Predictive Nomogram for Depressive Symptoms in Postgraduate Medical Students: A Case-Control Study

Abstract

Purpose: The screening and prediction of depressive symptoms in postgraduate medical students is a key issue. Many factors have been suggested, and the relevant measures of psychological intervention have been continuously improved, nevertheless, it is still of great challenge to predict depressive symptoms of medical students precisely. This study sought to create a nomogram for precise prediction of depressive symptoms in medical students during the postgraduate stage in order to provide reference for early identification of high risk groups and taking psychological intervention. Methods: We chose 937 postgraduate medical students from The Second Affiliated Hospital of Nanchang University by using convenience sampling method. We selected 211 postgraduate medical students with depressive symptoms as the case group, and selected 689 postgraduate medical students of the same age, gender and marital status as the control group for case-control matching. Influencing factors for depressive symptoms were identified by multivariable logistic regression analysis and used to create a nomogram, and nomogram was used to score each factors. Results: Family function (OR= 0.87, 0.80-0.94, P< 0.01), social support (OR= 0.95, 0.92-0.98, P< 0.01), life satisfaction (OR= 0.92, 0.88-0.96, P< 0.001), subjective well-being (OR= 0.63, 0.47-0.84, P< 0.01) and alcohol and tobacco use (OR= 1.54, 1.00-2.35, P< 0.05) were identified as significantly associated factors that could be combined for accurate prediction of depressive symptoms among postgraduate medical students. We created a nomogram for depressive symptoms by using these factors. The area under the curve was 0.80 (95% confidence interval 0.77-0.83). Conclusions: The nomogram is a useful measurement tool for precise prediction of depressive symptoms among medical students during the postgraduate stage, and can also identify high-risk groups in early times. On the basis of predicting the potential risk of depressive symptoms, taking specific psychological intervention as soon as possible to reduce the negative impact of depressive symptoms on postgraduate medical students is vital.