Evaluation of depression, anxiety and stress levels among medical students in Bihar: a questionnaire study

Abstract

Background: Medical College is recognized as a stressful environment that often exerts a negative effect on the academic performance, physical health and psychological wellbeing of the student. Objective:The objective of the study was to assess the depression, anxiety and stress levels among the medical students by using DASS.

Materials and Methods:This study was carried out in the Department of Physiology, Patna Medical College, Patna, Bihar, India from March 2019 to January 2020, after taking the approval of the protocol review committee and institutional ethics committee. After taking informed consent detailed history was taken from the participant.They were informed about the anonymous and voluntary nature of participation in the study without any undue fear, stigma, or adverse documentation and were contacted during their free time. A previously validated and standardized survey instrument, Depression Anxiety Stress Scale (DASS 21), was used to collect information on depression, anxiety, and stress. Results: A total of 200 students participated in the study giving a response rate of 96%. The overall mean age of students was 20.69 (standard deviation=1.96) years. It was also found that 33.5% had a family history of chronic non-communicable disease; 11.5%further mentioned that there was a family history of chronic mental illness while 24% of students had suffered with some medical conditions such as typhoid, malaria, pneumonia, and hospitalization due to injury in the past. It was found that 50(25%), 70(35%), and 80(40%) medical students were affected by symptoms suggestive of depression, anxiety, and stress, respectively. Some students were affected by >1 emotional state. It was observed on bivariate analysis that higher proportion of students with anxiety had a history of some medical condition and this was found to be statistically significant (p<0.05). Similarly, family history of chronic noncommunicable disorder was significantly (p<0.05) associated with stress and family history of mental illness with depression only. The correlation between depression, anxiety, and stress and it was found that they were highly correlated with each other. The correlation coefficient value between depression and anxiety was 0.70, depression and stress was 0.71, and anxiety and stress was 0.76. Conclusion: It is noted that emotional distress is common among medical students, and there is an urgent need for attention, support, and personalized counselling.

Keywords: Depression, Anxiety, Stress, Medical students