title: Burnout, depression and anxiety in preclinical medical students: a cross-sectional survey.
abstract: OBJECTIVE
  The purpose of this study was to assess the prevalences and correlates of adverse affective states (burnout-, depression- and anxiety-related symptoms) among preclinical medical students.
  
  
  METHODS
  Self-report questionnaires were sent to all preclinical medical students of Leiden University Medical Center (n=1311). Burnout-related symptoms were measured using the Maslach Burnout Inventory-General Survey (MBI-GS), depression and anxiety-related symptoms and vitality using the Symptom Questionnaire-48 (SQ-48). Furthermore, duration of sleep, quality of life (SF-36), need for recovery, happiness and dispositional optimism were assessed and analysed in relation to affective symptoms using regression analysis.
  
  
  RESULTS
  Among the 433 responders (response rate=33.0%), prevalences of self-reported burnout-, depression- and anxiety-related symptoms were 46.0% (n=199), 27.0% (n=117) and 29.1% (n=126), respectively. Independent correlates for burnout-related symptoms were <6 h sleep per night (p=0.02), low happiness (p<0.001) and a high need for recovery (p<0.001). Independent correlates for both depression- and anxiety-related symptoms were low optimism (p<0.001; p<0.001, respectively), low happiness (p<0.001; p=0.001, respectively) and a high need for recovery (p=0.03; p<0.001, respectively).
  
  
  CONCLUSIONS
  Prevalences for adverse affective states were high among preclinical medical students and mainly associated with personality trait-related factors and need for recovery, rather than work-related factors. These findings suggest that being a medical student increases one's risk to adverse affective states, and should inspire preventative initiatives.
authors.forename: Lennard T
authors.initials: LT
authors.lastname: van Venrooij
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Barnhoorn
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Giltay
authors.forename: Martijn S
authors.initials: MS
authors.lastname: van Noorden
keywords: medical students; mental distress; preclinical