Ana Margareth Siqueira Bassols

First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms?

OBJECTIVE Medical training is considered a significant stress factor. We sought to assess the prevalence and intensity of anxiety and depressive symptoms in medical students and compare samples of first-year and sixth-year students. METHOD This was a cross-sectional study of first- and sixth-year medical students who attended classes regularly. The study instruments were a sociodemographic questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). RESULTS A total of 232 students (110 first-year, 122 sixth-year) completed the questionnaires, for a response rate of 67.4%. Overall 50.4% of respondents were male (56.4% of first-year and 45.1% of sixth-year students). Anxiety symptoms were reported by 30.8% of first-year students and 9.4% of sixth-year students (p < 0.001). Female students were more affected by anxiety. There were no significant between-group differences in depressive symptoms. CONCLUSION A higher prevalence of anxiety symptoms was found in first-year medical students as compared with sixth-year students. Strategies should be developed to help medical students, particularly female students, manage these symptoms at the beginning of their medical training.

Alcohol, drugs, and risky sexual behavior are related to HIV infection in female adolescents

OBJECTIVE To examine associations between risk factors for HIV infection in a sample of young women who sought HIV testing in a city of southern Brazil. METHOD Cross-sectional study with a consecutive convenience sample of 258 female adolescents aged 13 to 20 years evaluated in an anonymous testing site for HIV and sexually transmitted diseases in Brazil. Risk behavior for HIV was assessed with the Brazilian version of the Risk Assessment Battery and HIV status was assessed through ELISA (Enzyme Linked Immunosorbent Assay). RESULTS Overall seropositivity rate was 7.4%. HIV-seropositive patients had significantly more sexual intercourse in exchange for money, higher rates of pregnancy and abortion, as well as earlier sexual debut. In multiple analyses with the inclusion of two composite variables (sex risk and drug risk), only drug risk was associated with positive HIV status (OR=4.178; IC 95%=1.476-11.827). CONCLUSION Our findings suggest that high HIV seropositivity among female adolescents seeking HIV testing in Brazil directly reflects the need for effective interventions specifically designed to prevent risk behaviors in order to halt the spread of HIV infection.

Therapeutic relationship on the web: to face or not to face?

In this age of unprecedented expansion of media and information dissemination and sharing, the use of electronic means should be reconsidered. The use of new technologies should be studied to understand how it may affect the relationship between patient and therapist during psychotherapy or psychoanalytic treatments. This study offers a critical discussion of the effect of technologies on clinical practice, and vignettes are used to describe their impact on frame, anonymity, abstinence and therapeutic neutrality. Transfer and countertransference issues resulting from these changes are also discussed. The potential benefits of new technologies in psychotherapy are appreciated, but the authors draw attention to the need to reflect about the presence of the therapist in those technologies and the preservation of the therapeutic setting, so that a satisfactory progression of the work of the dyad is ensured. This study also discusses the use of technologies in the expansion of learning and application of the therapeutic technique to overcome geographic and time barriers, among others.

Stress and coping in a sample of medical students in Brazil

Background: Medical training is a stressing situation, making medical students vulnerable to psychiatric disorders, such as depression and anxiety. Objective: The study aimed to assess the prevalence of stress and coping in students of a public medical school in Brazil, comparing the groups from the first and sixth years of training. Methods: Through a cross-sectional, observational study, a sample of 232 first and sixth-year regularly registered medical students has been evaluated. Students filled a socio-demographic questionnaire, the Lipp Inventory of Stress Symptoms (ISSL), and the Coping Strategies Inventory (CSI). Results: From the total sample of 232 students, 110 were first-year students and 122 sixth-year students. Stress symptoms were significantly higher in first-year students (49.1%) than in the sixth-year group (33.6%; p = 0.018). Variables significantly associated with stress were: year of the training (1 st year > 6th year), income (lower > higher income), satisfaction with the training (dissatisfied > satisfied) and the use of escape/avoidance copying strategy (positive association). Discussion: Considering the higher stress symptoms among first-year medical students and the positive association of the escape/avoidance copying strategy with stress, strategies must be developed to enable students starting medical school to be better at coping with this stressful situations.