title: Medical students' experience of and reaction to stress: the role of depression and anxiety.
abstract: BACKGROUND
  Medical school is recognized as a stressful environment that often has a negative effect on students' academic performance, physical health, and psychosocial well-being. Previous studies have not identified differences between depressed and nondepressed and anxious and nonanxious medical students' experiences of stress or their reactions to stressors. The present study aimed to identify the prevalence of depression and anxiety among a sample of 358 medical students attending a private university in Malaysia and to examine differences according to participants' gender, year of study, and stage of training (preclinical and clinical). Additionally, this study examined the extent to which stress predicts depression and anxiety, differences between depressed and nondepressed medical students' experiences of and reactions to stressors, and differences between anxious and nonanxious medical students' experiences of and reactions to stressors.
  
  
  METHODS
  The Student Life Stress Inventory was used to measure stress and reaction to stressors and the Depression, Anxiety, and Stress Scale was used to measure depression and anxiety.
  
  
  RESULTS
  The results showed that 44% (n = 158) of the students were anxious and 34.9% (n = 125) were depressed. More female students exhibited anxiety compared to male students. Stress is a predictor for depression and anxiety. A significant difference was found between depressed and nondepressed and anxious and nonanxious students' experience of stressors due to frustration, change, and their emotional reaction to stressors.
  
  
  CONCLUSIONS
  Overall, depressed and anxious students were found to experience more stress and react differently to stressors compared to nondepressed and nonanxious students.
authors.affiliation: Division of Psychology (& Behavioural Sciences), International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
authors.forename: Coumaravelou
authors.initials: C
authors.lastname: Saravanan
authors.affiliation: Division of Psychology (& Behavioural Sciences), International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
authors.forename: Ray
authors.identifier: 0000-0002-0399-9599
authors.initials: R
authors.lastname: Wilks
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D013337:Students, Medical / Q000523:psychology*