The prevalence and impact of depression among medical students: a nationwide cross-sectional study in South Korea

Socioeconomic status and the risk of depression among U.K. higher education students

BACKGROUND

Many university students experience some symptoms of depression during the course of their studies but there is evidence that students from less advantaged backgrounds may be more vulnerable.

METHODS

The study was a cross-sectional online survey of 923 undergraduate students attending 6 U.K. Universities in the academic year 2009-2010 who completed a modified version of the Zagazig Depression Scale (ZDS).

RESULTS

Overall, 58.1% of female and 59.9% of male study participants screened positive for depression (ZDS score >10). In the fully adjusted model, final year students (OR = 1.8) who lived in a more deprived area (OR = 2.3) were more likely to report higher rates of depressive symptoms. Additionally, students with high perceived control (OR = 1.6) whose mothers were highly educated (OR = 0.5) and from a family of a high affluence (OR = 0.3) were less likely to suffer from higher rates of depressive symptoms. The relationship between lower social economic status and depression was partly mediated by low sense of control.

CONCLUSION

Students from less advantaged backgrounds are more at risk of depression but a strong sense of control over one's life may be protective.

APPLICATION

Since depression has strong impact on students' learning and quality of life universities should consider confidential screening for mental health problems and provide additional support for students.

[Predictors and longitudinal changes of depression and anxiety among medical college students]

PURPOSE

This longitudinal study was designed to examine the change in depression and anxiety and their predictors over 1 year among premedical and medical students. We compared depression and anxiety from 2 waves and determined the predictive power of personality, narcissism, social comparison, and social reward value on them.

METHODS

Two hundred twenty-six students at a medical school in Seoul were divided into 4 groups according to academic year and completed a questionnaire at the end of 2010 and 2011. The questionnaire included the Zung Depression Scale; Zung Anxiety Scale; scales for social comparison, narcissism, and social reward value; and Neuroticism-Extraversion-Openness Personality Inventory.

RESULTS

Among first- and second-year medical students, depression and anxiety increased significantly over the previous year. However, irrespective of academic year, depression increased significantly after 1 year. Also, social reward value had a moderating effect. Specifically, among students with low social reward value who entered their first year of medical school, the negative impact of the tendency toward depression and anxiety was amplified compared with older students.

CONCLUSION

Because the predictors of mental health differ between groups, each group must receive specific, appropriate education. Also, because social reward value is important moderating factor of mental health, education and intervention programs that focus on social reward value are needed.

A systematic review of studies of depression prevalence in university students

BACKGROUND

Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. There is evidence to suggest that university students are at higher risk of depression, despite being a socially advantaged population, but the reported rates have shown wide variability across settings.

PURPOSE

To explore the prevalence of depression in university students.

METHOD

PubMed, PsycINFO, BioMed Central and Medline were searched to identify studies published between 1990 and 2010 reporting on depression prevalence among university students. Searches used a combination of the terms depression, depressive symptoms, depressive disorders, prevalence, university students, college students, undergraduate students, adolescents and/or young adults. Studies were evaluated with a quality rating.

RESULTS

Twenty-four articles were identified that met the inclusion and exclusion criteria. Reported prevalence rates ranged from 10% to 85% with a weighted mean prevalence of 30.6%.

CONCLUSIONS

The results suggest that university students experience rates of depression that are substantially higher than those found in the general population. Study quality has not improved since 1990.

Associations of pass-fail outcomes with psychological health of first-year medical students in a malaysian medical school

OBJECTIVES

The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms).

METHODS

A cross-sectional study was conducted on a cohort of first-year medical students in a Malaysian medical school. The depression anxiety stress scale 21-item assessment (DASS-21) was administered to them right after the final paper of the first-year final examination. Their final examination outcomes (i.e. pass or fail) were traced by using their student identity code (ID) through the Universiti Sains Malaysia academic office.

