Estrategias de afrontamiento y estrés. Estudio longitudinal con estudiantes de Medicina y Veterinaria de la Universidad Nacional Autónoma de México / Coping strategies and stress. A longitudinal study of medical and veterinary students at the National Autonomous University of Mexico

Introducción: Medicina y Veterinaria son licenciaturas con alta demanda académica que tiende a ocasionar niveles elevados de estrés entre sus estudiantes. Objetivo: El propósito de esta investigación fue indagar sobre el papel de las estrategias utilizadas por los alumnos para afrontar el estrés. Sujetos y métodos. Se aplicó una encuesta en línea a 244 estudiantes del primer año de ambas carreras en la Universidad Nacional Autónoma de México, al inicio del ciclo escolar y cuatro meses después. La encuesta incluyó la escala de estrés percibido de 10 ítems, el inventario de estilos de afrontamiento, y un apartado que indagó sobre aspectos sociodemográficos y académicos. Resultados: Se observó un incremento en el estrés de los alumnos de ambas licenciaturas, que fue estadísticamente significativo sólo en veterinaria (t(140)= –3,4; p < 0,001; d de Cohen = –0,29). El análisis estadístico mostró que mayores recursos económicos percibidos, mayor equilibrio entre la vida personal y académica, mayor resolución del problema y evitación del problema, así como menor expresión emocional, pensamiento desiderativo y autocrítica, notificados al inicio del ciclo académico, fueron los factores que se asociaron significativamente con un menor estrés percibido después de cuatromeses (F(15,228) = 14,16; p < 0,0001). Conclusión: Se destaca que las escuelas deberían incorporar actividades durante el proceso de formación de los futuros médicos y veterinarios, centradas en guiarlos y motivarlos para que desarrollen y utilicen estrategias que les permitan manejar adecuadamente situaciones desafiantes. De este modo, ellos pueden evitar el incremento de los niveles de estrés y el posible impacto negativo en su desempeño académico y salud mental.(AU)

Introduction: Medicine and Veterinary are careers with high academic demands that tend to cause high levels of stressamong students. Objective: This study investigated the role of strategies used by students to deal with stress.Subjects and methods. An online survey was administered to 244 medical and veterinary students at the National Autonomous University of Mexico, at the beginning of their first academic cycle and four months later. The survey included the perceived stress scale-10, the coping strategies inventory, as well as a section that inquired about sociodemographic and academic characteristics. Results: An increase in the stress of the students in both degrees was noted but this was only statistically significant (t(140) = –3.4, p < 0.001, Cohen’s d = –0.29) among students enrolled in veterinary. Perception of higher financial resources to cover tuition and fees, greater life and school balance, increased problem-solving and problem-avoidance, less emotional expression, wishful thinking, and self-criticism, mentioned at the beginning of the academic cycle were significantly associated with a lower perception of stress four months later (F(15,228) = 14.16, p < 0.0001).Conclusion: It is highlighted that schools should incorporate activities during the training process of future doctors and veterinarians, focused on guiding and motivating them to develop and use strategies that allow them to adequately handle challenging situations. In this way, they will be able to avoid increased stress levels and the possible negative impact on their academic performance and mental health.(AU)

Infants prenatally exposed to SARS-CoV-2 show the absence of fidgety movements and are at higher risk for neurological disorders: A comparative study.

