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    1 Comment for this article
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    Psychological disabilities among US medical students with special reference to depression, anxiety and suicide
    Tomoyuki Kawada, MD | Nippon Medical School
    Meeks et al. assessed disclosure of psychological disabilities in medical students (1). Overall, 1.4% of all students reported at least 1 psychological disability. Prevalence (95% confidence interval [CI]) of students with a primary diagnosis of anxiety and depression were 0.8% (0.7%-0.9%) and 0.3% (0.2%-0.3%), respectively. The authors considered factors regarding disclosing psychological disabilities in medical students, and concluded that recognizing psychological disability, removing barriers to disclosure, and ensuring appropriate supporting system should be established. I have some concerns.

    First, Rotenstein et al. conducted a meta-analysis and estimated the prevalence of depression/depressive symptoms and suicidal ideation among medical students being
    27.2% and 11.1%, respectively (2). There is a big difference between the prevalence and disclosure percentage of depression. I suspect that disclosure percentage of psychological disabilities might be differed from the prevalence of them. But gender difference would exist in disclosure percentage of depression as it was observed in the prevalence of depression (3).

    Second, the global prevalence rate (95% CI) of anxiety among medical students was 33.8% (29.2-38.7%) (4). Anxiety was most prevalent among medical students, and disclosing percentage of anxiety was also higher than that of depression. I suspect that overlapping of anxiety and depression would be existed in medical students.

    Finally, suicide prevention is effective by screening stages of suicide ideation. Health care of depression and anxiety in medical students should be conducted in combination with suicide prevention.


    References
    1. Meeks LM, Plegue M, Case B, et al. Assessment of Disclosure of Psychological Disability Among US Medical Students. JAMA Netw Open. 2020;3(7):e2011165. doi:10.1001/jamanetworkopen.2020.11165
    2. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016;316(21):2214-2236. doi:10.1001/jama.2016.17324
    3. Pacheco JPG, Silveira JB, Ferreira RPC, et al. Gender inequality and depression among medical students: A global meta-regression analysis. J Psychiatr Res. 2019;111:36-43. doi:10.1016/j.jpsychires.2019.01.013
    4. Quek TT, Tam WW, Tran BX, et al. The Global Prevalence of Anxiety Among Medical Students: A Meta-Analysis. Int J Environ Res Public Health. 2019;16(15):2735. doi:10.3390/ijerph16152735
    CONFLICT OF INTEREST: None Reported
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    Research Letter
    Medical Education
    July 23, 2020

    Assessment of Disclosure of Psychological Disability Among US Medical Students

    Author Affiliations
    • 1Department of Family Medicine, The University of Michigan Medical School, Ann Arbor
    • 2Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
    • 3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
    • 4Michigan Neuroscience Institute, The University of Michigan Medical School, Ann Arbor
    JAMA Netw Open. 2020;3(7):e2011165. doi:10.1001/jamanetworkopen.2020.11165

    According to a 2019 study,1 medical student disclosure of disability increased by 69% from 2016 to 2019. In a comparison of data from schools that responded both years, the largest gain was in psychological disability. To better understand whether a meaningful proportion of students with mental health diagnoses disclose their disability, we assessed the proportion of MD students reporting psychological disabilities and examined subcategories of psychological disability.

    This survey study was conducted between September 2018 and March 2019. A survey assessing the number of students reporting disabilities was sent to 140 fully accredited US allopathic medical schools’ disability offices or the school’s primary contact for disability disclosure. The study followed the American Association for Public Opinion Research (AAPOR) reporting guideline. Given the deidentified nature of the data, the University of Michigan Medical School institutional review board considered the study exempt. Aggregate data were used to estimate the proportion of medical students reporting a psychological disability and the prevalence of subcategories of psychological disability. Descriptive analyses were conducted in R version 3.5.1 (R Project for Statistical Computing). No prespecified level of statistical significance was set.

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