Risk factors for suicidal ideation and suicide attempt among medical students: A meta-analysis.

BACKGROUND: Medical training poses significant challenge to medical student wellbeing. With the alarming trend of trainee burnout, mental illness, and suicide, previous studies have reported potential risk factors associated with suicidal behaviours among medical students. The objective of this study is to provide a systematic overview of risk factors for suicidal ideation (SI) and suicide attempt (SA) among medical students and summarize the overall risk associated with each risk factor using a meta-analytic approach. METHODS: Systemic search of six electronic databases including MEDLINE, Embase, Education Source, Scopus, PsycInfo, and CINAHL was performed from database inception to March 19, 2021. Studies reporting original quantitative or epidemiological data on risk factors associated with SI and SA among undergraduate medical students were included. When two or more studies reported outcome on the same risk factor, a random-effects inverse variance meta-analysis was performed to estimate the overall effect size. RESULTS: Of 4,053 articles identified, 25 studies were included. Twenty-two studies reported outcomes on SI risk factors only, and three studies on both SI and SA risk factors. Meta-analysis was performed on 25 SI risk factors and 4 SA risk factors. Poor mental health outcomes including depression (OR 6.87; 95% CI [4.80-9.82] for SI; OR 9.34 [4.18-20.90] for SA), burnout (OR 6.29 [2.05-19.30] for SI), comorbid mental illness (OR 5.08 [2.81-9.18] for SI), and stress (OR 3.72 [1.39-9.94] for SI) presented the strongest risk for SI and SA among medical students. Conversely, smoking cigarette (OR 1.92 [0.94-3.92]), family history of mental illness (OR 1.79 [0.86-3.74]) and suicidal behaviour (OR 1.38 [0.80-2.39]) were not significant risk factors for SI, while stress (OR 3.25 [0.59-17.90]), female (OR 3.20 [0.95-10.81]), and alcohol use (OR 1.41 [0.64-3.09]) were not significant risk factors for SA among medical students. CONCLUSIONS: Medical students face a number of personal, environmental, and academic challenges that may put them at risk for SI and SA. Additional research on individual risk factors is needed to construct effective suicide prevention programs in medical school.

Síndrome de Burnout em residentes multiprofissionais em saúde / Burnout syndrome in multi-professional healthcare residents / Síndrome de Burnout en residentes multiprofesionales en salud

Objetivo: estimar a prevalência da Síndrome de Burnout e identificar o perfil sociodemográfico, laboral, estilo de vida e saúde de residentes multiprofissionais de saúde de uma Universidade pública da Bahia, Brasil. Metodologia: estudo transversal, descritivo, realizado com 63 residentes. Utilizou-se o Maslach Burnout Inventory e um questionário contendo questões sociodemográficas, laborais, estilo de vida e saúde. Resultados: ao analisar as dimensões da síndrome, 82,5% apresentaram nível alto de exaustão emocional; 55,5% nível moderado de despersonalização e 88,8% nível alto de reduzida realização profissional. Destaca-se a maior ocorrência do Burnout em enfermeiros (50%), profissionais atuantes no âmbito hospitalar (71,4%) e em recém-formados (média 2,1 anos). 60,3% dos residentes consideraram não ter uma alimentação saudável e 29,5% apresentaram excesso de peso. Conclusão: os resultados apontam uma prevalência significativa de síndrome de burnout, sendo encontradas altas alterações nas três dimensões da síndrome em 22,2% dos residentes.

Objective: to estimate the prevalence of Burnout Syndrome, and identify the sociodemographic, occupational, lifestyle, and health profile of multi-professional healthcare residents at a public university in Bahia, Brazil. Methods: a descriptive, crosssectional study was conducted with 63 residents, using the Maslach Burnout Inventory and a questionnaire on sociodemographic, labor, lifestyle, and health issues. Results: on examining the dimensions of the syndrome, 82.5% were found to present high levels of emotional exhaustion; 55.5%, moderate levels of depersonalization; and 88.8%, high levels of diminished professional fulfilment. Burnout occurred most often in nurses (50%), professionals working in hospitals (71.4%) and recent graduates (mean 2.1 years), while 60.3% of the residents regarded their diet at unhealthy, and 29.5% were overweight. Conclusion: the results indicate a significant prevalence of Burnout Syndrome, and marked changes in the three dimensions of the syndrome were found in 22.2% of the residents.

Objetivo: estimar la prevalencia del Síndrome de Burnout e identificar el perfil sociodemográfico, laboral, estilo de vida y salud de residentes multiprofesionales de salud de una universidad pública de Bahía, Brasil. Método: estudio transversal, descriptivo, realizado junto a 63 residentes. Se utilizó el Maslach Burnout Inventory y un cuestionario que contenía cuestiones sociodemográficas, laborales, estilo de vida y salud. Resultados: al analizar las dimensiones del síndrome, el 82,5% presentó un alto nivel de agotamiento emocional; 55,5% nivel moderado de despersonalización y 88,8% nivel alto de reducida realización profesional. Se destaca la mayor ocurrencia de Burnout en enfermeros (50%), profesionales actuantes en el ámbito hospitalario (71,4%) y recién graduados (promedio 2,1 años). El 60,3% de los residentes consideró no tener una alimentación sana y el 29,5% presentó un exceso de peso. Conclusión: los resultados apuntan a una prevalencia significativa de síndrome de Burnout y se encontraron grandes alteraciones en las tres dimensiones del síndrome en el 22,2% de los residentes.

