title: Mental health of medical school students and the effects of their strategy for enhancing self-esteem.
abstract: OBJECTIVE
  This study investigated the mental health status, self-esteem, social comparison, and narcissism among medical school students. In addition, the mediational effect of social comparison between self-esteem and narcissism was also tested with regard to whether the students compared themselves with others to enhance their own self-esteem.
  
  
  METHODS
  Data were collected from 427 medical school students at a medical school in Seoul. The questionnaire included the Minnesota Multiphasic Personality Inventory (MMPI) 383 scale, the self-esteem scale, the Iowa-Netherlands Comparison Orientation Measure, and the narcissism scale. Using the MMPI findings, a clinical psychologist screened for possible clinical cases. Then, the frequencies of those with distress were compared between three groups, based on affiliation; premedical, medical, and graduate medical students. Also, the level of self-esteem, social comparison, and narcissism was tested by analysis of (ANCOVA), and the mediational role of social comparison was explored.
  
  
  RESULTS
  Irrespective of affiliation, almost 10% of medical school students showed mental illness or distress. Of the clinical scales on the MMPI, the T scores of the Pa (Paranoia), Sc (Schizophrenia), and Ma (Hypomania) scales were higher in premedical and medical school students than in graduate medical school students. In addition, the mediational role of social comparison was confirmed only in medical school students.
  
  
  CONCLUSIONS
  We demonstrated that subjective distress in certain medical school students needs to be addressed. Also, self-esteem was an important factor that correlated with mental health and distress indices. However, comparing oneself with others to enhance self-esteem by derogating or focusing could result in increased narcissism.
authors: Department of Neuropsychiatry, Hanyang University Guri Hospital, Seoul, Korea.
authors: Jin-Hee
authors: JH
authors: Kim
authors: Department of Neuropsychiatry, Hanyang University Guri Hospital, Seoul, Korea.
authors: Eun-Young
authors: EY
authors: Jang
authors: Department of Neuropsychiatry, Hanyang University Guri Hospital, Seoul, Korea.
authors: Daeho
authors: D
authors: Kim
authors: Department of Neuropsychiatry, Hanyang University Guri Hospital, Seoul, Korea.
authors: Joon Ho
authors: JH
authors: Choi
authors: Department of Neuropsychiatry, Hanyang University Guri Hospital, Seoul, Korea.
authors: Yong-Chon
authors: YC
authors: Park
keywords: Comparison; MMPI; Mental health; Narcissism; Self-esteem