Comportamentos de risco para Doenças Crônicas Não Transmissíveis e Saúde Mental de estudantes de medicina

Abstract

During their course, medical students can present several health complaints, related to the excessive volume of studying required, the lack of time, physical fatigue and the draining contact with terminal patients and death. As a consequence, this population group usually sleeps less than is recommended and has a high prevalence of disorders which affect their mental health, such as depressive symptoms, Burnout syndrome and Common Mental Disorders. There are also significant changes in the lifestyles of students that increase the risks to their health, such as inadequate eating habits, a sedentary lifestyle, alcohol abuse, and smoking. All these aspects emphasize the need for more profound studies about this population group, especially those that are longitudinal in nature. The present study aimed to evaluate quality of life, mental health (common mental disorders, depressive symptoms, Burnout syndrome, excessive daytime sleepiness) and risk behaviors for noncommunicable chronic diseases among medical students over three years of the undergraduate course. Data collection was performed in 2015 with students from three medical schools in the north of Minas Gerais who were in the 1st, 7th and 11th academic periods, through self-administered and validated questionnaires. Data analysis included logistic and Poisson regression and Kruskal-Wallis comparison tests. It was found that 30.8% of the students had three or more types of food-related risk behaviors for chronic diseases. In joint analysis, it was observed that the prevalence of dietary risk behaviors was significantly higher among students in the first period. When assessing other risk behaviors, such as physical inactivity, alcohol abuse and smoking, the prevalence of clustering of three or more risk behaviors was 22.0%, and was associated with depressive symptoms and daytime sleepiness. Lower-income and married students were more likely to simultaneously be physically inactive and have inadequate diets, and the likelihood of experiencing physical inactivity, abusive alcohol consumption, and inadequate nutrition was higher among students in private institutions, and those with excessive daytime sleepiness. In relation to daytime sleepiness, 34.6% of the students had pathological levels and 6.9% had highly pathological levels. The prevalence of pathological daytime sleepiness was higher in students with Common Mental Disorders, emotional exhaustion and low professional efficacy, and lower in those who lived with their parents. During the three years of the undergraduate course, there was an increase in psychological morbidity and daytime sleepiness scores and in the dimensions of emotional exhaustion and cynicism, both part of Burnout Syndrome, and a reduction in professional effectiveness scores. There were no differences in quality of life scores between the three years of study, although the mean scores in all years were low. These results demonstrate that the mental health of many students has been impaired since graduation, and that exposure to medical school contributes to the psychic suffering of those who are most vulnerable. It is essential that mental health is the subject of debates, forums and seminars within the universities themselves, and that medical schools adopt more effective strategies to identify students at risk of psychic suffering. In relation to lifestyle, a significant number of students exhibited a clustering of risk behaviors for Chronic Noncommunicable Diseases, which are potentially harmful, and which can be related to the tiring routine of the students. Health promotion strategies should be developed by university administrators.