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      Burnout, depression and depersonalisation – Psychological factors and coping strategies in dental and medical students Translated title: Burnout, Depression und Depersonalisation – Psychologische Faktoren und Bewältigungsstrategien bei Studierenden der Zahn- und Humanmedizin


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          Background: Previous studies found that stress, depression, burnout, anxiety, and depersonalisation play a significant role amongst dental and medical students. We wanted to examine if students of the University of Erlangen-Nuremberg also would report elevated values as can been found in similar publications. Furthermore, particularly coping strategies were investigated.

          Methods: The data collection took place in April 2008 including 182 dental and medical students of the 4 th and 5 th academic year at the University of Erlangen-Nuremberg. Demographic data and the following screening instruments were used: Maslach Burnout Inventory (MBI), Cambridge Depersonalisation Scale (CDS-9), Hospital Anxiety and Depression Scale (HADS), Brief COPE.

          Results: Descriptive statistics showed higher pathological values in dental students than in medical students. The difference was especially pronounced on the depersonalisation scale (CDS-9), with 20.4% of the dental students, but only 5.5% of the medical students showing scores above a cut-off of 19. The scores decreased in the course of 3 semesters of dentistry. The students with elevated values showed a higher degree of dysfunctional coping.

          Conclusion: Our results obtained with the screening instruments are in line with the results of previous investigations of other authors and point out the importance of this issue. It might be useful to develop programs teaching dental students more adaptive coping strategies before their first patient contact.

          Translated abstract

          Hintergrund: Studien der vergangenen Jahre zeigten, dass Stress, Depression, Burnout-Syndrom, Angst und Depersonalisation während des Studiums der Zahn- und Humanmedizin einen besonderen Stellenwert einnehmen. Es stellt sich die Frage, ob auch bei Studierenden der Universität Erlangen-Nürnberg erhöhte Werte, wie sie in der Literatur gefunden werden, nachweisbar sind. Zudem soll untersucht werden, welche Arten von Bewältigungsstrategien vorkommen.

          Methodik: Die Datenerhebung fand im April 2008 bei 182 Studenten der Human- und Zahnmedizin des 4. und 5. Studienjahres an der Universität Erlangen-Nürnberg statt. Neben der demographischen Erhebung kamen folgende Screening Instrumente zum Einsatz: Maslach Burnout Inventory (MBI), Cambridge Depersonalisation Scale (CDS-9, Kurzversion), Hospital Anxiety and Depression Scale (HADS), Brief COPE.

          Ergebnisse: In der deskriptiven Statistik zeigten sich bei den Zahnmedizinstudenten erhöhte Werte im Vergleich zu den Humanmedizinstudenten. Besonders deutlich war der Unterschied bei den Werten der Depersonalisations-Skala (CDS-9). Es hatten 20.4% der Zahnmedizin- und nur 5,5% der Humanmedizinstudenten Werte über dem cut-off von 19. Im Querschnitt der drei Studiensemester Zahnmedizin nahm die Anzahl der Studierenden mit auffälligen Werten ab. Studierende mit auffälligen Werten zeigten ein höheres Maß an dysfunktionalen Bewältigungsstrategien.

          Schlussfolgerung: Die Messwerte der Screening Instrumente ähneln der Untersuchungen anderer Autoren und unterstreichen die Bedeutung der Thematik. Aus Sicht der Prävention könnte sich bei Studenten der Zahnmedizin die Zeit vor dem ersten Patientenkontakt anbieten, um geeignete Bewältigungsstrategien zu vermitteln.

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          Most cited references30

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          Psychological stress and burnout in medical students: a five-year prospective longitudinal study.

          The aim of this study was to assess psychological morbidity and symptoms of burnout in medical students during their undergraduate training, and to identify baseline factors that predict psychological morbidity in students in the final year of the course. It was a 5-year prospective longitudinal cohort study. Students were assessed in years 1, 4 and 5 of their medical undergraduate training by means of the GHQ-12 and the Maslach Burnout Inventory. 172 (84.3%), 157 (77.0%) and 155 (75.9%) students out of an original group of 204 completed assessments in years 1, 4 and 5, respectively. 18 students were above threshold on the GHQ-12 on all three occasions, 25 on two occasions and 43 on one occasion; 69 students were never a 'case'. Students who were cases on two or more occasions were more likely to find the medical course stressful during the first year, but not subsequent years. There was no significant difference between the percentages of men and women who scored as cases on the GHQ-12 in any of the years. The best predictor of psychological morbidity in the final year of the course was the GHQ-12 score in year 1. This study suggests that a small group of students repeatedly experience psychological distress during their medical training.
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            Coping as a mediator between personality and stress outcomes: a longitudinal study with cataract surgery patients

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              Psychological stress and health in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools.

              Psychological stress in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools. To compare the levels of a series of health-related indicators from a cohort of fifth year dental students from five European schools with their first year scores, and to investigate the relationship between these follow-up measures. Burnout was measured using the Maslach Burnout Inventory (MBI), consisting of three scales: Emotional Exhaustion (EE, alpha = 0.90), Depersonalisation (alpha = 0.80) and Personal Accomplishment (alpha = 0.72). Physical health was measured by the Physical Symptoms Questionnaire (alpha = 0.82), psychological distress was measured using the General Health Questionnaire (GHQ, alpha = 0.89) and student stress was captured using seven subscales of the Dental Environment Stress questionnaire (DES, alpha = 0.92). A total of 132 fifth year students responded from five dental schools (Manchester, Belfast, Cork, Helsinki and Amsterdam), a 51% response. Fifth year students showed relatively high mean MBI scores when compared with first year results, especially on EE; 39% could be labelled 'high scorers'; 44% of the students met the criteria for 'cases' on the GHQ. Highest mean scores on the DES were obtained on the subscales: Study Obligations, Patient-Related Aspects and Study Pressure respectively. Between schools interesting differences were detected on all variables. As hypothesised, a clear direct effect of stress on both burnout and physical symptoms was shown. An indirect effect of stress on mental health via burnout was shown. Dental students showed a negative development through the years from first to fifth year with regard to EE and psychological distress. Both burnout constructs related to physical and mental health. It is recommended that dental faculty focus on the importance of prevention and intervention of stress amongst undergraduates.

                Author and article information

                GMS Z Med Ausbild
                GMS Z Med Ausbild
                GMS Zeitschrift für Medizinische Ausbildung
                German Medical Science GMS Publishing House
                15 February 2012
                : 29
                : 1
                : Doc10
                [1 ]torhaus - Ihre Zahnärzte, Berlin, Deutschland
                [2 ]Universitätsklinikum Erlangen, Zahnklinik 3, Kieferorthopädie, Erlangen, Deutschland
                [3 ]Universitätsklinikum Erlangen, Psychosomatische und Psychotherapeutische Abteilung, Erlangen, Deutschland
                Author notes
                *To whom correspondence should be addressed: Patrick Prinz, torhaus - Ihre Zahnärzte, Robert-Koch-Platz 11, 10115 Berlin Berlin, Tel.: +49 (0)30/279074910, Fax: +49 (0)30/279074949, Deutschland, E-mail: info@ 123456zahnarzt-torhaus.de
                zma000780 Doc10 urn:nbn:de:0183-zma0007805
                Copyright © 2012 Prinz et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free to copy, distribute and transmit the work, provided the original author and source are credited.

                : 07 March 2011
                : 23 September 2011
                : 14 September 2011

                coping strategies,medical students,burnout,dental students,depersonalisation
                coping strategies, medical students, burnout, dental students, depersonalisation


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