PONE-D-22-10652Knowledge and Coping Style About Depression in Medical Students : A Cross-Sectional Study in North ChinaPLOS ONE

Dear Dr. Ping,

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Editorial Office

PLOS ONE

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7.  Thank you for submitting the above manuscript to PLOS ONE. During our internal evaluation of the manuscript, we found significant text overlap between your submission and the following previously published works, some of which you may be an author:

- https://journals.sagepub.com/doi/10.1177/0733464810374468

- https://www.cambridge.org/core/journals/international-psychogeriatrics/article/abs/lay-perceptions-about-mental-health-where-is-age-and-where-is-alzheimers-disease/08DD8B5191E8B6897AB3C24DA4E26BF7

- https://amhsjournal.org/article.asp?aulast=Bose&epage=235&issn=2321-4848&issue=2&spage=230&volume=8&year=2020

- https://www.semanticscholar.org/paper/Systematic-Review-of-Depression%2C-Anxiety%2C-and-Other-Dyrbye-Thomas/32c0691e8abd154312d5555193d0ff9fe224e5c4?p2df

- https://www.who.int/news-room/fact-sheets/detail/depression

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Reviewers' comments:

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: General remarks

From the summary to the discussion, there are typographical errors, due to lack of spaces. For example, see lines: 40, 45, 50, 105, 106, 124, 136, 151, 158, 177, 179, 180, 181, 192, 200, 218, 222, 243, 245, 246, 247, 249, 251, 255, 256, 257, 287, 288.

On line 182 it says "SDD”, and I guess it should say "SDS".

Line 183, Table 2, say “meidcal”

The citations, particularly noted in the discussion, do not correspond to the references. For example, 35 says Liselotte and is Mao, 37 says Lloyd and is Camp, 38 says Camp and is Clark, 39 says Clark and is Chen, …

Abstract

The results in terms of students' knowledge about depression are not observed

Introduction

1) The objectives of the study are not clear; they seem to be only descriptive but in their results, they present data of associations that are not indicated as objectives.

2) It is missing that they indicate the hypotheses (and their foundation) of the main associations of the study. For example, the authors could point out how knowledge affects the type of coping, or how knowledge and coping are associated with the presence of depression (depending on the real objectives of the study).

Methods

Indicate the total number of students invited to participate and the response rate.

It is not clear how the authors evaluated coping: by one or several questions? was/were open-ended or students could choose from multiple options?

In the statistical analysis, the authors indicate that they will present the percentage of people in each group (line 155), but it is not clear to which groups they refer.

Results

In point 3 of the results (line 186 to 192), the information that was already indicated in the method could be omitted.

Tables

1) Check that the sentences begin with a capital letter.

2) The tables do not have a presentation order, that is, they present Table 2 first.

3) In Table 2, the word "frequency" could be used instead of "number".

4) The tables do not specify which values are in parentheses. See Table 1 (columns 2 and 3), Tables 3 and 4.

Discussion

Missing put a paragraph with the conclusions.

Check references.

Reviewer #2: Overall, this is an interesting study that looked at depression through the lens of mental health literacy within a sample of Chinese medical students. The sample size was more than ample to detect effects. However, there were a lot of issues in the quality of communication that significantly impeded accessibility of the study. The manuscript would benefit from language editing. It was not practical to identify all the language issues within the manuscript as they were prevalent and significant. Some specific points for improvement:-

Introduction

-The intro overly focuses on presenting depression statistics and prevalence rates. However, this needs further development in order to effectively build a line of argument. For example, the authors could explore and expand on factors linked/related to the observed increased prevalence rates in college/university students as the population of interest for the current study.

-More is needed to contextualise the study in the geographical context within which the study was conducted. It needs to be clear what the state of knowledge is around depression within China, and in particular among Chinese university students.

-The literature on treatments for depression is presented in an entirely descriptive manner, and it is not directly relevant to the present study.

-The rationale for the present study is not clear. The introduction has not managed to make a case for why this particular study is needed, in this particular context, and within this particular population. It is not clear what the gap in knowledge is, that the present study aims to fill.

-Lines 98-100 need clarifying. It is not clear what the conflict being referred to here is. It is also not clear how the present study aims to resolve this conflict. The point about distinguishing depression in the population lacks clarity.

-Lines 100-103 need to be further expanded in order to help develop a rationale for the present study. In what way is gathering this information beneficial? The authors need to explicitly state how knowledge of the role of these factors would be beneficial in advancing the knowledge base further.

