An investigation into Familiar Dysfunctions among Medical Students
ABSTRACT Introduction The National Curricular Guidelines for Undergraduate Medicine Courses (2014) determine the profile of medical graduates as having a generalist, humanistic, critical, reflective and multicultural identity. This requires qualified biopsychomotor skills (skills of caring, healing and rehabilitating people and their families). The national psycho-pedagogical support centres find in these students personal, pedagogical and family conflicts translated into mental disorders. Will family dysfunctions be related to increased prevalence among medical undergraduate students (secondary socialization)? Would unsatisfactory primary socialization contribute to becoming ill in the ageing process? Objectives To verify the socio-demographic, psychiatric and family profile of medical students in a federal institution in the state of Rio de Janeiro, Brazil. Methods The research was a qualitative-quantitative study, involving an observational intervention, and of an exploratory, transversal, descriptive and inferential nature. Data collection was performed through two strategies: (1) a self-administered questionnaire built for this research, with socio-psycho-demographic variables and dysfunctional family categories described in the literature. (2) the Mini International Neuropsychiatric Interview (Mini), 5.0.0 version, compatible with the DSM-IV criteria; Validated by Patrícia Amorim/2000. Data were collected after an Informed Consent Form (ICF) was signed and a database was created in Excel. The analysis was performed with the statistical software R. Quantitative variables were analysed by standard deviation, mean, median and mode. The qualitative variables underwent frequency analyses. Statistical tests were performed by Fisher exact test, bilateral Wilcoxon, chi-Square and Shapiro-Wilk, according to the variables and objectives of the analysis. The research was approved by the Ethics and Research Committee under number CAAE: 67590317.5.0000.5258, on 25/07/2017. Results 129 students were evaluated, aged 18 to 32 years, ranging from the 1st to 12th semester of the undergraduate course, 49% were female and 51% male. The prevalence of generalized anxiety disorder was 39.53%; depression (current or recurrent), 32.56% and suicide risk, 28.68%. Depression had a strong correlation with a family history of psychiatric disorder (p-value: 7.639 e-08) and the parents’ relationship. It was present in those with divorced parents, widowed or without a relationship (P value: 0.008291). The risk of suicide was higher among students of the basic cycle, 1st to 4th semester of the course (p-value: 0.01), that had a strong correlation with suffering or still suffer bullying (p-value: 0.02), having a religion (p-value: 0.006), and depression (p-value: 0.03) or panic disorder (p-value: 4.903 e-05). There was a correlation between depression (p-value: 1.248 and-09) and suicide risk (p-value: 0.0009) in those who had communication problems in the family. Panic disorder was observed in 17.05% of the interviewees, females (p-value: 0.00583). This stems from the parents’ relationship. Students with married parents were the most affected. (p-value: 0.01284) Conclusions: The collected data showed correlations between family dysfunctions and psychiatric disorders such as depression, suicide risk, panic disorder, and generalized anxiety disorder. There is a need for a teaching/learning environment, including adequate spaces and scenarios, and also medical educators who can, at an early stage, identify psychological distress in the secondary socialization of the future physician.
