Test anxiety among German medical students and its impact on lifestyle and substance abuse

Dear Sir

Test anxiety (TA) is an underestimated and widespread problem among students (Neuderth et al. 2009). Like other anxiety disorders, untreated TA can lead to chronicity and aggravation of the symptoms. Also, it has been shown that TA becomes more severe in the course of the studies. Teaching medical students in their first semesters, we recently initiated a program which enables affected students to face their TA problem early (Tektas & Paulsen 2012). However, detailed data about the prevalence of TA among German medical students is lacking so far. For this purpose we performed an anonymous-questionnaire based cross-sectional examination among medical students of our faculty. We evaluated the frequency of self-reported TA and whether and how far self-reported TA is affecting study performance and alcohol, nicotine as well as drug consumption/abuse among medical students, as especially those have detailed knowledge of negative consequences and the range of drugs requiring prescription.

About 909 students in their first to fifth year of education participated in the study. 29.9% of the students answered that they believe they would suffer from TA. Applying a screening method, we were able to detect only these students who are seriously and objectively affected by TA. This method included the consideration of typical symptoms which could be indicated by the participating students. With this classification, it could be shown that approximately 10% of the students are affected by TA, which is similar to the results of other studies considering students of other disciplines. We could show that students affected by TA are older and significantly less successful in their first state exams when compared to students of the control group. Also, they show a different substance consumption/abuse behaviour as they are smoking tobacco much more often and also consume distinctly more often drugs requiring prescription (beta-blockers, benzodiazepines and methylphenidate) and stimulating drugs (amphetamines, cocaine), but less cannabis and alcohol when compared to students not affected by TA. Regarding the lecturer's attitude and awareness towards students affected from TA, more than 50% of the students in the first and second year and 70% of the students in the thired to fifth year stated that the lecturers are not considerate of students with obvious TA. Our results show that distinctly more efforts have to be made to offer special programs which enable affected students to face the problem as TA can lead to several negative long-term consequences among students.