Since the beginning of the COVID-19 pandemic, evidence shows the negative psychological impact of lockdown measures in the general population. It is also important to identify predictors of psychological distress in vulnerable people, particularly patients with history of depressive episodes (the most prevalent psychiatric disorder), in order to adapt mental health strategies for future lockdown measures. This study aim was to (1) compare in 69 healthy controls (HC) and 346 patients with a major depressive episode in the two previous years (PP) self-reported psychological symptoms (depression, anxiety, insomnia, suicidal ideation, traumatic stress, anger) and living conditions during the first national French lockdown, and (2) identify predictors of significant psychological distress in PP. The levels of psychological symptoms were very low in HC compared with PP, independently of the living conditions. Half of PP had no psychiatric contact during the lockdown. Loneliness and boredom were independent predictors of depression, anxiety and insomnia, whereas daily physical activity was a protective factor. Virtual contacts protected against suicidal ideation. Our results highlight the need of specific strategies to target loneliness and boredom and to improve care access, including telepsychiatry. Longitudinal studies must investigate the COVID-19 pandemic psychological impact in clinical samples.
Background: Medical students are exposed to an emotionally exhausting training/work environment and to stressful academic demands. Consequently, psychopathologies, burnout and suicidal ideation are frequent in this population. These factors can also affect their empathy and quality of care. Therefore, the development and implementation of programs to promote resilience to stress specifically in medical students and the evaluation of their efficiency are a priority. Here, we describe the protocol of the first French study to assess the long-term effectiveness and acceptability of a mindfulness-based intervention (MBI) compared with relaxation training (RT) to reduce emotional exhaustion in medical students. Methods: This multicenter randomized controlled trial ("Must prevent") plans to enroll 612 students in the fourth and fifth year of medical studies from nine French universities. After inclusion, they will be assigned randomly to the MBI or RT group. Both interventions are structured around an 8-week program that includes one group class per week and daily at-home exercises. The primary endpoint is the emotional exhaustion score assessed with the Maslach Burnout Inventory at month 12 of the follow-up. Secondary endpoints include anxiety-depressive symptomatology, suicidality, psychoactive substance use, depersonalization, psychological and physical pain, empathy, emotional regulation, selfcompassion, mindfulness, quality of life, and program acceptability. Evaluations will be done before and immediately after the 8-week intervention, and at month 6 and 12 of the post-intervention follow-up.
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