Congenital viral infections are believed to damage the developing neonatal brain. However, whether neonates exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) show manifestations of such damage remains unclear. For neurodevelopment evaluation, general movement assessments have been shown to be effective in identifying early indicators of neurological dysfunction, including the absence of fidgety movements. This study compared the early motor repertoire by general movement assessment at three to five months of age in neonates who were or were not prenatally exposed to SARS-CoV-2 to determine whether infants prenatally exposed to SARS-CoV-2 are at risk of developing neurological disorders. Fifty-six infants, including 28 in the exposed group of mothers without vaccination who had no need for intensive care and likely had SARS-CoV-2 infection close to the time of pregnancy resolution and 28 infants in the nonexposed group, were videotaped to compare their detailed early motor repertoires, in which a motor optimality score-revised (MOS-R) was calculated using Prechtl's method by using the chi-square or Mann-Whitney U tests. In the exposed group, 3 (11%) infants showed the absence of fidgety movements with a total MOS-R<14 points, and 3 (11%) other infants showed abnormal fidgety movements. Between groups, atypical body symmetry (p = 0.009) and MOS-R values were significantly lower (Z = -3.08, p = 0.002), with a large size effect (Cohen's d = 0.97). The consequences of this new virus go beyond the health of the pregnant mother, and these consequences in some of the infants in the exposed group are likely not transitory because of the absence of fidgety movements between 3-5 months; thus, these babies are at increased risk of developing a serious neurological disorder.

Propiedades psicométricas del cuestionario de estrés académico en la universidad (CEAU) en una muestra de estudiantes de Medicina mexicanos / Psychometric properties of the University Academic Stress Questionnaire (CEAU) in a sample of Mexican medical students

Introducción: El estrés se asocia a un pobre desempeño académico y problemas de salud mental entre los universitarios. Existen pocos instrumentos adaptados a esta población que identifiquen las fuentes de estrés académico. Objetivo: Evaluar las propiedades psicométricas del cuestionario de estrés académico en la universidad (CEAU) en estudiantes mexicanos. Sujetos y métodos: Contestaron el CEAU y la escala de malestar psicológico de Kessler (K-10) 232 alumnos de primer año de Medicina. El CEAU contiene 19 ítems sobre situaciones escolares potencialmente estresantes, mientras que la K-10 mide el malestar psicológico global inespecífico con 10 ítems. La validez de constructo se evaluó por composición factorial y por convergencia con la K-10. Las medidas de confiabilidad se obtuvieron por consistencia interna y estabilidad temporal. Resultados: Los reactivos se agruparon en los cuatro componentes de su versión original y explicaron el 45% de la varianza total, con cargas factoriales bajas en dos reactivos y uno fuera del factor propuesto inicialmente; eliminar este último reactivo produjo un mejor ajuste de los componentes y aumentó la explicación de la varianza al 57%. La consistencia interna fue de alfa = 0,88 para la puntuación total, con valores de alfa = 0,70-0,83 en sus subescalas y una estabilidad temporal de r(202) = 0,76 (p = 0,0001). La correlación del CEAU con la K-10 fue de r(232) = 0,64 (p = 0,0001). Conclusiones: El CEAU cumple con los criterios de confiabilidad y validez de constructo, se ajusta a los factores propuestos y correlaciona con el malestar psicológico en el sentido esperado.(AU)

Introduction: Stress is associated with poor academic performance and mental health problems among university students. There are few instruments adapted to this population that identify sources of academic stress. Objective: To evaluate the psychometric properties of the Academic Stress Questionnaire at University (CEAU) in Mexican students. Subjects and methods: 232 first-year medical students answered the CEAU and the Kessler psychological distress scale (K-10). The CEAU contains 19 items on potentially stressful school situations, while the K-10 measures nonspecific global psychological distress with 10 items. The construct validity was evaluated by factorial composition and by convergence with the K-10. Reliability measures were obtained by internal consistency and temporal stability. Results: The items were grouped into the four components of their original version and explained 45% of the total variance, with low factor loadings in two items and one outside the initially proposed factor; eliminating this last item produced a better fit of the components and increased the explanation of the variance to 57%. The internal consistency was α = 0.88 for the total score, with values from α = 0.70 to 0.83 in its subscales and a temporal stability of r(202) = 0.76 (p = .0001). The correlation between CEAU and K-10 was r(232) = 0.64 (p = .0001). Conclusions: The CEAU meets the reliability and construct validity criteria, adjusts to the proposed factors and correlates with psychological distress in the expected sense.(AU)

Habituation Alteration in Infants with Periventricular Echogenicity as an Indicator of Neurocognitive Impairment.

