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| 1 | Medical student depression and its correlates across three international medical schools显示文摘BACKGROUND Medical students have high rates of depression, anxiety, and burnout that have been found to affect their empathy, professional behaviors, and performance as a physician. While studies have examined predictors for burnout and depression in the United States (US), no study, to our knowledge, has compared depression in medical students cross-culturally, or has attempted to examine the effect of factors influencing rates including burnout, exercise, stress, unmet mental health needs, and region. AIM To examine rates of depression in three international cohorts of medical students, and determine variables that may explain these differences. METHODS Convenience samples of medical students from three countries (US, China, and a Middle Eastern country whose name remains anonymous per request from the school) were surveyed in this observational study. Using the Patient Health Questionnaire-2 (PHQ-2) and a modified Maslach Burnout Inventory, depression and burnout were examined among medical students from the three cohorts (n = 473). Chi-square test and analysis of variance were used to examine differences in demographics, behavioral, and psychological variables across these three schools to identify potentially confounding descriptive characteristics. Analysis of covariance compared depression and the emotional exhaustion component of burnout identified through Principal Component Analysis across countries. Multiple linear regression was used to analyze the impact of demographic, behavioral, and psychological variables on screening positive for depression. RESULTS Medical students from the Middle Eastern country had the highest rates of positive depression screens (41.1%), defined as a PHQ-2 score of ≥ 3, followed by China (14.1 %), and then the US (3.8%). More students in the Middle Eastern school had unmet mental health needs (50.8%) than at the medical school in China (34.8%) or the school in the US (32.8%)(Pearson chi-square significance < 0.05). Thus, PHQ-2 scores were adjusted for unmet mental health needs;however, the Middle Eastern country continued to have the highest depression. Adjusting for PHQ-2 score, medical students from the US scored the highest on emotional exhaustion (a measure of burnout). Demographic variables did not significantly predict medical student depression;however, lack of exercise, unmet mental health needs, stress, and emotional exhaustion predicted nearly half of depression in these cohorts. In comparison to the US, coming from the Middle Eastern country and China predicted higher levels of depression. CONCLUSION Depression rates differ in three international cohorts of medical students. Measured factors contributed to some observed differences. Identifying sitespecific prevention and intervention strategies in medical student mental health is warranted. | Jessica A Gold Xinran Hu Gan Huang Wan-Zhen Li Yi-Fan Wu Shan Gao Zhe-Ning Liu Mickey Trockel Wan-Zhen Li Yi-Fan Wu Shan Gao Zhe-Ning Liu Robert M Rohrbaugh Kirsten M Wilkins | 2019 | World Journal of Psychiatry2019，9，4： | 2 |
| 2 | Relationship of adiponectin with insulin sensitivity in humans, independent of lipid availability 显示文摘 | Furler S M Gan S K Poynten A M | 2006 | Obes Res2006，14，2： | 1 |
| 3 | 显示文摘 | Latroche M Rodiguez-Carvajal J Percheron-Guégan A | 1995 | J Alloys Comp1995，218，： | 1 |
| 4 | Goal-directed intraoperative fluid administration reduces length of hospital stay after major sur- gery 显示文摘 | Gan TJ Soppitt A Maroof M | 2002 | Anesthesiology2002，97，2： | 1 |
| 5 | Exercise Increases Adiponectin Levels and Insulin Sensitivity in Humans显示文摘 | Gan S K Poynten A M | 2004 | Dia-betes Care2004，27，7： | 1 |
| 6 | Association between chronic obstructive pulmonary disease and systemic inflammation:asystematie review and a meta-analysis显示文摘 | GAN W Q M A N SF SENTHILSELVAN | 2004 | Thorax2004，59，： | 1 |
| 7 | From a Gaussian mix- ture model to additive fuzzy systems 显示文摘 | GAN M T HANMANDLU M TAN A H | 2005 | IEEE Transactions on Fuzzy Systems2005，13，3： | 1 |
| 8 | Goal-directed intraoperative fluid administration reduces length of hospital stay after major sur gery显示文摘 | Gan TJ Soppitt A Maroof M | | 0，，04： | 1 |
| 9 | Evaluation of microbial trans- glutaminase and ribose cross - linked soy protein isolate - based mi- crocapsules containing fish oil 显示文摘 | GAN C Y CHENG L H EASA A M | 2008 | Innovative Food Science and E- merging Technologies2008，9，： | 1 |
| 10 | Role of exercise for type 2 diabetic patient management 显示文摘 | Pigman H T Gan D X Krousel-Wood M A | 2002 | South Med J2002，95，1： | 1 |
| 11 | Breast Screening and Health Issues among Rural Females in Malaysia:How Much do They Know and Practice?显示文摘 | Dahlui M Gan D E Taib N A | 2013 | Prey Med2013，，57： | 1 |
| 12 | Brittle-ductile transition in the diamond cutting of glasses with the aid of ultrasonic vibration显示文摘 | Zhou M Wang X J Ngoi B K A Gan J G K | 2002 | J Mater Process Technol2002，121，23： | 1 |
| 13 | ^1H NMR spectroscopy in the diagnosis of Pseudomonas aeruginosa-induced urinary tract infection 显示文摘 | Gupta A Dwivedi M Gowda GAN | 2005 | NMR Biomed2005，18，5： | 1 |
| 14 | Optical and magneto optical properties of FePt-SiO2 magnetic nanocomposires 显示文摘 | GAN E A KOCHNEVA M Y VASHUK M V | 2005 | Physics of the Solid State2005，47，9： | 1 |
| 15 | Physicoehemical properties and microstructures of soy protein isolate gels produced using combined cross-linking treatments of microbial transglutaminasc and Maillard cross- linking显示文摘 | GAN C Y CHENG L H EASA A M | 2008 | Food Research International2008，41，： | 1 |
| 16 | β Ⅲ-Tubulin is a multi-functional protein involved in drug sensitivity and tumorigenesis in non-small cell lung cancer显示文摘 | McCarroll J A Gan P P Liu M | 2010 | Cancer Res2010，70，12： | 1 |
| 17 | Physicochemical properties and microstructures of soy protein isolate gels produced using com- bined cross - linking treatments of microbial transglutaminase and Maillard cross - linking 显示文摘 | GAN C Y CHENG L H ESDA A M | 2008 | Food Research International2008，41，： | 1 |
| 18 | Goal - directed intraopera- tire fluild administration reduces length of hospital stay after major surgery 显示文摘 | Gan TG Soppitt A Maroof M | 2002 | Anesthesiology2002，97，4： | 1 |
| 19 | Signal Timing Optimization for Oversaturated Networks Using TRANSYT-7F显示文摘 | LI M T GAN A | 1999 | Transportation Research Record1999，，1683： | 1 |
| 20 | Sex differences in the impact of ozone on survival and alveolar macrophage function of mice after klebsiella pneumoniae infection 显示文摘 | Mikerov A N Gan X Umstead T M | 2008 | Respiratory Research2008，9，1： | 1 |
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