Interpersonal Communication Tendency as a Mediator Between Academic Distress and Depression Among Medical Students: A Cross-Sectional Study.

Background: Medical students frequently encounter high academic demands that increase their risk of depression. Understanding how academic distress interacts with interpersonal communication tendencies to influence depression can inform mental health interventions. This study aims to explore the direct effect of academic distress on depression and the mediating role of interpersonal communication tendency.

Methods: A cross-sectional survey was conducted among 7317 students in medicine and related fields at Xuzhou Medical University from September to December 2022, using stratified random cluster sampling. Data were collected using validated scales measuring academic distress, interpersonal communication tendency, and depressive symptoms. Structural equation modeling was employed to analyze the total, direct, and indirect effects of academic distress on depression, and a multi-group analysis was conducted to examine gender differences.

Results: Academic distress was found to directly and positively affect depression (β = 0.622, 95% CI: 0.556, 0.686). Additionally, interpersonal communication tendency significantly mediated the relationship between academic distress and depression (β = -0.253, 95% CI: -0.294, -0.217). Gender-based analysis indicated a slightly stronger direct effect of academic distress on depression among male students (β = 0.630) compared to female students (β = 0.606).

Conclusions: Academic distress is strongly associated with depression among medical students, with interpersonal communication tendency serving as an effective mediator that reduces depressive symptoms. These findings highlight the need for academic institutions to support medical students by enhancing interpersonal communication skills and providing mental health resources to alleviate academic distress.