Habituation difficulties may suggest neurocognitive impairment. Periventricular echogenicity (PVE) potentially causes subtle damage that poses neuropsychological risk. Habituation was evaluated through heart rate and behavioral states in infants at 36-37 weeks of corrected age between control and PVE groups. PVE infants showed early alertness and abrupt changes in behavioral states. However, the comparison group could better regulate their states. Heart rate was significantly high and remained unchanged in the PVE group but decreased in the control group. Alterations during the habituation paradigm in PVE infants could be early indicators of neuropsychological risk impairment. Scope of early habituation assessment is discussed.

Fetal growth restriction: From Polyvagal theory to developmental impairments?

BACKGROUND: The Polyvagal theory argues that behavioral modulation is a fundamental neurodevelopmental process that depends on autonomic regulation. OBJECTIVE: The present study aimed to assess sleep architecture in newborns with fetal growth restriction (FGR) using polysomnography as an indicator of Polyvagal theory. METHODS: We studied polysomnography recordings from 68 preterm infants, 34 with FGR and 34 born with appropriate growth for gestational age (AGA), who were matched according to the corrected age for prematurity (CA). Total sleep time, arousals, the percentage of quiet sleep, active sleep, indeterminate sleep, and heart rate were compared between the groups. Linear multiple regression analyses were used to evaluate polysomnography data for the FGR and AGA groups. RESULTS: Average heart rate was significantly lower in most FGR groups compared with AGA groups, and small to large effect sizes were observed in several sleep responses when comparing these groups. In the lineal regression model the CA explains significantly the differences in heart rate, controlled by FGR (p = .012). Additionally, there was evidence that sleeping states show similar trends, that is, increases in quiet and indeterminate sleep, as well as decreases in active sleep when CA was controlled by FGR. CONCLUSION: FGR probably intensifies the unfavorable effect of preterm birth in the responses evaluated by polysomnography. It seems that FGR is associated with alteration in sleep regulation and with differences in heart rate modulation, which may serve as a strategy to preserve energy and such differences likely underlie neurodevelopmental impairments in affected newborns.

Major depressive disorder in Mexican medical students and associated factors: A focus on current and past abuse experiences.

BACKGROUND: Major depressive disorder (MDD) is highly prevalent among medical students (MS). Abuse experiences, as well as stress, are among the factors associated with MDD. However, their association with MDD in MS has been scarcely addressed. METHODS: A cross-sectional study design was used to evaluate the association between MDD and possible risk factors, focusing on current and past abuse experiences inside and outside the academic setting in a large representative MS sample (n = 1,068) using self-report instruments to assess MDD (PHQ-9) and perceived academic stress levels during exam season. RESULTS: Depressive symptom severity directly correlates with levels of perceived academic stress. The prevalence of MDD was 16.2%. A history of emotional abuse during childhood or adolescence, as well as most types of current abuse were associated with MDD. Multiple logistic regression analysis showed that current emotional abuse outside school had the strongest association with MDD in MS, followed by a personal history of depression and suicide attempt, a family history of depression, and perceived academic stress levels. LIMITATIONS: Cross-sectional design, participants represent a specific population, and other variables that could be associated with MDD: comorbid psychiatric disorders, current antidepressant treatment and protective factors (resilience and health-promoting coping strategies) were not evaluated. CONCLUSIONS: MDD is strongly associated with several risk factors that include most types of current and past abuse experiences. Timely identification of individuals at-risk will be critical to establish preventive strategies to limit the impact of MDD in MS and offer prompt therapeutic alternatives when needed.

The Interactive Effect of Positive Mental Health and Subjective Sleep Quality on Depressive Symptoms in High School Students.

