ABSTRACT
Background?Psychological morbidities are high among undergraduate medical students. They experience the transition between pre-/para-clinical and clinical training as a stressful period, and cope differently. Research studies from India in this regard are lacking. Aims?The aim of this study is to assess and compare the prevalence of psychological morbidities and their respective associated factors and coping styles between pre-/para-clinical and clinical undergraduate medical students. Materials and Methods?This institution-based cross-sectional observational design study was conducted among undergraduate medical students (a total of 382) in pre-/para-clinical and clinical years by using a questionnaire in the period between April and June 2019. A stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like General Health Questionnaire-28 (GHQ-28) and Lin–Chen's coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities and coping styles between two groups were compared using the Chi-square test, independent t-test, and binary logistic regression analysis. Results?Out of the 382 responders, psychological morbidities (GHQ-28 score?>?23) were found in 61% participants. Both groups reported high levels of psychological morbidities; a slightly higher preponderance in clinical (61.5%) than in pre-/para-clinical students (60.6%) with a nonsignificant difference. Compared with the pre-/para-clinical group, the clinical group was found to have more substance consumption behavior (p?<?0.001), dissatisfaction with academic performance (p?<?0.001), sought psychiatric consultation (p?<?0.004), and at that time on psychiatric treatment (p?<?0.04). Active problem coping behavior was more significantly used by the pre-/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in the clinical group. Conclusion?This study suggests a significant correlation between psychological morbidities and passive coping styles in the clinical group. These students need interventions to encourage the use of more active coping styles during training to provide advances in future career. A strong correlation between psychological morbidities and dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.
ABSTRACT
Background: Bipolar disorder is the sixth leading cause of disability worldwide and has a lifetime prevalence of about 3% in general population. In patients with bipolar disorder there was 58 % lifetime prevalence of co-occurring alcohol abuse and a 38 % lifetime prevalence of co-occurring other substance abuse. Substance abuse interferes with treatment and management approaches of the bipolar disorder.Methods: A cross sectional observational study of 120 male patients divided in substance abusing (60) and non-substance abusing groups (60) with bipolar disorder according to DSM-V, who met the Inclusion criteria . A written informed consent was obtained from the patients and/ or their family members. Patient’s information was recorded on the socio-demographic and clinical profile sheet .Thereafter, YMRS or HAM-D scales were applied as per the phase of the illness.Results: Most of the patients were between 15-25 years in SAB group and 35-50 years in NSAB group, educated, semiskilled and married. Tobacco abuse was the commonest followed by cannabis and alcohol abuse. The mean duration of hospital stay in SAB group was 41.40 days and in NSAB group was 43.20 days. Dysphoric mania, aggressive behavior and suicidal attempts were more in SAB group. Mean total YMRS score of SAB group was greater than NSAB group.Conclusions: Maximum patients had onset of substance abuse before the onset of affective symptoms. Manic symptomatology was more severe in substance abusing group.