Depression, Anxiety, and Stress in Sudanese Medical Students: A Cross Sectional Study on Role of Quality of Life and Social Support

Mohamed Dafaalla^1, , Abdulraheem Farah², Shaima Bashir², Ammar Khalil², Rabab Abdulhamid², Mousab Mokhtar², Mohamed Mahadi², Zulfa Omer², Asgad Suliman², Mohammed Elkhalifa², Hanin Abdelgadir², Abdelmoneim E.M. Kheir³ and Ihab Abdalrahman⁴

¹Diploma of Statistics, Executive Manager of Soba Centre for Audit and Research, Soba university Hospital, Khartoum, Sudan

²Fellow of Soba Centre for Audit and Research (SCAR), Khartoum, Sudan

³Department of Paediatrics, Faculty of Medicine, University of Khartoum and Soba University Hospital

⁴Medicine, Faculty of Medicine, University of Khartoum and Soba University Hospital Khartoum, Sudan

Cite this paper:
Mohamed Dafaalla, Abdulraheem Farah, Shaima Bashir, Ammar Khalil, Rabab Abdulhamid, Mousab Mokhtar, Mohamed Mahadi, Zulfa Omer, Asgad Suliman, Mohammed Elkhalifa, Hanin Abdelgadir, Abdelmoneim E.M. Kheir and Ihab Abdalrahman. Depression, Anxiety, and Stress in Sudanese Medical Students: A Cross Sectional Study on Role of Quality of Life and Social Support. American Journal of Educational Research. 2016; 4(13):937-942. doi: 10.12691/education-4-13-4

Abstract

We aimed to find out the prevalence of depression, anxiety and stress among medical students in a developing country, and to find the possible role of social support and quality of life in developing depression, anxiety, and stress.We did a cross sectional study in medical students of faculty of medicine in Khartoum, Sudan. We did a clustered random sampling in students from the second to sixth year and collected 500 questionnaires of which 487 were suitable for analysis. The data collection tool composed of three questionnaires; MOS social support survey, Depression, anxiety, and stress scale (DASS21), and WHO quality of life brief (WHOQOLB) questionnaire. More than 50% of respondents had different grades of depression, anxiety, and stress where 21%, 22%, and 16% had moderate degree of depression, anxiety, and stress respectively. Quality of environment and physical health were the major determinant of depression, anxiety, and stress (R=0.252-0.465, P values <0.001). From the four domains of social support assessed by MOS survey, there was significant association only between positive social interaction domain and depression (R=0.354, P<0.001). There was no significant association between social support and stress and anxiety. There was no significant differences in depression scores among different academic years (P=0.246). However, stress and anxiety showed significant differences in different academic years, notably between the middle years, and second and final years (P=0.043 and 0.00 respectively). The quality of environment and physical health seems to play a key role in student mental health.

Keywords:
depression anxiety stress medical students social support quality of life developing country

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References:

