Stress, anxiety, and depression among students at the Faculty of Medicine of Sousse (Tunisia)

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Published Apr 9, 2022
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Vol. 100 No. 4 (2022): Issue Apr 2022

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Badii Amamou
Imen Ben Saida
Maha bejar
Dorsaf Messaoudi
Lotfi Gaha
Mohamed Boussarsar

Abstract

Objective: To evaluate the frequency of anxious and depressive symptoms and to determine their associated factors in a population of students enrolled at the Faculty of Medicine of Sousse (Tunisia).

Methods: this is a descriptive cross-sectional study that took place at the Faculty of Medicine of Sousse over the period from 09/15/2017 to 03/15/2018. An anonymous questionnaire was administered to the students in
the guided teaching rooms. The assessment of anxiety and depressive symptoms was based on the Anxiety and Depression Scale (HADS) and the quality of sleep was assessed by the PSQI questionnaire.

Results: A total of 202 medical students participated in the study. The average PSQI score was 5.62±2.87 and 47% of students had poor sleep quality (PSQI ≥ 6). Symptoms of anxiety and
depression were observed in 73 (36.1%) and 45 (22.3%) students respectively. The mean HADS-A score was 9.21±4.17 and that of the HADS-D score was 7.37±4.06. In univariate analysis, the
factors found to predict a high level of perceived stress were the study cycle (p=0.022) and poor quality of sleep (p<0.001). The predictive factors of anxious symptoms (HAD-A > 11) were the use of
sleeping pills (p=0.004), the quality of sleep (p<0.001), and a high level of perceived stress (p<0.001). The high level of perceived stress was found to predict depression (p=0.006).In the multivariate
analysis of variables in the present study, poor sleep quality was a factor independently related to high perceived stress in medical students (ORa=9.062 [4.247–19.334]) while being a medical
student of the 1st cycle proved to be a protective factor (ORa=0.101 [0.025-0.406]). Use of sleeping pills (ORa=4.481 [1.135-17.682]), poor sleep quality (ORa=2.131 [1.081–4.203]) and high level
of perceived stress (ORa=5.790 [2.444–13.716]) were factors independently related to anxiety symptoms. Female sex was a protective factor for depressive symptoms (ORa=0.440 [0.205-0.945])
while a high level of perceived stress was a factor independently related to depressive symptoms (ORa=3.429 [1.469-8.005]). HAD-A and HAD-D scores were correlated (r=0.631 ; p<0.001).

Conclusion: sleep disturbances, perceived stress, anxious and depressive symptoms are common among Tunisian medical students. Prevention strategies targeting
the improvement of sleep quality and student stress management should be developed at the faculty and ministerial level.

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