Prevalence of empathy, anxiety and depression, and their association with each other and with sex and intended specialty in medical students

Abstract

Introduction: Empathy and mental health are crucial for medical students’ self-care and performance as well as for patient care. Objective: to assess the prevalence of empathy, anxiety and depression, and their association with each other and sex, intended specialty and course semester. Method: Cross-sectional study with 405 of 543 students (74.6%) from odd semesters and from the 12th semester of the medical course of two universities in southern Brazil. Data were collected using a self-administered questionnaire containing information on age, sex, medical course semester, intended specialty, Jefferson Scale of Empathy (JSE) and Beck Anxiety and Depression Inventories (BAI and BDI). The data were analyzed using descriptive statistics, Student’s t-tests, Chi-square, and bidirectional ANOVA between groups. The level of significance was set at p < 0.05. Results: The mean JSE score was 120.2 (SD = 10.6) [116.9 (SD = 11.0) in men and 123.4 (SD = 9.2) in women, p = 0.000], being higher among students who wanted to follow medical areas aimed at people [123.1 (SD = 10.1)], than among those whose intended areas aimed at techniques and procedures [118.5 (SD = 11.2)], p = .003. There was no difference between the course periods. The anxiety and depression mean rates were, respectively, 16.2 (SD = 11.3) and 11.9 (SD = 9.0) [13.1 (SD = 10.3) and 9.9 (SD = 8.3) in men and 19.1 (SD = 11.4), and 13.8 (SD = 9.4) in women, p = .000 for both]. The prevalence rate of moderate and high anxiety was 33.8% and, when including mild anxiety, it was 59%. The prevalence rate of dysphoria (BDI = 16 - 20) and depression (BDI > 20) was 26.4%, and 11.9% for suicidal ideation. An association was observed between severe anxiety and the JSE subscale ‘Walking in patient’s shoes’, more related to empathic stress. Conclusions: Empathy is high and stable throughout the medical course at the studied institutions and higher in women and students who want to follow people-oriented specialties. Anxiety and depression have higher prevalence rates in women. Severe anxiety is associated with the JSE subscale ‘Walking in patient’s shoes’.