Evidências científicas sobre a associação entre burnout e síndrome metabólica: revisão integrativa / Evidencias científicas sobre la asociación entre el burnout y el síndrome metabólico: revisión integradora / Scientific evidence on the association between burnout and metabolic syndrome: integrative review

Resumo Objetivo Avaliar as evidências científicas disponíveis na literatura sobre a associação entre Síndrome de Burnout e Síndrome Metabólica. Métodos Revisão integrativa da literatura, com buscas nas bases de dados do Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online e Springer Link. Os artigos selecionados foram analisados de acordo com a Agency for Healthcare Research and Quality. Resultados A maioria (80%) dos 5 artigos que atenderam aos critérios de seleção estava na língua inglesa e indexada nas bases de dados Web of Science e Scopus. Dentre os trabalhos, 80% tinham médicos como autores principais. O continente asiático (Israel, Japão e China) concentrou a maior parte de produção. Não ocorreu predominância de desenho de estudo. A área financeira correspondeu a 60% do público pesquisado. Conclusão As evidências disponíveis na literatura são incipientes, apenas 20% dos artigos elegíveis apresentou associação entre as síndromes estudadas e os demais, indicam associação entre Burnout e componentes da SM separadamente.

Resumen Objetivo evaluar las evidencias científicas disponibles en la literatura sobre la asociación entre el síndrome de burnout y el síndrome metabólico. Métodos revisión integradora de la literatura, con búsquedas en las bases de datos del Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online y Springer Link. Los artículos seleccionados fueron analizados de acuerdo con la Agency for Healthcare Research and Quality. Resultados la mayoría (80%) de los cinco artículos que cumplieron los criterios de selección estaba en inglés e indexada en las bases de datos Web of Science y Scopus. Entre los trabajos, 80% tenía médicos como autores principales. El continente asiático (Israel, Japón y China) concentró la mayor parte de la producción. No ocurrió predominio de diseño de estudio. El área financiera correspondió al 60% del público investigado. Conclusión las evidencias disponibles en la literatura son incipientes, solo el 20% de los artículos elegibles presentó asociación entre los síndromes estudiados y los demás indican asociación entre burnout y componentes del SM separadamente.

Abstract Objective To evaluate the scientific evidence available in the literature on the association between Burnout Syndrome and Metabolic Syndrome. Methods Integrative literature review, searching the databases of the Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine, National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online and Springer Link. The selected articles were analyzed according to the Agency for Healthcare Research and Quality. Results Most (80%) of the 5 studies that met the selection criteria were in English language and indexed in the Web of Science and Scopus databases. Among the studies, 80% had physicians as the main authors. The Asian continent (Israel, Japan and China) concentrated the majority of production. There was no predominance of study design. The financial area corresponded to 60% of the study participants. Conclusion The available evidence in the literature is incipient, only 20% of the eligible articles showed association between the syndromes studied and the others, indicate association between Burnout and MS components separately.

Burnout Syndrome among Emergency Physicians and Nurses in Abha and Khamis Mushait Cities, Aseer Region, Southwestern Saudi Arabia.

OBJECTIVES: To explore the magnitude and determinants of burnout among emergency physicians and nurses working at emergency departments of hospitals in Abha and Khamis Mushait cities. SUBJECTS AND METHODS: A cross-sectional hospital-based study was conducted in emergency departments of hospitals in Abha and Khamis Mushait cities belonging to Ministry of Health. All physicians (n=95) and nurses (n=187) currently working at these sites were invited to participate in the study by filling a validated self-administered questionnaire including two main sections: personal and professional characteristics of physicians and nurses as well as Maslach burnout inventory (MBI) to assess the three components of the burnout syndrome: emotional exhaustion, depersonalization, and reduced personal accomplishment. RESULTS: The study included 282 physicians and nurses. The age of more than half of them (54.3%) ranged between 31 and 35 years. Most of them (70.9%) were females. About two-thirds of the respondents (66.3%) were nurses while the remaining 33.7% were physicians. Majority of the emergency healthcare professionals (88.7%) had high emotional exhaustion. The prevalence of high depersonalization (cynicism) was 20.6% whereas that of low personal accomplishment was 41.1% among emergency healthcare professionals. The overall prevalence of burnout among healthcare professionals was 16.3%. Multivariate logistic regression analysis revealed that male healthcare professionals were at almost higher three-folded risk for developing burnout compared to females (aOR=2.76; 95% confidence interval (CI): 1.21-6.28, p=0.017)). Smokers were at higher significant risk for burnout compared to nonsmokers (aOR=15.37; 95% CI: 7.06-33.45, p<0.001). Healthcare professionals who reported a history of taking medications for sleep disorders expressed higher risk for burnout opposed to those with no history of sleep disorder medication (aOR=6.59; 95% CI: 2.08-20.81, p=0.001). CONCLUSION: A considerable proportion of physicians and nurses working at emergency departments of hospitals in Abha and Khamis Mushait cities had burnout syndrome, particularly high emotional exhaustion and low personal accomplishment.