Objective/Background: The objective of this study was to observe the effect of positive mental health (PMH) and subjective sleep quality (SQ) on depressive symptoms in high school students. Participants: This cross-sectional study evaluated 2,186 students (55% female and 45% male) with a mean age of 16.8 years (SD ± 0.7) at 20 private high schools in Mexico City. Methods: An electronic survey was used, which included a questionnaire on sleep habits that is a Spanish-language adaptation of Rosenthal's Sleep-Wake Activity Inventory, the Pittsburgh Sleep Quality Index (PSQI), the Morningness-Eveningness Scale for Children and Adolescents (MESC), the combined scales to evaluate positive aspects of mental health, and the Patient Health Questionnaire (PHQ-9). Results: Main and interaction effects of PMH and SQ were observed, demonstrating that students with high-PMH (p ≤ .0001) or good-SQ (p ≤ .0001) had fewer depressive symptoms. Thus, the students with both high-PMH and good-SQ had the lowest depressive symptomatology (p ≤ .01). Conclusion: Depressive symptoms are associated with a combination of sleep quality and positive mental health.

Resilience, sleep quality and morningness as mediators of vulnerability to depression in medical students with sleep pattern alterations.

The medical career is considered highly stressful, especially during internships when academic and clinical demands, combined with changes in sleep patterns, increase students' likelihood to develop depression. Resilience, which is considered as opposite vulnerability to stress and, along with another protective factor, namely morningness, may cause a student to be less reactive to stimuli and, therefore, less prone to depression. The objective of this study was to evaluate the role of resilience and morningness facing to sleep quality and main risk factors, on the development of depression symptoms in a group of students with sleep pattern alterations. To this end, an observational and longitudinal study was performed with 30 undergraduate interns, with an average age of 22.63 years (SE ± 0.13), 33% men and 67% women. A survey was conducted in three different times during the year of internship: at the beginning (T1), in the middle (T2) and the end (T3). The instruments were the Brief Resilience Scale, Composite Scale of Morningness, Pittsburgh Sleep Quality Index and Patient Health Questionnaire. The path analysis examined the roles of morningness, sleep quality and resilience as potential mediators between family history of depression and depression symptoms at different times. The results showed that resilience had a protective effect on depression symptoms at T2 (ß = -0.18, p < 0.05) and with greater power at T3 (ß = -0.41, p < 0.05), as did morningness, although less strongly, on the symptoms at T3 (ß = -0.13, p < 0.05). A relationship between these two mediating variables was also observed (ß = 0.30, p < 0.05). The initial sleep quality had an effect on the increase of depression symptoms at T1 (ß = 0.61, p < 0.05) and T3 (ß = 0.21, p < 0.05), while family history of depression had a direct effect on the measures of depression at T2 (ß = 0.49, p < 0.05) and T3 (ß = 0.19, p < 0.05). Aside from personal risk factors, it is possible to conclude that the levels of resilience, morningness and sleep quality manifested by students at the beginning of their internship may explain the decrease in depression symptoms at the end of the course.

[Comparación de síntomas de hiperactividad e inatención en adolescentes con y sin antecedentes de embarazo].

Introduction: Teenage pregnancy has a negative impact both on mother's health and on her offspring quality life and development. In spite of its important social relevance, behavioral factors that can favor its occurrence have not been extensively explored. Objective: To compare symptoms of inattention and hyperactivity between adolescents with and without a history of pregnancy. Method: A sociodemographic record and the attention deficit hyperactivity disorder questionnaire (ADD) of the Neuropsi instrument were applied to 60 adolescents: 30 cases and 30 controls. The ADD was answered by the adolescents themselves, as well as by a close relative (parent or spouse) or by one of their teachers. Results: From the perspective of others (parents and teachers), adolescents with a history of pregnancy showed more symptoms of attention deficit and higher attention deficit and hyperactivity overall score (both p ≤ 0.01). In addition, ADD overall score was found to be associated with adolescent pregnancy (OR = 1.11, 95% CI = 1.01-1.24, p = 0.036). Conclusions: Symptoms of attention deficit and hyperactivity can represent another factor associated with teenage pregnancy.

