Prevalence of and Factors Associated with Depression and Anxiety in Brazilian Medical Students

Abstract: Introduction: Although mental health is an essential condition for the human development, the scientific literature shows a high frequency of depression and anxiety in university students, mainly among medical students. To contribute to a better understanding concerning medical students’ mental health, this study had the following objectives: (a) to estimate the prevalence of indicative scores for anxiety, depression, and for simultaneous anxiety and depression, and (b) to analyze factors associated with these conditions in medical students at a federal university in Brazil. Methods: This is a cross-sectional study including students from a federal medical school in the state of Rio de Janeiro. Participants were enrolled during the first semester of 2015. Mental disorders were assessed with Hospital Anxiety and Depression Scale (HADS). The magnitude of mental disorders and its associated factors were analyzed calculating prevalence rates and unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI). Results: We analyzed 355 students. Anxiety was the most common condition (41.4%), followed by depression (8.2%), and both anxiety and depression simultaneously (7.0%). After adjustment of multivariate models and considering both gender and age as confounding variables, our results showed a differentiated risk pattern in relation to three outcomes analyzed. Anxiety risk increased with ‘feeling alone’ (adjusted PR: 1.59; 95% CI: 1.123; 2.259), ‘having a history of psychological and/or psychiatric treatment before entering university’ (adjusted PR: 1.63; 95% CI: 1.052; 2.542), and ‘feeling morally harmed at college’ (adjusted PR: 1.66; (95% CI: 1.168; 2.364). Depression risk increased with ‘feeling alone’ (adjusted PR: 6.84; 95% CI: 2.047; 22.894) and ‘having a history of psychological and/or psychiatric treatment before entering university’ (adjusted PR: 4.74; 95% CI: 1.790; 12.579). Simultaneous anxiety and depression were associated with ‘feeling alone’ (adjusted PR: 8.90; 95%CI: 2.075; 38.208) and ‘having a history of psychological and/or psychiatric treatment during the medical course (adjusted PR: 3.16; 95% CI: 1.061; 9.439) and before (adjusted PR: 6.01; 95% CI: 2.000; 18.098) entering university’. Conclusion: Anxiety and depression are common conditions in medical students. The main associated factors were therapies for mental health before entering in university, loneliness and lack of respect in interpersonal relationships during the medical course. Therefore, initiatives aiming at better welcoming students and reducing conflicting situations can help minimizing these mental problems during university career, once they have a large impact not only in their quality of life, but also in the way they will deal with their patients in the future.

Download Full-text

Increases in Anxiety and Depression During COVID-19: A Large Longitudinal Study From China

Frontiers in Psychology ◽

10.3389/fpsyg.2021.706601 ◽

2021 ◽

Vol 12 ◽

Author(s):

Shizhen Wu ◽

Keshun Zhang ◽

Elizabeth J. Parks-Stamm ◽

Zhonghui Hu ◽

Yaqi Ji ◽

...

Keyword(s):

Mental Health ◽

Longitudinal Study ◽

Depression Scale ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Depression And Anxiety ◽

Factors Associated ◽

Self Rating ◽

Development Of Students

Although accumulating evidence suggests the COVID-19 pandemic is associated with costs in mental health, the development of students' mental health, including the change from their previous levels of depression and anxiety and the factors associated with this change, has not been well-studied. The present study investigates changes in students' anxiety and depression from before the pandemic to during the lockdown and identifies factors that are associated with these changes. 14,769 university students participated in a longitudinal study with two time points with a 6-month interval. Students completed the Anxiety and Depression subscales of the Symptom Checklist 90 (SCL-90) before the COVID-19 outbreak (October 2020, Time 1), and the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) during the pandemic (April 2020, Time 2). The prevalence of anxiety and depression symptoms were 1.44 and 1.46% at Time 1, and 4.06 and 22.09% at Time 2, respectively, showing a 181.94% increase in anxiety and a 1413.01% increase in depression. Furthermore, the increases in anxiety and depression from pre-pandemic levels were associated with students' gender and the severity of the pandemic in the province where they resided. This study contributes to the gap in knowledge regarding changes in students' mental health in response to the pandemic and the role of local factors in these changes. Implications for gender and the Typhoon Eye effect are discussed.