Agotamiento emocional en estudiantes de Odontología de la Universidad Nacional Mayor de San Marcos / Emotional exhaustion in dental students of the National University of San Marcos

Introducción: El agotamiento emocional entre los estudiantes puede repercutir en su desarrollo académico y desenvolviendo personal. Objetivo: describir las características del agotamiento emocional en estudiantes de Odontología. Material y Métodos: Se diseñó un estudio transversal, prospectivo que incluyó 139 estudiantes de la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos, Lima, Perú. Se utilizó la técnica de la encuesta a través del cuestionario Inventario Maslach para el Burnout que evaluó las dimensiones de agotamiento, despersonalización (cinismo) y logros personales. Resultados: Se encontró un puntaje promedio de 49,75 ± 9,57; el valor fue mayor en los estudiantes del último año (55,09 ± 9,08). El agotamiento emocional tuvo un valor de 16,78 ± 7,62; la despersonalización de 10,19 ± 4,49 y los logros personales de 22,78 ± 4,9. Respecto a la puntuación total del cuestionario y al agotamiento emocional, los estudiantes de quinto año evidenciaron diferencias significativas con los demás años; respecto al cinismo los estudiantes de tercer año evidenciaron diferencias significativas sobre los de quinto y segundo año. Conclusiones: Según los puntajes encontrados el nivel de agotamiento emocional es moderado en los estudiantes de Odontología y los valores aumentan a medida que avanzan los años de estudio y se agudiza principalmente en la transición de los cursos teórico-prácticos hacia los cursos y exigencias clínicas de atención con los pacientes(AU)

Introduction: Emotional exhaustion among students can have an impact on their academic and personal development. Objective: To describe the characteristics of emotional exhaustion in dental students. Material and Methods: A prospective, cross-sectional study was designed. It included 139 students of the Faculty of Dentistry of the National University of San Marcos, Lima. Peru. The Maslach Burnout Inventory-General Survey was used, which evaluated the exhaustion and depersonalization (cynicism) dimensions, as well as personal achievement. Results: An average score of 49.75 ± 9.57 was found; being higher in the students of the last year (55.09 ± 9.08). The value of emotional exhaustion was 16.78 ± 7.62, the one of depersonalization was 10.19 ± 4.49, and the values of personal achievements were 22.78 ± 4.9. Regarding the total score of the survey and the emotional exhaustion, the fifth-year students showed significant differences in regard to other years. In relation to cynicism, the third year students showed significant differences over the fifth and second years. Conclusions: According to the scores found, the level of emotional exhaustion is moderate in dental students and this increases as the years of study progress and becomes more acute in the transition from theoretical-practical courses to courses and clinical demands of patient care(AU)

Are Burnout Syndrome and Depression Predictors for Aggressive Behavior Among Mental Health Care Professionals?

AIM: This study aims to examine the possible relation between depression and burnout as predictors to aggressive behaviors among mental healthcare professionals. METHODS: For the purposes of this study 72 mental health care professionals were recruited and were evaluated in three questionnaires which were provided to them online. Firstly regarding depression, the Center for Epidemiologic Studies Depression Scale (CES-D) was administered, secondly, concerning burnout, Maslach Burnout Inventory (MBI) was applied and finally, regarding aggression, the Aggression Questionnaire (GAQ) was employed. Statistical data analysis was performed using the IBM SPSS Statistics Version 19. The level of statistical significance was set at up at 0.05. RESULTS: The results showed that depression is considered to be a statistically significant predictor of aggressive behaviors. However, burnout was not found to be a statistically significant predictor of aggression. In addition, a statistically significant relationship was found between burnout and depression. CONCLUSIONS: It seems to be of essential importance for mental healthcare professionals to be provided with support and assistance in order to diminish the potential high-stress levels and in that way to overcome depression and burnout of those who work in mental health settings.

Stimulus, response and feedback processing in burnout - An EEG study.

Professional burnout is a syndrome that is characterized by psychophysical or emotional exhaustion, depersonalization and diminished professional efficacy. Research on burnout often indicates deficits in cognitive functioning, such as memory problems or impaired voluntary control over attention. Many studies focus on behavioral and self-reported measures of burnout consequences; however, a limited number have focused on its consequences on a neural level. In our EEG study (N = 88; 42 with burnout), we analyzed the event-related potentials (ERP) associated with stimulus, response and feedback processing using two experimental procedures - the Go/NoGo Task and the Doors Task. Our results show that while there is no difference in performance between burnout and control group, on the neural level there are significant differences in all analyzed aspects of information processing: stimulus, response and feedback processing, indicated by the N200 and P300, Pe, and P200 event-related potentials, respectively.