LIST OF CHARTS
Chart 3.1. Distribution of students by gender 54
Chart 3.2. Distribution of students by Faculty 55
Chart 3.3. Distribution by school year 55
Chart 3.4. Distribution by ethnicity 56
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Some psychological disorders of students of Ho Chi Minh City University of Medicine and Pharmacy - 15 -
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Figure 3.5. Distribution of students by religion 56
Figure 3.6. Student residence 57
Chart 3.7. Means of transportation frequently used by students 58
Chart 3.8. Money-making jobs 58
Figure 3.9. Mental health counseling services 59
Chart 3.10. Students using the internet 60
Figure 3.11. Smoking 61
Chart 3.12. Alcohol/beer consumption rate of students 62
Figure 3.13. Level of depressive disorder in students 69
Figure 3.15. Level of anxiety disorders in 70 students
Figure 3.17. Representing the linear relationship between depression and anxiety 87
Figure 3.18. Representing the linear relationship between depression and stress 88
Figure 3.19. Representing the linear relationship between depression and stress 89
Figure 3.20 . Correlation coefficients between anxiety, depression, and stress of 88 students
Figure 1.1: Levels of psychological disturbance 20
Figure 1.2. Diagnostic diagram for a person with depressed mood 31
VIETNAMESE ABBREVIATIONS
- AABB: Obsessive-compulsive disorder
- BLTD: Sexual violence
- LATT: Generalized anxiety disorder
- RLCXTM: Seasonal affective disorder
- RLTCCY: Major depressive disorder
- SC: Acute stress disorder
- Reproductive health and sexual health: Reproductive health and sexual health
- SSCT: Post-traumatic stress disorder
- VTN- TN: Minors - youth
ENGLISH ABBREVIATIONS
- Biopsychosocial model: Psychological-Physiological-Social model
- Cross sectional/Synchronic study: research at one point in time
- DASS-42: Depression Anxiety Stress Scales-42 (SH Lovibond & PF Lovibond, 1995): Depression, anxiety, stress.
- DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV): ...
- GABA-benzodiazepine: gamma-aminobutyric acid
- GAD: Generalized Anxiety Disorder: Generalized Anxiety Disorder
- GAS: General adaptation syndrome: General adaptation syndrome
- GHQ-9: General health questionnaire GHQ-9: depression scale
- LST: Life Skills training: life skills training
- MDD: Major Depressive Disorder: Major Depressive Disorder
- Negative change: negative change
- PMSS: Perceived Medical School Stress:
- Positive change: positive change
- SASCAT: Adapted Social Capital Assessment Tool
- School-based mental health service: school-based mental health care model
- UNICEF: United Nations International Children's Emergency Fund: United Nations Children's Emergency Fund
- WCCL : Ways of Coping Check List: checklist of coping (stress)
- WHO: World Health Organization: World Health Organization
- WISC_R: Weschler Intelligence Scale for Children-Revised: Weschler Intelligence Scale for Children
- YLL= Years of Lost Life (death): years of lost life
1. Reason for choosing the topic.
INTRODUCTION
Mental disorders, particularly depression, suicidal thoughts, self-harm and alcohol/drug abuse, are ranked among the top 10 problems contributing to the overall burden of disease in the world today. By 2030, depression is projected to become the leading contributor to the burden of disease and disability in high-income countries [99]. Among non-communicable diseases, the World Health Organization estimates that mental disorders account for a greater burden of disease than any other group, including cancer or cardiovascular disease. This burden affects all age groups, including children and adolescents, and is an important cause of morbidity and mortality [35]. In some places in southern India and rural China, some studies show that the intersection between physical health and mental disorders is very important - the additional risks for cardiovascular disease, diabetes, reproductive health, injury, suicide, etc. are considered to be caused by mental disorders.
Mental health is an important issue in the health system as well as physical health for individuals, communities and the world. It is difficult to predict who will develop mental disorders, and it is difficult to apply effective health promotion measures to the population [79].
From journals published in Vietnam, English journals, researchers found that the results focused heavily on “health knowledge, attitudes and behaviors”, related to HIV/AIDS, tobacco and alcohol use [13], [59],[77] although these studies are important, they do not emphasize the psychological characteristics of the research participants, or the factors that determine poor psychological status. The limited capacity in the field of Health Psychology in developing countries has been highlighted by many articles especially in The Lancet ( 2008) and the journal of Child Psychology and Psychiatry [79],[84],[102]. There is no health without mental health [79],[80]. According to Belfer (2008) who analyzed the difficulties in improving mental health care in low- and middle-income countries, and proposed clear guidelines for solutions [35], another solution is to mobilize the community to engage with researchers in a meaningful way so that the local community is involved in the interpretation and use of the research results rather than “mechanically absorbing” solutions from developed countries. There are many scientific articles, data and research from English-speaking countries, countries with developed economies, but very few from other Asian countries and especially in Vietnam [94], [95].
Psychological disorders interact with many health conditions (WHO), people living in traumatic situations are susceptible to depression, anxiety, stress, emotions, learning and work disabilities and can be unemployed, more seriously can commit suicide....[59].
Psychological disorders greatly increase the risk of HIV infection, can reduce treatment adherence, and lead to the development of AIDS [36]. In many physical illnesses, people with pre-existing psychological disorders will delay seeking help [9],[19].
