Depression in medical students: prevalence, dynamics and comorbidity

Abstract

To verify the prevalence and dynamics of depressive disorders in medical students in order to develop recommendations for primary and secondary psychoprevention. A continuous sample of 1045 medical students of 1-6 grades, aged 17 to 24 years, including 724 Russian-speaking - 187 (25.8%) males and 537 (74.2%) females and 321 foreign students - 248 (80%) males and 73 (20%) females, was examined using a psychometric method. In total, mental disorders were diagnosed in 19.9% of medical students, significantly more often in fifth-year students (24.4%) than the first-year (16.2%) students (c2=4.526, p=0.034; OR=1.7, 95% CI=1.0-2.7). Half of all mental disorders were neurotic, stress-related and somatoform disorders. Depression in the Russian-speaking students was detected more often than in the foreign students (c2=11.2, p=0.0016; OR=1.8, 95% CI=1.3-2.5, 26.8% and 17.1% of cases, respectively). Clinically pronounced depression was observed in 15.5% of Russian-speaking and in 7.6% of foreign students with a history of suicidal behavior. The number of students, who made suicide attempts, was significantly higher in the Russian-speakers compared to the foreigners (c2=5.304, p=0.022; OR=3.1, 95% CI=1.2-9.2, 34 (4.7%) and 5 (1.6%), respectively). Correlation analysis revealed an average level of correlation between depression and anxiety in both Russian (r=0.528, p=0.000) and foreign (r=0.679, p=0.000) students. Depression more often was combined with stress in the Russian speakers (n=147 (70.7%)) than in the foreign students (n=29 (50.8%)) (c2=7.0, p=0.009; OR=2.3, 95% CI=1.2-4.4). Symptoms of depression of varying severity are included in the clinical structure of both prenosological and already formed mental disorders in almost half (44.9%) of cases. At the same time, local students are characterized by an increase in the frequency of depressive experiences from the 1st to the 6th year, and for foreign students there is an opposite trend.