# Association between social skills and mental health outcomes in Health Science Residents in Brazil

## TL;DR

This study found high rates of mental health issues among Brazilian health science residents and linked better social skills to lower symptoms of distress, anxiety, and depression.

## Contribution

The study is one of the first to examine mental health and social skills in multidisciplinary health science residency programs in Brazil.

## Key findings

- Emotional distress, anxiety, and depression were highly prevalent among residents (86.3%, 58.8%, and 56.9%, respectively).
- Higher social skills, especially in defending rights and expressing positive affect, were associated with reduced mental health symptoms.
- Residents showed generally satisfactory social skills, with the highest scores in starting and maintaining conversations.

## Abstract

Residency programs play a crucial role in the development and technical training of young health professionals. However, mental health issues such as psychological distress, anxiety, and depression are prevalent, often influenced by work satisfaction and the learning environment. Despite their relevance, studies investigating the prevalence and associated factors of these conditions across medical, multidisciplinary, and veterinary residency programs remain scarce. This study aimed to determine the prevalence of psychological distress, anxiety, and depression, and to examine their association with social skills among residents in Brazilian health science programs. We conducted a voluntary online survey with residents from three major residency programs (medical, multidisciplinary, and veterinary) across different Brazilian institutions. The cross-sectional study sample consisted of a total of 51 participants. Mental health outcomes were assessed using validated instruments: the Resident Questionnaire (RQ) for emotional distress, General Anxiety Disorder (GAD-7) for anxiety, and Patient Health Questionnaire (PHQ-9) for depression. The Multidimensional Scale of Social Expression (MSSE-M) measured social skills. Multivariable mixed-effects linear regression models addressed each mental health outcome separately, with social skill scores as primary explanatory variables. The results revealed a high prevalence of emotional distress (86.3%), anxiety (58.8%), and depression (56.9%) among residents. Greater satisfaction with the learning environment was significantly associated with lower mental health symptom levels. Residents demonstrated a generally satisfactory overall repertoire of social skills (60.78%), with the “Start and keeping conversations” and “Express positive affect” subscales scoring highest across all programs. For emotional distress, the “ability to defend rights” subscale was significantly associated with its reduction (−0.58), while a broader overall social skill repertoire was significantly associated with reductions in anxiety (−3.14) and depression (−3.92). These findings highlight the significant burden of mental health challenges among residents and emphasize the role of a supportive environment. Social skills training may help mitigate psychological distress and support resident well-being.