Depression, anxiety, stress and substance use in medical students in a 5-year curriculum

Abstract

Background. The mental health of medical students is a global concern, and medical training has been described by some as being detrimental to the health of medical students, affecting both their student experience and professional life.

Objectives. To determine the prevalence of depression, anxiety, stress and substance use among preclinical students in a 5-year outcomes-based medical curriculum. The study also investigated the association of selected demographic factors with these outcomes.

Methods. All University of the Free State medical students in semesters 3 (n=164) and 5 (n=131) during 2015 were included in this cross-sectional study. Depression, anxiety and stress levels were measured by means of the Depression Anxiety Stress Scales (DASS-21). Demographic questions were included in an anonymous self-administered questionnaire. Lifetime and past month substance use were determined.

Results. A prevalence of 26.5% for moderate to extremely severe depression, 26.5% for moderate to extremely severe anxiety, and 29.5% for moderate to extremely severe stress was recorded. Female students had significantly higher stress levels, but not increased anxiety. Relationship status and accommodation were not associated with these outcomes. Lifetime use of methylphenidate, lifetime use of alcohol, and past month use of alcohol were associated with depression.

Conclusion. The study revealed high levels of depression, anxiety and stress in 2nd- and 3rd-year medical students compared with the general population, but the levels were comparable to those of medical students elsewhere in the world. Past month substance use of alcohol and cannabis was lower than in international studies, but nicotine use was higher.