There is a high rate of symptoms related to mental health in medical students, stress occurs when medical students first start their training program [40]. In China, Hong Kong, Thailand and other Asian countries [65], [74], [104], there have also been studies on mental health in adolescents. Vietnam is a country of concern for community mental health in the developing world, in the 10 priorities to deal with serious global inequalities in care and mental health promotion, WHO recommends applying such as increasing access to treatment in primary health care [97], [100] on integrating mental health in primary health care. Recent research findings in Vietnam such as sexual violence [58], stress in parenting [20], risk factors for psychological trauma [59], measures of social capital [44], working in a medical environment [3] of the Asian Partnership program, also indicate risk factors affecting psychological disorders [49]. Learning is a high-stress environment, with many worries and emotions [5], often creating effects that affect students' academic performance, health and well-being.
For the above reason, the researcher conducted a survey on " Some psychological disorders of students at Ho Chi Minh City University of Medicine and Pharmacy ".
2. Research purpose
Research on the current status of psychological disorders of students of Ho Chi Minh City University of Medicine and Pharmacy.
3. Research tasks
Analyze and synthesize theoretical issues related to psychological disorders in students.
Determine the rate and levels of depressive disorders in students.
Determine the rate and levels of anxiety disorders in students.
Determine the rate and levels of stress disorders in students.
Determine the relationship between depression, anxiety, stress and other factors.
4. Research hypothesis.
There are signs of high level of psychological disturbance in students.
There are differences in the level of psychological disturbance of students according to the factors of gender, year of study, major, study time, accommodation, regular means of transportation, internet use, entertainment, study plan, smoking behavior, and drinking alcohol/beer.
5. Scope of research. 5.1. Content.
Among psychological disorders in students, the researcher only studied anxiety, depression, and stress disorders in students of Ho Chi Minh City University of Medicine and Pharmacy.
5.2.Scope.
1st and 3rd year students of Faculties of Ho Chi Minh City University of Medicine and Pharmacy.
6. Meaning.
New point of the topic.
This is the first study at Ho Chi Minh City University of Medicine and Pharmacy and the first in the country on student mental health.
Parameters of psychological disorders such as rate, level, etc. have been determined in relation to many factors such as year of study, major, smoking, drinking alcohol, gender, etc. that can affect psychological disorders in students.
These findings will be used to change educational practices and initiate mental health management programs to improve health and enhance the quality of learning and life of health care students.
Generalization and application.
The physical and mental health of medical students has the potential to impact the quality of care provided, interventions, and patient or community care, as they become Doctors, Public Health professionals, Nurses, Pharmacists.
Severe and very severe psychological disturbances in students can continue into internships, graduate school, and later into the actual lives of future health care professionals.
Stressed and anxious health care workers are less able to provide optimal patient care, design public health interventions, or improve community health.
Timely intervention to control psychological distress in medical students is likely to lead to better academic performance and better subsequent patient/community care.
Mental disorders can be cured but always leave sequelae. Prevention and control of mental disorders are the primary goals of primary health care, public health and psychotherapists.
This survey result is based on the target population of medical students, so the rate of psychological disturbance cannot be generalized to students of other schools and other majors.
Limitations of the research method.
In the qualitative interview questions, it is difficult to have complete agreement on the students' choice of answer options. In the DASS-42 scale, the interview with the subject occurred during the past week with multiple options allowed for qualitative questions as above, so the students' answer options may not be unified, and there is limited information recall bias. The cross-sectional study (at one point in time) should limit causal conclusions.
Limit student response results.
There may be students who answered yes, in a safe, general, and arbitrary way, unintentionally affecting the research results. However, they were eliminated according to the verification form for the honesty of the answers.
Chapter 1: THEORETICAL BASIS
1.1. HISTORY OF RESEARCH ON THE PROBLEM.
1.1.1. Overseas studies.
In the 1955s, some authors were interested in studying psychological factors affecting health [86], [89]. In 2007, the group of authors Naiemeh Seyedfatemi, Maryam Tafreshi1 and Hamid Hagani, the research results showed that the psychological disturbance of first-year students was 65.8%, increased workload in class was 66.9%, and the most frequent was stress in unfamiliar situations was 64.2% and long waiting was 60.4%. Stress was significantly more in the first year than in the fourth year students. Among the coping strategies in 12 areas, family problems trying to explain to parents and compromise was 73%, along with family rules was 68% were used frequently by most students. To cope with the demands of participating in activities, students frequently tried to find ways to cope with problems at a rate of 66.4% and tried to improve themselves at a rate of 64.5%. Self-control strategies, trying to follow one's own decisions at a rate of 62%, social support strategies at a rate of 59.6%, trying to help others solve their problems at a rate of 56.3%, and trying to keep up with friends or new friends at a rate of 54.4%, spiritual strategies such as prayer/meditation at a rate of 65.8%, diversion strategies such as listening to music at a rate of 57.7%, relaxation strategies at a rate of 52.5%, and trying to be close to someone who cares about you at a rate of 50.5% were used frequently by the majority of students. Most students cited strategies such as avoiding smoking (93.7%) and drinking beer or wine (92.9%), swearing (85.8%), getting professional counseling (74.6%) and talking to a teacher or counselor (67.2%) and joking and keeping a sense of humor (51.9%) [73].
In a study in Tehran, most of the students were female (87.2%) aged 18 to 24, about 57% of the students lived in university dormitories (from other cities). The results showed that students who had difficulty with stress were more likely to seek out friends (76.2%) and work with people they did not know (63.4%), work with people they did not know and change in social relationships were more often stressed than students in other groups, these differences were statistically significant. The most common factors influencing stress were new responsibilities (72.1%, p<0.001), starting university and entering a new environment (65.8%), and changes in sleep habits increased stress significantly more than other students.