RESULTS

A total of 194 (98.0%) of medical students responded to the DASS-21. An independent t-test showed that students who passed had significantly lower stress, anxiety, and depression symptoms than those who failed the first-year final examination (P <0.05). Those who experienced moderate to high stress were at 2.43 times higher risk for failing the examination than those who experienced normal to mild stress.

CONCLUSION

Medical students who failed in the final examination had higher psychological distress than those who passed the examination. Those who experienced high stress levels were more likely to fail than those who did not. Reducing the psychological distress of medical students prior to examination may help them to perform better in the examination.

Reliability of a shortened version of the Zagazig Depression Scale and prevalence of depression in an Egyptian university student sample

BACKGROUND

There is some evidence that university students are at higher risk of depression; but rates have been found to vary widely across different countries, and there have been few surveys in representative samples. This study was carried out to assess the reliability of the Arabic-language Zagazig Depression Scale (ZDS) in a sample of Egyptian university students and to use the ZDS to assess the prevalence of depression.

METHODS

The study was a cross-sectional survey of a representative sample of 988 undergraduate students from Assiut University, Egypt (response rate, 82.3%). Prevalence of depressive symptoms was assessed using the ZDS, a self-report Arabic-language version of the Hamilton Rating Scale, modeled on the Carroll Rating Scale for Depression.

RESULTS

Participants had a mean ZDS score of 17.8 (± 9.0) out of a possible maximum score of 46. Using the recommended cutoffs for the ZDS, 37.6% of the students were found to have at least moderate depression, with 71% exceeding the cutoff for mild depression. The internal consistency of the ZDS was excellent (Cronbach α = 0.904), as was the split-half correlation coefficient.

CONCLUSION

This survey revealed a worryingly high rate of depressive symptoms in a representative sample of Egyptian university students. The ZDS is a reliable and acceptable tool for assessing mental health in a university population.

A multidimensional perspective of the mental health of preclinical medical students

Previous research on medical students' mental health has focused almost exclusively on students' emotional well-being and/or their personal psychological functioning, neglecting the more public side of medical training - the students' social health. A total of 237 preclinical students completed surveys at the beginning and the end of their academic year assessing their emotional, psychological, and social well-being, respectively, as well as the overall negative impact medical school stressors had on their lives. Although first and second year students were found to significantly decrease in emotional well-being, first year students were found to increase in social well-being, with further analysis showing an increase among first year students specifically in the feelings of social integration and social acceptance. The overall negative impact from the stressors was found to predict the change in emotional well-being, but not other dimensions of well-being. However, the negative impact from stressors was also found to indirectly impact students' emotional well-being through negatively affecting their psychological and social well-being. The authors present the value in measuring medical students' well-being from a multidimensional perspective as well as highlight the potential "condensing" of students' social world as early as their first year of training. Recommendations are made that researchers continue to focus on the promotion and protection of students' positive mental health in the preliminary stages of medical education, as well as endorse programs that cultivate the benefits of solidarity and integration experienced by first year students.

Analysis of an Egyptian study on the socioeconomic distribution of depressive symptoms among undergraduates

BACKGROUND

Worldwide population surveys show that prevalence of mental disorders in developing countries was as common as in industrialized countries. College life is an important stage in every person's life; unfortunately, it may be the time to experience depression for the first time. Latterly, there has been a steady increase in the number of university students diagnosed and treated as depressed patients. This paper presents the results of a study carried out on a representative sample of undergraduate students of an Egyptian University, which aimed to study the relationship between social factors and the occurrence of depression. It was assumed that the poorer the socio-economic background the higher the rates of depression.

METHOD

Data were collected in 2004 from students at Assiut University using the Zagazig Depression scale (ZDS) and an Egyptian socio-economic status measure. This analysis, based on a refined version of the ZDS used STATA (v. 10.1.). Descriptive statistics, univariate and multivariate regression models were used to test for associations with the dimensions of SES and depression.