Methods

-A summary of demographic information for participants should be reported under a ‘Participants’ sub-heading (not ‘respondents’).

-The knowledge and coping style measure (lines 123-130) needs to be described more clearly. Including a couple of sample items will be helpful. It is unclear whether ‘knowledge’ and coping style are two separate subscales. As this is a newly developed measure, internal consistency and reliability/validity analyses should be reported. The scoring criteria is not described in an accessible manner.

Results

-Lines 180-182- reports factors ‘associated’ with higher SDS score. This needs revising for clarity, as no tests of association were conducted

-Lines 186-200- the description of the scoring for the depression knowledge measure should be clarified and placed in the ‘Method’. It is also not clear why analyses were conducted for individual items of the measure.

-Lines 217-229- the results reported here are inaccessible. It is not clear what the figures are referring to.

-Lines 224- 237- logistic regression results are difficult to decipher.

-Table 5 has not been referenced within the text.

Discussion

- Lines242-261- provide comparisons in prevalence rates between present and prior studies. It is not clear whether the prior studies were conducted in medical students specifically. And if this is the case, lines 251-261 are redundant as the reasons for high prevalence rates presented here are applicable to all medical students. The authors need to specifically explore reasons for differences in prevalence that are unique to Chinese medical students as compared to medical students from other countries.

-Lines 294-296 & Lines 303-306 need clarifying

-Limitations need to be much more substantive. For example, it is not clear how utilising a single measure of depression was a limitation. It is also not clear what the limitations of self report alluded to are.

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Reviewer #1: No

Reviewer #2: No

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PONE-D-22-10652R1Knowledge and Coping Style About Depression in Medical Students : A Cross-Sectional Study in North ChinaPLOS ONE

Dear Dr. Ping,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Jan 19 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Callam Davidson

Editorial Office

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: No

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors made all the changes, but I think some were misunderstood, for example removing the percentages and notes from the tables. Unless someone else has requested it.

The observations are already very brief, above all, to the presentation of the tables:

Table 1

I do not understand why the authors decided to eliminate the percentages, I hope my observation has not been misunderstood. In case of putting the percentages again, it would be advisable to put them without decimals.

It would be advisable to leave the values of the statistics (chi square and OR [but not the “p” values]) with two decimal places.

From my point of view, the standards give clarity to the table. Why remove them, did any reviewers suggest it?

Table 3

Be more detailed in the title, i.e. point out "what is associated with what" and/or be more specific in the table footnote.

Put percentages without decimals. Take care that it is all the data that shows a frequency.

Present the values of the statistics (X2 and OR) only with two decimal places.

Also, a typographical error check is again recommended, as in "sofeware" (Line 148)

Reviewer #2: Thank you for a considered attempt at addressing my earlier comments. However, there is still a significant number of issues that require addressing as noted below.

Abstract

• Line 43-48- the observed differences between groups (with and without depression need clarifying).

• Lines 45-53- it is not clear what the dependent variable being predicted here is

• The conclusion is not clear, and none of the statements made here are accessible. For example, does the reference to ‘broadcasting mental health’ infer the importance of sharing whether one has mental health problems? It is not clear.

Introduction

• Typos- line 70 page 3- should be ‘depression’ not depressing; line 86 page 4 ‘made no treated history’- should this be ‘had no history of treatment’?

• The introduction is very brief, and lacking in analysis of the presented information. For example, page 3 line 78 could comment on and explore reasons for the significant differences in prevalence rates (6-66.5%).

Method

• Page 4 line 104- should read ‘the questionnaire survey’ or simply ‘the survey’

• Arrangements for informed consent are slightly concerning. It is not clear how consent was informed based only on a ‘statement’ particularly given the sensitive nature of the study. Did participants explicitly consent (e.g. by ticking a box) or was consent inferred by progressing with questionnaire? How much information about the study did they receive prior to completing the questionnaires?

• Page 6 line 148 typo- should be ‘software’

Results

• Table 3 needs clarifying. For example, the % of correct answers column- percentages are in brackets but not clear what the number appearing before this is? Is this number of correct answers? Does the ‘with depression’ and ‘no depression’ colums show the number in each group endorsing a correct answer? This is not clear. Finally was the chi square comparing absolute numbers in each group (depression v no depression) endorsing the correct answer or the proportions? This needs explaining in the main body. It also needs to be clear what the significant results show.

