Depression, suicidal ideation and stress among Italian medical students: PRIMES multicentre study

Background Depression represents a public health priority and a major contributor to suicide worldwide. Medical students (MS) have been reported as a high-risk group and data are required to implement action plans. This study aimed to investigate depressive symptoms (DS), suicidal ideation (SI) and perceived stress (PS), and analyse factors that may impact on such conditions. Methods In 2018, a multicentre cross-sectional study (PRIMES) was carried out in 12 Medical Schools, reaching 2513 MS throughout Italy. Socio-demographic data and psychometric tests were collected. Main outcomes were measured by Beck Depression Inventory-II (DS and SI) and Perceived Stress Scale (PS). Mostly, multivariable logistic and linear regressions were run (p < 0.05 as significant). Results The prevalence of DS and SI was 29.5% and 14%. The mean PS score was 18.6 (SD = 7.8), within a range to 0 from 40. Preliminary results showed that the variables associated with a higher risk of reporting all outcomes (DS, SI, PS, respectively) were: increasing age (p = 0.004, p = 0.016, p = 0.003), bisexuality (p = 0.002, p < 0.001, p < 0.001), poor economic status (p = 0.010, p = 0.014, p < 0.001), psychiatric family history (p = 0.007, p = 0.003, p = 0.029), negative judgment about medical school choice (all p < 0.001), unsatisfying classmates' friendships (p = 0.027, p < 0.001, p < 0.001) and classmates' climate competitive and hostile (all p < 0.001). An excellent family bond reduced the odds instead (all p < 0.001). Other socio-demographic and university-related items resulted associated to the outcomes in different ways. Conclusions PRIMES showed a high prevalence of DS and SI among MS, with alarming PS levels. Since this issue seems common worldwide, further analyses to understand the determinants are needed and a population-based approach pertaining to public health must be addressed, e.g. to increase resilience. Universities must realize interventions, offer counselling and improve modifiable factors, such as learning climate. Key messages Italian medical students reported a prevalence of depressive symptoms and suicidal ideation of 29.5% and 14% respectively, both higher than the prevalence among same-aged general population. Depression, suicidal ideation and stress were mainly influenced by age, sexuality, finances, psychiatric family history, judgment on medical school, family bond, classmates’ friendships and climate