Study of Depression among Undergraduate Medical Students of a Medical College in Southern Maharashtra

Mental health is regarded as an essential component of health by the World Health Organization. Undergraduate medical education comprises strenuous study and training for 5–6 years. Depression is highly common and according to WHO by 2020, it would be the second-most prevalent condition worldwide1.However, the demands of the learning and training might adversely affect the student’s physical and mental health. It has been reported that medical students consequently suffer from depression, anxiety, and stress.2

Mental health refers to a broad array of activities directly or indirectly related to the mental well-being component included in the World Health Organization’s definition of Health. Mental Health problems are a major public health concern due to their high prevalence rates, difficulties related with identification, treatment and their tendencies to become chronic.4With level of demands in academics and psychosocial pressure, medical students during their course of training tend to become depressed, leading to problems later in professional life and compromising patient care. Depressant is a significant contributor to the global burden of disease and affects people in all countries across the world with a global prevalence of depressive episode of 3.2%. Depressive disorders often start at a young age and often are recurrent throughout life. For these reasons, depression is the leading cause of disability worldwide in terms of total years lost due to disability.5Psychological distress among students also reduces their self-esteem, quality of life and the quality of care they provide to patients with decreased empathy. They may engage in potentially harmful methods of coping strategy from stress such as tobacco, alcohol and other substance abuse. Medical students have a higher risk of suicidal ideation and suicide than age matched peers and general population. Therefore, it was considered to deal with the mental health issues of the medical students as early detection and intervention may help in preventing and minimizing the effects of distress and help the students to deliver the best comprehensive care to the patients in the future. Depression Anxiety Stress Scale developed by the Australian Psychology Foundation, Sydney and approved by the WHO6.Present study was conducted in Solapur Government Medical College to asses level of depression among undergraduate students.

Aims & Objectives-Study was done to assess the prevalence and associated factors of depression by using DASS.

It was a cross sectional study. It was conducted in 1st& 2nd year medical students. All the students who had spent more than six months in the medical college and willing to participate in the study were included in the study. Students who were already diagnosed and treated for any psychosocial disorders were also excluded from the study. The Depression Anxiety Stress Scales (DASS) short version by Lovibond and Lovibond, a 21-item self-reported measure was used to assess depression, anxiety and stress. Items on the DASS are rated on 4 point Likert - type, ranging from 0 (Did not apply to me at all) to 3 (Applied to me very much, or most of the time). The depression scale assesses dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest/involvement, and inertia. The Stress scale (items) is sensitive to levels of chronic non-specific arousal. It assesses difficulty relaxing, nervous arousal, and being easily upset.

Data was collected using a standard questionnaire, which had 2 sections consisting questions for socio-demographic information and the Depression Anxiety Stress Scale. 250 students had participated in the study. Students who had unfilled, incompletely filled the questionnaire were ultimately excluded from study too. So eventually, 216 students were analyzed. Informed written consent from hostel warden was taken prior to the study. Institutional Ethical Clearance was also obtained.

There were total 216 students in 1st (118) & 2nd year (98). Age ranged from 19 to 22 years. 99 Students (46%) suffered from depression. There was not significant difference among male & female. It was 49 (46%) & 50 (45%) respectively. But highly significant difference was seen among first & second year students (p=0.02). Second year students (54%) were more depressed than first year students (39%). Regarding level of depression among depressed, most of the depressed were moderately depressed (45%), followed by mildly depressed (31%).Severely & extremely depressed were (24%).Among  all the students,71 (33%) were suffering from stress. Most of them were moderately stressed (48%) followed by mild stress (39%), severely & extremely stressed (13%).Overall addiction was 16%, second year students (20%) were more addicted than first year students (13%).

Table No.1 Socio-demographic profile of study subjects

Table No.2 Depression among study subjects

Table No.3 Depression &Personal habits

(Either Smoking or Alcohol Consumption or Both)

There were 216 study subjects in final analysis, we found prevalence of depression 46% & prevalence of stress was 33%. we found higher prevalence of depression compared to study conducted by Anshuman Sharma et al 6in Bhopal which it was 31%. Another study conducted in Bareilly7 had prevalence of depression 49% while study conducted in kolkata5 had prevalence of 41%. In our study we found significantly higher prevalence in 2nd year students than 1st year students. It was 39% in 1st year students while 54% in 2nd year students while a study conducted in Banglore3found that 2nd year students had lower prevalence than successive third8year students. It may be due to increased academic distress with increase in successive years. In our study we did not significant difference among males & females. Most of the study subjects had moderate degree of depression followed by mild, severe & extremely severe level of depression. Similarly, a study conducted in Cameroon 4had higher prevalence of moderate depression to milder depression. We found 33% prevalence of stress among study subjects. A study conducted in Bhuvaneshwar8 had 53% prevalence of stress among medical undergraduates. Those who had stress, had depression too. In our study 12% study subjects had habits of alcohol consumption & smoking along with the depression.

Almost half of the students were suffering from depression. There was considerable level & prevalence of depression, stress in our study setting requiring urgent attention. So, institutes are required to seek out those students & it is needed to counsel them. We recommend that further studies on same group on larger scale.

1.        World Health Organization. Mental and neurological disorders. Fact sheet No. 265; 2001.

2.        2. Bibi Kulsoom N,asiraliafsar Stress, anxiety, and depression among medical students in a multiethnic setting. Dove press journal: Neuropsychiatric disease & treatment 16 july 2015.

3.        3.Naveen S.,Swapna M. Stress, anxiety and depression among students of selected medical and engineering colleges, Bangalore - a comparative study. International Journal of Public Mental Health and Neurosciences ISSN: 2394-4668.

4.        4.Stewart Ndutard Ngasa1, Carlson-BabilaSama,Prevalence and factors associated with depression among medical students in Cameroon: a cross-sectional study. Ngasa et al. BMC Psychiatry (2017) 17:216 DOI 10.1186/s12888-017-1382-3

5.        5.JhumaSarkar, Prajjalsen Gupta. Depressive symptoms among undergraduate Medical students: Study from a Medical college in Kolkata, India. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 4, Issue 3 (Jan.- Feb. 2013), PP 13-18.

6.        6.Anshuman Sharma1, Sanjay Kumar Gupta. Assessment of depression among medical students of private university in Bhopal, India. pISSN 0976 3325, eISSN 2229 6816.

7.        7.SukhwindarSingh, Ajit Singh. Prevalence of depression among private medical college in India. Journal of health & allied sciences. Jan2011.

8.        8.Shawaz Iqbal, sandhya Gupta& E. Venkatarao, Stress, anxiety & depression among medical undergraduate students & their socio-demographic correlates. Indian J Med Res 141, March 2015, pp 354-357.