Prevalence, characteristics and measurement of somatic symptoms related to mental health in medical students: a scoping review

References

• Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1–17. doi: 10.1001/archinternmed.2012.3199.
   Google Scholar
• Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976.
   PubMed Web of Science ®Google Scholar
• Mohanty A, Kabi A, Mohanty A. Health problems in healthcare workers: a review. J Family Med Prim Care. 2019;8(8):2568–2572. doi: 10.4103/jfmpc.jfmpc_431_19.
   PubMedGoogle Scholar
• Bryant-Genevier J, Rao CY, Lopes-Cardozo B, et al. Symptoms of depression, anxiety, Post-Traumatic stress disorder, and suicidal ideation among state, tribal, local, and territorial public health workers during the COVID-19 pandemic – United States, March–April 2021. MMWR Morb Mortal Wkly Rep. 2021;70(26):947–952. doi: 10.15585/mmwr.mm7026e1.
   PubMed Web of Science ®Google Scholar
• Windover AK, Martinez K, Mercer MB, et al. Correlates and outcomes of physician burnout within a large academic medical center. JAMA Intern Med. 2018;178(6):856–858. doi: 10.1001/jamainternmed.2018.0019.
   PubMed Web of Science ®Google Scholar
• De Cordova PB, Johansen ML, Grafova IB, et al. Burnout and intent to leave during COVID-19: a cross-sectional study of New Jersey hospital nurses. J Nurs Manag. 2022;30(6):1913–1921. doi: 10.1111/jonm.13647.
   PubMed Web of Science ®Google Scholar
• Rotenstein LS, Brown R, Sinsky C, et al. The association of work overload with burnout and intent to leave the job across the healthcare workforce during COVID-19. J Gen Intern Med. 2023;38(8):1920–1927. doi: 10.1007/s11606-023-08153-z.
   PubMed Web of Science ®Google Scholar
• Fochsen G, Josephson M, Hagberg M, et al. Predictors of leaving nursing care: a longitudinal study among Swedish nursing personnel. Occup Environ Med. 2006;63(3):198–201. doi: 10.1136/oem.2005.021956.
   PubMed Web of Science ®Google Scholar
• Nixon AE, Mazzola JJ, Bauer J, et al. Can work make you sick? A meta-analysis of the relationships between job stressors and physical symptoms. Work Stress. 2011;25(1):1–22. doi: 10.1080/02678373.2011.569175.
   Web of Science ®Google Scholar
• Ader R, Cohen N. Behaviorally conditioned immunosuppression. Psychosom Med. 1975;37(4):333–340. doi: 10.1097/00006842-197507000-00007.
   PubMed Web of Science ®Google Scholar
• Barsky AJ, Borus JE. Somatization and medicalization in the era of managed care. JAMA. 1995;274(24):1931–1934. doi: 10.1001/jama.1995.03530240041038.
   PubMed Web of Science ®Google Scholar
• Barsky AJ, Orav EJ, Bates DW. Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch Gen Psychiatry. 2005;62(8):903–910. doi: 10.1001/archpsyc.62.8.903.
   PubMed Web of Science ®Google Scholar
• Ader R. Psychoneuroimmunology. Curr Dir Psychol Sci. 2001;10(3):94–98. doi: 10.1111/1467-8721.00124.
   Web of Science ®Google Scholar
• Dantzer R. Somatization: a psychoneuroimmune perspective. Psychoneuroendocrinology. 2005;30(10):947–952. doi: 10.1016/j.psyneuen.2005.03.011.
   PubMed Web of Science ®Google Scholar
• Novack DH, Cameron O, Epel E, et al. Mental health-related somatic medicine: the scientific foundation of the biopsychosocial model. Acad Psychiatry. 2007;31(5):388–401. doi: 10.1176/appi.ap.31.5.388.
   PubMed Web of Science ®Google Scholar
• Taylor SE. Health psychology. 10th ed. New York, New York: McGraw-Hill Education; 2018.
   Google Scholar
• Berger M, Sarnyai Z. “More than skin deep”: stress neurobiology and mental health consequences of racial discrimination. Stress. 2015;18(1):1–10. doi: 10.3109/10253890.2014.989204.
   PubMed Web of Science ®Google Scholar
• Paradies Y. A systematic review of empirical research on self-reported racism and health. Int J Epidemiol. 2006;35(4):888–901. doi: 10.1093/ije/dyl056.
