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Evaluation of Psychopathological Indices in Students of Zanjan University of Medical Sciences

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Background & Object: Mental disorders affect various groups, including children, adolescents,and adults, imposing heavy socioeconomic costs on communities. Therefore, the dynamism and efficiency of countries could be guaranteed by improving the
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    Evaluation of Psychopathological Indices in Students of Zanjan University of Medical Sciences Sahel Khakpoor Borazjani 1 ,    Arezoo Heshmati Joda 1 ,   Majid Mohammadi 1 ,   Zahra Kosari 1 ,   Saede Zenoozian 2* 1  Master of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. 2  Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Article Info Article Type: Original Article Article history: Received 20 Aug 2018  Accepted 19 Dec 2018 Published 19 March 2019 Keywords: Psychopathology SCL-90 Students of Zanjan University of Medical Sciences Corresponding author:   Saede Zenoozian, Email:  zenoozian@zums.ac.ir  This article is referenced as follows: Khakpoor borazjani S, Heshmati Joda A, Mohammadi M, Kosari Z, Zenoozian S. Evaluation of Psychopathological Indices in Students of Zanjan University of Medical Sciences. J Med Educ Dev. 2019; 11 (32) :15-26   Journal of Medical Education Development, 2018, Vol 11, No 32,15-26 http://zums.ac.ir/edujournal/ Abstract Background Object:     Mental disorders affect various groups, including children, adolescents, and adults, imposing heavy socioeconomic costs on communities. Therefore, the dynamism and efficiency of countries could be guaranteed by improving the mental health level, which leads to enhanced academic levels of students. This study aimed to evaluate the psychopathological indices in students of Zanjan University of Medical Sciences. Materials and Methods:  This descriptive study was performed on 400 students of Zanjan University of Medical Sciences during the academic year of 2016-2017. After selecting the subjects by available sampling method, the symptoms checklists 90 revised (SCL-90-R) were provided to students and recollected after completion. Data analysis was performed using descriptive and inferential statistics. Results:  In this study, 79% of students were suspected of mental disorders (61.5% mild, 15.3% moderate, and 2.3% severe). Physical complaints and phobic anxiety were significantly higher in female students, compared to male students (P<0.05). Conclusion:  According to the results of the study, mental disorders are considerably common among students. Therefore, it is necessary to consider these disorders in the design of prevention and treatment programs.  Evaluation of Psychopathological Indices 16   Journal of Medical Education Development, Vol 11, No 32 Winter, 2019 Introduction Health is a multidimensional problem and different aspects affect each other and ultimately exert impacts the health of individuals and society (1). Mental disorder is a syndrome with an apparent symptom of considerable clinical disturbance of cognition, as well as emotional or behavioral regulation of individuals (2). Investing in people regardless of their mental health status cannot lead to the meeting of expectations (3). Therefore, the researchers consider the role of the epidemiology of mental disorders important in identifying the state of mental health of the community and assessing its required facilities at any time (4). Mental health is defined as our understanding of our own abilities, adaptation to the normal  pressures of life and community participation (5). Unfortunately, the inability of students to adapt to new conditions can be observed as a  problem in interpersonal relationships, direct or displaced aggression, indifference, helplessness, physical symptoms, anxiety and depression, and even psychosis and suicidal  behavior (6). Students are prone to losing their mental health due to special circumstances of the education  period, such as being away from the family, entering a large organization with an intense environment, economic problems, large volumes of courses, and intensive competitions. These stressors have undesirable effects on the general health of students, and the exacerbation of these factors increases  physical symptoms, anxiety, social dysfunction and depression while decreasing the general health of these individuals (8). In addition to dealing with problems faced by other students, medical students have their own specific issues, including the environmental  pressures of the hospital and emergency departments, facing patient-related problems, the length of education, and lack of clear career  prospects. Therefore, it seems that medical students are at a higher risk of losing mental health, compared to other students (9). Several factors related to university life, including university workload, competition, financial  problems, pressure for success, and concerns about career prospects may be potential stressors for the students that lead to mental damage or have negative impacts on academic  progress and academic satisfaction (10). Epidemiological studies estimate that between 12-50% of students fit the criteria for one or more mental disorders (11). These studies indicate an increase in the prevalence and severity of psychological problems in student  populations compared to non-students (12).  17 Khakpoor Borazjani et al Journal of Medical Education Development, Vol 11, No 32 Winter, 2019 Some studies have demonstrated that stress is most prevalent in student populations, and anxiety and depression are increasingly growing among these individuals (13). In recent studies on students' mental disorders, depression, panic disorder, and general anxiety disorder were found in 17.3%, 4.1%, and 7% of the cases, respectively (11). In a meta-analysis of 40 studies on the psychological complaints of American and Canadian medical students, the results were indicative of the higher prevalence of depression and anxiety among these individuals, compared to the general population (14). There have been various reports of the prevalence of different mental disorders, such as depression, substance abuse, eating disorders, and learning disabilities among students. About 15-23% of students with mental disorders often visit a counselor because of an educational problem (15). The results obtained by Nami et al. demonstrated that female students suffered more from symptoms of mental disorders, compared to male students (16). According to studies,   mental   disorders, especially depression, are more common   among Iranian students (17). In a meta-analysis, Zare et al. assessed the mental health status of university students in Iran. These scholars marked that the overall  prevalence of mental disorders among university students in the country was estimated at 33% according to the random effects model. In addition, the prevalence of mental disorders has increased over time (3). In a previous study, Benton et al. reported an increase in levels of anxiety, depression, suicidal thoughts, and personality disorders  based on the findings of clinical psychologists of university counseling centers of US (18). In addition, the results obtained by Shahabi Nejad et al. indicated that more than half of the students, especially nursing and paramedical students, are susceptible to mild-severe mental disorders (12). Mental disorders affect efficient human resources communities, such as children, adolescents, and adults, imposing heavysocial   and   economiccosts   on communities (19).   