Factors associated with substance use among preclinical medical students in Turkey: a cross-sectional study

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DOI:

https://doi.org/10.36834/cmej.77088

Abstract

Introduction: Medical students experience high levels of stress due to their rigorous training, which can negatively affect their mental health. This study aimed to investigate substance use habits of medical students at Istanbul University-Cerrahpaşa and the association on their mental health and demographic factors.

Methods: This cross-sectional survey study was conducted in March-April 2022 among preclinical medical students (years 1-3 of a 6-year program). A confidential, anonymous online survey consisting of four sections on sociodemographic and educational characteristics, nicotine use and dependence [Fagerström Test for Nicotine Dependence (FTND)], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)], mental health status [12-item General Health Questionnaire (GHQ-12)], was distributed to 1131 students via WhatsApp and Telegram text messages. Mann-Whitney U and Kruskal Wallis tests compared variables’ distribution in the questionnaire categories. Spearman's correlation assessed associations between scales. Significance was p < 0.05.

Results: The study included 190 medical students. A total of 26.3% of the participants were smokers, with 8.4% showing moderate to high levels of nicotine dependence. An estimated 45.8% and 8.4% reported low-risk consumption and risky usage of alcohol, respectively. There were statistically significant associations between substance use and demographic factors such as sex, GPA, and religious belief. The study found a statistically significant correlation between FTND scores and GHQ-12 scores, and, between FTND scores and AUDIT scores.

Conclusion: The findings of this study will inform the development of interventions to improve the mental health and academic performance of medical students at Istanbul University-Cerrahpaşa. Furthermore, it will raise awareness about the importance of addressing substance use among medical students in Turkey.

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References

Haykal KA, Pereira L, Power A, Fournier K. Medical student wellness assessment beyond anxiety and depression: a scoping review. PLoS One. 2022;17(10):e0276894. https://doi.org/10.1371/journal.pone.0276894 DOI: https://doi.org/10.1371/journal.pone.0276894

Moir F, Yielder J, Sanson J, Chen Y. Depression in medical students: current insights. Adv Med Educ Pract. 2018;9:323-333. https://doi.org/10.2147/AMEP.S137384 DOI: https://doi.org/10.2147/AMEP.S137384

Fares J, Al Tabosh H, Saadeddin Z, El Mouhayyar C, Aridi H. Stress, burnout and coping strategies in preclinical medical students. North Am J Med Sci. 2016;8(2):75. https://doi.org/10.4103/1947-2714.177299 DOI: https://doi.org/10.4103/1947-2714.177299

Hope V, Henderson M. Medical student depression, anxiety and distress outside North America: a systematic review. Med Educ. 2014;48(10):963-979. https://doi.org/10.1111/medu.12512 DOI: https://doi.org/10.1111/medu.12512

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):354-373. https://doi.org/10.1097/00001888-200604000-00009 DOI: https://doi.org/10.1097/00001888-200604000-00009

Farrell SM, Moir F, Molodynski A, Bhugra D. Psychological wellbeing, burnout and substance use amongst medical students in New Zealand. Int Rev Psychiatry. 2019;31(7-8):630-636. https://doi.org/10.1080/09540261.2019.1681204 DOI: https://doi.org/10.1080/09540261.2019.1681204

Flaherty JA, Richman JA. Substance use and addiction among medical students, residents, and physicians. Psychiatric Clinics. 1993;16(1):189-197. https://doi.org/10.1016/S0193-953X(18)30201-6 DOI: https://doi.org/10.1016/S0193-953X(18)30201-6

Dyrbye LN, Satele D, West CP. Association of characteristics of the learning environment and US medical student burnout, empathy, and career regret. JAMA Netw Open. 2021;4(8):e2119110. https://doi.org/10.1001/jamanetworkopen.2021.19110 DOI: https://doi.org/10.1001/jamanetworkopen.2021.19110

Arora A, Kannan S, Gowri S, Choudhary S, Sudarasanan S, Khosla PP. Substance abuse amongst the medical graduate students in a developing country. Indian J Med Res. 2016;143(1):101-103. https://doi.org/10.4103/0971-5916.178617 DOI: https://doi.org/10.4103/0971-5916.178617

Bryl N, Czrnecka-Iwańczuk M, Romanowska M, Stanisić M, Michalak M, Posadzy-Małaczyńska A. Drinking alcohol as a way of coping with stress in students of medical faculties. Psychiatr Pol. 2020;54(2):265-277. https://doi.org/10.12740/PP/99029 DOI: https://doi.org/10.12740/PP/99029

Freire BR, Castro PASV de, Petroianu A. Alcohol consumption by medical students. Rev Assoc Med Bras. 2020;66:943-947. https://doi.org/10.1590/1806-9282.66.7.943 DOI: https://doi.org/10.1590/1806-9282.66.7.943

Bahji A, Danilewitz M, Guerin E, Maser B, Frank E. Prevalence of and factors associated with substance use among Canadian medical students. JAMA Netw Open. 2021;4(11):e2133994. https://doi.org/10.1001/jamanetworkopen.2021.33994 DOI: https://doi.org/10.1001/jamanetworkopen.2021.33994

Baldwin DC Jr, Hughes PH, Conard SE, Storr CL, Sheehan DV. Substance use among senior medical students: a survey of 23 medical schools. JAMA. 1991;265(16):2074-2078. https://doi.org/10.1001/jama.1991.03460160052028 DOI: https://doi.org/10.1001/jama.265.16.2074

