Medical student mental health and the role of rumination

Mental illness is the second-leading reason for tertiary students in Aotearoa New Zealand to consider dropping out of studies. Meta-analyses report moderate or greater symptoms of depression in 27% and anxiety in 34% of medical students. Rumination has been identified as a transdiagnostic risk factor for anxiety and depression symptoms in medical student populations, but no studies in New Zealand thus far have studied rumination alongside mental health symptoms in tertiary students.

We conducted an online survey in 2023 to examine the rate of depression and anxiety symptoms, as well as rumination, in a Christchurch-based medical student sample. The survey included demographic questions (gender, ethnicity), the Depression Anxiety Stress Scale 21 (DASS-21) and the Ruminative Responses Scale (RRS), which includes questions on brooding, reflection and depression-related rumination symptoms.

One hundred out of a possible 335 (29.9%) medical students completed the survey. Seventy-six were female. Thirty-six percent reported moderate or greater symptom levels of depression, 45% of anxiety and 42% of stress. All RRS subscales were significantly positively correlated with depression, anxiety and stress symptoms. Female students reported significantly more symptoms of anxiety than male students. Asian students reported significantly higher levels of brooding and total rumination than Pākehā students.

This medical student cohort had concerningly high levels of depression, anxiety and stress symptoms. Rumination is likely an important contributor to negative mental health outcomes. Further research is required to tailor accessible interventions for students with high levels of rumination.