Why and when anxiety and depression occur in medical students: a qualitative study based on cognitive behavioral therapy

This study sought to understand anxiety and depression factors in medical students; to identify the moment and mechanism of symptoms’onset; to recognize cognitive distortions among medical students displaying symptoms; and to reveal treatment and prevention efforts. The author conducted a qualitative field research with an individualized cross-sectional observational design through semi-structured interviews. The participants were 12 male and female medical students from different semesters at the Pontifical Catholic University of Paraná School of Medicine, Brazil, over March and April 2019. The analysis of qualitative data was in light of Cognitive Behavioral Therapy. It identified that medical students’ schemas of thoughts, emotions, and behaviors influence their manifesting symptoms of anxiety and depression. This effect is due to the convergence of biological (temperament), environmental (characteristics of life at university), psychological (cognitive distortions), and personal factors (lack of coping strategies). The clinical manifestation of anxiety and depression lies in the impact suffered in the face of initial difficulties in taking the course. That implies considerable variation between medical students’ self-image before and after starting university, giving grounds for maladaptive beliefs. Cognitive Behavioral Therapy helps prevent and treat symptoms, but the results also suggest the need for system-level changes to mitigate the problem.