Prevalence of Depression among Medical Students at the University of The Gambia: A Cross-Sectional Study

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Introduction: Globally, the prevalence of depression is on the increase affecting about 5% of the adult population. University undergraduates’ particularly medical students are at a high risk of experiencing depression due to academic workload and demands in studying in the university. Depression among medical students is a significant public health concern. Despite several studies on depression among medical students worldwide, there is scarcity of studies on depression among medical students at the university of the Gambia. This study was therefore conducted to determine the prevalence and factors associated with depression among medical students at the University of Gambia. Methodology: This was a cross-sectional prevalence study conducted among 160 preclinical and clinical medical students of the University of the Gambia who met the inclusion criteria. The Patient Health Questionnaire-9 (PHQ-9) questionnaire was self-administered to the students. For making diagnosis of depression, PHQ-9 scores of ≥ 10 confirm the diagnosis. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Frequency and percentages were used to summarize descriptive statistics while association between categorical variables was determined using Chi-square with level of statistical significance set at P<0.05 Result: Overall, 160 medical students participated in the study. The mean age of the students was 23.9years with a median of 24.0 years. Most of the students (62.5%) were within the age range of 18-24 years and a majority was female (58.1%). Most participants were single (91.9%) and came from middle-class backgrounds (65.6%). A majority (27.5%) of the students was in their seventh-year (final year). The prevalence of depression among the students was 68.1%. Among the students who met criteria for depression, 30% of them had mild depression while 25% and 13.1% had moderate and severe depression respectively. Factors contributing to depression among the students included living arrangements, with most students living with family (55.6%), poor sleep quality (58.1%), poor academic performance (43.8%), and academic failure (50.0%) with academic pressure representing the most common stressor (80.6%). Gender was significantly associated with depression, with higher rates among females (p=0.010). Medical school curriculum (p<0.001), Financial issues (p=0.043) and poor personal relationships (p=0.008) were significantly associated with depression. Conclusion: The study reveals a high prevalence of depression among the medical students. A variety of risk factors identified in this study included socio-demographic, academic, and lifestyle factors. The findings of this study point to an urgent need for more research into the causes as well as early diagnosis of depression using standardized tools. The need of making psychiatric services, counseling as well as support services available to susceptible students is highly imperative as these will improve mental health and academic performance of medical students.