Download Full-text

Factors associated with psychiatric treatment dropout in a mental health reference center, Belo Horizonte

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462005000200008 ◽

2005 ◽

Vol 27 (2) ◽

pp. 113-118 ◽

Cited By ~ 17

Author(s):

Ana Paula Souto Melo ◽

Mark Drew Crosland Guimarães

Keyword(s):

Mental Health ◽

Cox Regression ◽

Psychiatric Treatment ◽

Treatment Interruption ◽

Treatment Dropout ◽

Factors Associated ◽

Psychiatric Hospitalizations ◽

History Of ◽

Belo Horizonte ◽

Social Demographic

OBJECTIVE: To characterize an outpatient public referral center for mental health and to assess factors associated with treatment dropout. METHODS: A non-concurrent prospective study was undertaken to review 295 patient files. Patients, whose first consultation took place between January and December 1997, were followed-up for at least four months until April 1998. Patients were considered as having abandoned their treatment when, following a recommendation for at least a second visit, they did not return within four months after the first consultation. Social, demographic and clinical variables were compared to verify possible factors associated with dropout of treatment. Statistical analysis was performed using relative hazard (RR) with 95% confidence interval (CI) estimated by the Cox Regression Model. RESULTS: Cumulative incidence of treatment dropout was 39.2% while multivariate analysis indicated that the following characteristics were statistically associated with treatment interruption: to live outside the referral area (RR = 1.95), no history of previous psychiatric hospitalizations (RR = 1.88), alcohol or drug use at admission (RR = 1.72), spontaneous demand to the service (RR = 2.12), lack of bus-passes (RR = 3.68) and to have less than four clinical appointments (RR = 7.31). CONCLUSIONS: Our findings suggest that services should be aware of the high incidence of treatment interruption, especially among those with no history of previous psychiatric hospitalizations and with less institutional bonds. This may indicate that mental health services should develop and implement public policies targeted at this population.

Download Full-text

Prevalence of Mental Disorders and Impact on Quality of Life in Patients With Pulmonary Arterial Hypertension

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.667602 ◽

2021 ◽

Vol 12 ◽

Author(s):

Karen M. Olsson ◽

Tanja Meltendorf ◽

Jan Fuge ◽

Jan C. Kamp ◽

Da-Hee Park ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Mental Disorders ◽

Panic Disorder ◽

Depression Scale ◽

Adjustment Disorder ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Pulmonary Arterial

Objective: Mental health may affect the quality of life (QoL) in patients with pulmonary arterial hypertension (PAH). However, mental disorders have not been systematically assessed in these patients. We examined the prevalence of mental disorders using structured interviews and determined their impact on QoL in patients with PAH.Methods: This study included 217 patients with PAH from two German referral centers. Psychiatric disorders were assessed using the structured clinical interview for DSM-V. QoL was assessed using the WHO Quality of Life questionnaire (short form). The diagnostic value of the Hospital Anxiety and Depression Scale was evaluated by receiver operating characteristic curve analysis.Results: More than one third of the patients had psychological disorders with current or past adjustment disorder (38.2%), current major depressive disorder (23.0%), and panic disorder (15.2%) being the most prevalent mental illnesses. About half of the patients with a history of adjustment disorder developed at least one other mental illness. The presence of mental disorders had a profound impact on QoL. The Hospital Anxiety and Depression Scale ruled out panic disorder and depression disorder with negative predictive values of almost 90%.Conclusion: Mental disorders, in particular adjustment disorder, major depression, and panic disorder, are common in patients with PAH and contribute to impaired QoL in these patients. The Hospital Anxiety and Depression Scale may be used as a screening tool for the most common mental health disorders. Future studies need to address interventional strategies targeting mental disorders in patients with PAH.

Download Full-text

Prevalence and Factors Associated with Depression and Anxiety of Hospitalized Patients with COVID-19 in St. Peter Specialized Hospital Treatment Centers

10.26420/austinpsychiatry.2021.1009 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Dereseh BA ◽

◽

Abraha M ◽

Haile K ◽

Fanta T ◽

...

Keyword(s):

Mental Health ◽

Social Support ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Hospital Treatment ◽

Depression And Anxiety ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Specialized Hospital