   PubMed Web of Science ®Google Scholar
• Mazurkiewicz R, Korenstein D, Fallar R, et al. The prevalence and correlations of medical student burnout in the pre-clinical years: a cross-sectional study. Psychol Health Med. 2012;17(2):188–195. doi: 10.1080/13548506.2011.597770.
   PubMed Web of Science ®Google Scholar
• Dyrbye LN, West CP, Satele D, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89(3):443–451. doi: 10.1097/ACM.0000000000000134.
   PubMed Web of Science ®Google Scholar
• Yaghmour NA, Brigham TP, Richter T, et al. Causes of death of residents in ACGME-accredited programs 2000 through 2014: implications for the learning environment. Acad Med. 2017;92(7):976–983. doi: 10.1097/ACM.0000000000001736.
   PubMed Web of Science ®Google Scholar
• Goebert D, Thompson D, Takeshita J, et al. Depressive symptoms in medical students and residents: a multischool study. Acad Med. 2009;84(2):236–241. doi: 10.1097/ACM.0b013e31819391bb.
   PubMed Web of Science ®Google Scholar
• Gold JA, Johnson B, Leydon G, et al. Mental health self-care in medical students: a comprehensive look at help-seeking. Acad Psychiatry. 2015;39(1):37–46. doi: 10.1007/s40596-014-0202-z.
   PubMed Web of Science ®Google Scholar
• Gottlieb M, Chung A, Battaglioli N, et al. Impostor syndrome among physicians and physicians in training: a scoping review. Med Educ. 2020;54(2):116–124. doi: 10.1111/medu.13956.
   PubMed Web of Science ®Google Scholar
• Zheng Y X, Jiao JR, Hao WN. Stress levels of nursing students: a systematic review and meta-analysis. Medicine. 2022;101(36):e30547. doi: 10.1097/MD.0000000000030547.
   PubMed Web of Science ®Google Scholar
• Ríos-Risquez MI, García-Izquierdo M, Sabuco-Tebar E de los A, et al. An exploratory study of the relationship between resilience, academic burnout and psychological health in nursing students. Contemp Nurse. 2016;52(4):430–439. doi: 10.1080/10376178.2016.1213648.
   PubMed Web of Science ®Google Scholar
• Basudan S, Binanzan N, Alhassan A. Depression, anxiety and stress in dental students. Int J Med Educ. 2017;8:179–186. doi: 10.5116/ijme.5910.b961.
   PubMed Web of Science ®Google Scholar
• Almhdawi KA, Kanaan SF, Khader Y, et al. Study-related mental health symptoms and their correlates among allied health professions students. Work. 2018;61(3):391–401. doi: 10.3233/WOR-182815.
   PubMedGoogle Scholar
• Gallas S, Knaz H, Methnani J, et al. Prevalence and risk factors of functional gastrointestinal disorders in early period medical students: a pilot study in Tunisia. Libyan J Med. 2022;17(1):2082029. doi: 10.1080/19932820.2022.2082029.
   PubMed Web of Science ®Google Scholar
• Tan YM, Goh KL, Muhidayah R, et al. Prevalence of irritable bowel syndrome in young adult malaysians: a survey among medical students. J Gastroenterol Hepatol. 2003;18(12):1412–1416. doi: 10.1046/j.1440-1746.2003.03212.x.
   PubMed Web of Science ®Google Scholar
• Gorter R, Freeman R, Hammen S, et al. Psychological stress and health in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools. Eur J Dent Educ. 2008;12(2):61–68. doi: 10.1111/j.1600-0579.2008.00468.x.
   PubMed Web of Science ®Google Scholar
• Algarni AD, Al-Saran Y, Al-Moawi A, et al. The prevalence of and factors associated with neck, shoulder, and low-back pains among medical students at university hospitals in Central Saudi Arabia. Pain Res Treat. 2017;2017:1235706. doi: 10.1155/2017/1235706.
   PubMed Web of Science ®Google Scholar
• Alshagga MA, Nimer AR, Yan LP, et al. Prevalence and factors associated with neck, shoulder and low back pains among medical students in a Malaysian medical college. BMC Res Notes. 2013;6(1):244. doi: 10.1186/1756-0500-6-244.
   PubMedGoogle Scholar
• Behera P, Majumdar A, Revadi G, et al. Neck pain among undergraduate medical students in a premier institute of Central India: a cross-sectional study of prevalence and associated factors. J Family Med Prim Care. 2020;9(7):3574–3581. doi: 10.4103/jfmpc.jfmpc_206_20.
