title: [From freshmanship to the first "Staatsexamen"--increase of depression and decline in sense of coherence and mental quality of life in advanced medical students].
abstract: Psychiatric disorders (Burnout, depression, anxiety disorders) are common among medical students with a distinctly higher prevalence compared to the general public. Although medi-cal students show a normal health status at the beginning of their university study period, a deterioration of these aspects in higher semesters is evident and continues when they become residents. In our study ESTRELLAS we examined 530 medical students in the preclinical semesters (1st-4th) before their first "Staatsexamen" with validated psychological questionnaires for depression, anxiety, quality of life and sense of coherence. Students in their 1st semester show normal values like the general public. During the 4 semesters a slow and continuous rise of depressive symptoms and anxiety was detected. Quality of life and sense of coherence constantly deteriorated. An increase of physical symptoms was not detected. In the 4th semester the number of depressive students had already doubled. The development of worsening psychological problems and resulting psychiatric disorders seems to be a continuous process, starting with the beginning of the medical studies and growing continuously during the preclinical semesters. Effect-ive strategies for coping with distress should be integrated in the medical curriculum at universities from the very first semester on. Relaxation techniques could thus be an opportunity.
authors.affiliation: Klinik Meissenberg AG, Psychiatrische und Psychotherapeutische Spezialklinik für Frauen, Zug/Schweiz.
authors.forename: Pascal H M
authors.initials: PH
authors.lastname: Burger
authors.affiliation: Institut für Anatomie II, FAU Erlangen-Nürnberg, Erlangen.
authors.forename: Ozan Y
authors.initials: OY
authors.lastname: Tektas
authors.affiliation: Institut für Anatomie II, FAU Erlangen-Nürnberg, Erlangen.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Paulsen
authors.affiliation: Institut für Anatomie II, FAU Erlangen-Nürnberg, Erlangen.
authors.forename: Michael
authors.initials: M
authors.lastname: Scholz
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D004501:Education, Medical; D005260:Female; D005858:Germany; D006801:Humans; D008007:Licensure, Medical; D008137:Longitudinal Studies; D008297:Male; D009784:Occupational Diseases / Q000175:diagnosis* / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D060685:Sense of Coherence; D013044:Specialty Boards; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult