Use of prescribed psychotropic drugs among medical students and associated factors

a cross-sectional study

Authors

Keywords:

Mental health, Students, medical, Psychotropic drugs, Anxiety, Depression

Abstract

BACKGROUND: The worldwide prevalences of anxiety and depressive disorders are 3.6% and 4.4%, respectively. Among medical students, many studies have indicated that the prevalences of these mental disorders vary between 19.7% and 47.1%, but there is a lack of information on psychotropic drug usage in this group of students. OBJECTIVE: To evaluate the prevalence of psychotropic drug use, adherence to therapy and main clinical and diagnostic indications relating to psychotropic drug use among medical students. DESIGN AND SETTING: Cross-sectional study at a Brazilian private university in the city of Sorocaba, state of São Paulo. METHODS: Observational analytical cross-sectional study, conducted during the second semester of 2019, through a semi-structured online questionnaire, answered by first to sixth-year medical students. RESULTS: Among the 263 participants (41.7% of the 630 enrolled students), the current prevalence of psychotropic drug usage was 30.4%. This prevalence increased over the course and 90.7% of the drugs were prescribed at regular medical consultations (85.5% by psychiatrists). The main indications for psychotropic drug usage were anxiety (30.0%), depression (22.8%), insomnia (7.2%), panic (5.3%) and att ention deficit hyperactivity disorder (3.8%). Women were more likely to present diagnoses of depression and panic. Most of the participants used antidepressants and had good adherence to medications. Adequate sleep and regular physical activity were identified as protective factors against mental disorders. CONCLUSION: The prevalence of mental disorders among medical students is high, which justifies the use of psychotropic drugs. This study provides valuable information and recommendations for institutional educational actions to improve students’ mental health.

Downloads

Download data is not yet available.

Author Biographies

Nicoli Abrão Fasanella, Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo

MD. Professor, Department of Public Health, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil.

Clarissa Garcia Custódio, Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo

Undergraduate Medicine Student, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil.

Júlia Santos do Cabo, Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo

Undergraduate Medicine Student, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil.

Gabriel Sousa Andrade, Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo

BSc, LPsy. Psychologist, Incorporee Instituto de Saúde, Guarapuava (PR), Brazil.

Fernando Antônio de Almeida, Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo

MD, PhD. Full Professor, Department of Clinics, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP) Sorocaba (SP), Brazil.

Maria Valéria Pavan, Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo

MD, MSc, PhD. Professor, Department of Public Health, Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil.

References

Manwell LA, Barbic SP, Roberts K, et al. What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey. BMJ Open. 2015;5(6):e007079. PMID: 26038353; https://doi.org/10.1136/bmjopen-2014-007079.

Chan V, Moore J, Derenne J, Fuchs DC. Transitional Age Youth and College Mental Health. Child Adolesc Psychiatr Clin N Am. 2019;28(3):363-75. PMID: 31076114; https://doi.org/10.1016/j.chc.2019.02.008.

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. PMID: 31370266; https://doi.org/10.3390/ijerph16152735.

Damiano RF, de Oliveira IN, Ezequiel ODS, Lucchetti AL, Lucchetti G. The root of the problem: identifying major sources of stress in Brazilian medical students and developing the Medical Student Stress Factor Scale. Braz J Psychiatry. 2021;43(1):35-42. PMID: 32696807; https://doi.org/10.1590/1516-4446-2019-0824.

Del-Ben CM, Machado VF, Madisson MM, et al. Relationship between academic performance and affective changes during the first year at medical school. Med Teach. 2013;35(5):404-10. PMID: 23444889; https://doi.org/10.3109/0142159X.2013.769675.

World Health Organization. Depression and other common mental disorders: global health estimates. Geneva: World Health Organization. 2017;2. Available from: https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf?sequence=1&isAllowed=y. Accessed in 2021 (Nov 24).

Moutinho ILD, Maddalena NC, Roland RK, et al. Depression, stress and anxiety in medical students: A cross-sectional comparison between students from different semesters. Rev Assoc Med Bras. 2017;63(1):21-8. PMID: 28225885; https://doi.org/10.1590/1806-9282.63.01.21.

Bassols AM, Okabayashi LS, da Silva AB, et al. First- and last-year medical students: Is there a difference in the prevalence and intensity of anxiety and depressive symptoms? Braz J Psychiatry. 2014;36(3):233-40. PMID: 24676042; https://doi.org/10.1590/1516-4446-2013-1183.

Vasconcelos TC, Dias BRT, Andrade LR, et al. Prevalence of Anxiety and Depression Symptoms among Medicine Students. Rev Bras Educ Med. 2015;39(1):135-42. https://doi.org/10.1590/1981-52712015v39n1e00042014

Pacheco JP, Giacomin HT, Tam WW, et al. Mental health problems among medical students in Brazil: A systematic review and meta-analysis. Braz J Psychiatry. 2017;39(4):369-78. PMID: 28876408; https://doi.org/10.1590/1516-4446-2017-2223.

Cassimiro EE. Frequência do uso de psicofármacos entre jovens estudantes que cursam pré-vestibular. Adolesc Saude. 2012;9(4):27-36. Available from: https://docplayer.com.br/60017331-Frequencia-do-uso-de-psicofarmacos-entre-jovens-estudantes-que-cursam-pre-vestibular.html Accessed in 2021 (Nov 24).

Quintana MI, Andreoli SB, Moreira FG, et al. Epidemiology of Psychotropic Drug Use in Rio de Janeiro, Brazil: Gaps in Mental Illness Treatments. PLoS One. 2013;14(8):e62270. PMID: 23690934; https://doi.org/10.1371/journal.pone.0062270.

Prado MAMBD, Francisco PMSB, Barros MBA. UUse of psychotropic medications in adults and elderly living in Campinas, São Paulo, Brazil: cross-sectional population-based study. Epidemiol Serv Saude. 2017;26(4):747-58. PMID: 29211139; https://doi.org/10.5123/S1679-49742017000400007.

Wege N, Muth T, Li J, Angerer P. Mental health among currently enrolled medical students in Germany. Public Health. 2016;132:92-100. PMID: 26880490; https://doi.org/10.1016/j.puhe.2015.12.014.

Ribeiro AG, Cruz LP, Marchi KC, Tirapelli CR, Miasso AI. Antidepressivos: Uso, adesão e conhecimento entre estudantes de medicina [Antidepressants: use, adherence and awareness among medical students]. Cienc Saude Colet. 2014;19(6):1825-33. PMID: 24897482; https://doi.org/10.1590/1413-81232014196.06332013.

Silva RCG, Oliveira TM, Casimiro TS, et al. Automedicação em acadêmicos do curso de medicina. Rev Soc Bras Clin Med. 2012;16(3):167-70. https://doi.org/10.11606/issn.2176-7262.v45i1p5-11.

Borba LO, Capistrano FC, Ferreira ACZ, et al. Adaptation and validation of the Measuring of Treatment Adherence for mental health. Rev Bras Enferm. 2018;71(Suppl 5):2243-50. PMID: 30365790; https://doi.org/10.1590/0034-7167-2017-0796.

Barbetta PA. Estatística aplicada às ciências sociais. Florianópolis. Editora da UFSC, 2002. Available from: https://www.academia.edu/32231809/BARBERETA_Estatistica_Aplicada_As_Ciencias_Sociais?pop_sutd=true Accessed in 2021 (Nov 24).

Scheffer M, Cassenote A, Guilloux AGA. et al. Demografia Médica no Brasil 2018. São Paulo, SP: FMUSP, CFM, Cremesp; 2018. Available from: https://jornal.usp.br/wp-content/uploads/DemografiaMedica2018.pdf Accessed in 2022 (Jun 20).

Silva V, Costa P, Pereira I, et al. Depression in medical students: Insights from a longitudinal study. BMC Med Educ. 2017;17(1):184. PMID: 29017594; https://doi.org/10.1186/s12909-017-1006-0.

Baggio S, Studer J, Mohler-Kuo M, Daeppen JB, Gmel G. Non-medical prescription drug and illicit street drug use among young Swiss men and associated mental health issues. Int J Adolesc Med Health. 2014;26(4):525-30. PMID: 24447983 https://doi.org/10.1515/ijamh-2013-0330.

Conselho Federal de Medicina. Código de Ética Médica. Resolução CFM n° 2.217, de 27 de setembro de 2018, modificada pelas Resoluções CFM no 2.222/2018 e 2.226/2019. Brasília: CFM; 2018. Available from: https://portal.cfm.org.br/images/PDF/cem2019.pdf Accessed in 2021 (Nov 24).

Fleck MP, Berlim MT, Lafer B, et al. Revisão das diretrizes da Associação Médica Brasileira para o tratamento da depressão (Versão integral) [Review of the guidelines of the Brazilian Medical Association for the treatment of depression (Complete version)]. Braz J Psychiatry. 2009;31 Suppl 1:S7-17. PMID: 19565151; https://doi.org/10.1590/s1516-44462009000500003

APA. Treating major depressive disorders. In: Practice Guidelines for the Treatment of Psychiatric Disorders: Quick Reference Guidelines. 3rd ed, American Psychiatric Association; 2010. p. 22. Available from: https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf Accessed in 2021 (Nov 24).

Velligan DI, Weiden PJ, Sajatovic M, et al. Strategies for addressing adherence problems in patients with serious and persistent mental illness: recommendations from the expert consensus guidelines. J Psychiatr Pract. 2010;16(5):306-24. PMID: 20859108; https://doi.org/10.1097/01.pra.0000388626.98662.a0.

Cape J, Whittington C, Bower P. What is the role of consultation–liaison psychiatry in the management of depression in primary care? A systematic review and meta-analysis. Gen Hosp Psychiatry. 2010;32(3):246-54. PMID: 20430227; https://doi.org/10.1016/j.genhosppsych.2010.02.003.

da Silva AG, Baldaçara L, Cavalcante DA, Fasanella NA, Palha AP. The Impact of Mental Illness Stigma on Psychiatric Emergencies. Front Psychiatry. 2020;11:573. PMID: 32636773; https://doi.org/10.3389/fpsyt.2020.00573.

Stein DJ, Stahl S. Serotonin and anxiety: current models. Int Clin Psychopharmacol. 2000;15 Suppl 2:S1-6. PMID: 11110013; https://doi.org/10.1097/00004850-200008002-00002.

Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation’s updated sleep duration recommendations: Final report. Sleep Heal. 2015;1(4):233-43. PMID: 29073398; https://doi.org/10.1016/j.sleh.2015.10.004.

Buysse DJ. Insomnia. JAMA. 2013;309(7):706-16. PMID: 23423416; https://doi.org/10.1001/jama.2013.193

Perotta B, Arantes-Costa FM, Enns SC, et al. Sleepiness, sleep deprivation, quality of life, mental symptoms and perception of academic environment in medical students. BMC Med Educ. 2021;21(1):111. PMID: 33596885; https://doi.org/10.1186/s12909-021-02544-8.

Mammen G, Faulkner G. Physical Activity, and the Prevention of Depression: A Systematic Review of Prospective Studies. Am J Prev Med. 2013;45(5):649-57. PMID: 24139780; https://doi.org/10.1016/j.amepre.2013.08.001.

Oliveira LG, Barroso LP, Wagner GA, et al. Drug consumption among medical students in São Paulo, Brazil: influences of gender and academic year. Braz J Psychiatry. 2009;31(3):227-39. PMID: 19784490; https://doi.org/10.1590/s1516-44462009000300008.

Oliveira LG, Alberghini DG, Santos BD, Andrade AG. Polydrug use among college students in Brazil: A nationwide survey. Rev Bras Psiquiatr. 2013;35(3):221-30. PMID: 24068301; https://doi.org/10.1590/1516-4446-2012-0775.

Borges G, Bagge CL, Orozco R. A literature review and meta-analyses of cannabis use and suicidality. J Affect Disord. 2016;195:63-74. PMID: 26872332; https://doi.org/10.1016/j.jad.2016.02.007.

Downloads

Published

2022-09-01

How to Cite

1.
Fasanella NA, Custódio CG, Cabo JS do, Andrade GS, Almeida FA de, Pavan MV. Use of prescribed psychotropic drugs among medical students and associated factors: a cross-sectional study. Sao Paulo Med J [Internet]. 2022 Sep. 1 [cited 2025 Mar. 14];140(5):697-704. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1070

Issue

Section

Original Article