Introducción: El embarazo adolescente ejerce un impacto negativo tanto en la salud de la madre como en la calidad de vida y desarrollo de sus hijos. Pese a su importante carga social, no se han explorado con detalle los factores conductuales que pueden favorecer su presencia. Objetivo: Comparar los síntomas de inatención e hiperactividad entre adolescentes con y sin antecedente de embarazo. Método: A 60 adolescentes se aplicó una ficha de datos sociodemográficos y el Cuestionario de Trastorno por Déficit de Atención e Hiperactividad (DDA) del Neuropsi, 30 casos y 30 controles. El DDA fue contestado por las propias adolescentes, así como por un familiar cercano (padre o pareja) y/o por un profesor del adolescente. Resultados: Desde la perspectiva de los otros (padres y profesores), las adolescentes con antecedentes de embarazo presentaron más síntomas de déficit de atención y mayor puntuación global de déficit de atención e hiperactividad (ambas con p ≤ 0.01). Asimismo, se encontró que la puntuación global del DDA se asoció con el embarazo adolescente (RM = 1.11, IC 95 % = 1.01-1.24, p = 0.036). Conclusiones: Los síntomas de déficit de atención e hiperactividad pueden representar otro factor asociado con el embarazo adolescente.

La capacidad de los neonatos de regular sus estados de conciencia y la habituación ¿marcadores tempranos de dificultades en el desarrollo? / Neonatal capacity of regulation of behavioral states and habituation ¿Early markers of neurodevelopment impairment?

Desde la etapa neonatal, la detección temprana de marcadores conductuales de alteraciones sutiles en el neurodesarrollo, es un campo todavía en crecimiento. El objetivo de esta revisión es describir los mecanismos que subyacen a la conducta del neonato durante la aplicación de la subescala de habituación que forma parte de la Neonatal Behavioral Assessment Scale (NBAS), con especial énfasis en la vía visual. Se destacan el papel de la habituación y la regulación de los estados de conciencia como los mecanismos fundamentales durante el primer estímulo y del segundo al décimo estímulo, en dicha escala. Estos procesos representan una capacidad fundamental para la adaptación del recién nacido y se discuten sus posibles implicaciones en el desempeño cognitivo posterior.

Since the neonatal stage, early detection of behavioral markers of subtle impairments in neurodevelopment is a field still under growth. The objective of this review is to describe the mechanisms underlying neonatal behavior during the habituation scale of NBAS, that emphasizes the visual pathway. The role of habituation and the regulation of behavioral states are highlighted during the first stimuli and the second to ten stimuli, during performance of NBAS. Those processes represent a fundamental capacity for newborns´ adaptation and are discussed in line to later cognitive performance.

The association between chronotype and perceived academic stress to depression in medical students.

Depression is a multifactorial illness that is highly prevalent among medical students (MS). Chronotypes, which reflect circadian preference in humans, as well as academic stress have been associated with depression in different populations. However, it is not known how chronotype and stress might alone or in combination, associate with depression in MS. Thus, we aimed to evaluate the association between stress, chronotype and depression in MS. In a cross-sectional study, we evaluated a total of 1068 medical students from a public Medical School in Mexico City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate depressive symptom severity and the presence of a current depressive episode with a cutoff score of 10 or higher. The Morning-Evening Questionnaire (MEQ) was used to establish chronotype and the Academic Stress Inventory was used to measure perceived academic stress (PAS). We observed that depressive symptom severity was higher in non-morning chronotypes and moderate/severe PAS groups. A factorial ANOVA showed an association between PAS groups and depressive symptom severity. Linear regression showed an association between depressive symptom severity and variables such as PAS scores (p = 0.001), family history of depression (p = 0.001), gender (p = 0.001) and academic year (p = 0.029). Logistic regression analysis showed that evening chronotype (OR: 2.3, 95% CI: 1.2-4.3, p = 0.01) and severe PAS (OR: 4.4, 95% CI: 2.8-7.0, p = 0.0001) were associated with depression. Further, MS with the combination of severe PAS and morning (OR: 5.9, 95% CI: 1.6-22.2, p = 0.01), intermediate (OR: 7.5, 95% CI: 2.3-24.4, p = 0.001) or evening (OR: 10.6, 95% CI: 2.8-40.0, p = 0.001) chronotypes showed a greater association with depression than any PAS or chronotype group alone. Being female, perceiving restricted or limited economic resources, having severe scores of academic stress, and evening chronotype were associated with an increased probability to suffer a current depressive episode. Collectively, these results show that chronotype and PAS are factors associated with depression in MS, and when combined promote this association. Our results might aid in early identification of MS susceptible to depression. Future research could focus on the implementation of simple, low cost preventive strategies, such as chronotype-oriented academic schedules.