   PubMedGoogle Scholar
• Dighriri Y, Akkur M, Alharbi S, et al. Prevalence and associated factors of neck, shoulder, and low-back pains among medical students at Jazan university, Saudi Arabia: a cross-sectional study. J Family Med Prim Care. 2019;8(12):3826–3831. doi: 10.4103/jfmpc.jfmpc_721_19.
   PubMedGoogle Scholar
• Smith DR, Wei N, Ishitake T, et al. Musculoskeletal disorders among Chinese medical students. Kurume Med J. 2005;52(4):139–146. doi: 10.2739/kurumemedj.52.139.
   PubMedGoogle Scholar
• Feussner O, Rehnisch C, Rabkow N, et al. Somatization symptoms—prevalence and risk, stress and resilience factors among medical and dental students at a mid-sized German university. PeerJ. 2022;10:e13803. doi: 10.7717/peerj.13803.
   PubMed Web of Science ®Google Scholar
• Glaser R, Kiecolt-Glaser JK, Bonneau RH, et al. Mental health-related modulation of the immune response to recombinant hepatitis B vaccine. Psychosom Med. 1992;54(1):22–29. doi: 10.1097/00006842-199201000-00005.
   PubMed Web of Science ®Google Scholar
• Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–473. doi: 10.7326/M18-0850.
   PubMed Web of Science ®Google Scholar
• Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. doi: 10.1080/1364557032000119616.
   Google Scholar
• Tausk F, Elenkov I, Moynihan JJ. Psychoneuroimmunology. Dermatol Ther. 2008;21(1):22–31. doi: 10.1111/j.1529-8019.2008.00166.x.
   PubMed Web of Science ®Google Scholar
• Diebig M, Li J, Forthmann B, et al. A three-wave longitudinal study on the relation between commuting strain and somatic symptoms in university students: exploring the role of learning-family conflicts. BMC Psychol. 2021;9(1):199. doi: 10.1186/s40359-021-00702-7.
   PubMedGoogle Scholar
• Oró P, Esquerda M, Mas B, et al. Effectiveness of a mindfulness-based programme on perceived stress, psychopathological symptomatology and burnout in medical students. Mindfulness (N Y). 2021;12(5):1138–1147. doi: 10.1007/s12671-020-01582-5.
   PubMed Web of Science ®Google Scholar
• Scheuch K, Pietuschka WD, Hentschel E, et al. Physiological and psychological response to a three-month mental strain period in students. Acti Nerv Super. 1988;30(3):169–173.
   PubMedGoogle Scholar
• Tang W, Kang Y, Xu J, et al. Associations of suicidality with adverse life events, psychological distress and somatic complaints in a chinese medical student sample. Community Ment Health J. 2020;56(4):635–644. doi: 10.1007/s10597-019-00523-4.
   PubMed Web of Science ®Google Scholar
• Vitaliano PP, Maiuro RD, Russo J, et al. A biopsychosocial model of medical student distress. J Behav Med. 1988;11(4):311–331. doi: 10.1007/BF00844933.
   PubMed Web of Science ®Google Scholar
• Ruzhenkova VV, Ruzhenkov VA, Gomelyak JN, et al. Psychopharmacotherapy for somatoform autonomic dysfunction in students-medicans 1 course. IAJPS. 2018;5(7). doi: 10.5281/ZENODO.1324401.
   Google Scholar
• Fino E, Martoni M, Russo PM. Specific mindfulness traits protect against negative effects of trait anxiety on medical student wellbeing during high-pressure periods. Adv Health Sci Educ Theory Pract. 2021;26(3):1095–1111. doi: 10.1007/s10459-021-10039-w.
   PubMed Web of Science ®Google Scholar
• Sekas G, Wile MZ. Stress-related illnesses and sources of stress: comparing M.D.-Ph.D., M.D., and Ph.D. students. J Med Educ. 1980;55:440–446.
   PubMedGoogle Scholar
• Adhikari A, Dutta A, Sapkota S, et al. Prevalence of poor mental health among medical students in Nepal: a cross-sectional study. BMC Med Educ. 2017;17(1):232. doi: 10.1186/s12909-017-1083-0.
