Depression is a multifactorial illness that is highly prevalent among medical students (MS). Chronotypes, which reflect circadian preference in humans, as well as academic stress have been associated with depression in different populations. However, it is not known how chronotype and stress might alone or in combination, associate with depression in MS. Thus, we aimed to evaluate the association between stress, chronotype and depression in MS. In a cross-sectional study, we evaluated a total of 1068 medical students from a public Medical School in Mexico City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate depressive symptom severity and the presence of a current depressive episode with a cutoff score of 10 or higher. The Morning-Evening Questionnaire (MEQ) was used to establish chronotype and the Academic Stress Inventory was used to measure perceived academic stress (PAS). We observed that depressive symptom severity was higher in non-morning chronotypes and moderate/severe PAS groups. A factorial ANOVA showed an association between PAS groups and depressive symptom severity. Linear regression showed an association between depressive symptom severity and variables such as PAS scores (p = 0.001), family history of depression (p = 0.001), gender (p = 0.001) and academic year (p = 0.029). Logistic regression analysis showed that evening chronotype (OR: 2.3, 95% CI: 1.2–4.3, p = 0.01) and severe PAS (OR: 4.4, 95% CI: 2.8–7.0, p = 0.0001) were associated with depression. Further, MS with the combination of severe PAS and morning (OR: 5.9, 95% CI: 1.6–22.2, p = 0.01), intermediate (OR: 7.5, 95% CI: 2.3–24.4, p = 0.001) or evening (OR: 10.6, 95% CI: 2.8–40.0, p = 0.001) chronotypes showed a greater association with depression than any PAS or chronotype group alone. Being female, perceiving restricted or limited economic resources, having severe scores of academic stress, and evening chronotype were associated with an increased probability to suffer a current depressive episode. Collectively, these results show that chronotype and PAS are factors associated with depression in MS, and when combined promote this association. Our results might aid in early identification of MS susceptible to depression. Future research could focus on the implementation of simple, low cost preventive strategies, such as chronotype-oriented academic schedules.

Congenital viral infections are believed to damage the developing neonatal brain. However, whether neonates exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) show manifestations of such damage remains unclear. For neurodevelopment evaluation, general movement assessments have been shown to be effective in identifying early indicators of neurological dysfunction, including the absence of fidgety movements. This study compared the early motor repertoire by general movement assessment at three to five months of age in neonates who were or were not prenatally exposed to SARS-CoV-2 to determine whether infants prenatally exposed to SARS-CoV-2 are at risk of developing neurological disorders. Fifty-six infants, including 28 in the exposed group of mothers without vaccination who had no need for intensive care and likely had SARS-CoV-2 infection close to the time of pregnancy resolution and 28 infants in the nonexposed group, were videotaped to compare their detailed early motor repertoires, in which a motor optimality score-revised (MOS-R) was calculated using Prechtl’s method by using the chi-square or Mann–Whitney U tests. In the exposed group, 3 (11%) infants showed the absence of fidgety movements with a total MOS-R<14 points, and 3 (11%) other infants showed abnormal fidgety movements. Between groups, atypical body symmetry (p = 0.009) and MOS-R values were significantly lower (Z = -3.08, p = 0.002), with a large size effect (Cohen’s d = 0.97). The consequences of this new virus go beyond the health of the pregnant mother, and these consequences in some of the infants in the exposed group are likely not transitory because of the absence of fidgety movements between 3–5 months; thus, these babies are at increased risk of developing a serious neurological disorder.

The medical career is considered highly stressful, especially during internships when academic and clinical demands, combined with changes in sleep patterns, increase students’ likelihood to develop depression. Resilience, which is considered as opposite vulnerability to stress and, along with another protective factor, namely morningness, may cause a student to be less reactive to stimuli and, therefore, less prone to depression. The objective of this study was to evaluate the role of resilience and morningness facing to sleep quality and main risk factors, on the development of depression symptoms in a group of students with sleep pattern alterations. To this end, an observational and longitudinal study was performed with 30 undergraduate interns, with an average age of 22.63 years (SE ± 0.13), 33% men and 67% women. A survey was conducted in three different times during the year of internship: at the beginning (T₁), in the middle (T₂) and the end (T₃). The instruments were the Brief Resilience Scale, Composite Scale of Morningness, Pittsburgh Sleep Quality Index and Patient Health Questionnaire. The path analysis examined the roles of morningness, sleep quality and resilience as potential mediators between family history of depression and depression symptoms at different times. The results showed that resilience had a protective effect on depression symptoms at T₂ (β = −0.18, p < 0.05) and with greater power at T₃ (β = −0.41, p < 0.05), as did morningness, although less strongly, on the symptoms at T₃ (β = −0.13, p < 0.05). A relationship between these two mediating variables was also observed (β = 0.30, p < 0.05). The initial sleep quality had an effect on the increase of depression symptoms at T₁ (β = 0.61, p < 0.05) and T₃ (β = 0.21, p < 0.05), while family history of depression had a direct effect on the measures of depression at T₂ (β = 0.49, p < 0.05) and T₃ (β = 0.19, p < 0.05). Aside from personal risk factors, it is possible to conclude that the levels of resilience, morningness and sleep quality manifested by students at the beginning of their internship may explain the decrease in depression symptoms at the end of the course.

