A Study of Stressful Life Events and Pattern of Substance use Among Medical Students: A Cross Sectional Study
Ayisha Rana, Abbas Mehdi*, Vighnesh K. Singh, Aditi Jain and Parul Prasad
June 04, 2025
DOI : 10.56831/PSMPH-06-219
Abstract
Introduction: The medical program is one of the most demanding academic programs in the world, which has a detrimental impact on medical students' mental and physical health. Stress among students jeopardizes their perceptions and leads to maladaptive practices like addiction to substances, self-medication, and absenteeism.
Objective: To correlate stressful life events and patterns of substance use among Indian medical student.
Methods: A cross-sectional randomized study was conducted involving 250 medical students. Participants were given four self-administered scales to assess stressful life events and substance use patterns in them. Statistical analysis was performed using SPSS v29.0 to determine the correlation of stressful life events and patterns of substance use among Indian medical students.
Results: In this study 34.0% of medical students were found to be substance users. Stressful Life Event Scale scores were compared in the substance users (10.79±5.37) and the non-substance users (9.27±5.03), with a statistically significant difference (p < 0.05). A significant positive correlation was observed between substance use and the stressful life event scale score (p=0.031), suggesting that higher stressful life event scores were associated with an increased likelihood of substance use.
Conclusions: This study confirms that high educational stress among medical students is linked with psychological morbidity and substance abuse, highlighting the need for regular mental health screening and targeted interventions in medical schools.
Keywords: Stressful life events; substance use; medical students
References
- Brahmbhatt KR., et al. “Perceived stress and sources of stress among medical undergraduates in a private medical college in Mangalore”. India Int J Biomed Adv Res 4 (2013): 128-36.
- Sani M., et al. “Prevalence of stress among medical students in Jizan University, Kingdom of Saudi Arabia”. Gulf Med J 1 (2012): 19-25.
- Cheng DR., et al. “Stigma and perception of psychological distress and depression in Australian trained medical students: results from an interstate medical school survey”. Psychiatry Res 209 (2013): 684-90.
- Dyrbye LN., et al. “Relationship between burnout and professional conduct and attitudes among US medical students”. J Am Med Assoc 304 (2010): 1173-80.
- Aktekin M., et al. “Anxiety, depression and stressful life events among medical students: a prospective study in Antalya, Turkey”. Med Educ 35.1 (2001): 12-17.
- Edwards M and Zimet C. “Problems and concerns among medical students”. Journal of Medical Education 51 (1975): 619-625.
- Yusoff MSB., et al. “Prevalence and associated factors of stress, anxiety, and depression among prospective medical students”. Asian Journal of Psychiatry 6.2 (2013): 128-133.
- O’Rourke M., et al. “The medical student stress profile: a tool for stress audit in medical training”. Medical Education 44.10 (2010): 1027-1037.
- Machado CS, Moura TM and Almeida RJ. “Estudantes de Medicina e as Drogas: Evidências de um Grave Problema TT - Medical Students and Drugs: Evidences of a Serious Problem”. Rev Bras Educ Med 39 (2015): 159-167.
- Widom CS., et al. “Long-term effects of child abuse and neglect on alcohol use and excessive drinking in middle adulthood”. Journal of Studies on Alcohol and Drugs 68 (2007): 317-326.
- Park CL and Levenson MR. “Drinking to cope among college students: Prevalence, problems, and coping processes”. Journal of Studies on Alcohol and Drugs 63 (2002): 486-497.
- Golekanye Morutwa and Ilse Elisabeth Platner. “Self-control and alcohol consumption among university students in Botswana”. African Journal of Drug &Alcohol Studies 13.2 (2014): 69-78.
- Mangus R, Hawkins C and Miller M. “Tobacco and alcohol use among 1996 medical school graduates”. JAMA 280 (1998): 1192-1193.
- Chew-Graham CA, Rogers A and Yassin N. “I wouldn’t want it on my CV or their records: Medical students’ experiences of help-seeking for mental health problems”. Med Educ 37 (2003): 873-80.
- Singh M., et al. “Prevalence and pattern of nicotine use among college students in northern India”. International Journal of Research and Review 6.3 (2019): 26- 32.
- Mannapur B., et al. “A study of psychological stress in undergraduate medical students at S.N. Medical College, Bagalkot, Karnataka”. J Clin Diagn Res 4 (2010): 2869 74.
- Ponnudurai R., et al. “Alcohol and drug abuse among internees”. Indian J Psychiatry 26 (1996): 128-32.
- Arria AM., et al. “Drug exposure opportunities and use patterns among college students: Results of a longitudinal prospective cohort study”. Subt Abus 29 (2008): 19-38.
- Ayala EE., et al. “Prevalence, perceptions, and consequences of substance use in medical students”. Med Educ Online 22 (2017): 1392824.
- Anuradha R., et al. “Stress and stressors among medical undergraduate students: A cross-sectional study in a private medical college in Tamil Nadu”. Indian J Community Med 42 (2017): 222-5.
- Shah M., et al. “Perceived stress, sources, and severity of stress among medical undergraduates in a Pakistani medical school”. BMC Med Educ 10 (2010): 2.
- Sherina MS, Rampal L and Kaneson N. “Psychological stress among undergraduate medical students”. Med J Malaysia 59 (2004): 207-11.
- Shaikh BT., et al. “Students, stress, and coping strategies: A case of Pakistani medical school”. Educ Health (Abingdon) 17 (2004): 346-53.
- Ko SM, Kua EH and Fones CS. “Stress and the undergraduates”. Singapore Med J 40 (1999): 627-30.
- Mane Abhay B., et al. “Differences in perceived stress and its correlates among students in professional courses”. J Clin Diagn Res 5 Suppl 1 (2011): 1228-33.
- Sreeramareddy CT., et al. “Psychological morbidity, sources of stress, and coping strategies among undergraduate medical students of Nepal”. BMC Med Educ 7 (2007): 26.
- Gebremariam TB, Mruts KB and Neway TK. “Substance use and associated factors among Debre Berhan University students, Central Ethiopia”. Subst Abuse Treat Prev Policy 13 (2018): 13.
- Khafagy M, Gomaa Z and Elwasify M. “Substance use patterns among university students in Egypt”. Middle East Curr Psychiatry 28 (2021): 1-9.
- Ranjbaran M., et al. “Risk factors for addiction potential among college students”. Int J Prev Med 9 (2018): 17.
- Karatay G and Baş NG. “Factors affecting substance use and self-efficacy status of students in eastern Turkey”. Cien Saude Colet 24 (2019): 1317-26.
- Welsh JW, Shentu Y and Sarvey DB. “Substance use among college students”. Focus (Am Psychiatr Publ) 17 (2019): 117-27.
- Saxena SK., et al. “Association of educational stress with depression, anxiety, and substance use among medical and engineering undergraduates in India”. Ind Psychiatry J 28.2 (2019): 160-169.