{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:54:52Z","timestamp":1781592892557,"version":"3.54.5"},"reference-count":32,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Soc Psychiatry"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Further research is crucial to clarify the factors associated with mental disorders that directly impact the well-being of medical students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>To investigate the various stressors experienced by medical students and the longitudinal association between these stressors and mental health outcomes (depression, anxiety, and stress).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>A two-year longitudinal study was conducted with medical students completing questionnaires at baseline and after 2\u2009years of follow-up. Mental health outcomes (depression, anxiety, and stress) were assessed using the depression, anxiety, and stress scale \u2013 21 items, while stressors were assessed using the Medical Student Stress Factor Scale. Structural equation modeling (SEM) was employed for statistical analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study included 231 participants, of which 45.9% reported depression in 2016, rising to 48.9% in 2018. Anxiety decreased from 52.8% to 48.9%, whereas stress increased from 56.7% to 59.7% over the same period. The most prevalent stressors were related to \u201clack of time\u201d and \u201clearning environment\/academic performance.\u201d SEM analyses revealed that follow-up depression was linked to the \u201clearning environment\/academic performance,\u201d baseline depression, and \u201crelationships\u201d; follow-up anxiety was associated with \u201clearning issues,\u201d \u201chealth,\u201d and baseline anxiety; and follow-up stress correlated with \u201clearning environment\/academic performance,\u201d \u201clearning issues,\u201d \u201chealth,\u201d and baseline stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The high prevalence of mental health symptoms and the identification of specific stressors associated with these symptoms call for urgent action by medical schools. Interventions should focus on establishing psychological support programs, promoting a balance between academic and personal lives, and reducing the stigma surrounding mental health help-seeking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00207640251384081","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T10:50:55Z","timestamp":1761907855000},"page":"841-850","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Relationship Between Medical Students\u2019 Stressors and Mental Health Outcomes: A Structural Equation Modeling Analysis"],"prefix":"10.1177","volume":"72","author":[{"given":"Paula de Moura e Silva","family":"Toledo","sequence":"first","affiliation":[{"name":"School of Medicine, Universidade Federal de Juiz de Fora, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5384-9476","authenticated-orcid":false,"given":"Giancarlo","family":"Lucchetti","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidade Federal de Juiz de Fora, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrine Teixeira Ferraz","family":"Grunewald","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidade Federal de Juiz de Fora, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscarina da Silva","family":"Ezequiel","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidade Federal de Juiz de Fora, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra Lamas Granero","family":"Lucchetti","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidade Federal de Juiz de Fora, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"e_1_3_3_2_1","article-title":"Adaptation of the Medical Student Stress Factor Scale into Turkish: Validity and reliability study","volume":"62","author":"Akova \u0130.","year":"2025","unstructured":"Akova \u0130., A\u011faday\u0131 E., Ekici Ko\u015faro\u011flu N., G\u00fcndo\u011fdu G. 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