Can positive emotional writing improve the emotional health level of international medical students? Evidence from a randomized controlled trial

Background Depression and anxiety are common among international medical students and negatively affect learning and life. This study evaluated whether positive emotional writing alleviates anxiety and depression and enhances subjective well-being in this population. Method Ninety-two eligible international medical students at a university in central China were randomized in a single-blind trial to either routine psychological care (control; n=46) or positive emotional writing plus routine care (experimental; n=46) for 8 weeks. Outcomes were assessed with the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and General Well-being Scale (GWB). Data from 89 completers (experimental n=44; control n=45) were analyzed. Results After intervention, SDS and SAS scores decreased and GWB increased significantly in the experimental group. The control group showed a smaller reduction in SAS and a decrease in GWB; SDS did not change significantly. Between-group comparisons favored the experimental group for greater decreases in SDS and SAS and greater increase in GWB. Conclusion Positive emotional writing effectively reduces depression and anxiety and significantly enhances subjective well-being among international medical students, offering a practical approach for managing their psychological problems. Trial registration ChiCTR2400087815.