First-year French medical students consume antidepressants and anxiolytics while second-years consume non-medical drugs (2020)

Background: First year exams are a major source of stress amongst first-year medical students.
Objective: To explore antidepressant and anxiolytic consumption and addictive behavior of medical students before and after exams.
Methods: Medical students of the 35 French medical schools were recruited through mailing lists and social networks between December 2016 and May 2017 and completed online Internet anonymized questionnaires.
Results: Overall, 4345 medical students were included (3051 first year vs. 1294 second year). In multivariate analyses, compared to those in the first year of medicine, second year students were found to have lower anxiolytic (adjusted odd ratio (aOR)=0.56, p = 0.01) and antidepressant consumption (aOR=0.21, p<0.0001) but higher psychiatric follow-up (aOR=1.95, p<0.0001) after adjustment for age, gender and relationship status. Whilst second year students reported slightly higher quality of life (especially for mental health), they also reported more daily tobacco smoking (aOR=1.78, p<0.0001), more cannabis use disorders (aOR=2.37, p<0.0001), hazardous drinking (aOR=3.61, p<0.0001), and alcohol dependence (aOR=3.66, p<0.0001). Second year medical students reported fewer difficulties relating to studying in comparison to first year students (aOR=0.60, p<0.0001) yet they reported a higher rate of recreational drugs use with a variety of reasons including self-treatment of anxiety; disinhibition and to copy their peers (all p<0.05). Limits : These results should be confirmed by longitudinal studies.
Conclusion: First year medical students who are faced with challenges relating to studying consume more antidepressants and anxiolytics, whilst second year students have a higher consumption of recreational drugs for a range of reasons. This suggests that the first two years at medical school are an important contributor to adverse mental health and therefore present a window of opportunity for preventative intervention.
Highlights:
We found that first year consumed more anxiolytic and antidepressant.
Second year were more frequently followed-up by psychiatrist, smoked more tobacco and cannabis and drank more alcohol.
Second year medical students reported to have lower study difficulties.
They also reported to seek more disinhibition and alleviating anxiety, to seek to stimulate and sedate themselves and to follow group.
The two first years of medical studies are crucial to prevent later mental health issues.