European Journal of Cardiovascular Medicine

Medical education is widely regarded as one of the most demanding academic pursuits. Medical students often face academic overload, frequent examinations, and exposure to emotionally challenging clinical situations. These factors contribute significantly to psychological distress

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Depression and anxiety are among the most common mental health disorders affecting medical students worldwide. Studies have reported prevalence rates of depression ranging from 27% to 60% and anxiety from 30% to 65%. These conditions not only affect academic performance but also impair professional development and patient care.

In India, the competitive educational environment, societal expectations, and limited mental health support systems further exacerbate the problem. Early identification of risk factors such as poor sleep, lack of social support, and substance use is crucial for timely intervention.

The present study aims to assess the prevalence of depression and anxiety among medical students and identify associated risk factors in a tertiary care teaching hospital setting.a

Study Design and Setting

A cross-sectional study conducted over 6 months in a tertiary care teaching hospital.

Study Population

Undergraduate MBBS students from all academic years.

Sample Size

A total of 250 students were included based on prevalence estimates from previous studies.

Inclusion Criteria

• Medical students aged ≥18 years
• Willing to participate

Exclusion Criteria

• Known psychiatric illness under treatment
• Incomplete questionnaires

Data Collection Tools

1. Patient Health Questionnaire-9 (PHQ-9)

• Assesses severity of depression
• Score ≥10 indicates moderate to severe depression

2. Generalized Anxiety Disorder-7 (GAD-7)
   • Assesses anxiety levels
   • Score ≥10 indicates moderate to severe anxiety

3. Structured Questionnaire

• Sociodemographic details
• Sleep pattern
• Physical activity
• Academic stress

Statistical Analysis

• Data analyzed using SPSS v25
• Descriptive statistics (mean, percentage)
• Chi-square test for association
• Logistic regression for risk factors
• p < 0.05 considered significant

The present study included a total of undergraduate medical students with a mean age of 21 ± 2 years, representing a relatively young and academically active population. Among the participants, females constituted 55%, while males accounted for 45%, indicating a slight female predominance in the study cohort. In terms of academic distribution, 40% of students belonged to the pre-clinical phase, whereas 60% were from the clinical years, reflecting greater representation of students exposed to clinical responsibilities and patient care. The overall prevalence of depression among the participants was found to be 46%, while anxiety was reported in 52% of students, highlighting a substantial burden of psychological morbidity within this population. When categorized based on severity, mild depression was observed in 25% of students, moderate depression in 15%, and severe depression in 6%. Similarly, mild anxiety was present in 28% of participants, moderate anxiety in 17%, and severe anxiety in 7%, indicating that a considerable proportion of students were experiencing clinically significant levels of psychological distress.

Further analysis of associated risk factors revealed several significant correlations. Female students were found to have a higher prevalence of both depression and anxiety compared to their male counterparts, and this association was statistically significant (p = 0.02). Poor sleep quality emerged as one of the most significant contributing factors, with a strong association observed with both depression and anxiety (p < 0.001). Students reporting inadequate or disturbed sleep patterns were more likely to experience higher levels of psychological distress. Academic stress was another major determinant identified in the study, showing a highly significant association (p < 0.001). The demanding nature of medical education, including frequent examinations, vast syllabus, and pressure to perform, likely contributes to this increased stress burden. Additionally, lack of physical activity was found to be significantly associated with mental health outcomes (p = 0.01), suggesting that sedentary lifestyle habits may further exacerbate psychological symptoms.

To further evaluate the independent effect of these variables, logistic regression analysis was performed. The results demonstrated

The present study revealed a high prevalence of depression (46%) and anxiety (52%) among medical students, which is consistent with global and Indian studies. Previous research has reported similar findings, indicating that medical students are at a significantly higher risk of psychological distress compared to the general population.

Academic stress emerged as the most significant risk factor in this study. The demanding curriculum, frequent examinations, and pressure to perform contribute to increased stress levels. Students with poor sleep quality were more likely to develop both depression and anxiety, highlighting the critical role of sleep in mental health.

Female students were found to have higher prevalence rates, which may be attributed to biological, psychological, and social factors. Lack of physical activity was another important modifiable risk factor identified.

The findings emphasize the need for institutional support systems, including counseling services, stress management programs, and promotion of healthy lifestyle practices.

Depression and anxiety are highly prevalent among medical students and are significantly associated with modifiable risk factors such as sleep disturbance, academic stress, and physical inactivity. Early identification and intervention are crucial to improve mental health outcomes.

Limitations

• Cross-sectional design
• Self-reported data
• Single-center study

Recommendations

• Regular mental health screening
• Counseling and mentorship programs
• Stress management workshops

·         Promotion of physical activity and sleep hygiene

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