Estudio comparativo sobre depresión y los factores asociados en alumnos del primer año de la Facultad de Medicina y del Internado / A Comparative study on depression and associated factors between medical student of first and last academic years

The prevalence of depression in Medical Students (MS) is higher than in the general population and changes with time. It is not known whether the prevalence of depression is higher and the associated factors different between students that initiate the last and first academic years in Medical School. Objective To compare the prevalence of depression and the associated factors in MS that start their academic courses in the first and the last academic years. Methods This is a cross sectional, observational and analytical study. A total of 1871 MS participated: 1240 were in the initiation of the first academic year, and 631 in the initiation of the last academic year. Participants answered a written survey conformed by a questionnaire about risk factors for depression and assessed for current depression with the Patients Health Questionnaire-9 (PHQ-9). Results The prevalence of depression (PHQ-9>10) was significantly higher in last year MS compared to first year MS (5.7 vs. 3.5%). The percentage of MS with a personal history of depression was higher in last year compared to first year MS (12.1% vs. 7.1%), as was the mean for previous depressive episodes (3.2 vs. 1.6). The age of onset for depressive episodes was higher in the last year group. Conclussions The prevalence of depression in MS that initiated the academic year is higher in the last year than at the beginning of the first year of the career, and could be attributed, among other factors, to a cumulative phenomenon resulting from the allostatic load that this academic process currently generates. A personal history of depression and other situational factors are associated to the presence of depression in a differential manner according to the academic year and should be considered in future studies.

La prevalencia de depresión en estudiantes de la Facultad de Medicina (EM) es mayor que en la población general y cambia a lo largo del tiempo. No se conoce si la prevalencia de depresión es mayor y los factores asociados son diferentes en estudiantes que inician el último y el primer año académico de la carrera de Medicina. Objetivo Comparar la prevalencia de Depresión y los factores asociados en EM que inician el año académico en primer año y aquellos que realizan el año de internado. Método Este es un estudio observacional, transversal y analítico. Participaron un total de 1871 EM: 1240 que iniciaban el primer año de la carrera y 631 que iniciaban el año de internado. Los alumnos contestaron una encuesta en papel compuesta por el Cuestionario sobre Factores de riesgo para Depresión y el Cuestionario sobre la Salud del Paciente (PHQ-9, por sus siglas en inglés) para evaluar la presencia actual de depresión. Resultados La prevalencia de Depresión (PHQ-9>10) resultó significativamente mayor en los estudiantes de internado comparados con los de primer año (5.7 vs. 3.5%). El porcentaje de alumnos con antecedente personal de depresión fue mayor en los alumnos de internado con respecto a los de primer año (12.1% vs. 7.1%), como lo fue el promedio de episodios depresivos previos (3.2 vs. 1.6). La edad de inicio del primer episodio depresivo fue significativamente mayor para los del quinto año. Conclusiones La prevalencia de Depresión en EM que inician el año académico es mayor en la etapa final de la carrera y puede ser atribuible, entre otros factores, a un fenómeno acumulativo de carga alostática que actualmente genera este proceso educativo. Los antecedentes personales para depresión y los factores situacionales se asocian a la presencia de depresión de una forma diferente de acuerdo al año académico y deben de ser considerados en futuros estudios.