   PubMed Web of Science ®Google Scholar
• Bolotav AK, Seisembekov TZ, Smailova DS, et al. Burnout syndrome among medical students in Kazakhstan. BMC Psychology. 2022;10(1):193–204. doi: 10.1186/s40359-022-00901-w.
   PubMedGoogle Scholar
• Chinawa JM, Nwokocha ARC, Manyike PC, et al. Mental health-related somatic problems among medical students: a myth or reality? Int J Ment Health Syst. 2016;10(1):72. doi: 10.1186/s13033-016-0105-3.
   PubMedGoogle Scholar
• Clarvit SR. Stress and menstrual dysfunction in medical students. Mental Health Relat Somat. 1988;29(4):404–409. doi: 10.1016/S0033-3182(88)72341-5.
   Google Scholar
• El-Gilany AH, Amro M, Eladawi N, et al. Mental health status of medical students: a single faculty study in Egypt. J Nerv Ment Dis. 2019;207(5):348–354. doi: 10.1097/NMD.0000000000000970.
   PubMed Web of Science ®Google Scholar
• Goweda RA, Hassan-Hussein A, Ali Alqahtani M, et al. Prevalence of sleep disorders among medical students of umm Al-Qura university, Makkah, Kingdom of Saudi Arabia. J Public Health Res. 2020;9(Suppl 1):2020. doi: 10.4081/jphr.2020.1921.
   PubMedGoogle Scholar
• Ivashchenko D, Yashina Y, Voznesenskaya T. State anxiety, degree of autonomic symptoms in medical students in various situations during studying process in correspondence to gender. Eur Psychiatry. 2013;28(Suppl 1):1. doi: 10.1016/S0924-9338(13)76374-0.
   PubMedGoogle Scholar
• Lloyd C, Gartrell NK. Psychiatric symptoms in medical students. Compr Psychiatry. 1984;25(6):552–565. doi: 10.1016/0010-440x(84)90036-1.
   PubMed Web of Science ®Google Scholar
• Mosley TH, Perrin SG, Neral SM, et al. Stress, coping, and well-being among third-year medical students. Acad Med. 1994;69(9):765–767. doi: 10.1097/00001888-199409000-00024.
   PubMed Web of Science ®Google Scholar
• Pikó B. Frequency of common mental health-related somatic symptoms and its influence on self-perceived health in a Hungarian student population. Eur J Public Health. 1997;7(3):243–247. doi: 10.1093/eurpub/7.3.243.
   Web of Science ®Google Scholar
• Sohrabi M-R, Karimi H-R, Malih N, et al. Mental health status of medical students: A cross sectional study. Social Determinants of Health. 2015;1(2):81–88.
   Google Scholar
• Wege N, Muth T, Li J, et al. Mental health among currently enrolled medical students in Germany. Public Health. 2016;132:92–100. doi: 10.1016/j.puhe.2015.12.014.
   PubMed Web of Science ®Google Scholar
• Volel BA, Ragimova AA, Burchakov DI, et al. Stress-related menstrual disorders. Consilium Medicum. 2016;18(6):8–13. doi: 10.26442/2075-1753_2016.6.8-13.
   Google Scholar
• Igbokwe D. Confirmatory factor analysis of the Enugu somatization scale. IFE PsychologIA. 2011;19(1):19. doi: 10.4314/ifep.v19i1.64598.
   Google Scholar
• O’Looney BA, Harding CM. A psychometric investigation of two measures of type a behaviour in a British sample. J Chronic Dis. 1985;38(10):841–848. doi: 10.1016/0021-9681(85)90108-0.
   PubMedGoogle Scholar
• Zhang YL, Liang W, Chen ZM, et al. Validity and reliability of patient health questionnaire-9 and patient health questionnaire-2 to screen for depression among college students in China: depression screening among college students. Asia Pac Psychiatry. 2013;5(4):268–275. doi: 10.1111/appy.12103.
   PubMed Web of Science ®Google Scholar
• Kroenke K, Spitzer RL, Williams JBW, et al. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry. 2010;32(4):345–359. doi: 10.1016/j.genhosppsych.2010.03.006.
   PubMed Web of Science ®Google Scholar
• Kocalevent RD, Hinz A, Brähler E. Standardization of a screening instrument (PHQ-15) for somatization syndromes in the general population. BMC Psychiatry. 2013;13(1):91. doi: 10.1186/1471-244X-13-91.
   PubMedGoogle Scholar
• Hagquist C. Psychometric properties of the mental health-related somatic problems scale: a rasch analysis on adolescent data. Soc Indic Res. 2008;86(3):511–523. doi: 10.1007/s11205-007-9186-3.
