gms | German Medical Science

Objective: It has already been shown in various studies that the prevalence of mental disorders among medical students increases dramatically the longer they study at university. This constellation is remarkable, as students begin with a prevalence of disorders such as depression and anxiety disorders comparable to that of the general population. Therefore, we wanted to investigate mental health by quantifying two salutogenetic factors of our medical students in the first year: resilience and coherence.

Methods: Antonovsky's salutogenesis model looks at what helps patients stay healthy and focuses on the availability of personal resources. The development of disorders in the salutogenetic model is based on the perception and assessment of stressors by the individual. Resilience is an individual's ability to deal with stressors and to integrate them into everyday life without lasting psychological damage. It includes behaviours and thoughts that can be learned and developed. The sense of coherence (SOC) states that

1.

the stimuli that arise from the internal and external environment during the course of life are structured, predictable and explainable,

2.

the individual has the resources to meet the demands that these stimuli make, and

3.

these demands are challenges worth engaging and explaining.

The SOC is something like an attitude to life. We tested 236 medical students in the first year for these parameters with validated, self-administered questionnaires: RS-13 (resilience) and SOC-L9 (coherence sense scale, Leipzig short form) (see figure 1 [Fig. 1]).

Results: There were significantly lower values for both parameters in our students compared with the average population. Another significant difference was found between male and female students concerning resilience but not sense of coherence in our study collective. Female gender was related significantly to lower resilience.

Discussion: While the feeling of coherence is a parameter that can hardly or not at all be influenced by life events, resilience can be learned and practiced. Structured presentations and explanations, the definition of achievable goals and requirements and the experience of the meaningfulness of actions should characterise the teaching units and help medical students to maintain their mental health. Female students in particular could benefit, as women seem to be less resilient and are 2.5-3 times more likely to develop psychiatric disorders such as depression and anxiety disorders.

Take home message: Medical curricula should be designed to teach the subject matter in such a way that a certain resilience can be built up.