A Study On The Efficacy Of Group Problem Management Plus (PM+) On The Depressed Mood Of Medical Students

Objective:The prevalence of mental health problems among medical students is higher than among students in other professions and continues to rise,which may pose a risk to their future studies,employment and development.Problem management plus（PM+）,a low-intensity,highly structured psychological intervention that can be delivered by non-specialists,has been shown to be effective in improving patients’anxiety and depression.This study will use group PM+to intervene with medical students and investigate the effectiveness of this therapy on depression and anxiety,loneliness,alexithymia and interpersonal empathy in medical students.Also,this study uses the event-related potential（ERP）technique to test the paradigm as the pain empathy paradigm to explore the neural mechanisms of pain empathy in medical students.The study will demonstrate the effectiveness of PM+in treating depressed mood and other social functions,and will provide an important theoretical and experimental basis for new treatments to improve the physical and mental health of medical students in the future.Methods:（1）Subjects:52 subjects were recruited through a network distribution scale and randomly divided into a test group（23,1 incomplete）and a control group（21,6incomplete）after being interviewed one by one.A pretest and posttest design with test and control groups was used.The test group was divided into three groups according to the random allocation principle and received five group PM+interventions,while the control group had one weekly psychological knowledge sharing.（2）Scales:Subjects in both groups were administered the Chinese versions of the Patient Health Questionnaire-9（PHQ-9）,General Anxiety Disorder-7（GAD-7）,UCLA Loneliness Scale,Toronto Alexithymia Scale（TAS）,and Chinese version of the Interpersonal（IRI-C）before and after.（3）Pain empathy paradigm:A total of 70 pain-negative and70 neutral pictures were taken,based on previous studies.The experimental tasks were demonstrated through the use of a computer:pain judgement,in which subjects were asked to quickly and accurately determine whether the person’s hands and feet in the pictures were in pain after each picture was presented and to respond by pressing a key（episodic task）;and left-right judgement,in which subjects were asked to rate the left and right of the hands or legs in the pictures and to respond by pressing a key（implicit task）,and to simultaneously record the subject’s electroencephalogram（EEG）was recorded simultaneously.Results:（1）PHQ-9:there was a significant difference in depression in the experimental group before and after the test(F_（1,44）=46.500,P<0.001),but no significant difference between the experimental and control groups in the post-test(F_（1,44）=3.399,P=0.072);（2）GAD-7:in the post-test,there was a non-significant difference between the experimental group and the control group(F_（1,44）=1.185,P=0.282),difference between pre-test and post-test-significant difference between experimental and control group test scores(F_（1,44）=22.851,P<0.001),no significant difference between control group pre-test and post-test scores(F_（1,44）=2.025,P=0.162);（3）UCLA Loneliness Scale:significant difference between experimental and control group post-test(F_（1,44）=18.409,P<0.001),significant difference between experimental and control post-tests(F_（1,44）=65.659,P<0.001);（4）TAS-20:significant difference between experimental and control post-tests(F_（1,44）=4.178,P=0.047),significant difference between pre-tests and control post-tests experimental group(F_（1,44）=54.355,P<0.001),the experimental group was significantly lower than the control group in emotional inability to speak,emotional recognition and extroverted thinking（P<0.05）;（5）IRI-C:compared to the pretest,the experimental group had significantly higher FS factor scores（t=-2.421,P=0.024）and significantly lower PD scores（t=2.332,P=0.029）and post-test,while PT and EC factor scores were not significantly different（t=-1.649,P=0.113;t=-0.331,P=0.774）;（6）Pain empathy:no significant difference in the changes of N1 and P3 components between the experimental and control groups.Conclusions:（1）The group PM+intervention was effective in improving medical students’depressive and anxious mood;（2）the group PM+intervention was effective in reducing medical students’loneliness and decreasing medical students’alexithymia;（3）the group PM+intervention had a partial effect on medical students’interpersonal empathy,but had no significant effect on the neural mechanisms of pain empathy.