   Web of Science ®Google Scholar
• Sereda Y, Dembitskyi S. Validity assessment of the symptom checklist SCL-90-R and shortened versions for the general population in Ukraine. BMC Psychiatry. 2016;16(1):300. doi: 10.1186/s12888-016-1014-3.
   PubMed Web of Science ®Google Scholar
• Zavlin D, Jubbal KT, Noé JG, et al. A comparison of medical education in Germany and the United States: from applying to medical school to the beginnings of residency. Ger Med Sci. 2017;15:doc15. doi: 10.3205/000256.
   PubMedGoogle Scholar
• Fabião C, Silva M, Barbosa A, et al. Assessing medically unexplained symptoms: evaluation of a shortened version of the SOMS for use in primary care. BMC Psychiatry. 2010;10(1):34. doi: 10.1186/1471-244X-10-34.
   PubMedGoogle Scholar
• van der Westhuizen C, Wyatt G, Williams JK, et al. Validation of the self reporting questionnaire 20-Item (SRQ-20) for use in a low- and middle-income country emergency centre setting. Int J Ment Health Addict. 2016;14(1):37–48. doi: 10.1007/s11469-015-9566-x.
   PubMed Web of Science ®Google Scholar
• Gierk B, Kohlmann S, Kroenke K, et al. The somatic symptom scale–8 (SSS-8): a brief measure of somatic symptom burden. JAMA Intern Med. 2014;174(3):399–407. doi: 10.1001/jamainternmed.2013.12179.
   PubMed Web of Science ®Google Scholar
• Smith JK, Jozefowicz RF. Diagnosis and treatment of somatoform disorders. Neurol Clin Pract. 2012;2(2):94–102. doi: 10.1212/CPJ.0b013e31825a6183.
   PubMedGoogle Scholar
• Kabat-Zinn J. Wherever you go, there you are: mindfulness meditation in everyday life. Connecticut: Hyperion; 1994.
   Google Scholar
• Kabat-Zinn J. Coming to our senses: healing ourselves and the world through mindfulness. Connecticut: Hyperion; 2005.
   Google Scholar
• Neufeld A, Malin G. How medical students cope with stress: a cross-sectional look at strategies and their sociodemographic antecedents. BMC Med Educ. 2021;21(1):299. doi: 10.1186/s12909-021-02734-4.
   PubMed Web of Science ®Google Scholar
• Ragab EA, Dafallah MA, Salih MH, et al. Stress and its correlates among medical students in six medical colleges: an attempt to understand the current situation. Middle East Curr Psychiatry. 2021;28(1):75. doi: 10.1186/s43045-021-00158-w.
   Google Scholar
• Graves BS, Hall ME, Dias-Karch C, et al. Gender differences in perceived stress and coping among college students. PLOS One. 2021;16(8):e0255634. doi: 10.1371/journal.pone.0255634.
   PubMed Web of Science ®Google Scholar
• Carroll L. Problem-focused coping. In: Gellman MD, Turner JR, editors. Encyclopedia of behavioral medicine. New York, NY: Springer New York; 2013. p. 1540–1541.
   Google Scholar
• Sperling EL, Hulett JM, Sherwin LB. et al. The effect of mindfulness interventions on stress in medical students: a systematic review and meta-analysis. PLOS One. [In press]. DOI: 10.1371/journal.pone.0286387
   Web of Science ®Google Scholar
• Witthöft M, Hiller W. Psychological approaches to origins and treatments of somatoform disorders. Annu Rev Clin Psychol. 2010;6(1):257–283. doi: 10.1146/annurev.clinpsy.121208.131505.
   PubMedGoogle Scholar
• Lahmann C, Loew TH, Tritt K, et al. Efficacy of functional relaxation and patient education in the treatment of somatoform heart disorders: a randomized, controlled clinical investigation. Mental Health Relat Somat. 2008;49(5):378–385. doi: 10.1176/appi.psy.49.5.378.
   Google Scholar
• Hendricks ML, Testa RJ. A conceptual framework for clinical work with transgender and gender nonconforming clients: an adaptation of the minority stress model. Prof Psychol Res Pr. 2012;43(5):460–467. doi: 10.1037/a0029597.
   Web of Science ®Google Scholar
• Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–697. doi: 10.1037/0033-2909.129.5.674.