Los hábitos de salud como posibles protectores de dificultades en el sueño en estudiantes de medicina de una universidad nacional de México / Healthy habits as possible sleep difficulty protectors in a Mexican national university’s medical students

Las dificultades del sueño son altamente prevalentes en los estudiantes de medicina, por lo que es necesario contar con mayor evidencia acerca de cómo sus hábitos contribuyen sobre la calidad del mismo. Objetivos: Evaluar la asociación entre algunos hábitos de salud y tener dificultad en el sueño en alumnos de medicina de primer año. Diseño: Estudio transversal, descriptivo. Institución: Facultad de Medicina, Universidad Nacional Autónoma de México. Participantes: Alumnos de primer año de medicina. Intervenciones: Estudio en 572 alumnos de primer año de medicina con edad promedio de 18,6 años, 37% hombres, de una institución educativa pública de México, seleccionados a través de un muestreo no probabilístico. Se utilizó tres preguntas de la Symptom Check List (SCL90) para considerar dificultad del sueño y 18 preguntas correspondientes al apartado II del Perfil de Estrés de Nowack para evaluar los hábitos de salud. Mediante regresiones logísticas simples, se obtuvo los odds ratio (OR) de los hábitos de salud con respecto a la presencia/ausencia de dificultad del sueño. Principales medidas de resultados: Hábitos de sueño. Resultados: Los hábitos como ‘alta promoción del descanso-sueño’ (OR=0,15; IC=0,04 a 0,64) y ‘alta prevención del riesgo’ (OR=0,59; IC=0,41 a 0,86) se asociaron 95%95% a la ausencia de dificultad del sueño. Conclusiones: Pese a que la ‘promoción del descanso sueño’ fue el hábito menos comunicado por los estudiantes, estuvo asociado a la ausencia de dificultad del sueño con respecto a otros hábitos de salud.

Medical students have a high percentage of poor sleepers; more evidence on how health habits contribute to sleep better in this population is needed. Objectives: To identify the association of some health habits with presence/absence of sleep difficulties in medical freshmen. Design: Cross-sectional, descriptive study. Setting: Faculty of Medicine, Universidad Nacional Autonoma de Mexico. Participants: Medical students. Interventions: The presence/absence of sleep difficulties was assessed by three items from the Symptom Check List (SCL90) in 572 medical students 18.6 year-old (SD±2.7) average, 37% men and 63% women. Sleep-related habits were determined by 18 items from the Nowack Stress Profile. Main outcome measures: Sleep habits. Results: Simple analyses showed that absence of sleep difficulties was associated with the "high promotion of restsleep" (OR=0.15; CI95%=0.04-0.64) and "high risk prevention" (OR=0.59; CI95%=0.41-0.86). Conclusions: The "promotion of rest-sleep" was the least reported habit by students, but explained absence of sleep difficulties better than other health habits.

[Sleep difficulties and psychological symptoms in medicine students in Mexico]. / Dificultades del sueño y síntomas psicológicos en estudiantes de medicina de la ciudad de México.

The purpose of this study was to describe sleep difficulties in first year medical students associated with psychopathological symptoms. A cross-sectional study in 572 Medicine students, who were assessed by the Symptom Check List-90 (SCL-90), was performed. A 3.5% of students reported having a hard time sleeping, 6.3% had difficulty staying asleep and 11.4% waking up very early. Sleep difficulties were significantly associated with all psychopathological symptoms. The best predictors of sleep difficulties were anxiety, hostility and interpersonal sensitivity. In conclusion, the symptoms associated with stress, anger, worry, cognitive hyperarousal and hypervigilance are the best predictors for sleep difficulties in this population.