Background: Since December 2019, an outbreak of corona virus disease 2019(COVID-19), caused by the Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) has widely and rapidly spread in China and around the world. Since 31 December 2019 and as of 30 April 2020, more than 25,000,000 cases of COVID-19 and 800,000 deaths have been reported. The grim epidemic has caused increasing public panic and mental health stress. Mental health is becoming an issue that cannot be ignored, while trying to control the outbreak. Cross sectional study was conducted to assess magnitude and factors associated depression among patients with COVID-19 in St. Peter Specialized Hospital Treatment Centers Addis Ababa, Ethiopia. Methods: Institutional based cross-sectional study was conducted among 422 Patients with COVID-19 admitted at St. Peter Specialized Hospital COVID-19 treatment center. The Anxiety and Depression was assessed through face to face interviews by trained psychiatry nurses using 14-items Hospital Anxiety and Depression Scale (HADS).Correlates for depression & anxiety were assessed using a structured questionnaire and Oslo social support scale. Result: A total of 373 participants were volunteer to be included in the study which makes the response rate88.4%. The mean age of the respondents was 37.46 (±SD=16.09) years. This study revealed that the Magnitude of Depression 36.5 % (136) and Anxiety 21.2 % (79) among COVID-19 patients. By using Multivariate (Anxiety) Logistic Regression, Patients who were Male (AOR 5.01, 95%CI (2.11, 11.87)), Housewife (AOR 11.43, 95%CI ( 2.67, 48.90)), Selfemployed (AOR 2.45,, 95%CI (1.07, 5.60)), having Diagnosed Chronic illness (AOR 2.56, 95%CI (1.19, 5.53)), having COVID-19 Symptoms for below 7 days and for 8-14 days ((AOR 3.21, 95%CI (1.21, 8.58)) & AOR 3.70, 95%CI (1.55, 8.84)) respectively) and those who had Poor/low Social Support (AOR 3.42, 95%CI (1.21, 9.63)) had Statistically Significant Association with Anxiety. By using Multivariate (Depression) Logistic Regression, Patients who were 41 and above years of old (AOR 3.95, 95% CI (1.80, 8.69)), had Monthly Income of less than 1000 birr (AOR 2.99, 95%CI (1.11, 8.05)), Having COVID-19 Symptoms for 8-14 days (AOR 2.63, 95% CI (1.34, 5.17)) and who had Poor Social Support (AOR 3.13, 95% CI (1.34, 7.30)) were Statistically Significant Associated with Depression. Conclusion: In the current study area the magnitude of depression and anxiety was high. Factors like sex, Job, having Diagnosed Chronic illness, Duration of COVID-19 symptom and social support with anxiety and factors such as age, income, duration of COVID-19 symptom and social support had statistically significant associated with depression.

Download Full-text

Affective Disorder and Functional Status as well as Selected Sociodemographic Characteristics in Patients with Multiple Sclerosis, Parkinson’s Disease and History of Stroke

Medicina ◽

10.3390/medicina56030117 ◽

2020 ◽

Vol 56 (3) ◽

pp. 117 ◽

Cited By ~ 1

Author(s):

Andrzej Knapik ◽

Ewa Krzystanek ◽

Justyna Szefler–Derela ◽

Joanna Siuda ◽

Jerzy Rottermund ◽

...

Keyword(s):

Multiple Sclerosis ◽

Functional Status ◽

Affective Disorders ◽

Depression Scale ◽

Anxiety And Depression ◽

Sociodemographic Characteristics ◽

Stroke Survivors ◽

Depression And Anxiety ◽

Diagnostic Threshold ◽

History Of

The main arguments in support of researching anxiety and depression in patients with chronic somatic diseases are the prevalence of affective disorders in the population, somatic conditions as risk factors of affective disorders and the search for effective preventative and therapeutic strategies. The aim of the study was to determine the association between the functional status, selected sociodemographic characteristics and prevalence as well as severity of anxiety and depression in patients with multiple sclerosis (MS), Parkinson’s disease (PD) and history of stroke (S). Material and methods: Eighty participants (44 women and 36 men) with MS (n = 22), PD (n = 31) and history of stroke (n = 27) were enrolled. All participants completed a questionnaire consisting of metrics, the Katz Index of Independence in Activities of Daily Living and the Hospital Anxiety and Depression Scale (HADS). Results: Fifty-five per cent of all participants did not present with anxiety or depression, 20% scored above the diagnostic threshold on the anxiety scale and 26% scored above the diagnostic threshold on the depression scale. Subgroup analysis revealed that anxiety and depression sufferers were 13.64% and 13.64% of MS patients, respectively; 22.58% and 35.48% of PD patients, respectively; and 22.22% and 25.93% of stroke survivors, respectively. There was a significant correlation between depression and independence level in the entire group and between depression and marital status in stroke survivors. Conclusions: Although depression and anxiety are highly prevalent in patients with neurological conditions, the disorder has a very individual nature and is not associated with the patient’s age, duration of a condition or concomitant diseases. Screening for depression and anxiety as a part of comprehensive approach may increase treatment efficacy in neurological patients

Download Full-text

A Cross-Sectional Research on Factors Associated with Depression Among Transgender Women in Bangkok, Thailand

International Journal of Innovative Technology and Exploring Engineering - Special Issue ◽

10.35940/ijitee.i1175.0789s219 ◽

2019 ◽

Vol 8 (9S2) ◽

pp. 851-856

Keyword(s):

Mental Health ◽

Regression Analysis ◽

Associated Factors ◽

Multivariate Logistic Regression Analysis ◽

Depression Scale ◽

Transgender Women ◽

Sex Reassignment Surgery ◽

Cross Sectional ◽

Factors Associated ◽

Prevalence Of Depression

Depression is becoming a major mental health problem globally. Thailand is known as the accepting society for transgender but the available study on transgender women dealing with depression is scarce. This study aims to describe the prevalence of depression among Thai transgender women in Bangkok and to explore the associated factors. A cross-sectional study was conducted among 108 Thai transgender women in Bangkok, Thailand from January 2019 to April 2019. Data were collected through self-administered. Depression was assessed by using The Center for Epidemiological Studies-Depression Scale (CES-D). Multivariate regression analysis was conducted to explore the associated factors of depression. The prevalence of depression among transgender women in this study was 54.6%. Factors associated with depression in the crude analysis were: sex reassignment surgery (OR=2.45, 95%CI=0.96-6.24), illness history (OR=1.79, 95%CI=0.72-4.50). In multivariate logistic regression analysis, depression was significantly associated with drinking alcohol >1 time/month in the past 12months (adjusted OR=0.33, 95%CI=0.12-0.91). Transgender tend to experience higher rates of mental health issues than the general population. This study suggested that alcohol drinking was only significantly associated with depression in Thai transgender women. For further study, we need to find other associations with depression in transgender community.

Download Full-text

Relative prevalence of anxiety and depression in cubital tunnel syndrome patients and associated factors

10.21203/rs.3.rs-24784/v1 ◽

2020 ◽

Author(s):

siming jia ◽

Xiaoying Shi ◽

Guanglian Liu ◽

Li Wang ◽

Xiaoran Zhang ◽

...

Keyword(s):

Associated Factors ◽

Univariate Analysis ◽

Depression Scale ◽

Cubital Tunnel Syndrome ◽

Cubital Tunnel ◽

Controlled Study ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Increased Risk ◽

Tunnel Syndrome

Abstract Purpose: Cubital tunnel syndrome (CuTS) is the second most common peripheral entrapment neuropathy. This study aimed to assess the prevalence of anxiety and depressive symptoms and explore associated factors among CuTS patients.Methods: This is a cross-controlled study. We used the Hospital Anxiety and Depression Scale to assess the prevalence of depression and anxiety. We calculated the proportion of depression and anxiety symptoms and compared characteristics between groups. Univariate analysis and multivariate regression were carried out to identify variables that were independently associated with anxiety and depression.Results: A total of 246 individuals diagnosed with CuTS were included. The results of the HADS demonstrated that 17.8% (n = 44) of the patients presented possible/probable depression, and 14.2% (n = 35) presented possible/probable anxiety. Logistic regression analysis revealed that diabetes Mellitus was independently associated with depression. And modified McGowan grade was independently associated with anxiety.Conclusions: Patients with cubital tunnel syndrome were at an increased risk of anxiety and depression. Abnormal mental states may have a negative impact in the course and outcome of the disease. Early screening for anxiety and depression in CuTS patients should be recommended.

Download Full-text

Lessons from the COVID-19 pandemic: Perspectives of medical students

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.4177 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Nadia Saeed ◽

Nismat Javed

Keyword(s):

Mental Health ◽

Medical Students ◽

Lifestyle Changes ◽

Anxiety And Depression ◽

Rank Test ◽

Depression And Anxiety ◽

Physical And Mental Health ◽

Signed Rank ◽

Wilcoxon Signed Rank Test ◽

Signed Rank Test

Objective: The objective of the study was to assess the impacts of the COVID-19 pandemic on the mental health and lifestyle of our medical students. Methods: This observational study was conducted on medical students of Shifa College of Medicine, Islamabad from June to August 2020. The GAD-7 and PHQ-9 questionnaires were used for anxiety and depression assessment. Different aspects of changes in lifestyle were evaluated and students were inquired about their views regarding the COVID-19 pandemic. The chi-square test was applied to assess the associations between levels of anxiety and depression with student’s responses to the concerns and lifestyle changes. The binomial logistic analysis was used to highlight important predictors of anxiety and depression. The Wilcoxon signed-rank test was used to compare the time spent on various activities before and during the pandemic. Results: There were 234 participants in the study. The depression and anxiety were detected in 151 (64.5%) and 146 (66.7%) students. The college closure led to a significant increase in sleeping time, sedentary time, and time on gadgets (Z=-4.67, Z=-7.23, Z= -6.72, respectively) on the Wilcoxon signed-rank test. The binomial regression analysis identified study years be the significant predictors for the development of depression and anxiety (p<0.05). Conclusions: Our study emphasizes prioritizing both the physical and mental health of medical students is vital to avoid complications related to the pandemic. doi: https://doi.org/10.12669/pjms.37.5.4177 How to cite this:Saeed N, Javed N. Lessons from the COVID-19 pandemic: perspectives of medical students. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4177 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download Full-text

