Effectivity of Psychotherapy Interventions for Anxiety in Medical Students: A Systematic Review

Authors

  • Andrian Fajar Kusumadewi Department of Psychiatry, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital, Yogyakarta, Indonesia
  • Carla Raymondalexas Marchira Department of Psychiatry, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital, Yogyakarta, Indonesia
  • Widyandana Widyandana Department of Medical Education and Bioethics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital, Yogyakarta, Indonesia
  • Ronny Tri Wirasto Department of Psychiatry, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.7244

Keywords:

Mental health, Medical students, Anxiety disorders, Mindfulness, Depression

Abstract

BACKGROUND: The mental health of medical students has long been a topic of concern in many countries. Much research in Europe reported that around 30% of medical students suffered from anxiety. Anxiety disorders have significant physical and emotional consequences. Various studies show that excessive, unmanaged stress related to poor academic performance in medical students leads to cynical personalities, lack of empathy, and suicidal ideas.

AIM: This study aimed to identify studies for psychotherapy interventions carried out in medical students and analyze each impact on anxiety level in medical students.

METHODS: This systematic review was conducted with evidence sourced from 2000 to 2020. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was registered with the Prospective Registering of Systematic Reviews database (Protocol ID: CRD42020180650).

RESULTS: Twenty-three studies meet the inclusion criteria, and there are various psychotherapy interventions to deal with anxiety. Most studies reported that students who received mindfulness-based interventions reported lower anxiety, depression, and stress.

CONCLUSION: There are various interventions carried out to decrease stress levels, depression, and anxiety in medical students. The most effective psychotherapy was found in cognitive and behavior intervention and mindfulness intervention.

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References

Boni RA, Paiva CE, de Oliveira MA, Lucchetti G, Fregnani JH, Paiva BS. Burnout among medical students during the first years of undergraduate school: Prevalence and associated factors. PLoS One. 2018;13(3):e0191746. PMid:29513668

Ghodasara SL, Davidson MA, Reich MS, Savoie CV, Rodgers SM. Assessing student mental health at the Vanderbilt University School of Medicine. Acad Med. 2011;86(1):116-21. PMid:21099385

Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81(4):354-73. PMid:16565188

Haldorsen H, Bak NH, Dissing A, Petersson B. Stress and symptoms of depression among medical students at the University of Copenhagen. Scand J Public Health. 2014;42(1):89-95. PMid:23999855

Bassols AM, Okabayashi LS, Silva AB, Carneiro BB, Feijó F, Guimarães GC, et al. First- and last-year medical students: Is there a difference in the prevalence and intensity of anxiety and depressive symptoms? Rev Bras Psiquiatr. 2014;36(3):233-40.

de Sousa JM, Moreira CA, Telles-Correia D. Anxiety, depression and academic performance: A study amongst Portuguese medical students versus non-medical students. Acta Med Port. 2018;31(9):454-62. PMid:30332368

Chandavarkar U, Azzam A, Mathews CA. Anxiety symptoms and perceived performance in medical students. Depress Anxiety. 2007;24(2):103-11. Mid:16845642

Patriquin MA, Mathew SJ. The neurobiological mechanisms of generalized anxiety disorder and chronic stress. Chronic stress (Thousand Oaks). 2017;1:2470547017703993. PMid:29503978

Kim KJ. Factors associated with medical student test anxiety in objective structured clinical examinations: A preliminary study. Int J Med Educ. 2017;7:424-7. PMid:28035056

Ibrahim N, Al-Kharboush D, El-Khatib L, Al-Habib A, Asali D. Prevalence and predictors of anxiety and depression among female medical students in King Abdulaziz University, Jeddah, Saudi Arabia. Iran J Public Health. 2013;42(7):726-36. PMid:24427751

Cook AF, Arora VM, Rasinski KA, Curlin FA, Yoon JD. The prevalence of medical student mistreatment and its association with burnout. Acad Med. 2014;89(5):749-54. PMid:24667503

Moriyama TS, Polanczyk G, Caye A, Banaschewski T, Brandeis D, Rohde LA. Evidence-based information on the clinical use of neurofeedback for ADHD. Neurotherapeutics. 2012;9(3):588-98. PMid:22930416

Marzbani H, Marateb HR, Mansourian M. Neurofeedback: A comprehensive review on system design, methodology and clinical applications. Basic Clin Neurosci. 2016;7(2):143-58. PMid:27303609

Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al. Guidance on the Conduct of Narrative Synthesis in Systematic Reviews. A Product from the ESRC Methods Programme; 2006. Available from: https://www.lancaster.ac.uk/media/lancaster-university/content-assets/documents/fhm/dhr/chir/NSsynthesisguidanceVersion1-April2006.pdf.

