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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 3  |  Page : 219-222

A cross-sectional study on the preponderance of stress and depression among medical students and their association with various recent factors


1 Final MBBS Part-1, Konaseema Institute of Medical Sciences and Research Foundation (KIMS&RF), Amalapuram, Uttar Pradesh, India
2 Department of Physiology, Government Medical College, Ongole, Uttar Pradesh, India
3 Department of Psychiatry, Konaseema Institute of Medical Sciences and Research Foundation (KIMS&RF), Amalapuram, Uttar Pradesh, India
4 Department of Physiology, Government Institute of Medical Sciences, Greater Noida (Delhi-NCR), Uttar Pradesh, India
5 Final MBBS Part-2, Konaseema Institute of Medical Sciences and Research Foundation (KIMS&RF), Amalapuram, India

Date of Submission25-Jul-2019
Date of Decision20-Oct-2019
Date of Acceptance26-Dec-2019
Date of Web Publication25-Jan-2021

Correspondence Address:
Lakshmi Venkata Simhachalam Kutikuppala
Konaseema Institute of Medical Sciences and Research Foundation, Chaitanya Nagar, NH-216, Amalapuram - 533 201, East Godavari, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cjhr.cjhr_80_19

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  Abstract 


Background: Stress and depression among medical students are the prevalent and global concern these days. Stress is a critical risk factor for depression as it can contribute to depression through various pathways. Stress is multifactorial in causation which can be associated or attributable to depression. Aims: The aim of this study is to evaluate and elicit the levels of stress and depression in association with various recent factors, accounting and resulting to stress and depression. Subjects and Methods: This is a cross-sectional study conducted among medical students of a well-recognized medical college. Analysis sheets consisting of Beck's Depression Inventory (BDI), Perceived Stress Scale (PSS), and other criteria comprising demographic details such as gender, age, year of studying and some associated factors which include appetite, gastrointestinal (GI) problem, sleep, social feelings, body mass index (BMI), and hair fall adding to stress and depression were made to fill by 288 medical students of a medical college. Results: Majority of the study participants have moderate-or-high levels of stress but no depression. Nearly 46.5% of the study participants have normal values of BMI, and 42.7% are over the levels of their normal BMI. Nearly 59.7% of the total students have hair fall, 76.7% have normal sleep-wake cycle, 77.4% have normal social feelings, 75.6% have normal appetite, and 84.7% do not have any GI problems. When the relation between stress and these study variables was observed, the association between BMI and hair fall was found to be significant. Conclusions: First-year students feel more stressed that could be due to their recent entry into the course. Female students are more prone to these stressors and depressors. Juniors are more stressed when compared to senior students.

Keywords: Beck's Depression Inventory, body mass index, Hair fall, Perceived Stress Scale, stress


How to cite this article:
Simhachalam Kutikuppala LV, Vadugu S, Salaam MA, Sundara Kiran A N, Sathvika M V. A cross-sectional study on the preponderance of stress and depression among medical students and their association with various recent factors. CHRISMED J Health Res 2020;7:219-22

How to cite this URL:
Simhachalam Kutikuppala LV, Vadugu S, Salaam MA, Sundara Kiran A N, Sathvika M V. A cross-sectional study on the preponderance of stress and depression among medical students and their association with various recent factors. CHRISMED J Health Res [serial online] 2020 [cited 2021 Feb 25];7:219-22. Available from: https://www.cjhr.org/text.asp?2020/7/3/219/307825




  Introduction Top


Stress and depression are the leading causes of mental illness in the recent scenario. Stress is a critical risk factor for depression as it can contribute to the development of depression through various pathways.[1] Many campaigns are being conducted globally on these two eminent sources of psychological sickness.[2] More than 300 million individuals are suffering from depression globally, with a rise of more than 18% between 2005 and 2015.[3] To add up, “Depression – Let's talk” is the theme of World Health Day 2017.[2],[4]

This study aims to rule out some of the factors of human life in relation to their daily activities leading to stress and depression. The main aim of this study is to evaluate and elicit the levels of stress and depression in association with various recent factors accounting and result them. The prevalence of stress and depression in relation to factors such as body mass index (BMI), social feelings, gastric problems, appetite, and hair fall is also assessed.[5]