Thehigh    prevalence   of mental disorders among students leads to academic failure . In   this   regard,most   studies   haveemphasized   the   antecedent   roleof    mental disorders in the academic failure of students (15). The increasing risk of mental disorders among the medical experts and paying attention to their effective role in the mental health of the community is important in achieving the desired goals of the job, especially for therapeutic purposes. In fact, mental disorders can play a role in reducing the efficacy of these individuals [12]. Symptoms of mental  Evaluation of Psychopathological Indices 18   Journal of Medical Education Development, Vol 11, No 32 Winter, 2019 disorders, especially depression, might facilitate the emergence of more dangerous  phenomena (e.g., disappointment and suicide) in a person and affect the academic success of students. Recent studies have shown that the increased risk of suicide among students has  become an epidemic, which necessitates attention to the mental health of students (20). Determining the mental health status of students can help recognize their psychological  problems and design appropriate treatment  programs for these individuals before graduation. Reports from several studies have shown that long-term psychological distress is related to boredom and helplessness, reduced academic achievement, unprofessional  performance, and psychological weakness. On the other hand, promoting the mental health of students may prevent harmful behaviors, improve their quality of life, and have a major impact on the quality of care provided by these individuals in the future (21). Moreover, it is crucial to focus on the efficiency of students in educational and cultural areas. We can ensure the dynamism and efficiency of countries by improving mental health and, consequently, promoting the educational levels of individuals. Considering the destructive consequences of mental disorders, their prevention, identification, and treatment can have widespread benefits for students and communities. Given the fact that students are a special social group, promoting their mental health, reducing their psychological stress and increasing their general health and adaptation to the academic environment are of utmost importance (16). Awareness of the mental health levels of students with academic  problems leads to the formation of policies that  provide the necessary tools to reduce mental disorders and ultimately lead to the promotion of individual and social mental health levels and prevention of social, cultural and economic harm (22). With this background in mind, this study aimed to evaluate the  psychopathological indices in students of Zanjan University of Medical Sciences, Iran.   Materials and Methods   This descriptive research was approved by the ethics committee of the vice-chancellor for research of Zanjan University of Medical Sciences with the code of ethics of ZUMS.REC.1396.215. Participants included all students of Zanjan University of Medical Sciences (N=3500) in the academic year of 2016-2017. In total, 347 subjects were selected  based on Cochran Formula by estimation of 5% error rate (23). In order to increase data  19 Khakpoor Borazjani et al Journal of Medical Education Development, Vol 11, No 32 Winter, 2019 accuracy, 400 students were selected by the available sampling method. Demographic characteristics included in the questionnaire were gender, educational degree, and place of residence. Data analysis was performed in SPSS using descriptive and inferential statistics. Data collection tool was the 90-item symptom checklist 90 revised (SCL-90-R), which is one of the most common screening tools applied to evaluate mental symptoms (24). Items are scored based on a five-point Likert scale from never (score=zero) to extremely high (score=four). The mentioned questionnaire encompasses nine components for mental disorders, namely somatization, obsessive-compulsive,   interpersonal sensitivity,   depression,   anxiety,   hostility, phobic anxiety, paranoid ideation, and psychoticism (25). The reliability of SCL-90-R was estimated at 0.91, 0.91, and 0.97 by Fouladvandi, Guttman, and through Cronbach’s alpha, respectively (24). Results   In this research, from a total of 400 students, 36.8% were male and 63.3% were female. Regarding the place of residence, 81.3% of the subjects lived in dormitories while 18.8% lived at home. The mean and standard deviation of the age of the subjects was reported to be 23.2 (3.6) years. In addition, the prevalence of the mental disorders, the general severity index (GSI) and positive symptoms distress index (PSDI) are reported in Table and Figure 1 in four levels of healthy, mild, moderate, and severe, respectively. Table 1: Prevalence of Psychological Disorders among Students of Zanjan University of Medical Sciences no   mild   moderate   severvariableIndex n%   n%   n%   n% Psychological Disorders   SOM 16541.3   18145.3   4411   102.5O-C   5714.3   22756.5   9223   246   I-S   9323.3   21152.8   7919.8   174.3   DEP   10325.8   19949.8   7218   266.5   ANX   19248   14837   4110.3   194.7   HOS   15939.8   17944.8   5213   102.5   PHOB   21854.5   15338.3   256.3   41   PAR    6616.5   19849.5   10726.8   297.3   PS   13132.8   22155.3   4310.8   51.3   GSI   8421   24661.5   6115.3   92.3   PSDI   10.3   16040   20952.3   307.5 Note: SOM= Somatization, O-C= Obsessive-compulsive, I-S= Interpersonal sensitivity, DEP= Depression, ANX =Anxiety, HOS= Hostility, PHOB= Phobic anxiety, PAR= Paranoid ideation, PS= Psychoticism, GSI= Global Severity Index, PSDI= Positive Symptom Distress Index.
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