Akvardar Y, Demiral Y, Ergor G, Ergor A. Substance use among medical students and physicians in a medical school in Turkey. Soc Psychiatry Psychiatr Epidemiol. 2004;39(6):502-506. https://doi.org/10.1007/s00127-004-0765-1 DOI: https://doi.org/10.1007/s00127-004-0765-1

Frank E, Elon L, Naimi T, Brewer R. Alcohol consumption and alcohol counselling behaviour among US medical students: cohort study. BMJ. 2008;337:a2155. https://doi.org/10.1136/bmj.a2155 DOI: https://doi.org/10.1136/bmj.a2155

Smith D, Leggat P. An international review of tobacco smoking among medical students. J Postgrad Med. 2007;53(1):55. https://doi.org/10.4103/0022-3859.30333 DOI: https://doi.org/10.4103/0022-3859.30333

Al-Haqwi AI. Perception among medical students in Riyadh, Saudi Arabia, regarding alcohol and substance abuse in the community: a cross-sectional survey. Subst Abuse: Treat Prev Policy. 2010;5(1):2. https://doi.org/10.1186/1747-597X-5-2 DOI: https://doi.org/10.1186/1747-597X-5-2

Ayala EE, Roseman D, Winseman JS, Mason HRC. Prevalence, perceptions, and consequences of substance use in medical students. Med Ed Online. 2017;22(1):1392824. https://doi.org/10.1080/10872981.2017.1392824 DOI: https://doi.org/10.1080/10872981.2017.1392824

Babaei Heydarabadi A, Ramezankhani A, Barekati H, et al. Prevalence of substance abuse among dormitory students of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Int J High Risk Behav Addict. 2015;4(2). https://doi.org/10.5812/ijhrba.22350v2 DOI: https://doi.org/10.5812/ijhrba.22350v2

Candido FJ, Souza R, Stumpf MA, et al. The use of drugs and medical students: a literature review. Rev Assoc Med Bras. 2018;64:462-468. https://doi.org/10.1590/1806-9282.64.05.462 DOI: https://doi.org/10.1590/1806-9282.64.05.462

Kabbash IA, Sarsik SM, Kabbash MI, et al. Perception and practices of tobacco smoking among medical students in the Nile Delta, Egypt. Environ Sci Pollut Res. 2018;25(31):30839-30846. https://doi.org/10.1007/s11356-017-9443-1 DOI: https://doi.org/10.1007/s11356-017-9443-1

Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. Addiction. 1991;86(9):1119-1127. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x DOI: https://doi.org/10.1111/j.1360-0443.1991.tb01879.x

Etter JF, Le Houezec J, Perneger TV. A self-administered questionnaire to measure dependence on cigarettes: the cigarette dependence scale. Neuropsychopharmacol. 2003;28(2):359-370. https://doi.org/10.1038/sj.npp.1300030 DOI: https://doi.org/10.1038/sj.npp.1300030

Reinert DF, Allen JP. The Alcohol Use Disorders Identification Test: an update of research findings. Alcoholism Clin Exp Res. 2007;31(2):185-199. https://doi.org/10.1111/j.1530-0277.2006.00295.x DOI: https://doi.org/10.1111/j.1530-0277.2006.00295.x

Saunders JB, Aasland OG, Babor TF, De La Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88(6):791-804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x DOI: https://doi.org/10.1111/j.1360-0443.1993.tb02093.x

Lundin A, Hallgren M, Theobald H, Hellgren C, Torgén M. Validity of the 12-item version of the general health questionnaire in detecting depression in the general population. Public Health. 2016;136:66-74. https://doi.org/10.1016/j.puhe.2016.03.005 DOI: https://doi.org/10.1016/j.puhe.2016.03.005

Goldberg DP, Gater R, Sartorius N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27(1):191-197. https://doi.org/10.1017/S0033291796004242 DOI: https://doi.org/10.1017/S0033291796004242

Guthrie EA, Black D, Shaw CM, Hamilton J, Creed FH, Tomenson B. Embarking upon a medical career: psychological morbidity in first year medical students. Medical Education. 1995;29(5):337-341. https://doi.org/10.1111/j.1365-2923.1995.tb00022.x DOI: https://doi.org/10.1111/j.1365-2923.1995.tb00022.x

RStudio Team. RStudio: integrated development for R. RStudio, PBC, Boston, MA. Published online 2020. http://www.rstudio.com/

Garnett C, Oldham M, Shahab L, Tattan-Birch H, Cox S. Characterising smoking and smoking cessation attempts by risk of alcohol dependence: a representative, cross-sectional study of adults in England between 2014-2021. The Lancet Regional Health - Europe. 2022;18:100418. https://doi.org/10.1016/j.lanepe.2022.100418 DOI: https://doi.org/10.1016/j.lanepe.2022.100418

Cherkil S, Gardens SJ, Soman DK. Coping styles and its association with sources of stress in undergraduate medical students. Ind J Psychol Med. 2013;35(4):389-393. https://doi.org/10.4103/0253-7176.122235 DOI: https://doi.org/10.4103/0253-7176.122235

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2024-02-12

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1.
Karabacak M, Kose EB, Bahadir Z, Demirel Y, Mutlu EB, Ozcan Z, Ozkara BB. Factors associated with substance use among preclinical medical students in Turkey: a cross-sectional study. Can. Med. Ed. J [Internet]. 2024 Feb. 12 [cited 2024 Nov. 18];15(3):37-44. Available from: https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77088

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