Evidence based primarily on a small number of either prospective or retrospective case studies that included a small number of participants and often used non-validated outcome measures for a short period of follow-up, suggests that antidepressants, particularly SSRIs, show improvement of aggression and self-injurious behaviour on average in less than 50% of cases and the rest show either no improvement or deterioration. The effect is most pronounced in the presence of an underlying anxiety or an associated diagnosis of obsessive-compulsive disorder. Most studies have highlighted the concern regarding adverse effects.

BackgroundStress levels and psychological morbidity are high among undergraduate medical students (UGs), but there is a lack of research into the psychological health of UK graduate-entry medical students (GEs). GEs are likely to experience different (perhaps more severe) stressors and to cope with stress differently. We compared stress levels, psychological morbidity and coping styles in GE versus UG medical students studying at the same UK medical school in the same academic year.A cross-sectional self-rated questionnaire study of all first- and second-year GE and UG medical students was conducted. Perceived stress, psychological morbidity, recent adverse life events, stress-related personality traits and coping styles were assessed using standard questionnaires.Results75% GEs and 46% UGs responded to the questionnaire. Both groups reported equally high levels, and similar profiles of, perceived stress and psychological morbidity. Levels of recent adverse life events and stress-related personality traits were similar in both groups. Compared to UGs, GEs were more likely to use active coping (p = 0.02) and positive reframing (p = 0.03), but were also more likely to use substances (alcohol and other drugs; p < 0.001) to help them cope. Unlike UGs, second-year GEs showed less perceived stress (p = 0.007) and psychological morbidity (p = 0.006) than first-year GEs although levels of both were still high.ConclusionOur results show that both GE students and their younger UG counterparts on a traditional medical course have similar profiles of stress symptoms. They do, however, cope with stress differently. GEs are more likely to use active problem-focused coping strategies, and they are also more likely to cope by using substances (alcohol or other drugs). GE students need interventions to prevent maladaptive coping styles and encourage adaptive coping that are tailored to their needs. Such interventions should be targeted at first-year students. It is vital that these students develop positive coping skills to benefit them during training and in a future career that is inherently stressful.

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Background The current study examines a model relating to the concept of reciprocity and burnout in staff, incorporating previous research findings based upon Weiner's (1980Weiner's ( , 1986 cognitive-emotional model linking emotions, optimism and helping behaviour, with the aim of testing the model. Materials Staff working in community homes within the voluntary, private and public sector for people with intellectual disabilities within an urban borough completed a self-report questionnaire including measures of reciprocity, burnout, emotion, optimism and helping behaviour. Results Support was found for an association between lack of reciprocity and levels of burnout. Burnout was found to be correlated with emotion, optimism and helping behaviour. Path analysis revealed significant associations between a lack of reciprocity with the organization and colleagues, burnout, positive affect, optimism and helping. Conclusions The findings provide support for the role of reciprocal relationships between care staff, the organization and work colleagues in burnout. Some support was found for the proposed model. The clinical implications of the study, methodological considerations and recommendations for future research are discussed.

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