{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T17:05:55Z","timestamp":1794330355106,"version":"4.9.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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":["Journal of Medical Education and Curricular Development"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This cross-sectional study examined whether anxiety and depression symptoms decrease as medical students progress through training (suggesting adjustment disorder) or persist (suggesting chronic conditions), while identifying associated risk factors, including student debt burden and treatment effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We surveyed medical students (years 1-4) at VHS-ODU using a sociodemographic questionnaire and validated screening instruments (GAD-7 for anxiety and PHQ-9 for depression) via RedCap from September to November 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 126 students, Scores were higher in Years 2\u20133 than in Years 1 and 4, but differences by year were not significant (GAD-7 p=0.055; PHQ-9 p=0.352). Students with a prior mental-health diagnosis had higher symptoms (GAD-7 8.09 vs 4.31; PHQ-9 10.18 vs 4.72; p\u22640.001). Among those with a prior diagnosis, scores did not differ by current treatment category (GAD-7, p = 0.900; PHQ-9, p = 0.263). Higher student-loan balances were associated with higher scores (descriptive only; group Ns were unavailable for testing).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Medical schools should prioritize proactive screening and timely access to care, bolster support during clinical training, and address financial stressors; longitudinal studies are needed to test whether such changes reduce symptom burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23821205261449382","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T04:13:11Z","timestamp":1782965591000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and Correlates of Anxiety and Depression Symptoms Among Medical Students: The Role of Student Debt Burden"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0510-1148","authenticated-orcid":false,"given":"Foroozan","family":"Afsharchi","sequence":"first","affiliation":[{"name":"Old Dominion University, Norfolk-Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua F.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Virginia Health Sciences at Old Dominion University, Norfolk-Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7998-7064","authenticated-orcid":false,"given":"Kailash S.","family":"Ram","sequence":"additional","affiliation":[{"name":"Virginia Health Sciences at Old Dominion University, Norfolk-Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingru","family":"Huang","sequence":"additional","affiliation":[{"name":"Virginia Health Sciences at Old Dominion University, Norfolk-Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valicia","family":"Hale","sequence":"additional","affiliation":[{"name":"Virginia Health Sciences at Old Dominion University, Norfolk-Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"El Moudden","sequence":"additional","affiliation":[{"name":"Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk-Virginia, 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