Estrés y salud mental en estudiantes de Medicina: Relación con afrontamiento y actividades extracurriculares

espanolIntroduccion: el estres cronico y la ausencia de adecuados mecanismos de afrontamiento predisponen a presentar problemas de disregulacion emocional, tales como depresion y ansiedad, ademas de efectos deletereos en la salud cardiovascular. La formacion medica ha sido relacionada con la presentacion de estres cronico y sus efectos. Objetivo: caracterizar los niveles de estres, salud mental y su asociacion con variables psicologicas, fisiologicas y de educacion en estudiantes de medicina colombianos. Metodo: estudio transversal con 217 estudiantes seleccionados aleatoriamente, estratificando segun el ciclo academico. Se aplicaron el Cuestionario de estres percibido (PSS14), Cuestionario de salud (PHQ-9) para depresion, cuestionario de ansiedad generalizada (GAD 7), Cuestionario de Apoyo Social (MOS-SSS) y cuestionario de estrategias de afrontamiento modificado; asi como medidas fisiologicas y un registro de actividades extracurriculares. Resultados: Se presentaron niveles altos de estres (64%), depresion (56.2%) y ansiedad (48.3%). Mediante una regresion logistica bivariada se encontro que ser mujer (OR 2.64, I.C. 95% 1.29–5.39), estar en el ciclo basico (OR 0.38, I.C. 95% 0.19–0.78), no realizar actividades extracurriculares (OR 2.14, I.C. 95% 1.05–4.36), bajas puntuaciones en solucion de problemas (OR 0.93, I.C. 95% 0.89 – 0.93), altas en reaccion agresiva (OR 1.13, I.C. 95% 1.05–1.22) y expresion de dificultad de afrontamiento (OR 1.17, I.C. 95% 1.04–1.30) fueron factores de riesgo para el estres y sintomas emocionales. Conclusiones: la prevalencia de estres y trastornos emocionales en estudiantes de medicina es importante; por esto es necesario llevar a cabo programas de intervencion, orientados a fortalecer la realizacion de actividades extracurriculares y un afrontamiento activo del estres. EnglishIntroduction: Chronic stress and lack of adequate coping mechanisms predispose to present emotional dysregulation problems, such as depression and anxiety, as well as deleterious effects on cardiovascular health. Medical training has been related to the presentation of chronic stress and its effects. Objective: to characterize stress, mental health levels and their association with the psychological, hysiological and educational variables in Colombian edical students. Method: cross sectional study with a randomized sample of 217 students, stratified according to the academic cycle. Participants completed the Perceived Stress Scale (PSS-14), Patient Health Questionairre (PHQ-9) for depression, Generalized Anxiety Disorder questionnaire (GAD-7), Medical Outcomes Study – Social Support Survey (MOS-SSS) and a coping questionnaire. Extracurricular activities and physiological variables were also measured. Results: There were high levels of stress (64%), depression (56.2%) and anxiety (48.3%). It was found that risk factors for stress and emotional symptoms were being female (OR 2.64, C.I. 95% 1.29 – 5.39), being in the basic cycle (OR 0.38, C.I. 95% 0.19 – 0.78), not performing extracurricular activities (OR 2.14, C.I. 95% 1.05 – 4.36), low problem solving scores (OR 0.93, C.I. 95% 0.89 – 0.93), high in aggressivereaction (OR 1.13, C.I. 95% 1.05 – 1.22 and expressing difficulty in coping (OR 1.17, C.I 95% 1.04 – 1.30). Conclusions: There is a high prevalence of stress and emotional disorders in this population. This shows the importance of design intervention programs in students oriented to strengthen the realization of extracurricular activities and an active coping of stress.