Abstract. The study evaluates the presence of traumatic experiences occurring before age 18 and the negative mental health outcomes in terms of clinical symptoms, traits, quality of life, and suicide risk among medical students. This is an observational, retrospective, cross-sectional study with a non-clinical sample consisting of sixth-year medical students from the Medical University of Sofia, Bulgaria. The survey is conducted online between October 2021 and March 2022. Two hundred and ten participants completed the survey with a mean age of 25 (SD=3), 60% females, 53% foreign students, overall good quality of life (EQ VAS M=80.5 (SD=16.3), and a high level of empathy (TEQ mean score 47.8 (SD=6.6). Childhood traumatic experiences were common, with a mean score for ETISF-SR 6.4 (4.4) and general trauma being the most common type of trauma (81%), followed by physical abuse (75%), emotional abuse (65%), and sexual abuse (26%). The prevalence of current negative mental health outcomes is 10% for depression, 14% for anxiety, 22% for obsessive-compulsive symptoms, 9% for alexithymia, and 10% for suicide ideations. Eleven (8%) of the participants had received a psychiatric diagnosis, most commonly depression or eating disorder. Childhood trauma has statistically significant correlations with clinical outcome measures, alexithymia, and quality of life, while empathy has a statistically significant negative correlation with physical abuse, alexithymia, and quality of life (p<.05 for all outcome measures). The subgroup with severe exposure to trauma (ETISF-SR≥12) had statistically and clinically significant higher rates of depression (23%), anxiety (43%), obsessive-compulsive symptoms (49%), alexithymia (20%) and suicide ideation (29%), as well as increased exposure to sexual traumatic experiences (63%).

Key words: alexithymia, childhood trauma, negative mental health outcomes, suicide ideation, medical students

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