Prevalence of Depression and Anxiety Among Patients with Noncommunicable Diseases in The Kingdom of Bahrain

Journal of the Bahrain Medical Society ◽

10.26715/jbms.3_29102018 ◽

2018 ◽

Vol 30 (3) ◽

pp. 10-19

Keyword(s):

Risk Factors ◽

Mental Illness ◽

Low Income ◽

Depression Scale ◽

Personal History ◽

Noncommunicable Diseases ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Prevalence Of Depression ◽

History Of

Background and objectives: There is a high coexistence between mental disorders and chronic noncommunicable diseases (NCD). Patients with chronic illnesses have higher rates of depression and anxiety when compared to the healthy individuals. The study aimed to estimate the prevalence of depression and anxiety and to explore the associated risk factors. Methods: A cross sectional study conducted in the NCD clinics of five health centers in the Kingdom of Bahrain included all patients attending these clinics from January 2016 to March 2016. Hospital anxiety and depression scale (HADS) was used to screen patients for depression and anxiety. Logistic regression analyses were used to identify risk factors associated with anxiety and depression. All the analyses were conducted using STATA 12; P < 0.05 was considered statistically significant. Results: A total of 456 patients were included in the study. Mild and moderate to severe type of depression were observed in 71 (15.6%) and 53 (11.6%) patients, respectively. According to the multivariable model, the odds of having high depression score was significantly higher in patients aged < 45 years (adjusted odds ratio (OR) = 2.01; P = 0.01), with low income (adjusted OR = 1.99; P = 0.02), with personal history of mental illness (adjusted OR = 5.13; P = 0.001), and with lower educational levels (P = 0.02). Mild and moderate to severe anxiety scores were observed in 55 (12.1%) and 34 (7.5%) patients, respectively. According to the multivariate model, the odds of having high anxiety score was significantly higher in females (adjusted OR = 2.85; P < 0.001), patients aged < 45 years (adjusted OR = 2.41; P = 0.005), in patients with low income (adjusted OR = 3.62; P < 0.001), and in those with personal history of mental illness (adjusted OR = 4.5; P = 0.004). Conclusion: There is a high prevalence of depression and anxiety among patients attending NCD clinics in the Kingdom of Bahrain. Therefore, screening of mental health diseases should be established.

Download Full-text

A survey on anxiety and depression level among South Indian medical students during the COVID 19 pandemic

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3082 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 779-786

Author(s):

Nihmath Nisha S ◽

Yuvaraj Maria Francis ◽

Balaji K ◽

Gunapriya Raghunath ◽

Kumaresan M

Keyword(s):

Mental Health ◽

Medical Students ◽

Depression Scale ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Cross Sectional ◽

General Anxiety Disorder ◽

Indian Medical ◽

South Indian

The COVID-19 pandemic is being a global Heath crisis. The rate of transmission of the disease is very high. At this time there is no specific vaccine or treatment. This widespread outbreak is also associated with psychological distress like depression and anxiety. The effect of COVID 19 on medical students is considerable. The medical students are in a transitory period which could be one of the most stressful times in a person’s life. The aim of this study is to assess the mental health of South Indian medical students during the COVID-19 pandemic and to see if there is any influence of gender on mental health. A cross sectional study was conducted using convenient sampling method. A total of 359 responses were analysed. Anxiety and depression symptoms were assessed based on four point Likert scale. GAD-7 (General Anxiety Disorder-7) scale and CES-D (Center for Epidemiology Studies for Depression) scale is used to assess anxiety and depression symptoms with a small modification respectively. Data analysis was performed using IBM SPSS statistics version 25. Out of 359 participants 50.4% of participants were male and 49.6% of them were females; majority of them (95.3%) were between the age group of 18-21. In total 75.5% and 74.6% of participants showed varying levels of anxiety and depression symptoms respectively. Anxiety and depression symptoms are found to have a mild association with gender. Symptoms are slightly higher among females than males.

Download Full-text