Background
The well-being of medical students has become a growing concern, with numerous studies highlighting the prevalence of mental health issues such as depression, anxiety, and burnout. On the other hand, many studies have been carried out on substance use by medical students given the significance of the issue. It is in this same line that studies investigating the correlation between mental health and substance use among medical students have been carried out. However, studies exploring the chronological relationship between these two parameters are missing.
Methods
We conducted a cross-sectional study involving a sample of medical students from the University of Lausanne. Participants were asked to complete a detailed questionnaire covering various aspects of their mental health and substance use. The tools used for data collection included the Centre for Epidemiological Studies-Depression (CES-D) scale for depression, the State-Trait Anxiety Inventory (STAI) for anxiety, and the Maslach Burnout Inventory-Student Survey (MBI-SS) for burnout. Substance use, such as alcohol and cannabis were assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) while the Cohort Study on Substance Use Risk Factors questionnaire was used for neuroenhancement drugs and non-medical use of prescription drugs. The data were analyzed using Stata Statistical Software, with a focus on identifying significant correlations between the variables.
Results
Cross-sectional associations were mostly significant at T1, except for the anxiety/cannabis and burnout/neuroenhancement drugs models. At T2, cross-sectional paths were non-significant except for two ASSIST models, the ones with depression and anxiety. At T3, cross-sectional pathways were significant for all ASSIST and non-medical use of prescription drugs models, as well as for the depression/alcohol model. When it comes to cross-lagged paths, the effects were smaller, and two distinct patterns emerge:
1. For ASSIST total score and cannabis use, there were significant links from substance use to subsequent mental health parameters.
2. For alcohol, neuroenhancement drugs, and non-medical use of prescription drugs, there were significant links from mental health parameters to subsequent substance use measures.
Conclusion
This study underscores the urgent need for early interventions and robust support systems to help medical students manage stress and mental health issues without resorting to substance use. Future research should explore these relationships in a wider range of contexts to validate our findings. Additionally, more longitudinal studies are needed to establish causal links between the observed variables. Finally, further studies are required to evaluate the effectiveness of specific interventions in addressing the identified issues and to ensure that students' needs are satisfied.