McGrady A, Brennan, J, Lynch D, Whearty K. A wellness program for first year medical students. Appl Psychophysiol Biofeedback. 2012;37(4):253-60. PMid:22699926

Brennan J, McGrady A, Lynch DJ, Schaefer P, Whearty K. A stress management program for higher risk medical students: Preliminary findings. Appl Psychophysiol Biofeedback. 2016;41(3):301-5. PMid:26969177

Finkelstein C, Brownstein A, Scott C, Lan YL. Anxiety and stress reduction in medical education: An intervention. Med Educ. 2007;41(3):258-64. PMid:17316210

Rosenzweig S, Reibel DK, Greeson JM, Brainard GC, Hojat M. Mindfulness-based stress reduction lowers psychological distress in medical students. Teach Learn Med. 2003;15(2):88-92. PMid:12708065

Lattie EG, Kashima K, Duffecy JL. An open trial of internet-based cognitive behavioral therapy for first year medical students. Internet Interv. 2019;18:100279. PMid:31534911

Phang CK, Mukhtar F, Ibrahim N, Keng SL, Sidik SM. Effects of a brief mindfulness-based intervention program for stress management among medical students: The Mindful-Gym randomized controlled study. Adv Health Sci Educ Theory Pract. 2015;20(5):1115-34. PMid:25697124

Saravanan C, Kingston R. A randomized control study of psychological intervention to reduce anxiety, amotivation and psychological distress among medical students. J Res Med Sci. 2014;19(5):391-7. Mid:25097619

Gurupriya R, Mathangi DC. Effect of super brain yoga on heart rate variability among undergraduate medical students. Ann Trop Med Public Health. 2020;23(S13A):SP231313.

Bansal R, Gupta M, Agarwal B, Sharma S. Impact of short term yoga intervention on mental well being of medical students posted in community medicine: A pilot study. Indian J Community Med. 2013;38(2):105-8. PMid:23878424

Velayudhan A, Gayatridevi S, Bhattacharjee R. Efficacy of behavioral intervention in reducing anxiety and depression among medical students. Ind Psychiatry J. 2010;19(1):41-6. PMid:21694790

Li C, Chu F, Wang H, Wang XP. Efficacy of Williams LifeSkills training for improving psychological health: A pilot comparison study of Chinese medical students. Asia Pac Psychiatry. 2014;6(2):161-9. PMid:23857943

Xu YY, Feng ZQ, Xie YJ, Zhang J, Peng SH, Yu YJ, et al. Frontal alpha EEG asymmetry before and after positive psychological interventions for medical students. Front Psychiatry. 2018;9:432. PMid:30254589

Xu YY, Wu T, Yu YJ, Li M. A randomized controlled trial of well-being therapy to promote adaptation and alleviate emotional distress among medical freshmen. BMC Med Educ. 2019;19(1):182.

Moir F, Henning M, Hassed C, Moyes SA, Elley CR. A peer-support and mindfulness program to improve the mental health of medical students. Teach Learn Med. 2016;28(3):293-302. PMid:27092397

Warnecke E, Quinn S, Ogden K, Towle N, Nelson MR. A randomised controlled trial of the effects of mindfulness practice on medical student stress levels. Med Educ. 2011;45(4):381-8. PMid:21401686

Bermudez MB, Costanzi M, Macedo MJ, Tatton-Ramos T, Xavier AC, Ferrão YA, et al. Improved quality of life and reduced depressive symptoms in medical students after a single-session intervention. Braz J Psychiatry. 2019;42(2):145-52. PMid:31859792

Neto AD, Lucchetti AL, Ezequiel OS, Lucchetti G. Effects of a required large-group mindfulness meditation course on first-year medical students’ mental health and quality of life: A randomized controlled trial. J Gen Intern Med. 2020;35(3):672-8. PMid:31452038