Background: High levels of stress are frequent in university education, and a lack of sleep has been reported to make students more vulnerable to stress. The mechanisms through which sleep harms students have not been sufficiently clarified; therefore, this study aimed to explore the mediating role of self-control and resilience in the relationship between sleep quality and duration and perceived stress. Methods: Of 32 first-year college students, 21 (78%) were women, with a mean age of 18.47 (±0.84). They responded to a self-administered survey that included questions on stress, resilience, and sleep quality and recorded their daily sleep duration using a wristband for six days. Results: Perceived stress was significantly correlated with resilience (r = −0.63), self-control (r = −0.46), sleep duration (r = −0.35), and lower sleep quality (r = 0.57). Path analysis revealed that self-control and resilience were partially mediated by sleep quality (R² = 0.62; p < 0.01) and completely mediated by sleep duration (R² = 0.46; p < 0.01). In both models, self-control had a direct effect on resilience and had a good-fit index. Conclusion: Being resilient seems to play a mediating role in the relationship between sleep and perceived stress; this ability can be favored by self-control, which is directly influenced by sleep.

Esta investigación tuvo como objetivo identificar la relación entre la práctica de actividad física y aspectos positivos de la salud mental de alumnos de medicina en México. Se trata de un estudio transversal realizado con una muestra aleatoria de 190 estudiantes, con edad media de 19.0 ±1.4 años, del primero y segundo grado de una escuela de medicina en la Ciudad de México. Se aplicó una batería de test de salud mental positiva que comprendía escalas para evaluar la satisfacción de los jóvenes con la vida, su resiliencia, autoconcepto y compromiso, así como el IPAQ que evalúa su práctica de actividad física. Se llevaron a cabo análisis descriptivos, comparativos y de regresión lineal múltiple. Se encontró una asociación significativa del nivel de actividad física practicada por los alumnos con su satisfacción con la vida (B = –1.64, IC95% = –2.90, –0.38, p = .011) y su capacidad de resiliencia (B = –2.41, IC95% = –3.87, –0.95, p = .001), controlando por factores sociodemográficos. La actividad física tuvo una asociación significativa con aspectos positivos de la salud mental de estudiantes de medicina en México; por ello, intervenciones orientadas a favorecer la práctica de actividad física pueden diseñarse y utilizarse no sólo en el tratamiento y prevención de trastornos mentales, sino también para promover la salud mental entre esta población. This study aimed to identify the relationship between the practice of physical activity and positive aspects of medical students’ mental health in Mexico. This was a cross-sectional study that applied randomized sampling, and data from 190 students, with a mean age of 19.0 ±1.4 years, from the first and second grades of a medical school in Mexico City were analyzed. The questionnaire comprised scales to assess students’ satisfaction with life, resilience, self-concept, and engagement, as well as the IPAQ that evaluates their practice of physical activity. Descriptive, comparative and multiple linear regression analyses were carried out. A significant association was found between students’ levels of physical activity, their satisfaction with life (B = –1.64, IC95% = –2.90, –0.38, p = .011) and their resilience skills (B = –2.41, IC95% = –3.87, –0.95, p = .001), controlling for sociodemographic factors. Physical activity had a significant association with positive aspects of Mexican medical students’ mental health; thus, interventions aimed at improving physical activity practice can be designed and utilized not only in the treatment and prevention of mental disorders but also to promote mental health among this population. Este estudo teve como objetivo identificar a relação entre a prática de atividade física e aspectos positivos da saúde mental de estudantes de medicina do México. Este é um estudo transversal realizado com uma amostra aleatória de 190 alunos, com idade média de 19.0 ±1.4 anos, do primeiro e segundo ano de uma escola de medicina na Cidade do México. Foi aplicado um questionário que incluía escalas para avaliar a satisfação dos alunos com a vida, sua resiliência, autoconceito e comprometimento, além do IPAQ que avalia sua prática de atividade física. Foram realizadas análises descritivas, comparativas e de regressão linear múltipla. Foi encontrada associação significativa entre os níveis de atividade física praticados pelos alunos, a satisfação com a vida (B = –1.64, IC95% = –2.90, –0.38, p = .011) e a resiliência (B = –2.41, IC95% = –3.87, –0.95, p = .001), controlando para fatores sociodemográficos. A atividade física teve associação significativa com aspectos positivos da saúde mental de estudantes de medicina mexicanos; portanto, intervenções destinadas a promover a prática de atividade física podem ser planejadas e utilizadas não apenas no tratamento e prevenção de transtornos mentais, mas também para promover a saúde mental dessa população.