   PubMed Web of Science ®Google Scholar
• Abbasi S, Mubeen N, Ayub T, et al. Comparison of stress levels among medical and dental students in the clinical years of training and their coping strategies. J Pak Med Assoc. 2020;70(6):1006–1008. doi: 10.5455/JPMA.294959.
   PubMed Web of Science ®Google Scholar
• Stewart SM, Betson C, Lam TH, et al. Predicting stress in first year medical students: a longitudinal study. Med Educ. 1997;31(3):163–168. doi: 10.1111/j.1365-2923.1997.tb02560.x.
   PubMed Web of Science ®Google Scholar
• Huang Z, Zhang L, Wang J, et al. Social support and subjective well-being among postgraduate medical students: the mediating role of anxiety and the moderating role of alcohol and tobacco use. Heliyon. 2021;7(12):e08621. doi: 10.1016/j.heliyon.2021.e08621.
   PubMed Web of Science ®Google Scholar
• Tsatsoulis A, Fountoulakis S. The protective role of exercise on stress system dysregulation and comorbidities. Ann N Y Acad Sci. 2006;1083(1):196–213. doi: 10.1196/annals.1367.020.
   PubMedGoogle Scholar
• Rathi A, Ransing RS, Mishra KK, et al. Quality of sleep among medical students: relationship with personality traits. JCDR. 2018;12(9):VC01–VC04. doi: 10.7860/JCDR/2018/24685.12025.
   Google Scholar
• Finkelstein C, Brownstein A, Scott C, et al. Anxiety and stress reduction in medical education: an intervention. Med Educ. 2007;41(3):258–264. doi: 10.1111/j.1365-2929.2007.02685.x.
   PubMed Web of Science ®Google Scholar
• Greeson J, Toohey M, Pearce M. An adapted, four-week mind–body skills group for medical students: reducing stress, increasing mindfulness, and enhancing self-care. Explore. 2015;11(3):186–192. doi: 10.1016/j.explore.2015.02.003.
   Google Scholar
• Hassed C, de Lisle S, Sullivan G, et al. Enhancing the health of medical students: outcomes of an integrated mindfulness and lifestyle program. Adv Health Sci Educ Theory Pract. 2009;14(3):387–398. doi: 10.1007/s10459-008-9125-3.
   PubMed Web of Science ®Google Scholar
• Kakoschke N, Hassed C, Chambers R, et al. The importance of formal versus informal mindfulness practice for enhancing psychological wellbeing and study engagement in a medical student cohort with a 5-week mindfulness-based lifestyle program. PLOS One. 2021;16(10):e0258999. doi: 10.1371/journal.pone.0258999.
   PubMed Web of Science ®Google Scholar
• Kraemer KM, Luberto CM, O’Bryan EM, et al. Mind-body skills training to improve distress tolerance in medical students: a pilot study. Teach Learn Med. 2016;28(2):219–228. doi: 10.1080/10401334.2016.1146605.
   PubMed Web of Science ®Google Scholar
• MacLean H, Braschi E, Archibald D, et al. A pilot study of a longitudinal mindfulness curriculum in undergraduate medical education. Can Med Educ J. 2020;11(4):e5–e18. doi: 10.36834/cmej.56726.
   PubMedGoogle Scholar
• Motz K, Graves K, Gross C, et al. Impact of a mind-body medicine skills course on medical students’ perceived stress, mindfulness and elements of emotional intelligence. BMC Complement Altern Med. 2012;12(Suppl 1):1. doi: 10.1186/1472-6882-12-S1-O19.
   Google Scholar
• Slavin SJ, Schindler DL, Chibnall JT. Medical student mental health 3.0: improving student wellness through curricular changes. Acad Med. 2014;89(4):573–577. doi: 10.1097/ACM.0000000000000166.
   PubMed Web of Science ®Google Scholar
• Williams M, Estores I, Merlo L. Promoting resilience in medicine: the effects of a mind-body medicine elective to improve medical student well-being. Glob Adv Health Med. 2020;9:2164956120927367. doi: 10.1177/2164956120927367.
   Google Scholar
• Zúñiga D, Torres-Sahli M, Nitsche P, et al. Reduced burnout and higher mindfulness in medical students after a self-care program during the COVID-19 pandemic. Rev Med Chil. 2021;149(6):846–855. doi: 10.4067/s0034-98872021000600846.
   PubMed Web of Science ®Google Scholar