Clinical Structure and Comorbidity of Additive Behavior and De-pendencies in Medical Students

Author Name(s): Victor A. Ruzhenkov, Inna S. Lukyantseva, Victoria V. Ruzhenkova, Julia N. Gomelyak
Author Email: ruzhenkov@bsu.edu.ru

Abstract

A high level of academic load and stress create the risk of addictive behavior and addictions in medical students as a way of stress overcoming. The purpose of our study was to verify the prevalence of addictive behavior and dependencies in medical students and their comorbidity with mental disorders for the development of approaches to their prevention. In this regard, we examined 455 senior students of the Medical Institute using the medical-sociological, psychometric methods and the “Method of clinical screening-diagnostics of addictive and dependent behavior”. It was found that the addictive behavior and formed dependence were revealed in 37.1% of students. At the same time, various kinds of addictive behavior and dependencies were combined among themselves in 37.5% of cases. Persons with addictive behavior and dependence were characterized by personal immaturity, low level of responsibility, tolerance and negative thinking. The study revealed a high level of comorbidity of addictive behavior and addictions to mental disorders, among which neurotic, stress-related and somatoform disorders (58.5%), as well as personality disorders (14.2%), prevailed. Persons with addictive behavior and addictions had a higher incidence of asthenia, anxiety and depression, as well as obsessive-compulsive symptoms, social phobia and dysmorphophobia, which created additional difficulties in social adaptation. Thus, prevention of addictive behavior and addictions should, first of all, be aimed at the timely detection and therapy of mental disorders, as well as includes measures to reduce the level of educational stress.

Introduction

The activity of a medical student is one of the emotional types of labor, which affects the level of their mental and physical health [1]. The prevalence of chronic stress among medical students is higher than among the general population and ranges from 38% to 62% [2, 3, 4]. Stress is caused by a large amount of training load, uncertainty about one’s own professional qualities and a significant amount of effort required for doing homework, fear of the future [5, 6]. The pressure from the part of teachers, the increased workload before the exams [1, 7], the need to work with cadaver material and the strict schedule of the day, as well as the lack of time planning skills and self-discipline are stressful [3, 8]. The highest prevalence of stress is observed among the first-year students, which is due to the need to adapt to new conditions in life away from family [9-12].

Tobacco smoking was one of the ways to combat stress [13]. According to [12], there is a direct relationship between the stress and the use of psychoactive substances. According to [14], 36.7% of freshmen students struggled with stress symptoms through taking herbal medicines, 1.8% took tranquilizers and 3% – antidepressants. A significant number – 34.3% used alcohol, and 82.5% communicated in social networks for a long time to eliminate anxiety and internal tension. Using these methods to combat stress is a risk factor for the formation of addictive behavior and dependencies.

By addictive behavior, we understood the unsystematic use of psychoactive substances or addiction to certain subjects or actions before the formation of the 1st stage of addiction. Thus, the addictive behavior is a stage on the way of dependence formation – the actual painful predilection with the characteristic clinical picture.

Conclusion

The study showed that addictive behavior and dependencies in medical students were revealed in 37.1% of cases. At the same time, various kinds of addictive behavior and dependencies were combined among themselves in 37.5% of cases: 36.2% among males and 38% – females.

The risk factors for the formation of addictive behavior and dependence are as follows: individual-personal (male gender, personal immaturity, low level of responsibility, tolerance, predominance of negative thinking, high level of anxiety and depression and neurotic disorders) and social environment (father’s weak position in the family, lack of trust between father and child, separate role is played by a lack of desire to learn and frustration in the future profession).

The primary psycho-prophylaxis should include adequate career guidance, reduction in the level of educational stress and training for personal growth, early identification of a risk group. The secondary psycho prophylaxis consists in the qualified assistance of a medical psychologist and a doctor-psychotherapist, aimed at freeing from dependence and reorienting the individual to constructive activities.

References

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