Introduction The overall environment of the medical school is often considered very stressful. It projects negative effects not only on the academic performances of medical students but also deteriorate their physical health and psychosocial wellbeing. The aim of this study was to determine the frequency of depression, stress, and anxiety among final year medical students. Methods This observational study was conducted in public and private medical colleges in February 2019. The instrument utilized in this study was Depression, Anxiety, and Stress Scale (DASS-21). Factors predisposing to depression, stress, and anxiety were also recorded. Data were entered and analyzed using SPSS v. 21. Results The mean scores of depression, anxiety, and stress were 18.00 ± 11.5, 19.15 ± 11.2, and 20.92 ± 11.2, respectively. The mean score of anxiety and stress was higher in private college students, while that of depression was higher in public college students. Overall, 57.6% of the students suffered from moderate to extremely severe depression, 74% of the students suffered from moderate to extremely severe anxiety, and 57.7% students had moderate to extremely severe stress. The common reasons to high stress and anxiety included the pressure of passing exams, the pressure of living up to family’s expectations, fear of stepping into the real world of medicine, and dissatisfaction with the administration. Discussion Depression, anxiety, and stress among medical students are often underrecognized and undertreated. Medical students also seldom seek professional help, mostly because of shame and taboo concerning mental health . Anxiety and depression in medical students in Pakistan were significantly higher as compared to the students in western countries. University of Michigan Medical School, in 2010, reported 14.3% of their students to be depressed . The prevalence of depression among medical students in the United Kingdom was reported to be 24%. In comparison, the study reported 57.6% of medical students in Pakistan to be depressed. Another study conducted in Pakistan showed anxiety and depression to be prevalent among 60% of medical students in a private institute and 43% in a public institute . Various factors can be attributed to these ratios of higher incidence in this part of the world. There has been reported the correlation of anxiety and depression with dissatisfaction with examination criteria, overburdening test schedule, and the pressure to pass examinations . In Asian families, the pressure from the family to choose medicine as a profession is far greater which is then followed by the need to live up to the family’s expectations regarding their academic performance . The next step after finding the prevalence of anxiety, depression, and stress among medical students is to identify the factors that lead to these mental health issues. This can be done by appointment of student and health counselors that can help to identify stressors such as frustration, pressure, and changes in mood and emotions. Identifying these stressors at the early stage in the medical students will prevent students from succumbing to debilitating psychological issues which, if left unattended, eventually lead to graves outcomes including suicidal attempts . Along with counselors, conducting workshops regarding stress management, awareness programs about stresses and mental health services in campuses will give the students sufficient knowledge and insight about depression, anxiety, and stress and how to deal with it amidst the high pressure of medical school. Academic workload in the field of medicine is universal and almost unavoidable; however, students should be enabled to manage their workload and pressure with the help of counselors. In this regard, an Indian interventional study concluded that students who benefited from a counselor showed lower anxiety and depression scores as compared to the control group who was not exposed to mental health counselors . This study has a few limitations. One of the limitations is that this study did not focus on other causes for depression and anxiety such as personality, time of academic year, and family pressure. The second limitation is that the findings of this study may not be generalized as the results are based upon one private university and one public university. Large scale multi-centric studies are required that measure stress, anxiety, and depression levels among medical students across various time of academic year. Barriers that lead to seeking medical help for mental issues by medical students should also be addressed. Conclusions The incidence of psychological illnesses including anxiety and stress are higher in private college students, while that of depression was higher in public college students. More than half of the students suffer depression and stress, and the incidence of anxiety is even higher. The common reasons to high stress and anxiety included pressure of passing exams, pressure of living up to family’s expectations, fear of stepping into the real world of medicine, and dissatisfaction with the administration. This profession is highly demanding and requires utmost focus and expertise. There is a desperate need to take measures to enhance the mental health of medical students who will be the future lifesavers. Source
It's disheartening to see how prevalent depression, anxiety, and stress are among final-year medical students. Your study sheds light on a crucial issue that often goes unnoticed or downplayed. PTSD, or Post-Traumatic Stress Disorder, is another serious mental health condition that can affect individuals who have experienced or witnessed traumatic events. It's not uncommon in medical professionals who might encounter distressing situations regularly. I believe it's essential for medical schools to prioritize mental health support for students. Beyond just identifying stressors, offering accessible resources like counseling and inpatient trauma treatment can make a significant difference. Creating a culture where seeking help for mental health is encouraged and destigmatized is key.
