While the BDI is a valid measure of depression, the fact that not all students/subjects participated at each of the assessments begs the question of how conclusive is the data? A true baseline could not be established to determine the absolute effects of medical school “stress” on the amount of dysphoria experienced by the subjects. The researchers did not address the comparison of dysphoria experienced by these medical students to medical students in other areas of the world, nor did they compare results from other studies to determine whether medical school is more or less stressful than, for example, law school Therefore it is difficult to generalize the findings of the study to the general population or to future medical school students.
Chan (1991), conducted a study designed to determine the incidence of depression in Chinese medical students in Hong Kong. This study specifically aimed to identify the common depressive symptoms as assessed by the BDI, to examine the association between depression, obsessionality, and assertiveness in medical students, and compare the BDI scores of medical and non-medical students along with assessing for any gender differences on depressive symptoms.
Three-hundred-thirty-five first to fourth year medical students (239 males, 96 females) and 213 first to fourth year non-medical undergraduate students (51 males, 162 females) participated in the study. All students were between the ages of 18-29. Results showed that the BDI score distribution did not differ significantly between the two groups of students, although a greater percentage of non-medical students scored in the severe range. Since gender distribution was significantly different (p < .001) with male students predominating in the medial sample and female students in the non-medical sample, comparisons were made between medical and non-medical students within each gender. There were no significant differences in BDI score distribution, distribution of student severity categories and mean BDI scores separately for male and female students. In comparison to American medical students, a comparable and possibly larger percentage of Chinese medical students scored in the depressed range as reported by Zoccolillo, et al (1986) and Clark and Zeldow (1988), although elevated scores were not specific to Chinese medical students, as Chinese undergraduates in general reported equally elevated scores. The only difference in mean BDI was the significantly higher scores of female medical students than from female non-medical students in the severely depressed category. Therefore, the findings indicate that Chinese medical students are no more vulnerable to depressed mood than Chinese non-medical students. There was some evidence that obsessionality and non-assertiveness were associated with depressed mood among medical students to a greater degree than in the non-medical students. The findings in this study were consistent with other studies that have indicated that females in general suffer from depression to a significant degree more than males. (Russo et al, 1985; Vitaliano, 1989; Miao, 1977)
