are related to examinations and clinical factors. Bulgarian students experienced higher mean levels of stress compared to their French colleges. The differences in mean stress levels are associated with socio-cultural factors and variations in educational curriculums at both dental faculties.
authors.affiliation: Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria. mimaci@yahoo.com
authors.forename: Maria S
authors.initials: MS
authors.lastname: Manolova
authors.forename: Vesela P
authors.initials: VP
authors.lastname: Stefanova
authors.forename: Ivan V
authors.initials: IV
authors.lastname: Panayotov
authors.forename: Guilhem
authors.initials: G
authors.lastname: Romieu
authors.forename: Ani B
authors.initials: AB
authors.lastname: Belcheva
authors.forename: Kremena B
authors.initials: KB
authors.lastname: Markova
authors.forename: Bernard
authors.initials: B
authors.lastname: Levallois
mesh_terms: D001291:Attitude of Health Personnel; D002031:Bulgaria; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013312:Stress, Physiological / Q000502:physiology*; D013315:Stress, Psychological / Q000523:psychology*; D013335:Students, Dental / Q000523:psychology*; D016526:Workload