Prevalence of mental health problems among medical students in Brazil: an updated systematic review and meta-analysis of 126 studies

Abstract

Background: Medical students in Brazil experience high rates of mental health problems (MHPs). However, the current prevalence rates in
this population remain unknown. Therefore, the authors aimed to estimate the prevalence of MHPs among medical students in Brazil. Methods: In this systematic review and meta-analysis, PubMed, Embase, Scopus, LILACS, and PsycINFO were searched for cross-sectional studies published in peer-reviewed journals that reported the prevalence of MHPs in a medical student sample in Brazil and utilized validated instruments translated to Portuguese. A DerSimonian-Laird random-effects model was used to calculate the pooled prevalence of each different MHP, for males and females, and for studies conducted before and after the pandemic outbreak. Registered in PROSPERO, number: CRD42024499416. Results: Ultimately, 126 studies were included, aggregating data from 47,513 medical trainees. The pooled prevalence was
36.3% (95% CI 31.2–41.6) for depressive symptoms, 41.2% (33.8–48.8) for anxiety symptoms, 38.7% (32.3–45.3) for common mental disorders, 65.6% (58.5–72.4) for poor sleep quality, among other MHPs. Female students showed higher prevalence rates than males, except for alcohol abuse. For depression, pre-Covid-onset studies yielded a pooled prevalence of 34.8% (29.1-40.7) compared to 43.4% (31.0-56.3) in post-Covid-onset studies (p=0.22). Conclusions: These findings underscore the need for greater emphasis on mental health care and support during medical training in Brazil.