How to stay mentally healthy during medical education. Stress coping and relaxation behaviour of female and male students

Dear Sir

Due to study reforms in Germany students complain about an increase of pressure and responsibility in view of the permanent competition and intensified workload (Hensen 2011). To deal with study pressure and workload, there is a strong need for students to renew their subjective energy levels (Netterstrom & Bech 2011). This study investigated the practice of relaxation activities to cope with daily hassles among German students and gender differences. A cross-sectional study design was performed in Germany during 10/2010–05/2011. We analysed students of different fields of study and different semesters/academic stages. Students were asked to fill out an anonymous online questionnaire about their personal use of different stimulants and relaxation habits. A total of 1513 surveys were analysed (773 women/740 men).

The most common relaxation activities were meeting friends (86% of the participating students reported doing so) and sleeping (83%). Students also try to eat healthy food (81%) and go for a walk more often than usual (74%). More harmful health activities were also mentioned, such as drinking alcohol (55%), smoking cigarettes (21%), watching TV (77%) and having additional cups of coffee (39%) were reported. Taking drugs to relax were reported relatively rare: taking ecstasy (0.5%), taking cocaine, heroine (0.7%) and taking performance enhancing substances e.g. amphetamine 1.2%. Eight per cent of the students mentioned the use of cannabis and marijuana. Sedatives and tranquillizers are taken by 4.5% of the participating students.

Gender differences in relaxation activities are: male students smoking cigarettes, taking cannabis and/or marijuana significantly more often than female students (p < 0.05). Drinking alcohol was also mentioned significantly more often by male students than by female students (p < 0.05). In contrast, female students try to relax more often by doing exercises, yoga, spa wellness or walking. In addition, female students try to relax more by cooking something special, eating healthy food and by sleeping more than usual.

There was no significant difference between male and female students with regard to the following activities: meeting friends, watching TV, taking ecstasy, cocaine, sedatives, cognitive enhancing substances (e.g. amphetamine) or uppers (e.g. caffeine).

Interventions aiming to decrease unhealthy substance abuse in this area should be implemented in a higher extent during study time. Our results may help health providers to identify more effectively the population of students at high risk for illness related to unfavourable stress coping behaviour. In addition, based on our findings prevention programmes and effective interventions can be developed.