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Cited by 2,479Healthcare professionals’ stress and burnoutMental Health Treatment and AccessSuicide and Self-Harm Studies

Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis

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Rotenstein, Lisa S., Ramos, Marco A., Torre, Matthew, Segal, J. Bradley, Peluso, Michael J., Guille, Constance, Sen, Srijan, Mata, Douglas A.·2016·JAMA
DOI 10.1001/jama.2016.17324PMC PMC5613659
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Abstract

Importance: Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies. Objective: To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students. Data Sources and Study Selection: Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included. Data Extraction and Synthesis: Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. Main Outcomes and Measures: Point or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview. Results: Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n = 116 628) and 16 longitudinal studies (n = 5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37 933/122 356 individuals; 95% CI, 24.7% to 29.9%, I2 = 98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982-2015; slope, 0.2% increase per year [95% CI, -0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during medical school (n = 2432), the median absolute increase in symptoms was 13.5% (range, 0.6% to 35.3%). Prevalence estimates did not significantly differ between studies of only preclinical students and studies of only clinical students (23.7% [95% CI, 19.5% to 28.5%] vs 22.4% [95% CI, 17.6% to 28.2%]; P = .72). The percentage of medical students screening positive for depression who sought psychiatric treatment was 15.7% (110/954 individuals; 95% CI, 10.2% to 23.4%, I2 = 70.1%). Suicidal ideation prevalence data were extracted from 24 cross-sectional studies (n = 21 002) from 15 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of suicidal ideation was 11.1% (2043/21 002 individuals; 95% CI, 9.0% to 13.7%, I2 = 95.8%). Summary prevalence estimates ranged across assessment modalities from 7.4% to 24.2%. Conclusions and Relevance: In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%. Further research is needed to identify strategies for preventing and treating these disorders in this population.

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  • Medical students exhibit a prevalence rate of 27.2% for depression, compared to 9.3% in the general populace.

    “medical students exhibit a notable prevalence rate of 27.2% for depression, compared to 9.3% in the general populace [6].”

    From Effectiveness of an Internet-Based Self-Help Acceptance and Commitment Therapy Program on Medical Students’ Mental Well-Being: Follow-Up Randomized Controlled Trial (2024) · cites this paper as [6]

    The Results report a pooled 27.2% prevalence of depression or depressive symptoms among medical students. The Discussion gives 9.3% for a 12-month major depressive episode among 18- to 25-year-olds in a US general-population study—not for the general populace as a whole. The measures and populations therefore differ from the comparison as stated; page numbers were not provided. (LLM, conf=0.88)

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  • Burnout and depression among medical students have serious consequences, including suicidal ideation, dropping out, substance abuse, poor sleep quality, decreased work engagement, decreased professionalism, decreased academic effectiveness, and poor mental health overall.

    “Burnout and depression among medical students have serious consequences, including suicidal ideation [1, 2], dropping out [3], substance abuse, poor sleep quality, decreased work engagement [4], decreased professionalism [5], decreased academic effectiveness, poor mental health overall [6, 7].”

    From The mediating role of psychological flexibility in the association of autistic-like traits with burnout and depression in medical students during clinical clerkships in Japan: a university-based cross-sectional study (2023) · cites this paper as [2]

    The Discussion reports that 11.1% of medical students experienced suicidal ideation and 27.2% screened positive for depression. This supports the cited point that suicidal ideation is a serious concern among medical students, but the paper does not establish it as a consequence of burnout or depression. The other listed outcomes have separate citations and are not attributed to this source. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Anxiety and depression disorders are highly prevalent in medical students.

    “The high prevalence of anxiety and depression disorders in this group has been clearly established,3,4”

    From Improved quality of life and reduced depressive symptoms in medical students after a single-session intervention (2020) · cites this paper as [3]

    The Discussion reports that 27.2% of medical students screened positive for depression, supporting a high prevalence of depression or depressive symptoms. The paper does not establish a high prevalence of anxiety disorders; its Future Directions section instead calls for future studies to screen for comorbid anxiety disorders. The reported depression estimate also largely comes from self-report screening, not confirmed diagnoses. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • Depression and depressive symptoms are more common among medical students than in the general population, with a prevalence rate estimated at 27.2 vs. 9.3%-7.2%.

    “compared to the general population, depression and depressive symptoms are more common among medical students, with a prevalence rate estimated at 27.2 vs. 9.3%-7.2% in the general population [4].”

    From Effectiveness of online mindfulness interventions on medical students’ mental health: a systematic review (2021) · cites this paper as [4]

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Authors
Rotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C., Sen, S., & Mata, D. A.
Affiliations
  • Harvard University (US)
  • Yale University (US)
  • Brigham and Women's Hospital (US)
  • Medical University of South Carolina (US)
  • University of Michigan (US)
Corresponding author
Mata, Douglas A.
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2016-12-06
Volume
316
Issue
21
Pages
2214
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2016.17324
PMC
PMC5613659
OpenAlex
W2560290367
Cited by
2,479
References
226
Citations by year
2026: 294 · 2025: 287 · 2024: 320 · 2023: 266 · 2022: 311 · 2021: 351 · 2020: 273 · 2019: 196 · 2018: 119 · 2017: 58 · 2016: 2 · 2012: 1
FWCI
233.47
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health (F31MH064299, K23MH095109, R01MH101459)
  • National Institute of General Medical Sciences (T32GM007205)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Keywords
depression, depressive symptoms, suicidal ideation, medical students, prevalence, medical education, student mental health, preclinical vs clinical students, help-seeking, risk factors for depression
MeSH terms
Depression, Depressive Disorder, Humans, Longitudinal Studies, Students, Medical, Prevalence, Suicidal Ideation

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