The purpose of another study conducted by Clark and Zeldow (1988) was to determine the adverse effects of the medical education on physicians-in-training, by describing the vicissitudes, unpredictable changes in life, on depressed mood during four years of medical school. More specifically, the researchers questioned: What is the incidence of suicidal ideation? Does depressed mood vary as a function of gender? Are there markers (e.g. personality traits, family history) that predict vulnerability to depressed mood at the outset of medical school? What is the relationship between depressed mood and participation in psychotherapy? Does depressed mood diminish academic performance?
The Beck Depression Inventory (BDI) was used (N=121) as the main indicator of depression/dysphoria. Results indicated that dysphoria was lowest at initial assessment (4%), but never less than 12% thereafter during the first three years. In contrast, 25% of the class was dysphoric at the end of the second year. The results indicated that there were no significant gender differences within any assessment. However, in the fourth year, the mean neuroticism score (an abbreviated, six item adaptation taken from the neuroticism scale of the Eysenck personality Inventory, Eysenck,1964) for males suddenly dropped. When severe depression was evaluated (BDI >21), the relationship between severe dysphoria and the act of quitting medical school was significant. The highest rate of positive response to the suicide item (N=95) was manifest at the end of the second year when 3 students yielded a score of 2 (“I would like to kill myself”). In terms of personality, men who described themselves as relatively independent, active, and competitive were less vulnerable to depressive symptoms. Women who described themselves as relatively aggressive, worldly, or not easily hurt were also less vulnerable to depressive symptoms. Familial history of depression, substance abuse, and academic performance was not found to have a significant correlation to depression. However, there was a significant association between greater dysphoria and use of psychotherapy during the first two years.
