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Stress and its risk factors in medical students: an observational study from a medical college in India.

OBJECTIVES
Stress in medical students is well established. It may affect academic performance and lead to anxiety, depression, substance abuse, and burnouts. There is limited data on stress in Indian medical students. We conducted an analytical observational study to assess the magnitude of stress and identify possible "stressors" in medical students of a teaching hospital in Kolkata.


MATERIALS AND METHODS
This questionnaire-based study was conducted in the Institute of Post Graduate Medical Education and Research, Kolkata with consenting undergraduate students of 3rd, 6th, and 9th (final) semesters, during lecture classes in individual semesters on a particular day. The students were not informed about the session beforehand and were assured of confidentiality. The first part of the questionnaire captured personal and interpersonal details which could be sources of stress. The rest comprised three rating scales--the 28-item General Health Questionnaire to identify the existence of stress, the Warwick-Edinburgh mental well-being scale to assess the mental well-being, and the revised version of the Lubben social network scale to assess the social networking. The responses and scores were compared between the three semesters as well as between various subgroups based on baseline characteristics.


RESULTS
Data from 215 respondents were analyzed--approximately 75% were male, 45% came from rural background, 25% from low-income families, and 60% from vernacular medium. Totally, 113 (52.56%; 95% confidence interval: 43.35-61.76%) students were found to be stressed, without significant difference in stress incidence between the semesters. About 60% of the female students were stressed in contrast to 50% of the males, but this observed difference was not statistically significant. The mental well-being and social networking of stressed respondents suffered in comparison to their non-stressed counterparts.


CONCLUSIONS
The stress incidence in medical students in this institution in India is high and is negatively affecting their mental well-being. Further multicentric and longitudinal studies are needed to explore the incidence, causes, and consequences of stress in our setting.