• Logistic regression results- the concept of ‘no to coping with’ which is the outcome variable needs clarifying as it is not accessible- i.e. not clear what it means.

• Multiple comparisons increase risk of family-wise error rate. Thus Bonferroni correction is needed for all analyses.

Discussion

• Page 13 line 224-225 is directly contradicting lines 220-222.

• Lines 225-227- not clear here whether the comparisons being discussed are of other medical students.

• Line 232- do you mean ‘wellness’

• Linbe 268- do you mean ‘will be qualified’?

• Line 270- do you mean ‘could affect’

• Line 271-272 (and throughout the paper)- you refer to ‘no coping way’- do you mean ‘no coping mechanisms’? or ‘no ways of coping’?

• Iine 272-273- it is not clear how your results compare to Thompson as there is a lack of clarity in regards to your conceptualisation of ‘no coping way’.

• Lines 273-281- need revising for grammar

• Lines 292-296- not substantive. Multiple tools can still capture depression adequately, and there is never an expectation for a study to use all available tools

• Lines 296-298- need revising for meaning

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If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

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While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-22-10652R2Knowledge and Coping Style About Depression in Medical Students : A Cross-Sectional Study in North ChinaPLOS ONE

Dear Dr. Ping,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Mar 24 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Nabeel Al-Yateem, PhD

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #3: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #3: Partly

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #3: No

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: All comments have been addressed.

I note some style errors that will surely be pointed out when editing the manuscript.

Reviewer #3: I would suggest that the author hires someone to correct the English language. It turns out that the previous version was much better than the update one when it comes to grammar and language editing.

On the titles of the summary tables, it is not clear what the Odds Ratio (OR) is about. Specifically, what is the outcome variable, and what is the model predicting?

I suggest clearly distinguishing between crude OR and adjusted OR.

The selected sample may not represent the entire student population. Thus, the result may not be generalizable.

It would be nice to show the interval reliability measures of the responses.

Some formatting is needed for representing the OR with CI and similar places throughout the paper.

For example, OR with confidence intervals are written as 1.027(0.744,1.418)

There should be a space after 1.027 and after the comma, to look like the following: 1.027 (0.744, 1.418)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #3: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-22-10652R3Knowledge and Coping Style About Depression in Medical Students : A Cross-Sectional Study in North ChinaPLOS ONE

Dear Dr. Ping,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Jun 16 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Nabeel Al-Yateem, PhD

Academic Editor

PLOS ONE

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #3: All comments have been addressed

Reviewer #4: (No Response)

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #3: Yes

Reviewer #4: Partly

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #3: Yes

Reviewer #4: N/A

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #3: (No Response)

Reviewer #4: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #3: Yes

Reviewer #4: No

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #3: (No Response)

Reviewer #4: 1.The language used lacks academic rigor and coherence, which affects the clarity and precision of the text.

2.There are errors in the expression of some statistical symbols used in the study, such as the chi-square value. It is recommended to carefully review and correct these errors.

3.The selection of keywords and the phrasing of the title may benefit from further optimization to accurately and effectively communicate the study's focus and contribution.

4.The current research lacks substantial depth in both its content and analysis.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #3: Yes: Enayetur Raheem

Reviewer #4: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-22-10652R4Knowledge and Coping Style About Depression in Medical Students : A Cross-Sectional Study in North ChinaPLOS ONE

Dear Dr. Ping,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Sep 14 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Nabeel Al-Yateem, PhD

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #5: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #5: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #5: I Don't Know

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #5: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #5: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #5: Please clarify the number of respondents excluded and the reasons for exclusion to provide transparency in sample selection.

Provide more details about the demographic characteristics (e.g., age range, gender distribution) to enhance the understanding of the study population.

Include mean and standard deviation values for continuous variables (e.g., age, SDS score) in addition to frequencies.

Provide a more comprehensive discussion of the findings, including comparisons with previous studies and an analysis of the implications for medical education and student support services.

Discuss the potential reasons behind the high prevalence of depression among medical students in China, considering factors such as academic pressure, long study duration, and clinical practice stress.

Address the limitations of the study more explicitly, including the potential biases associated with self-reporting surveys and the need for further research in different regions of China.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #5: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Knowledge and Coping Style about Depression in Medical Students: A Cross-Sectional Study in China

PONE-D-22-10652R5

Dear Dr. Ping,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Nabeel Al-Yateem, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: