Does ragging play a role in medical student depression — Cause or effect?
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Background Medical students experience a lot of stress what may contribute to symptoms of depression. In this study we set out to look at the environmental factors which may be contributing in one medical school in Brazil. Methods We assessed depressive symptoms using Beck's Depression Inventory in 465 and 267 medical students in 2001 and 2006 respectively. We explored possible social and environmental causes using qualitative data. Results Nearly 15% scored above the cut off for depression in both the samples. Males in the pre-clinical stage in 2006 showed an increase in depressive symptoms than males in the same cycle in 2001 (aOR=7.36 [95% CI=0.85-63.5] p=0.07). Qualitative data confirmed that factors such as ragging and low social involvement were correlated with depressive symptoms in pre-clinical stage males. Limitations The sample size was small both for quantitative and qualitative aspects of the study. Conclusions It appears that ragging plays an important role in the genesis of depressive symptoms in medical students.
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Few minutes of fun for seniors can water the roots of negative emotions including perpetuating fear, low self-esteem, irritability, anger and in severe cases long-term consequences such as depression and institutional phobia.
“few minutes of fun for seniors can water the roots of negative emotions including perpetuating fear, low self-esteem, irritability, anger and in severe case one may develop long-term consequences such as depression and institutional phobia (Castaldelli-Maia, 2012; Wajahat, 2014).”
From Ragging: A Harmless Tradition or Menace? Perspective of Newly Admitted Medical Students of Karachi, Pakistan (2021) · cites this paper as Castaldelli-Maia, 2012
The Discussion (page unavailable) reports a correlation between increased ragging and higher depressive-symptom levels among pre-clinical male medical students. The Conclusion describes a possible correlation, not a demonstrated causal or long-term effect. The cited passages do not support the specific claims about fear, low self-esteem, irritability, anger, or institutional phobia. (LLM, conf=0.88)
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Self-citationDamiano, R. F., Berto, L. F., Garcia, C., Damiano, B. B. F., Gonçalves, J. P. D. B., Franklin, D., Kerschner, D. J., Allan, E. J., Ezequiel, O. D. S., Lucchetti, A. L. G., et al. (2025) · Research Square · doi:10.21203/rs.3.rs-7501520/v1
Yang, Y., Su, Y., Cao, G., Liu, B., Zhang, X., Yu, X., Zhang, L., Yu, Y., Su, X., Mo, D., et al. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1916116
- Authors
- Castaldelli-Maia, J. M., Martins, S. S., Bhugra, D., Machado, M. P., Andrade, A. G. D., Alexandrino-Silva, C., Baldassin, S., & de Toledo Ferraz Alves, T. C.
- Affiliations
- Universidade de São Paulo (BR)
- Johns Hopkins University (US)
- King's College London (GB)
- Fundação do ABC (BR)
- Corresponding author
- Castaldelli-Maia, João Maurício
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 139
- Issue
- 3
- Pages
- 291-297
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC3495061
- OpenAlex
- W2157453774
- Cited by
- 55
- References
- 38
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 2 · 2022: 5 · 2021: 4 · 2020: 10 · 2019: 7 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 2 · 2014: 4 · 2013: 1 · 2012: 1
- FWCI
- 4.55
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute on Drug Abuse (R21DA020667, DA 020667, R03DA023434, DA023434)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD060072, R01HD060072)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Sociology and Political Science › Workplace Violence and Bullying
- Keywords
- ragging, medical students, depression, depressive symptoms, medical student stress, social exclusion, preclinical medical students, gender differences
- MeSH terms
- Adult, Brazil, Depression, Female, Humans, Male, Social Behavior, Social Isolation, Stress, Psychological, Students, Medical
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