Hammer CM, Scholz M, Bischofsberger L, Paulsen F, Burger PH. Feasibility of clinical hypnosis for test anxiety in first-year medical students. Int J Clin Exp Hypn. 2020;68(4):511-20. PMid:32804002

Kötter T, Niebuhr F. Resource-oriented coaching for reduction of examination-related stress in medical students: An exploratory randomized controlled trial. Adv Med Educ Pract. 2016;7:497-504. PMid:27601935

Danilewitz M, Bradwejn J, Koszycki D. A pilot feasibility study of a peer-led mindfulness program for medical students. Can Med Educ J. 2016;7(1):e31-7. PMid:27103950

Paholpak S, Piyavhatkul N, Rangseekajee P, Krisanaprakornkit T, Arunpongpaisal S, Pajanasoontorn N, et al. Breathing meditation by medical students at Khon Kaen University: Effect on psychiatric symptoms, memory, intelligence and academic achievement. J Med Assoc Thai. 2012;95(3):461-9. PMid:22550848

Dehghan-Nayeri N, Adib-Hajbaghery M. Effects of progressive relaxation on anxiety and quality of life in female students: A non-randomized controlled trial. Complement Ther Med. 2011;19(4):194-200. PMid:21827933

Hammond DC. Hypnosis in the treatment of anxiety- and stress-related disorders. Expert Rev Neurother. 2010;10(2):263-73. PMid:20136382

Keng SL, Phang CK, Oei TP. Effects of a brief mindfulness-based intervention program on psychological symptoms and well-being among medical students in Malaysia: A controlled study. Int J Cognitive Ther. 2015;8(4):335-50.

Patnaik A, Choudhury KC. Assessment of risk factors associated with hypertension among undergraduate medical students in a medical college in Odisha. Adv Biomed Res. 2015;4:38. PMid:25789264

Ali U, Hasan S. The effectiveness of relaxation therapy in the reduction of anxiety related symptoms (a case study). Int J Psychol Stud. 2010;2(2):202-8.

Esch T, Fricchione GL, Stefano GB. The therapeutic use of the relaxation response in stress-related diseases. Med Sci Monit. 2003;9(2):RA23-34. PMid:12601303

Schaefer A, Matthess H, Pfitzer G, Köhle K. Mental health and performance of medical students with high and low test anxiety. Psychother Psychosom Med Psychol. 2007;57(7):289-97. PMid:17357900

Farooqi YN, Ghani R, Spielberger CD. Gender differences in test anxiety and academic performance of medical students. Int J Psychol Behav Sci. 2012;2(2):38-43.

Lyndon MP, Strom JM, Alyami HM, Yu TC, Wilson NC, Singh PP, et al. The relationship between academic assessment and psychological distress among medical students: A systematic review. Perspect Med Educ. 2014;3(6):405-18. PMid:25428333

Backović DV, Zivojinović JI, Maksimović J, Maksimović M. Gender differences in academic stress and burnout among medical students in final years of education. Psychiatr Danub. 2012;24(2):175-81. PMid:22706416

Kipping CJ. Stress in mental health nursing. Int J Nurs Stud. 2000;37(3):207-18. PMid:10754186

Obradović J, Long JD, Cutuli JJ, Chan CK, Hinz E, Heistad D, et al. Academic achievement of homeless and highly mobile children in an urban school district: Longitudinal evidence on risk, growth, and resilience. Dev Psychopathol. 2009;21(2):493-518. PMid:19338695

Huang J, Nigatu YT, Smail-Crevier R, Zhang X, Wang J. Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. J Psychiatr Res. 2018;107:1-10. PMid:30300732

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Published

2021-10-11

How to Cite

1.
Kusumadewi AF, Marchira CR, Widyandana W, Wirasto RT. Effectivity of Psychotherapy Interventions for Anxiety in Medical Students: A Systematic Review. Open Access Maced J Med Sci [Internet]. 2021 Oct. 11 [cited 2026 Oct. 19];9(F):453-6. Available from: https://oamjms.eu/index.php/mjms/article/view/7244

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Systematic Review Article

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