Introduction
depression, mistakes, anxiety
CHRONIC PAIN, DISEASE, SECONDARY
In the scientific literature, the responsibilities and pressures of medical school and residency are widely known for putting a strain on medical student's personal wellbeing, leading to high rates of anxiety, depression, burnout, and emotional discomfortTo make things worse, the recent Covid-19 pandemic has placed an additional burden on students around the worldSuch a situation is obviously not desirable since, other than putting medical students under a heavy mental distress, it gives space to numerous risk factors that can cause the development of later clinical mental conditionsAware of this situation, medical students are using different coping strategies to reduce distress. While taking drugs and substances, such as tranquilizers, stimulants, and alcohol, overthinking and rumination have negative or side effects, taking social support such as seeking help from friends or family and physical activity have positive effects to reduce distressMindfulness-Based Intervention (MBI) is an effective complement to these strategies. Defining mindfulness is not an easy task, however, a generally accepted and synthetic definition of this concept can be found in the work of Jon Kabat-Zinn, where it is formulated as “The benefits of such a state of being is well-known in literature. Empirical research shows that mindfulness-based therapies can reduce stress and anxiety, as well as psychological distress, chronic pain, and depression, and improve overall quality of lifeFor medical students MBIs for reducing stress include Mindfulness-Based Stress-Reduction (MBSR) or meditation techniques, self-hypnosis, and pass/fail gradingMBIs are getting popular in medical education to such an extent that medical schools around the world are beginning to acknowledge mindfulness as a helpful practice for their students, residents, and staffThese data take on further importance considering the result of the medical service depends not only on the doctor's ability to diagnose and treat a disease, but also on the ability to establish a positive relationship with the patient.Additionally, mindfulness training, directed to build a metacognitive standpoint toward the thinking process, could reduce the great number of misdiagnoses attributed to cognitive biases such as anchoring mistakes or attribution errorHence to develop and apply easily accessible and low-cost strategies to diminish the levels of stress of medical students is crucial for their academic performance and professional development.The aim of the present study was to assess the efficacy of a comprehensive MBI, entirely administered online, consisting of a mindfulness-based practice, called Integral Meditation (IM), dietary advice, and brief yoga sessions, in two cohorts of Italian medical students randomized to intervention or control group. Our primary hypothesis was that participants in the intervention group would report a decrease of perceived stress and state anxiety and an increase of mental well-being. Our secondary hypothesis was that participants in the intervention group would report higher scores on different measures of positive affect, resilience, emotion regulation and attentional control. The investigated outcomes were measured using nine self-report questionnaires administered online to both groups before and after the intervention. For the second cohort only, 3 months follow-up data was also collected and analyzed.