The aim of this study was to examine whether student characteristics
affect the risk of health conditions, and explore whether the
degree of academic stress affects the level of distress.
We surveyed medical students in the Inner Mongolia Medical College China using
a questionnaire. A logistic regression analysis was used
to ascertain factors associated with distress. The Wilcoxon Mann-Whitney
test was used to determine the relationship between distress and different
academic stress levels. Of the 6044 students completing questionnaires,
47.5% self-reported distressing body symptoms induced by academic stress. Chi
square tests showed statistically significant associations between distress
and gender, academic stress, and residence; feeling academic stress caused a
more than 1.5 times risk of distress. Gender and academic stress were significantly
associated with distress in non-conditional binary logistic regression
models. Compared with male students, female students was more likely to feel
distress. The Wilcoxon Mann-Whitney test also showed that the distress rate
increased with academic stress and a
dose-response relationship between the distress rate and stress level
was found. The present study indicates that it is important to reduce academic
stress and manage it in order that better outcomes be achieved in regard to
distress, especially in females.
Cite this paper
Chen, J. , Wu, Y. , Yi, H. , Li, Z. , Eshita, Y. , Qin, P. , Chen, L. and Sun, J. (2013) The impact of academic stress on medical students attending college in the Inner Mongolia Area of China. Open Journal of Preventive Medicine, 3, 149-154. doi: 10.4236/ojpm.2013.32019.
 Kanter, S.L. (2008) Global health is more important in a smaller world. Academic Medicine, 83, 115-116.
 Christensson, A., Runeson, B., Dickman, P.W. and Vaez, M. (2010) Change in depressive symptoms over higher education and professional establishment—A longitudinal investigation in a national cohort of Swedish nursing students. BMC Public Health, 10, 343.
 Penacoba-Puente, C., Fernandez-de-Las-Penas, C., Gonzalez-Gutierrez, J.L., Miangolarra-Page, J.C. and Pareja, J.A. (2008) Interaction between anxiety, depression, quality of life and clinical parameters in chronic tension-type headache. European Journal of Pain, 12, 886-894.
 Pierceall, E.A. and Keim, M.C. (2007) Stress and coping strategies among community college students. Community College Journal of Research and Practice, 31, 703712. doi:10.1080/10668920600866579
 Brougham, R., Zail, C., Mendoza, C. and Miller, J. (2009) Stress, sex differences, and coping strategies among college students. Current Psychology, 28, 85-97.
 Gibbons, C., Dempster, M. and Moutray, M. (2011) Stress, coping and satisfaction in nursing students. Journal of Advanced Nursing, 67, 621-632.
 Freeburn, M. and Sinclair, M. (2009) Mental health nursing students’ experience of stress: Burdened by a heavy load. Journal of Psychiatric and Mental Health Nursing, 16, 335-342. doi:10.1111/j.1365-2850.2008.01376.x
 Dyrbye, L.N., Thomas, M.R. and Shanafelt, T.D. (2006) Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Academic Medicine, 81, 354-373.
 Dyrbye, L.N., Thomas, M.R., Huschka, M.M., Lawson, K.L., Novotny, P.J., Sloan, J.A. and Shanafelt, T.D. (2006) A multicenter study of burnout, depression, and quality of life in minority and nonminority US medical students. Mayo Clinic Proceedings, 81, 1435-1442.
 Rosal, M.C., Ockene, I.S., Ockene, J.K., Barrett, S.V., Ma, Y. and Hebert, J.R. (1997) A longitudinal study of students’ depression at one medical school. Academic Medicine, 72, 542-546.
 Helmers, K.F., Danoff, D., Steinert, Y., Leyton, M. and Young, S.N. (1997) Stress and depressed mood in medical students, law students, and graduate students at McGill University. Academic Medicine, 72, 708-714.
 Dahlin, M., Joneborg, N. and Runeson, B. (2005) Stress and depression among medical students: A cross-sectional study. Medical Education, 39, 594-604.
 Guthrie, E., Black, D., Bagalkote, H., Shaw, C., Campbell, M. and Creed, F. (1998) Psychological stress and burnout in medical students: A five-year prospective longitudinal study. Journal of the Royal Society of Medicine, 91, 237243.
 Tyssen, R., Vaglum, P., Gronvold, N.T. and Ekeberg, O. (2001) Suicidal ideation among medical students and young physicians: A nationwide and prospective study of prevalence and predictors. Journal of Affective Disorders, 64, 69-79. doi:10.1016/S0165-0327(00)00205-6
 Selye, H. (1985) The nature of stress. The Best of Basal Facts, 7, 3-11.
 Falavigna, A., Teles, A.R., Velho, M.C., Vedana, V.M., Silva, R.C., Mazzocchin, T., Basso, M. and Braga, G.L. (2010) Prevalence and impact of headache in undergraduate students in Southern Brazil. Arquivos de NeuroPsiquiatria, 68, 873-877.
