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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 | The Effect of Ageand Chilling Temperature on the Concentration ofscopolin and caffeoylquinic Acids in Tobacco显示文摘 | D Koeppe L Rohrbaugh E Rice | 1970 | Physiologia Plantarum1970，23，2： | 1 |
| 3 | MIntegrated medical care for patients with serious psychiatric illness : a randomized trial 显示文摘 | Drnss BG Rohrbaugh RM Levinson C | 2001 | Arch Gen Psychiatry2001，58，9： | 1 |
| 4 | The effects of age and chilling temperature on the concentration of scopolin and caffeoylquinic acids in tobacco显示文摘 | Koeppe D E Rohrbaugh L M Rice E L | 1970 | Physiol Plant1970，23，2： | 1 |
| 5 | Circular scan lines and circular windows:new tools for characterizing the geometry of fracture traces 显示文摘 | Mauldon M Dunne W M Rohrbaugh M B | 2001 | Journal of Structural Geology2001，23，23： | 1 |
| 6 | The effects of age and chilling temperatures on the concen- tration of seopolin and eaffeoylquinic acids on tobacco 显示文摘 | Koeppe D E Rohrbaugh L M Rice E L | 1990 | Physiol Plant1990，23，： | 1 |
| 7 | Estimating fracture trace intensity,density,and mean length using circular scan lines and windows 显示文摘 | Rohrbaugh M B Dunne W M Mauldon M | 2002 | AAPG Bulletin2002，86，12： | 1 |
| 8 | The role of CCR5 and CCR2 polymorphisms in HIV-1 transmission and disease progression显示文摘 | Michael NL Louie LG Rohrbaugh AL | 1997 | Nat Med1997，3，10： | 1 |
| 9 | A questionnaire to measure quality of life in adults with nocturnal allergic rhinocon- junctivitis显示文摘 | Juniper EF Rohrbaugh T Meltzer EO | 2003 | J Allergy Clin Immunol2003，111，： | 1 |
| 10 | Circular Scan Lines and Circular Windows: New Tools for Characterizing the Geometry of Fracture Traces 显示文摘 | MAULDON M DUNNE W M ROHRBAUGH M B Jr | 2001 | Journal of Structural Geology2001，，23： | 1 |
| 11 | A Spatial Model of Effectiveness Criteria:Towards a Competing Values Approach to Organizational Analysis显示文摘 | Quinn R Rohrbaugh J | | 0，，： | 1 |
| 12 | The effect of nitrogen deficiency on the concentration of caffeoylquinic acid and scopolamine in tobacco 显示文摘 | ARMSTRONG G W ROHRBAUGH L M RICE E L | 1970 | Phutochem1970，9，： | 1 |
| 13 | Identification of neochlorogenic and 3-O-feruloylquinic acids in tomato plants 显示文摘 | Bragt JV Rohrbaugh LM Wender SH | 1965 | Phytochemistry1965，4，6： | 1 |
| 14 | A competing values framework approach to organizational effectiveness 显示文摘 | Quinn R E Rohrbaugh J | 1981 | Public Productivity Review1981，5，2： | 1 |
| 15 | Lacunarity definition for ramified data sets based on optimal cover显示文摘 | Tolle CR Mcjunkin TR Rohrbaugh DT | 2003 | Physical D2003，179，： | 1 |
| 16 | Prognostic importance of marital quality for survival of congestive heart failure显示文摘 | Coyne JC Rohrbaugh MJ Shoham V | 2001 | Am J Cardiol2001，88，： | 1 |
| 17 | A spatial model of effective- ness criteria: towards a competing values approach to or-ganizational analysis显示文摘 | QUINN K Rohrbaugh J | 1983 | Management Science1983，29，： | 1 |
| 18 | The framework topology of zeolite beta显示文摘 | LaPierre R B Schlenker J L,Rohrman A C Wood J D Kerr G T Rohrbaugh W J | 1988 | Zeolites1988，8，： | 1 |
| 19 | A spatial model of effectiveness criteria:Towards a competing values approach to organizational analysis显示文摘 | Quinn R E Rohrbaugh J | 1983 | Management Science1983，29，3： | 1 |
| 20 | A spatial model of effectiveness criteria: Towards a competing values approach to organizational analysis 显示文摘 | Quinn R E Rohrbaugh J | 1983 | Management Science1983，29，3： | 1 |
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