Abstract: Objective To analyze factors influencing the mental health of residents undergoing standardized residency training based on the Biopsychosocial (BPS) model, and inform subsequent targeted psychological interventions. Methods From February to March 2024, a stratified cluster sampling method was used to select 327 residents from two standardized training bases in Wenzhou for a questionnaire survey. A self-designed ″General Information and BPS-Related Factors Questionnaire for Standardized Training Residents″ was administered based on the BPS model, and the Depression, Anxiety and Stress Scale-21 (DASS-21) was used to assess depression, anxiety, and stress levels. Chi-square tests and multivariate binary logistic regression were employed to examine the associations of biological, psychological, and social factors with mental health. Results The detection rates of depressive, anxiety, and stress symptoms among the residents were 29.2% (95/325), 28.9% (94/325), and 15.1% (49/325), respectively. Multivariate binary logistic regression analysis showed: (1) In terms of biological factors, residents with regular sleep patterns were 0.253 times as likely to report depressive symptoms (95%CI: 0.136-0.469) and 0.337 times as likely to report anxiety symptoms (95%CI: 0.183-0.621) as those with irregular patterns (all P<0.05); those with regular dietary habits were 0.223 times as likely to report stress symptoms as those with irregular habits (95%CI: 0.102-0.491), P<0.05. (2) In terms of psychological factors, residents with high professional identity were 0.277 times (95%CI: 0.155-0.496), 0.307 times (95%CI: 0.170-0.554), and 0.108 times (95%CI: 0.043-0.268) as likely to report depressive, anxiety, and stress symptoms, respectively, as those with moderate identity (all P<0.05); those with career development confusion were 1.874 times (95%CI: 1.062-3.306), 2.827 times (95%CI: 1.555-5.139), and 2.327 times (95%CI: 1.111-4.877) as likely to report the three types of symptoms, respectively, as those without such confusion (all P<0.05); those with high training load were 2.055 times (95%CI: 1.072-3.938) and 2.369 times (95%CI: 1.054-5.325) as likely to report anxiety and stress symptoms, respectively, as those with moderate load (all P<0.05). (3) In terms of social factors, residents with good interpersonal relationships were 0.385 times (95%CI: 0.214-0.691), 0.443 times (95%CI: 0.247-0.792), and 0.404 times (95%CI: 0.196-0.832) as likely to report depressive, anxiety, and stress symptoms, respectively, as those with moderate relationships (all P<0.05); second-year residents were 0.406 times as likely to report depressive symptoms as first-year residents (95%CI: 0.194-0.853, P=0.003). Conclusions The mental health of residents is associated with biological, psychological, and social factors. High professional identity and good interpersonal relationships were associated with lower detection rates of all three types of symptoms, serving as core protective factors. Regular sleep was mainly associated with lower detection rates of depression and anxiety, while a regular diet was mainly associated with lower detection rates of stress, demonstrating a symptom-specific association pattern. It is recommended to develop a stratified intervention system focusing on ensuring regular routines, cultivating professional identity, and optimizing interpersonal ecology.

Key words: Questionnaires, Standardized residency training, Mental health, Biopsychosocial model, Influencing factors, Depression anxiety stress scale-21