A Multistate Analysis of Longitudinal Care Outcomes Among People Newly Linked to Human Immunodeficiency Virus Care in Missouri.

Depression has emerged as a significant public health issue among university students worldwide, particularly those enrolled in medical programs [, ]. Medical students are frequently exposed to intense academic workloads, highly competitive environments, long study hours, and emotionally demanding clinical experiences, which together create a particularly high‐risk context for the development of psychological distress [–]. Epidemiological evidence indicates that depressive symptoms (DSs) affect approximately 20%–50% of medical students, a prevalence consistently higher than that reported in the general university student population [–]. In China, recent surveys have similarly reported high levels of DS among undergraduate medical students, with a considerable proportion experiencing moderate to severe psychological difficulties [, ]. Together, these findings underscore the need not only to better understand the determinants of DS among medical students but also to identify psychological mechanisms that may distinguish this population from other university students. The consequences of depression in medical students are multifaceted and far‐reaching. Persistent DS can impair cognitive functioning [], reduce motivation, and hinder learning [, ], which in turn compromises academic achievement []. It is also strongly associated with burnout [], dropout intention [], substance use [], and suicidal ideation [, ]. These adverse outcomes extend beyond the individual, potentially undermining the quality of care delivered during clinical training and later professional practice [, ]. Therefore, promoting mental well‐being among medical students is essential not only for their personal and professional development but also for safeguarding the quality, safety, and sustainability of future healthcare systems from both public health and medical education perspectives. Given the high prevalence and adverse consequences of DS among medical students, researchers have increasingly focused on identifying psychological factors that may exacerbate or buffer the risk of depression in this group [–]. Personality traits (PTs) represent one such factor. Across diverse populations, empirical evidence consistently suggests that high neuroticism is strongly associated with DS, whereas conscientiousness, extraversion, openness to experience, and agreeableness are generally considered protective factors [–]. However, whether these associations are equally applicable to medical students remains insufficiently understood, as this population is exposed to unique academic, clinical, and professional demands that may alter the relationships between personality and mental health outcomes. Therefore, clarifying whether these personality‐depression associations are similarly observed among medical students is important for identifying individuals at elevated risk and developing targeted prevention and intervention strategies tailored to this population.