  Subjects and Methods Top


This is a cross-sectional study conducted among medical students of a well-recognized and reputed medical college. This study is registered under the Institutional Ethical Committee of our institution numbered 124/018 and dated January 12, 2018. Verbal consent has been obtained by all the students before distributing the questionnaire. The study population was made of 288 medical students of 1st year, 2nd year, and 3rd year of the course. All necessary permissions and Institutional Ethical Clearance were obtained before proceeding with the study. After obtaining verbal consent, 288 medical students were requested to answer the analysis sheet comprising Beck's Depression Inventory (BDI), Perceived Stress Scale (PSS), and other criteria comprising some selected factors adding to stress and depression. All the answered data were collected in Excel sheets and then evaluated to obtain the results.

Data analysis

Data collected were entered into the MS Excel, and GraphPad Instat version 3.06 for Windows, (GraphPad Software Inc., La Jolla, California, USA) was used for the statistical analysis. The factors were tabulated, and comparison between the stages of curricula and genders with respect to each factor was performed by the independent t-test. P < 0.05 was considered statistically significant.

The standard scales used to conduct this study are as follows:

  • PSS to measure the stress levels:[6] the PSS is a 10-question multiple-choice self-report inventory and is most widely used psychological instrument for measuring the perception of stress. It is a measure of the degree to which situations in one's life are appraised as stressful. The questions in the PSS ask about the feelings and thoughts during the last month. The validity and reliability of this cohen 10-item PSS were remarkable with KMO coefficient 0.82, which was statistically significant with P < 0.0001. This is in accordance with a study conducted by Khalili et al.[7]
  • BDI to measure the depression levels:[8] the BDI is a 21-question multiple-choice self-report inventory and one of the most widely used psychometric tests for measuring the severity of depression. The validity and reliability of this BDI had an excellent coefficient of 0.92, which is in accordance with a study conducted by Beck et al.[9]



  Results Top


A total of 288 medical students participated in this study, of which 117 (40.6%) were male and 171 (59.4%) were female. The factors such as BMI, sleep, appetite, social feelings, and hair fall are assessed in relation to stress and depression. The study population was classified based on their BMI [Table 1].
Table 1: Classification of the study population based on their body mass index

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Sleep pattern, social feelings, and hair fall of the study population are depicted in [Table 2], [Table 3], [Table 4], respectively.
Table 2: Sleep pattern among the study population

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Table 3: Social feelings among the study population

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Table 4: Hair fall among the study population

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Stress and depression were evaluated among the study population using PSS and BDI, as shown in [Table 5] and [Table 6].
Table 5: Depression score among the study population

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Table 6: Stress score among the study population

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The statistical results of all the study variables are tested for significance with stress and depression among various factors, as shown in [Table 7].
Table 7: Significance of study variables with P values

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When the relation between stress and above-mentioned study variables was observed, the association between BMI and hair fall was found to be significant.


  Discussion Top


Two hundred and eighty-eight medical students participated in this study, of which 117 were male and 171 were female. Nearly 46.5% of the study participants have the normal values of BMI. About 42.7% of the study participants are over the levels of their normal BMI, which is in accordance with the study conducted by Kumar et al.[10] Nearly 59.7% of the total students have hair fall, whose relation with stress is greatly significant with P < 0.0001, which is in accordance with the study conducted by Hunt and McHale.[11] Nearly 76.7% of the total students have normal sleep-wake cycle, which is in accordance with the study conducted by Minkel et al.[12] About 77.4% of the total students have normal social feelings. 75.6% of the total students have normal appetite, which is in accordance with the study conducted by Liu et al.[13] 84.7% of the total students do not have any gastrointestinal (GI)-related problems, which is in accordance with a study conducted by Huerta-Franco et al.[14] 34.7% of the total students have moderate stress levels and 40.6% have high levels of psychological stress. 46.8% of the total students are found with mild-to-severe levels of depression. Depressive symptoms were significantly associated with chronic illness, clinical level students, and female gender. Juniors are more prone to stress when compared to senior students, which is in accordance with a study conducted by Kittu and Patil.[15] Most of the students experienced higher levels of stress during the period of examinations. They experience higher stress levels because they are freshers to the course and more worried and confused about their career, which is in accordance with a study conducted by Garg et al.[16] When the relation between the above study variables and stress was observed, the association between BMI and hair fall was found to be significant [Table 7].

