Chronotype, eating disorders, and perceived stress among medical students in Eskişehir, Türkiye

Abstract Background Medical education is widely recognized as a highly stressful process that can increase health risks and lead to various pathologies. Understanding how stress is associated with other factors is therefore crucial for developing effective interventions. This study aimed to assess chronotype, eating disorder symptoms, and perceived stress among medical students in Eskişehir, Türkiye. Methods A cross-sectional study was conducted in 2024 at a medical faculty in Eskişehir, Türkiye. Of 1,773 students, 1,091 (61.6%) participated. Data were collected through a questionnaire covering sociodemographic variables, the Perceived Stress Scale(PSS), Eating Disorder Examination Questionnaire - 13 (EDE-Q-13), and the Morningness-Eveningness Questionnaire. Statistical analyses included Kruskal-Wallis, Mann-Whitney U, Spearman correlation, and multiple linear regression analysis. Results The mean age of students was 21.1±2.3 years, and 51.9% were female. Evening chronotype was observed in 22.6% of students. Mean PSS score was 11.7±2.8 (median: 12.0); EDE-Q-13 score was 1.3±1.1 (0.93). In multiple linear regression, higher perceived stress was associated with being female (B = 0.86, 95% CI: 0.54-1.18), younger than 21 (B = 0.40, 95% CI: 0.07-0.73), low income (B = 1.18, 95% CI: 0.38-1.99), evening chronotype (B = 0.48, 95% CI: 0.10-0.87), smoking (B = 0.49, 95% CI: 0.11-0.87), and feeling hopeless (B = 2.51, 95% CI: 1.88-3.14). Increased screen time (B = 0.06, 95% CI: 0.004-0.12) and higher eating disorder scores (B = 0.36, 95% CI: 0.23-0.50) were also positively associated with stress. Conclusions One in five students had an evening chronotype, and 54% reported above-average stress. Interventions targeting reduced screen time and disordered eating may help decrease perceived stress. Identifying students with an evening chronotype and feelings of hopelessness and prioritizing them in stress management programs, may enhance the effectiveness of interventions. Key messages • Perceived stress in medical students is linked to health-risk behaviors and may be significant for public health, as they are future role models. Supporting stress management could be beneficial. • Informative activities during medical education on reducing screen time and addressing eating disorders may help improve students’ well-being.