Social anxiety symptoms and body image dissatisfaction in medical students: prevalence and correlates

ABSTRACT Objective Social anxiety disorder (SAD) and body image dissatisfaction (BID) are common problems among college students, but few studies focused on medical students. We aimed to estimate the prevalence, severity and correlates of SAD symptoms and BID among medical students of a Brazilian public university. Methods A cross-sectional study with 479 students, using structured instruments: Social Phobia Inventory (SPIN), Body Shape Questionnaire (BSQ), and Beck Depression Inventory (BDI). Bivariate analyses were followed by logistic regression models to obtain independent predictors of SAD symptoms, BID and both outcomes combined. Results Most students were single (99%) and female (58.7%). The prevalence rates of SAD symptoms (SPIN ≥ 19) and BID (BSQ ≥ 81) were 36.3% and 34.7%, respectively. Depressive symptoms (BDI ≥ 19) occurred in 8.8% of the sample. SAD symptoms were independently associated with: BID, thoughts of abandoning the course, difficulty making friends, depressive symptoms, and mental health treatment prior to university. Besides SAD symptoms, BID was associated with female sex, difficulty making friends, depressive symptoms, and body mass index (BMI). Seventy-eight students (16.3%) presented SAD symptoms and BID, which was associated with female sex, difficulty making friends, dissatisfaction with the course, depressive symptoms and BMI. Conclusion SAD symptoms and BID are common and related problems that should be screened for among medical students. The identification of specific correlates could contribute to the elaboration of preventive measures, minimizing the distress and negative impact of these mental health problems on relationships and academic performance.

摘要
目的 社交焦虑障碍（Social Anxiety Disorder, SAD）与身体意象不满（Body Image Dissatisfaction, BID）在大学生群体中较为常见，但针对医学生的相关研究较为匮乏。本研究旨在评估某巴西公立大学医学生的社交焦虑症状、身体意象不满的患病率、严重程度及其相关影响因素。
方法 本研究为横断面研究，共纳入479名医学生，采用标准化测评工具：社交恐怖症量表（Social Phobia Inventory, SPIN）、身体形态问卷（Body Shape Questionnaire, BSQ）以及贝克抑郁量表（Beck Depression Inventory, BDI）。先开展双变量分析，随后通过逻辑回归模型分析社交焦虑症状、身体意象不满及二者共病的独立预测因素。
结果 本次研究对象中，绝大多数为单身（99%），女性占比58.7%。社交焦虑症状（社交恐怖症量表得分≥19）与身体意象不满（身体形态问卷得分≥81）的患病率分别为36.3%和34.7%。样本中8.8%的个体存在抑郁症状（贝克抑郁量表得分≥19）。社交焦虑症状独立相关的因素包括：身体意象不满、退学念头、交友困难、抑郁症状以及入学前的精神卫生治疗史。除社交焦虑症状外，身体意象不满还与女性性别、交友困难、抑郁症状以及体重指数（Body Mass Index, BMI）相关。共有78名学生（16.3%）同时存在社交焦虑症状与身体意象不满，该共病情况与女性性别、交友困难、专业不满、抑郁症状及体重指数相关。
结论 社交焦虑障碍症状与身体意象不满是医学生群体中常见且相关的心理问题，应将其纳入医学生的常规筛查范畴。明确其特定相关因素有助于制定针对性预防措施，以减轻此类精神健康问题对人际关系与学业表现造成的困扰与负面影响。