 Jensen, R., Mitsikostas, D.D., Valade, D. and Antonaci, F. (2010) Guidelines for the organization of headache education in Europe: The headache school II. The Journal of Headache and Pain, 11, 161-165.
 Ojini, F.I., Okubadejo, N.U. and Danesi, M.A. (2009) Prevalence and clinical characteristics of headache in medical students of the University of Lagos, Nigeria. Cephalalgia, 29, 472-477.
 Bicakci, S., Over, F., Aslan, K., Bozdemir, N., Saatci, E. and Sarica, Y. (2007) Headache characteristics in senior medical students in Turkey. The Tohoku Journal of Experimental Medicine, 213, 277-282.
 Nash, J.M. and Thebarge, R.W. (2006) Understanding psychological stress, its biological processes, and impact on primary headache. Headache: The Journal of Head and Face Pain, 46, 1377-1386.
 Kubo, M., Fuji-wara, Y., Shiba, M., Kohata, Y., Yamagami, H., Tanigawa, T., Watanabe, K., Watanabe, T., Tominaga, K. and Arakawa, T. (2011) Differences between risk factors among irritable bowel syndrome subtypes in Japanese adults. Neurogastroenterology & Motility, 23, 249254. doi:10.1111/j.1365-2982.2010.01640.x
 Kaynak Key, F.N., Donmez, S. and Tuzun, U. (2004) Epidemiological and clinical characteristics with psychosocial aspects of tension-type headache in Turkish college students. Cephalalgia, 24, 669-674.
 Attia, E. and Walsh, B.T. (2007) Anorexia nervosa. The American Journal of Psychiatry, 164, 1805-1810.
 Isralowitz, R.E. and Hong, O.T. (1990) Singapore youth: The impact of social status on perceptions of adolescent problems. Adolescence, 25, 357-362.
 Bian, J. (2012) Prevalence of and factors associated with various level of body weight among Inner Mongolia medical students in China. Open Journal of Preventive Medicine, 2, 123-130. doi:10.4236/ojpm.2012.22018
 Bian, J., Du, M.L., Liu, Z.Y., Fan, Y.C., Eshita, Y. and Sun, J. (2012) Prevalence of and factors associated with daily smoking among Inner Mongolia medical students in China: A cross-sectional questionnaire survey. Substance Abuse Treatment, Prevention, and Policy, 7, 20.
 Hystad, S.W., Eid, J., Laberg, J.C., Johnsen, B. H. and Bartone, P.T. (2009) Academic stress and health: Exploring the moderating role of personality hardiness. Scandinavian Journal of Educational Research, 53, 421-429.
 Lue, B.H., Chen, H.J., Wang, C.W., Cheng, Y. and Chen, M.C. (2010) Stress, personal characteristics and burnout among first postgraduate year residents: A nationwide study in Taiwan. Medical Teacher, 32, 400-407.
 Segerstrom, S.C. and O’Connor, D.B. (2012) Stress, health and illness: Four challenges for the future. Psychology & Health, 27, 128-140. doi:10.1080/08870446.2012.659516
 Frankenhaeuser, M., Von Wright, M.R., Collins, A., Von Wright, J., Sedvall, G. and Swahn, C.G. (1978) Sex differences in psychoneuroendocrine reactions to examination stress. Psychosomatic Medicine, 40, 334-343.
 Dyson, R. and Renk, K. (2006) Freshmen adaptation to university life: Depressive symptoms, stress, and coping. Journal of Clinical Psychology, 62, 1231-1244.
 Barra-Almagia, E. (2009) Influence of stress and depressed mood on adolescent health: Concurrent and prospective analysis. Universitas Psychologica, 8, 175-182.
 Aasland, O.G., Olff, M., Falkum, E., Schweder, T. and Ursin, H. (1997) Health complaints and job stress in Norwegian physicians: The use of an overlapping questionnaire design. Social Science & Medicine, 45, 16151629. doi:10.1016/S0277-9536(97)00093-2
 Soffer, M. (2010) The role of stress in the relationships between gender and health-promoting behaviours. Scandinavian Journal of Caring Sciences, 24, 572-580.
 Hellhammer, D.H., Stone, A.A., Hellhammer, J. and Broderick, J. (2010) Measuring Stress. Encyclopedia of Behavioral Neuroscience, 2, 186-191.
 Nixona, A.E., Mazzola, J.J., Bauera, J., Kruegerc, J.R. and Spectora, P.E. (2011) Can work make you sick? A meta-analysis of the relationships between job stressors and physical symptoms. Work & Stress, 25, 1-22.
 Saito, K., Hiya, A., Uemura, Y. and Furuta, M. (2008) Clinical training stress and autonomic nervous function in female medical technology students: Analysis of heart rate variability and 1/f fluctuation. The Journal of Medical Investigation, 55, 227-230. doi:10.2152/jmi.55.227
 Janig, W. (2003) Relationship between pain and autonomic phenomena in headache and other pain conditions. Cephalalgia, 23, 43-48.
 Kanter, S.L. (2008) Toward a sound philosophy of premedical education. Academic Medicine, 83, 423-424.