[1]	Schwenk TL, Davis L, Wimsatt LA. DEpression, stigma, and suicidal ideation in medical students. JAMA. 2010; 304(11): 1181-90.
[2]	Guthrie EA, Black D, Shaw CM, Hamilton J, Creed FH, Tomenson B. Embarking upon a medical career: psychological morbidity in first year medical students. Med Educ. 1995; 29(5): 337-41.
[3]	Ibrahim N, Al-Kharboush D, El-Khatib L, Al-Habib A, Asali D. Prevalence and Predictors of Anxiety and Depression among Female Medical Students in King Abdulaziz University, Jeddah, Saudi Arabia. Iranian Journal of Public Health. 2013; 42(7): 726-36.
[4]	Mosley TH, Jr., Perrin SG, Neral SM, Dubbert PM, Grothues CA, Pinto BM. Stress, coping, and well-being among third-year medical students. Academic medicine : journal of the Association of American Medical Colleges. 1994; 69(9): 765-7.
[5]	Eller T, Aluoja A, Vasar V, Veldi M. Symptoms of anxiety and depression in Estonian medical students with sleep problems. Depression and Anxiety. 2006; 23(4): 250-6.
[6]	Bunevicius A, Katkute A, Bunevicius R. Symptoms of anxiety and depression in medical students and in humanities students: relationship with big-five personality dimensions and vulnerability to stress. The International journal of social psychiatry. 2008; 54(6): 494-501.
[7]	Iqbal S, Gupta S, Venkatarao E. Stress, anxiety & depression among medical undergraduate students & their socio-demographic correlates. The Indian journal of medical research. 2015; 141(3): 354-7.
[8]	Rakatansky H. Physician Suicide. New England Journal of Medicine. 2005; 353(11): 1184-5.
[9]	Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005; 39(6): 594-604.
[10]	DYRBYE L. N., THOMAS M. R., SHANAFELT A. D. Medical Student Distress: Causes, Consequences, and Proposed Solutions. Mayo Clin Proc. 2005; 80(12): 1613-22.
[11]	Troyer D, Ullrich IH, Yeater RA, Hopewell R. Physical activity and condition, dietary habits, and serum lipids in second-year medical students. Journal of the American College of Nutrition. 1990;9(4): 303-7.
[12]	Ray I., Joseph D. S tress in Medical S tudents. JK SCIENCE. 2010; 12(4): 163-4.
[13]	Misra R, McKean M, West S, T. R. Academic stress of college students: Comparison of student and faculty perceptions. College Student Journal. 2000; 34(2): 236-45.
[14]	Rahman N I, Ismail S, Seman T, Rosli N, Aisyah S, Jusoh B, et al. Stress Among Preclinical Medical Students of University Sultan Zainal Abidin Journal of Applied Pharmaceutical Science. 2013; 2(11): 076-81.
[15]	Fang DZ, Young CB, Golshan S, Fellows I, Moutier C, Zisook S. Depression in Premedical Undergraduates:A Cross-Sectional Survey. Primary Care Companion to The Journal of Clinical Psychiatry. 2010; 12(6): PCC.10m00958.
[16]	Polychronopoulou A, Divaris K. A longitudinal study of Greek dental students' perceived sources of stress. Journal of dental education. 2010; 74(5): 524-30.
[17]	Rosenthal JM, Okie S. White coat, mood indigo--depression in medical school. The New England journal of medicine. 2005; 353(11): 1085-8.
[18]	STEWART CDSaAL. THE MOS SOCIAL SUPPORT SURVEY Sot Sci Med. 1991; 32(6): 705-14.
[19]	Miriam Taouk PFL, Roy Laube. Psychometric Properties of an Arabic Version of the Depression Anxiety Stress Scales (DASS). School of Psychology, University of New South Wales, Sydney, Australia; 2015 [cited 2015 October]. Available from: http://www2.psy.unsw.edu.au/dass/Arabic/Arabic.htm.
[20]	Abdallah A. R., M. GH. Depression, anxiety and stress among first year medical students in an Egyptian public university. International Research Journal of Medicine and Medical Sciences 2014; 2(1): 11-9.
[21]	Nazeer M., R. S. Stress and it’s Coping Strategies in Medical Students. Sch J App Med Sci. 2014; 2(6D): 3111-7.
[22]	Supe AN. A study of stress in medical students at Seth G.S. Medical College. Journal of postgraduate medicine. 1998; 44(1): 1-6.
[23]	Park KH, Kim D, Kim SK, Yi YH, Jeong JH, Chae J, et al. The relationships between empathy, stress and social support among medical students. Int J Med Educ. 2015; 6: 103-8.
[24]	Murphy RJ, Gray SA, Sterling G, Reeves K, DuCette J. A comparative study of professional student stress. Journal of dental education. 2009; 73(3): 328-37.
[25]	Zaid ZA, Chan SC, Ho JJ. Emotional disorders among medical students in a Malaysian private medical school. Singapore medical journal. 2007; 48(10): 895-9.
[26]	Beck DL, Hackett MB, Srivastava R, McKim E, Rockwell B. Perceived level and sources of stress in university professional schools. The Journal of nursing education. 1997; 36(4): 180-6.
[27]	Wolf TM. Stress, coping and health: enhancing well-being during medical school. Med Educ. 1994; 28(1): 8-17; discussion 55-7.
[28]	Borjalilu S, Mohammadi A, Mojtahedzadeh R. Sources and Severity of Perceived Stress Among Iranian Medical Students. Iran Red Crescent Med J. 2015; 17(10): e17767.