Mood & Stress Shakhawan Salih. Shanyar Kadir. Shkar Dilshad

Introduction A mood is an emotional state. Moods differ from emotions in that they are less specific, less intense, and less likely to be triggered by a particular stimulus or event. Moods generally have either a positive or negative valence. In other words, people typically speak of being in a good mood or a bad mood.

Introduction Stress is a feeling of strain and pressure. Symptoms may include a sense of: Being overwhelmed Feelings of anxiety Overall irritability Insecurity Nervousness Social withdrawal Loss of appetite Depression Others

Introduction Two groups of mood disorders are broadly recognized: 1) Depressive disorders A) Major depressive disorder (MDD) B) Dysthymia C) Double depression 2) Bipolar disorders A) Bipolar I & II B) Cyclothymia

Introduction Objectives: To identify the level of stress among different stages of the medical school To identify any gender differences related to stress To identify if mood & stress are affected by studying or exam marks and vice versa.

Methodology Study Design Cross-sectional study (survey) Questionnaire Sociodemographic (7) Mood and Stress Questions (48)

Methodology Study Population and Sample Population = Students of Sulaymaniyah Medical School Sample = All 6 Stages, Random Sampling, Evey 4 th Student Data Collection Took 3 days First 4 stages in a single day 5 th and 6 th stages within 2 days

Methodology Data Processing 162 complete questionnaires (9 ignored because incomplete) Entered into IBM SPSS v21 Frequency tables for socio-demographic data and statistical measures of distribution for age, height, and weight Chi-Squared and Fisher’s Exact tests used to find associations If 20.0% or more of data cells in contingency table had expected count below 5, Fisher’s exact was used p value of less than 0.05 taken as significant

Results (sociodemographic data) FrequencyPercent Gender Male % Female % Stage % % % % % % Socioeconomic status Moderate % High (Rich) % NR21.2 % Residence Village31.9 % City % NR21.2 %

Results Does your stress increase when you have a family problem? TotalP-value (X 2 ) Never or not at all Some of the time or mildly Often or moderately Always or severely Student Gender Female Count % 4.7%18.8%35.3%41.2%100.0% Male Count % 9.1%29.9%41.6%19.5%100.0% Total Count % 6.8%24.1%38.3%30.9%100.0%

Results Does other people’s pain (accidents, death,…etc) affect your mood? TotalP-value (X 2 ) Never or not at all Some of the time or mildly Often or moderately Always or severely Student Gender Female Count % 9.4%22.4%38.8%29.4%100.0% Male Count % 24.0%28.0%30.7%17.3%100.0% Total Count % 16.3%25.0%35.0%23.8%100.0%

Results Do you feel nauseous or get reflux when stressed? TotalP-value (X 2 ) Never or not at all Some of the time or mildly Often or moderately Always or severely Student Gender Female Count % 27.7%30.1%20.5%21.7%100.0% Male Count % 50.7%29.6%15.5%4.2%100.0% Total Count % 38.3%29.9%18.2%13.6%100.0%

Results Do you get more stressed out while studying for the examinations? TotalP-value (X 2 ) Never or not at all Some of the time or mildly Often or moderately Always or severely Student Gender Female Count % 7.2%12.0%33.7%47.0%100.0% Male Count % 7.9%42.1%31.6%18.4%100.0% Total Count % 7.5%26.4%32.7%33.3%100.0%

Results Do you get sleep-deprived during examination times? TotalP-value (X 2 ) Never or not at all Some of the time or mildly Often or moderately Always or severely Student Gender Female Count % 18.1%30.1%20.5%31.3%100.0% Male Count % 34.2%35.5%21.1%9.2%100.0% Total Count % 25.8%32.7%20.8% 100.0%

Results Do your exam marks affect your mood? TotalP-value (X 2 ) Never or not at all Some of the time or mildly Often or moderately Always or severely Student Gender Female Count % 9.4%30.6%22.4%37.6%100.0% Male Count % 22.1%41.6%14.3%22.1%100.0% Total Count % 15.4%35.8%18.5%30.2%100.0%

Results Do you have a tendency to addictions or substance abuse when under stress? Total P-value (Fisher’s Exact) Never or not at all Some of the time or mildly Often or moderately Always or severely Student Gender Female Count % 94.1%2.4%1.2%2.4%100.0% Male Count % 63.2%19.7%9.2%7.9%100.0% Total Count % 79.5%10.6%5.0% 100.0%

Does your mood affect your relationship with your friends? Total P-value (Fisher’s Exact) Never or not at all Some of the time or mildly Often or moderately Always or severely College Stage 1 Count % 46.2%26.9%23.1%3.8%100.0% 2 Count % 50.0%15.4%23.1%11.5%100.0% 3 Count % 18.5%40.7%37.0%3.7%100.0% 4 Count % 30.8%34.6%19.2%15.4%100.0% 5 Count % 51.9%29.6%11.1%7.4%100.0% 6 Count % 24.1%62.1%13.8%0.0%100.0% Total Count % 36.6%35.4%21.1%6.8%100.0%

Does hanging out with friends make your mood better?Total P-value (Fisher’s Exact) Never or not at all Some of the time or mildly Often or moderately Always or severely College Stage 1 Count % 15.4%19.2%30.8%34.6%100.0% 2 Count % 11.1%25.9%14.8%48.1%100.0% 3 Count % 11.1%22.2%25.9%40.7%100.0% 4 Count % 0.0%32.0%56.0%12.0%100.0% 5 Count % 7.4%37.0%44.4%11.1%100.0% 6 Count % 0.0%48.3%31.0%20.7%100.0% Total Count % 7.5%31.1%33.5%28.0%100.0%

Do you think about committing suicide to get rid of stress? Total P-value (Fisher’s Exact) Never or not at all Some of the time or mildly Often or moderately Always or severely College Stage 1 Count % 60.0%24.0%12.0%4.0%100.0% 2 Count % 58.3%16.7% 8.3%100.0% 3 Count % 81.5%14.8%0.0%3.7%100.0% 4 Count % 69.2%26.9%3.8%0.0%100.0% 5 Count % 96.2%0.0% 3.8%100.0% 6 Count % 75.9%20.7%0.0%3.4%100.0% Total Count % 73.9%17.2%5.1%3.8%100.0%

Results Do you have an increased sensitivity to pain? Total P-value (Fisher’s Exact) Never or not at all Some of the time or mildly Often or moderately Always or severely Socioeconomic Status Moderate Count % 50.4%30.7%13.4%5.5%100.0% High (Rich) Count % 31.3%56.3%3.1%9.4%100.0% Total Count % 46.5%35.8%11.3%6.3%100.0%

Results Do you lack stamina or tire easily? TotalP-value (X 2 ) Never or not at all Some of the time or mildly Often or moderately Always or severely Socioeconomic Status Moderate Count % 22.4%44.8%24.0%8.8%100.0% High (Rich) Count % 40.6%50.0%6.3%3.1%100.0% Total Count % 26.1%45.9%20.4%7.6%100.0%

Conclusions Females more prone to stress Affected more by family problems Affected more by other people’s pain More likely to get nausea and reflux under stress Get more stress out while studying for exams Get more sleep-deprived by exams Affected more by exam marks Males A higher tendency for addictions

Conclusions By Stage Mood gets better when hanging out with friends (increases with stage) Suicidal ideation higher among the first two stages By SES High SES: increased sensitivity to pain Low SES: lack stamina and tire more easily

Recommendations Classes to the medical students About risk factors for stress How to deal with stress How to detect serious suicidal ideations in others