Dificultades del sueño y síntomas psicológicos en estudiantes de medicina de la Ciudad de México / Sleep difficulties and psychological symptoms in medicine students in Mexico

El objetivo del estudio fue describir las dificultades del sueño en estudiantes de Medicina de primer año de una institución pública en la Ciudad de México, en relación con algunos síntomas psicológicos. Se realizó un estudio transversal en 572 alumnos de primer año de Medicina, quienes fueron evaluados mediante la Symptom Check List-90 (SCL-90). Un 3.5% de los estudiantes manifestó tener muchas dificultades para conciliar el sueño, 6.3% para mantenerlo y 11.4% despertaban muy temprano. Las dificultades del sueño se asociaron en forma significativa con todas las dimensiones de psicopatología. Sus mejores predictores fueron la ansiedad, la hostilidad y la sensibilidad interpersonal. Se concluye que los síntomas asociados a tensión, enojo, preocupación, hiperactivación cognitiva e hipervigilancia son los mejores predictores para las dificultades del sueño en esta población.

The purpose of this study was to describe sleep difficulties in first year medical students associated with psychopathological symptoms. A cross-sectional study in 572 Medicine students, who were assessed by the Symptom Check List-90 (SCL-90), was performed. A 3.5% of students reported having a hard time sleeping, 6.3% had difficulty staying asleep and 11.4% waking up very early. Sleep difficulties were significantly associated with all psychopathological symptoms. The best predictors of sleep difficulties were anxiety, hostility and interpersonal sensitivity. In conclusion, the symptoms associated with stress, anger, worry, cognitive hyperarousal and hypervigilance are the best predictors for sleep difficulties in this population.

Dificultades del sueño y síntomas psicológicos en estudiantes de medicina de la Ciudad de México / Sleep difficulties and psychological symptoms in medicine students in Mexico

El objetivo del estudio fue describir las dificultades del sueño en estudiantes de Medicina de primer año de una institución pública en la Ciudad de México, en relación con algunos síntomas psicológicos. Se realizó un estudio transversal en 572 alumnos de primer año de Medicina, quienes fueron evaluados mediante la Symptom Check List-90 (SCL-90). Un 3.5% de los estudiantes manifestó tener muchas dificultades para conciliar el sueño, 6.3% para mantenerlo y 11.4% despertaban muy temprano. Las dificultades del sueño se asociaron en forma significativa con todas las dimensiones de psicopatología. Sus mejores predictores fueron la ansiedad, la hostilidad y la sensibilidad interpersonal. Se concluye que los síntomas asociados a tensión, enojo, preocupación, hiperactivación cognitiva e hipervigilancia son los mejores predictores para las dificultades del sueño en esta población.(AU)

The purpose of this study was to describe sleep difficulties in first year medical students associated with psychopathological symptoms. A cross-sectional study in 572 Medicine students, who were assessed by the Symptom Check List-90 (SCL-90), was performed. A 3.5% of students reported having a hard time sleeping, 6.3% had difficulty staying asleep and 11.4% waking up very early. Sleep difficulties were significantly associated with all psychopathological symptoms. The best predictors of sleep difficulties were anxiety, hostility and interpersonal sensitivity. In conclusion, the symptoms associated with stress, anger, worry, cognitive hyperarousal and hypervigilance are the best predictors for sleep difficulties in this population.(AU)

Dificultades del sueño y síntomas psicológicos en estudiantes de medicina de la ciudad de México. / [Sleep difficulties and psychological symptoms in medicine students in Mexico].

The purpose of this study was to describe sleep difficulties in first year medical students associated with psychopathological symptoms. A cross-sectional study in 572 Medicine students, who were assessed by the Symptom Check List-90 (SCL-90), was performed. A 3.5

of students reported having a hard time sleeping, 6.3

had difficulty staying asleep and 11.4

waking up very early. Sleep difficulties were significantly associated with all psychopathological symptoms. The best predictors of sleep difficulties were anxiety, hostility and interpersonal sensitivity. In conclusion, the symptoms associated with stress, anger, worry, cognitive hyperarousal and hypervigilance are the best predictors for sleep difficulties in this population.