Development of depression and deterioration in quality of life in German dental medical students in preclinical semesters.

PURPOSE: Early intervention to counter mental disorders during the course of studies in dentistry is indicated in view of the pronounced prevalence of burnout in this student collective. To assess the proportion of students in whom these risk states can be quantified in measurable parameters for concrete mental disorders, we conducted surveys among students of dental medicine during the first 2.5 years of their studies. METHODS: We surveyed a total of 163 students of dental medicine in their first 5 semesters of study. Standardized, validated psychological questionnaires on depressive symptoms (Beck Depression Inventory; BDI-II) and mental and physical quality of life (Short Form Survey; SF-12) were used in the survey, with per-semester participant quotas of around 90%. RESULTS: Regarding depression, the students were within the range of the normal populace at the beginning of the 1st semester. Symptoms of depression then became more pronounced with every succeeding semester. In the fifth semester, the average levels determined were equivalent to a depression with a clinical treatment indication. Hardly any change was registered for physical wellbeing in the quality of life questionnaire. The mental sum scores, however, reflected dramatic downturns in quality of life. Highly significant correlations between the parameters described here - depressivity and mental quality of life - were observed in all semesters. CONCLUSION: The participating students begin their course of studies at the level of the average populace for the symptoms surveyed, then develop, on average, a clinically manifest depression after 2.5 years. The personal experience of a deterioration of mental quality of life appears to be crucial in the phenomena observed.

Risk factors for mental disorders develop early in German students of dentistry.

PURPOSE: We investigated mental risk factors such as symptoms of burnout and sense of coherence in students of dental medicine at the University of Erlangen in the context of a learning type survey. Our aim was to assess the presence of analogies to the results we had previously determined for students of human medicine. METHODS: We surveyed a total of 163 dentistry students during the first 2.5 years, up to the first state examination. To ensure comparability, the data were collected from all students at the beginning of each semester. Standardized, validated questionnaires on burnout symptoms (Burnout Screening Scales; BOSS-II), sense of coherence (Sense of Coherence Scale; SOC-L9) and learning type according to Kolb were used in the survey. RESULTS: A total of about 90% of the students provided responses to the voluntary survey. The extent and manifest dynamics of the stress levels observed can be characterized as dramatic. Having started out at cognitive and emotional stress levels typical of the normal populace, a massive deterioration of these parameters was observed in the students by the time they were facing their first state examination in the 5th semester. At the same time, their sense of coherence also suffered a pronounced drop-off. No significant learning type-correlated differences were determined in a mean comparison of the measured parameters. CONCLUSION: Based on the results obtained, we see a need for preventive course offerings to students of dentistry to reduce the prevalence of mental disorders in this group. We discern additional potential for enhancement of mental health with courses more specifically geared to the different learning styles among the students.

Exacerbation of migraine attacks during treatment with the selective serotonin reuptake inhibitor sertraline. A case report.

Abnormal signal transmission in central serotonergic pathways is supposed to play an important role in the pathogenesis of migraine and major depression. We report on a patient, who was treated during an episode of depression with the selective serotonin reuptake inhibitor (SSRI) sertraline and developed frequent migraine attacks under this therapeutical regime. Single migraine attacks were treated successfully with triptanes. Although SSRIs may be beneficial for migraine prophylaxis at long term administration, this case suggests that acute administration of SSRIs in migraineurs may include the risk of worsening migraine.