Psychoactive Substance Use and Its Association with Mental Health Symptomatology Among Latvian Medical Students: A Cross-Sectional Study.

Medical students are at elevated risk for psychoactive substance use and mental health challenges due to academic pressures and environmental stressors. This study aimed to determine the prevalence and trends of psychoactive substance use among medical students at Riga Stradins University (RSU) and to examine associations with symptoms of anxiety, depression, and resilience to stress. A bilingual, anonymous cross-sectional study was conducted using a SurveyMonkey-hosted questionnaire. The survey included a socio-demographic questionnaire, the Generalized Anxiety Disorder Questionnaire-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Brief Resilience Scale (BRS), and the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (WHO ASSIST V3.1). A total of 559 RSU medical students participated (response rate: 31.8%). Lifetime substance use prevalence was highest for caffeine 98.7%, alcohol 93.9%, tobacco 68.4%, and cannabis 50.9%. High-risk use was noted for tobacco 6.8%, inhalants 4.2%, cocaine 3.6%, and alcohol 1.4%. Significant differences in total substance use were observed by gender (p = 0.006) and depression symptom severity by PHQ-9 (p < 0.001), which were predictors of the total involvement score. The findings suggest that further attention to mental health and substance use patterns among medical students may be beneficial for student well-being and professional development.