An Epidemiological Study on Burden of Psychological Morbidities and Their Determinants among Undergraduate Medical Students of a Government Medical College of Eastern India

Abstract

Background: Medical education can impose a significant amount of psychological stress and strain on undergraduates. In India, there are limited shreds of evidence regarding the magnitude of different psychological morbidities (i.e. stress, anxiety and depression) among medical undergraduates.
 Aims & Objectives: To find out the proportion of medical undergraduates suffering from psychological morbidities and their determinants.
 Material and Methods: It was a cross-sectional hospital-based analytical observational study conducted from July to November 2017. In total 327 undergraduate medical students of a government medical college of Kolkata were interviewed with a structured schedule comprising of socio-demographic, behavioural related questionnaire and DASS (Depression Anxiety Stress Scale) 21. Data were analysed by the Statistical Package for Social Sciences, SPSS (version 16).
 Results: The burden of stress, anxiety and depression among medical undergraduates were found out to be 33.0%, 26.9% and 21.1% respectively. The burden was much higher in females compared to males and increased with semester and age. In the multivariable model depression, anxiety and stress were significant predictors of each other along with sex, semester, both smoking and alcohol drinking, sleep adequacy and satisfaction with own educational performance. The variables in the multivariable models were explaining 29.0% of stress, 30.8% of anxiety and 32.2% of depression.
 Conclusion: The proportion of undergraduate medical students with psychological morbidity was found to be high in the current study. Smoking, alcohol drinking, sleep adequacy and educational satisfaction were some critical modifiable predictors of different psychological morbidities identified in the study.

Psychological Morbidities and Coping Styles: A Rural Institution-Based Cross-Sectional Comparative Study between Undergraduate Medical Students Undergoing Different Phases of Training

“…19,26 The observation of the present survey demonstrated that socio-demographic variables such as age and substance consumption behavior were statistically significant between the comparable groups with psychological morbidities. These results were nearly similar to the observations of few studies done by Mangalesh et al 9 and Biswas et al 35 in which psychological morbidities among different years of UGs training were statistically significantly associated with age, gender, living status, and substance consumption behavior. Zvauya et al 21 and Kiran et al 32 also found that psychological morbidities among pre-/para-clinical and clinical UGs were statistically significantly associated with age of the participants.…”

“…These findings align with previous research in the literature which reported that dissatisfaction with academic performance was one of the key factors in inducing the mental health issues among medical students. 9 35 43 44 In the present survey, it was also highlighted that students in the clinical group were more in proportion with dissatisfied academic performance than the pre-/para-clinical group, validating the already existing findings where dissatisfaction with academic performance proportionally increased with advancement in phase training. 15 This could possibly be due to self-perceived lack of knowledge in clinics, and insecurities about clinical competencies and future careers, leading to fear of failure in exam, due to which students might have feelings of worthlessness, hopelessness, and uselessness that ultimately lead to multiple mental health issues.…”

“…This might suggest a decrease in the psychological health of medical students when one compares the findings of the present study with the studies conducted previously in different areas of the world which evaluated a lower prevalence of psychological morbidities. 5,10,21,[34][35][36][37] Also, the prevalence of psychological morbidities in the present survey was much higher than the global prevalence estimated by a meta-analysis of medical students in Asia 6 and Nigeria. 38 These discrepancies might be related to differences in socio-cultural background, sample size, and study design used.…”

“…On the contrary, the cross-sectional survey by Beniwal et al 5 pointed out that socio-demographic factors were nonsignificant between the comparable groups with psychological morbidities. Recently, a few authors from India 9 35 established a significant association where substance consumption behavior increases five to 10 times odds risk of psychological morbidities among medical educators. The present study also investigated that the substance consumption behavior among clinical UGs significantly increased the propensity of psychological morbidities, having approximately five times higher odds, though it cannot be said for the pre-/para-clinical UGs as the association between psychological morbidities and substance consumption behavior was not statistically significant despite having higher odds (1.25 times).…”