Predictors and coping strategies for stress, anxiety and depression among medical undergraduates and postgraduates in Puducherry
Keywords:Anxiety, Coping strategies, DASS 42, Depression, Stress
Background: Higher proportion of medical students experience stress, anxiety and depression than compared to general population in Indian settings which are often underdiagnosed. This study aim was to assess the frequency, predictors and coping strategies of stress, anxiety and depression among the medical undergraduates and postgraduates of a tertiary care teaching hospital.
Methods: Questionnaire based online cross-sectional study was conducted among 350 medical undergraduates and post graduate students from June to July, 2021. Sociodemographic profile, questions from the depression, anxiety, stress scale-4 and details of coping strategies were collected. The data were analysed using SPSS 21.0 Descriptive statistics, Chi square test and Multinomial logistic regression analysis were used. P value <0.05 was considered statistically significant.
Results: The mean age of the participants was 21.5±3.1 years. Majority (63.1%) belonged to upper middle class. 92.3% joined the medical course with personal interest. The frequency of severe depression, anxiety and stress was 22.4%, 16.2% and 18% respectively. The frequency of extremely severe depression, anxiety and stress was 16.4%, 23.2% and 9% respectively. Acceptance, self-distraction and positive reframing were commonly followed coping strategies. Substance abuse and behavioural disengagement were the least followed. Significant association was observed between Emotion focused and avoidant coping with depression, anxiety and stress.
Conclusions: Higher frequency of depression (47.1%), anxiety (52.9%), and stress (38%), was observed among the students. Acceptance, positive reframing and self-distraction were commonly used coping strategies. Significant association seen with depression, anxiety and stress with emotion- focused and avoidant coping strategies.
Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization. 2017; Available from: https://apps.who.int/iris/handle/10665/254610. Accessed on 1 March 2023.
Grover S, Sahoo S, Bhalla A, Avasthi A. Psychological problems and burnout among medical professionals of a tertiary care hospital of north India: a cross-sectional study. Indian J Psychiatr. 2018;60:175-88.
Iqbal S, Gupta S, Venkatarao E. Stress, anxiety and depression among medical undergraduate students and their socio-demographic correlates. Indian J Med Res. 2015;141(3):354-7.
Kumar B, Shah M A, Kumari R, Kumar A, Kumar J, Tahir A. Depression, anxiety, and stress among final-year medical students. Cureus. 2019;11(3).
Anuradha R, Dutta R, Raja JD, Sivaprakasam P, Patil AB. Stress and stressors among medical undergraduate students: a cross-sectional study in a private medical college in Tamil Nadu. Indian J Community Med. 2017;42(4):222-5.
Schwenk TL, Davis L, Wimsatt LA. Depression, stigma, and suicidal ideation in medical students. JAMA 2010;304:1181-90.
Semwal P, Kumari R, Rawat VS, Aravindan N, Dhankar A. Psychological and other correlates of academic performance in medical students at a tertiary care hospital: a cross-sectional study. Indian J Community Med. 2022;47(3):364-8.
Patil SP, Sadhanala S, Bansode Gokhe SS. Study of depression, anxiety and stress among undergraduate medical students of a teaching medical institution. Nat J Community Med. 2018;9(8):566-9.
Holubova M, Prasko J, Ociskova M, Grambal A, Slepecky M, Marackova M, et al. Quality of life and coping strategies of outpatients with a depressive disorder in maintenance therapy- a cross-sectional study. Neuropsychiatr Dis Treat. 2017;14:73-82.
Carver CS. You want to measure coping but your protocol’stoo long: Consider the brief COPE. Int J Behav Med. 1997;4(1):92-100.
Goyal P, Upadhyah AA, Pandit DP, Sharma D, Howale D. A study of stress, stressors, and coping strategies among students of a newly established medical college in South Gujarat. Nat J Physiol Pharm Pharmacol. 2016;6(6):604-11.
Lovibond SH, Lovibond PF. Manual for the depression anxiety stress scales. 2nd edn. Sydney: Psychology Foundation; 1995.
Kebede MA, Anbessie B, Ayano G. Prevalence and predictors of depression and anxiety among medical students in Addis Ababa, Ethiopia. Int J Ment Health Syst. 2019;13(1):1-8.
Agha S. Mental well-being and association of the four factors coping structure model: a perspective of people living in lockdown during COVID-19. Ethics Med Public Health. 2021;16:100605.
Sarkar S, Gupta R, Menon V. A systematic review of depression, anxiety, and stress among medical students in India. J Ment Health Hum Behav. 2017;22:88-96.
Taneja N, Sachdeva S, Dwivedi N. Assessment of depression, anxiety and stress among medical students enrolled in a medical college of New Delhi, India. Indian J Soc Psychiatr. 2018;34:157-62.
Dahlin ME, Runeson B. Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study. BMC Med Educ. 2007;7:6.
Babar V, Gedam SR, Manore S, Dewangan K, Gaikwad P, Patond S. Study of stress, anxiety, depression, coping, and associated factors among medical students from central India. J Datta Meghe Inst Med Sci Univ. 2020;15:391-6.
Abouammoh N, Irfan F, AlFaris E. Stress coping strategies among medical students and trainees in Saudi Arabia: a qualitative study. BMC Med Educ. 2020;20(1):124.