The influence of the academic exams routine on the perceived stress, resilience and salivary cortisol in Brazilian pharmacy undergraduate students

The exams periods are commonly reported to be stressful experiences. The relationship between perceived stress and resilience is well established, however, the relationship with cortisol remains unclear. Considering the stressful environment provided by the university and the lack of studies in the Brazilian context, this study aimed to evaluate and associate perceived stress, resilience and salivary cortisol in pharmacy students during the exams period. Seventy-nine pharmacy undergraduates answered questionnaires related to perceived stress and resilience and collected five saliva samples in an exam and a rest day for cortisol measures at the final exams at the end of the school year. They reported higher scores of perceived stress and intermediate resilience. Women are less resilient and their total cortisol output (AUC) on exams day is significantly higher compared to the rest day, but this difference tends to disappear over the academic year or at the end years. Furthermore, they exhibited cortisol rhythmicity and preserved CAR, with no changes in a short period by the exams, indicating normal, healthy and adaptive HPA-axis reactions to stressors. This study highlighted that students can adapt to stressful situations due to a modulation in the production of cortisol over the time.

Automated summary

This study investigated the perceived stress, resilience, and salivary cortisol levels in pharmacy students during exam periods. Results showed that female students had lower resilience and higher cortisol output on exam days, though this difference decreased over the academic year. The study highlighted that students can adapt to stress through modulation of cortisol production over time.