RESULT

Thirty-seven percent of the students had symptoms scored above the threshold for moderate depression. In the fully adjusted model: faculty of study, father's occupation, family income and number of persons per room were associated with depression in this sample.

CONCLUSION

The high prevalence of depressive symptoms among Egyptian students found in this study call attention to the need for a student counseling service offering mental health support. This service should particularly discover an approach for low affluence students.

Correlations between psychological symptoms and social relationships among medical undergraduates in Anhui Province of China

OBJECTIVES

To assess the prevalence of psychological symptoms (depression, anxiety) among Chinese medical students and to find the possible relationships between psychological symptoms and social relationships.

METHODS

A sample of 10,140 medical students was investigated with a structured questionnaire, that included the Beck Depression Inventory, Beck Anxiety Inventory, Social Support Rating Scale, and Family APGAR Index (adaptability, partnership, growth, affection, resolve).

RESULTS

The present study revealed that 16.8% of the medical students suffered from depressive symptoms and 14.1% from anxiety symptoms. Female students were more likely to have anxiety, the second-year students had higher levels of psychological symptoms than the first-year students. Likewise, significant differences were found among college, satisfaction of specialty, and economic condition of the family in anxiety and depression symptoms. Social support, family function, and all dimensions were significantly negatively associated with depression and anxiety symptoms. Multivariable ordinal logistic regression showed that less social support, poor family function, the second-year students, and unsatisfactory specialty were associated with more psychological symptoms, after adjusting the effects of sex, age, and college.

CONCLUSIONS

Medical students have a relatively high level of depression and anxiety symptoms. These findings support the hypothesis that if medical students are better supported and cared for, negative psychosocial consequences might be prevented or at least reduced.

Burnout Syndrome and associated factors among medical students: a cross-sectional study

OBJECTIVES

To assess the prevalence and levels of burnout syndrome among medical students at the Universidade Federal de Sergipe-Brazil and to identify associated factors.

METHODS

A cross-sectional study was performed with randomly selected students in 2009. The Maslach Burnout Inventory/Student Survey (MBI-SS) and a structured questionnaire on socio-demographic characteristics, the educational process, and individual aspects were used. Statistical evaluation of multiple variables was performed through backward stepwise logistic regression analysis.

RESULTS

The prevalence of burnout was 10.3% (n = 369). The prevalence was higher among those who did not have confidence in their clinical skills (Odds Ratio-OR = 6.47), those who felt uncomfortable with course activities (OR = 5.76), and those who did not see the coursework as a source of pleasure (OR = 4.68).

CONCLUSION

There was a significant prevalence of burnout among the medical students studied. Three variables, in particular, were associated with burnout and were directly related to the medical education process. Preventive and intervention measures must be adopted, and longitudinal studies should be conducted.

The Associations between Social Support, Health-Related Behaviors, Socioeconomic Status and Depression in Medical Students

OBJECTIVES

The objective of this study was to estimate the prevalence of depression in medical students and to evaluate whether interpersonal social support, health-related behaviors, and socio-economic factors were associated with depression in medical students.

METHODS

The subjects in this study were 120 medical students in Seoul, Korea who were surveyed in September, 2008. The subjects were all women and over the age of 20. Their age, body mass index (BMI), quality of sleep, diet, household income, smoking, alcohol consumption, exercise levels, and self-reported health status were surveyed. The degree of perceived social support was measured using the interpersonal support evaluation list (ISEL). Depression was evaluated using the center for epidemiology studies depression scale (CES-D).

RESULTS

The mean CES-D score was 14.1±8.6 and 37.1% of the participants appeared to suffer from depression. Low levels of perceived interpersonal support increased the risk of depression by more than 10 times and having higher household income did not necessarily decrease the risk of depression.

CONCLUSION

Medical students have a relatively high level of depression. Efforts should be made to encourage social support in order to promote mental health in medical students.