Mental disorders in medical students at the University of the West Indies, Trinidad and Tobago - Audit at a doctor's practice

A series of 32 consecutive students from one medical school presenting for psychiatric treatment over a two year period between September 1997 and August 1999 is described. The author treated 31 of these students, representing 288 visits and 312 hours. On the basis of retrospective case note reviews, the author presents demographic data, the year of medical school in which the illness began, DSM IV diagnoses, treatment modalities, time absent from University as a result of mental illness and major stressors. Of the 32 subjects, 50% were male, with ages ranging from 20 to 34 years (mean 24.9 years). Ninety-four per cent were single, and 78% were Trinidadians. Thirty-one per cent were Trinidad and Tobago National Scholars. This finding achieved statistical significance. Seventy-two per cent presented during their clinical training. The most common source of referral was from members of the Faculty of Medical Sciences (31%). Relationship issues were the most commonly identified stressors in 31% of the subjects. Mood disorders and anxiety disorders were present in 59% of the students. Pharmacotherapy was used in 75% of the students. The majority (53%) of medical students with mental disorders were absent from university for less than one month. At follow-up in July 2001, 26 (81%) of the students had graduated, three (9%) were still in medical school and three (9%) had withdrawn from medical school as a result of mental illness. The study is limited in that only those seeking assistance from one doctor's practice are described The findings would be further explored in longitudinal studies.