Venus and Mars on the benches of the faculty: Influence of gender on mental health and behavior of medical students. Results from the BOURBON national study (2018)

Medical student wellness has emerged as an important issue in medical education.
Objective: To evaluate the gender influence on psychiatric and/or psychological follow-up, psychotropic and illicit drug consumption, addictive behaviors, quality of life and motives for consumption in a large multicentric national sample of medical students.
Methods: Medical students of the 35 French Medicine faculties were recruited through mailing lists and social networks between December 2016 and May 2017 and fulfilled Internet anonymized questionnaires.
Results: Overall, 10,985 medical students were included in the present study (mean age 21.8 years, 9640 (87.8%) women). Compared to men, women were found to smoke tobacco and cannabis less frequently (aOR = 0.8 [0.7-0.9], p < 0.0001 and aOR = 0.3 [0.3-0.4], p < 0.0001 respectively), to have lower rate of alcohol use disorders (aOR = 0.7 [0.6-0.7], p < 0.0001). Men were also found to consume more frequently ecstasy, cocaine, mushrooms, amphetamine, LSD, codeine and ketamine (all p < 0.0001) for pleasure and novelty seeking, group effect, but also alleviating anxiety, sedative and stimulant effect and stress before exam (all p < 0.001) while women were more frequently followed-up by a psychiatrist and/or a psychologist (aOR = 2.0 [1.7-2.3],p < 0.0001), consumed more frequently anxiolytics (aOR = 1.6[1.3-1.9], p < 0.0001) and antidepressants (aOR = 1.4[1.1-1.9], p = 0.01), reported lower rates of physical and mental quality of life in all subscores (all p < 0.0001). They were more frequently exposed to sexual assault (aOR = 4.1 [2.5-6.9], p < 0.0001) and domestic violence (aOR = 1.6[1.1-2.5], p = 0.02) while men were more frequently exposed to physical assault (aOR = 0.4[0.4-0.5], p < 0.0001) during their medical studies.
Conclusions: Medical students are mostly women. While men and women are both exposed to professional and personal stress with differences, men are more frequently involved in addictive behavior and psychoactive substance consumption while women are mostly followed-up by psychiatrist and/or psychologist and psychotropic drug consumers, with more impaired self-reported mental and physical quality of life scores. These results should orientate future health strategies for the prevention of later mental illness onset and stress at work in hospital.
Highlights:
A national sample of 10,985 undergraduated and postgraduated medical students were included in the present study.
Compared to men, women were found to smoke tobacco and cannabis less frequently, to have lower rate of alcohol use disorders.
Men were also found to consume more frequently illicit drugs for pleasure and novelty seeking, group effect, but also alleviating anxiety, sedative and stimulant effect and stress before exam.
Women were more frequently followed-up by a psychiatrist and/or a psychologist, consumed more frequently anxiolytics and antidepressants, reported lower rates of physical and mental quality of life in all subscores.
Women were more frequently exposed to sexual assault and domestic violence while men were more frequently exposed to physical assault during their medical studies.