Implications

The factors considered such as GI problems, appetite, sleep, social feelings remain insignificant and did not show any impact on the levels of stress and depression among the study population.

Recommendations

This study recommends stress and depression are highly associated factors which must be given little more importance in upcoming studies and medical curriculum to prevent the morbidity in the medical students.

Limitations

There was no control population used in the study, which will be impossible to compare the results assessed.


  Conclusions Top


First-year students have more scoring in stress and depression. Female students are more prone to these stressors and depressors than males. Hair fall and BMI are the most significant factors supporting the study. Increased levels of stress and depression can cause hair fall and weight gain, which is already proven globally.

Acknowledgment

The authors wish to thank the Management, Dean, Principal, and Head of the Department of Psychiatry of our institution for all the support, encouragement, and help rendered. We would also like to thank all the study participants for their valuable cooperation provided.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Available from: https://education.stateuniversity.com/pages/2457/Stress-Depression.html. [Last accessed on 2018 Aug 01].  Back to cited text no. 1
    
2.
Friedrich MJ. Depression is the leading cause of disability around the world. JAMA 2017;317:1517.  Back to cited text no. 2
    
3.
4.
World Health Organization. Depression. World Health Organization; 2018. Available from: http://www.who.int/en/news-room/fact-sheets/detail/depression. [Last accessed on 2018 Dec 12].  Back to cited text no. 4
    
5.
Haldorsen H, Bak NH, Dissing A, Petersson B. Stress and symptoms of depression among medical students at the University of Copenhagen. Scand J Public Health 2014;42:89-95.  Back to cited text no. 5
    
6.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385-96.  Back to cited text no. 6
    
7.
Khalili R, Sirati Nir M, Ebadi A, Tavallai A, Habibi M. Validity and reliability of the Cohen 10-item perceived stress scale in patients with chronic headache: Persian version. Asian J Psychiatr 2017;26:136-40.  Back to cited text no. 7
    
8.
9.
Beck AT, Steer RA, Ball R, Ranieri W. Comparison of beck depression Inventories -IA and -II in psychiatric outpatients. J Pers Assess 1996;67:588-97.  Back to cited text no. 9
    
10.
Kumar SG, Kattimani S, Sarkar S, Kar SS. Prevalence of depression and its relation to stress level among medical students in Puducherry, India. Ind Psychiatry J 2017;26:86-90.  Back to cited text no. 10
[PUBMED]  [Full text]  
11.
Hunt N, McHale S. The psychological impact of alopecia. BMJ 2005;331:951-3.  Back to cited text no. 11
    
12.
Minkel JD, Banks S, Htaik O, Moreta MC, Jones CW, McGlinchey EL, et al. Sleep deprivation and stressors: Evidence for elevated negative affect in response to mild stressors when sleep deprived. Emotion 2012;12:1015-20.  Back to cited text no. 12
    
13.
Liu C, Xie B, Chou CP, Koprowski C, Zhou D, Palmer P, et al. Perceived stress, depression and food consumption frequency in the college students of China Seven Cities. Physiol Behav 2007;92:748-54.  Back to cited text no. 13
    
14.
Huerta-Franco MR, Vargas-Luna M, Tienda P, Delgadillo-Holtfort I, Balleza-Ordaz M, Flores-Hernandez C. Effects of occupational stress on the gastrointestinal tract. World J Gastrointest Pathophysiol 2013;4:108-18.  Back to cited text no. 14
    
15.
Kittu D, Patil R. Study of association of psychological stress and depression among undergraduate medical students in Pondicherry. Natl J Community Med 2013;4:555-8.  Back to cited text no. 15
    
16.
Garg K, Agarwal M, Dalal PK. Stress among medical students: A cross-sectional study from a North Indian Medical University. Indian J Psychiatry 2017;59:502-4.  Back to cited text no. 16
[PUBMED]  [Full text]  



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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Introduction
Subjects and Methods
Results
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