Depressão e ideação suicida em estudantes de Medicina: uma revisão sistemática.

Abstract

It is estimated that depression accounts 4.3% of worldwide diseases, being one of the major global causes of incapacity. About 15% to 25% of college students present with a psychiatric disorder, specially depression and anxiety, which are notably associated with suicidal ideation. Undergraduate students in medicine are exposed to a range of stressful situations that predispose them to depression and suicidal ideation; therefore, such disorders may influence their labour activities and patient care. Aim: To investigate the prevalence of depression and suicidal ideation among medical undergraduate students from distinct countries over a 15 year-period. Methods: A systematic review was carried out considering observational studies in depression disorders and suicidal ideation, published in full between 2001 and 2015, in Portuguese, English and Spanish. Data were obtained from MEDLINE, LILACS and Scielo databases, which are all collapsed into Virtual Health Library. Studies that do not use standardized tools to assess depression, do not separate medical students from other students or staff, that have low methodological quality and studies with less than 50% of the surveyed variables were excluded from this study. Results: Nine studies were included in this review, involving 7922 participants aged from 16.5 to 36 years old. Single females who lived with parents composed a sizeable majority. Undergraduate course duration ranged from four up to six years. The prevalence of depressive disorders in the sample was 46.11% (n=3653) and suicidal ideation affected 11% (n=876) of subjects, allocated in eight of the nine analysed studies. Conclusion: The medical undergraduate student profile investigated in this review was consistent with worldwide literature, revealing that prevalence of depressive disorders within this population outnumbers general population, other undergraduate students and even physicians. Suicidal ideation rates, however, were lower than found in literature. It was also seen that the female and living in high-income country may represent potential risk factors for depression. Those disorders are common throughout medical degree and affect career perception, students’ health and patients. Considering this, medical schools should be critically appraised in order to assess possibilities that could ensure manageable stress levels. As few studies encompassing depression symptoms and suicidal ideation were found and most of them were crossover analysis rather than multicenter trials, further research is required.