Abstract
Stress is highly prevalent among medical students due to academic demands, clinical responsibilities, and psychosocial factors. Persistent stress has been linked to impaired cognitive performance and long-term neuropsychological consequences. However, objective assessment of cognition in relation to stress among medical undergraduates remains limited. Stress was assessed using MSSQ-40 which evaluates six stressor domains, and categorized as mild, moderate, high, and severe. For correlation analysis, 125 students were recruited and subjected to cognitive assessment using auditory P300 event-related potentials recorded at the Cz electrode placement. The overall prevalence of stress (high + severe categories) was 53.37%. Academic-related stressors (72.8%) and teaching-learning related stressors (69.0%) were the most predominant domains. Statically significant differences in mean stress scores across phases were observed for academic related, teaching learning, Social related and group activities related stressor (p <0.05). P300 latency showed a significant positive correlation with academic related (r=0.28, p=0.04), teaching learning (r=0.31, p=0.02), Drive related (r=0.527, p<0.001), and group activities related stressor (r=0.39, p<0.001). More than half of the medical students experienced significant stress, predominantly academic related factors. Higher stress levels were associated with prolonged P300 latency, suggesting stress-related cognitive slowing. Early identification and targeted interventions may help improve both mental well-being and cognitive performance among medical undergraduates.
References
- Melaku L, Mossie A, Negash A. Stress among medical students and its association with substance use and academic performance. J Biomed Educ. 2015;2015:149509.
- Panchu P, Bahuleyan B, Vijayan V. An analysis of the factors leading to stress in Indian medical students. Int J Clin Exp Physiol. 2017;4:48–50.
- Esch T, Stefano GB, Fricchione GL, Benson H. The role of stress in neurodegenerative diseases and mental disorders. Neuro Endocrinol Lett. 2002;23(3):199–208.
- Gupta S, Choudhury S, Das M, Mondol A, Pradhan R. Factors causing stress among students of a medical college in Kolkata, India. Educ Health (Abingdon). 2015;28:92–95.
- Sarkar S, Gupta R, Menon V. A systematic review of depression, anxiety, and stress among medical students in India. J Ment Health Hum Behav. 2017;22:88–96.
- Kumar SG, Kattimani S, Sarkar S, Kar S. Prevalence of depression and its relation to stress level among medical students in Puducherry, India. Ind Psychiatry J. 2017;26(1):86.
- Nandi M, Sarkar S, Mondal R, Ghosal M, Hazra A. Stress and its risk factors in medical students: An observational study from a medical college in India. Indian J Med Sci. 2012;66(1):1.
- Johansson L, Guo X, Waern M, Ostling S, Gustafson D, Bengtsson C, et al. Midlife psychological stress and risk of dementia: A 35-year longitudinal population study. Brain. 2010;133(Pt 8):2217–2224.
- Pradhan G, Mendinca NL, Kar M. Evaluation of examination stress and its effect on cognitive function among first-year medical students. J Clin Diagn Res. 2014;8(8):BC05–BC07.
- Nabe-Nielsen K, Rod NH, Hansen ÅM, Prescott E, Grynderup MB, Islamoska S, et al. Perceived stress and dementia: Results from the Copenhagen City Heart Study. Aging Ment Health. 2020;24(11):1828–1836.
- Pickering TG. Mental stress as a causal factor in the development of hypertension and cardiovascular disease. Curr Hypertens Rep. 2001;3(3):249–254.
- Yuen EY, Wei J, Liu W, Zhong P, Li X, Yan Z. Repeated stress causes cognitive impairment by suppressing glutamate receptor expression and function in prefrontal cortex. Neuron. 2012;73(5):962–977.
- Anderer P, Saletu B, Gruber D, Linzmayer L, Semlitsch HV, Saletu-Zyhlarz G, et al. Age-related cognitive decline in the menopause: Effects of hormone replacement therapy on cognitive event-related potentials. Maturitas. 2005;51(3):254–269.
- Himani A, Tandon OP, Bhatia MS. A study of P300 event-related evoked potential in patients with major depression. Indian J Physiol Pharmacol. 1999;43(3):367–372.
- Shah SMA, Mohammad D, Qureshi MFH, Abbas MZ, Aleem S. Prevalence, psychological responses and associated correlates of depression, anxiety and stress in a global population during the COVID-19 pandemic. Community Ment Health J. 2021;57(1):101–110.
- von Keyserlingk L, Yamaguchi-Pedroza K, Arum R, Eccles JS. Stress of university students before and after campus closure in response to COVID-19. J Community Psychol. 2022;50(1):285–301.
- Halliburton AE, Hill MB, Dawson BL, Hightower JM, Rueden H. Increased stress, declining mental health: Emerging adults’ experiences in college during COVID-19. Emerg Adulthood. 2021;9(5):433–448.
- Punita P, Saranya K, Kumar SS. Effect of gender on six domains of stress in medical students. Int J Curr Res. 2016;8.
- Ghosal K, Behera A. Study on prevalence of stress in medical students. J Res Med Dent Sci. 2018;6(5):182–186.
- Lupien SJ, Maheu F, Tu M, Fiocco A, Schramek TE. The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition. Brain Cogn. 2007;65(3):209–237.
- Pandey SK, Sharma V. Sudden and early death among medical professionals: How to reverse this trend? Indian J Ophthalmol. 2023;71(5):2286–2287.
- Chahal S, Nadda A, Govil N, Gupta N, Nadda D, Goel K, et al. Suicide deaths among medical students, residents and physicians in India spanning a decade (2010–2019): An exploratory study using online news portals and Google database. Int J Soc Psychiatry. 2022;68(4):718–728.