Depression,anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study

Objectives:To quantify the extent and variation of depression, anxiety and stress among medical and non-medical Saudi Arabian students.Methods:In this cross-sectional study, students from Umm Al-Qura University, Makkah, Saudi Arabia, were recruited. The Faculty of Education was randomly selected to represent the non-medical colleges. The depression, anxiety and stress scale-21 items (DASS-21) was used to estimate the study outcomes.Results:Of the 465 undergraduates recruited in this study, 49.68% (n=231) were medical students and 50.32% (n=234) were non-medical students. Approximately 54%, 53%, and 38% of the participants were found to be suffering from depression, anxiety, and stress, respectively. The analyses showed that the two groups did not differ significantly with respect to stress and depression (p=0.934 and 0.423, respectively). However, the non-medical students exhibited a significantly higher anxiety score compared to the medical students (p=0.002). Family conflicts was a common risk factor for the studied psychological disturbances. Female gender and travel time from home to university were significant predictors of depression and anxiety, whereas a positive history of a psychological condition increased the likelihood of depression and stress.Conclusion:There was a high prevalence of anxiety, stress, and depression among the students, with a significantly higher anxiety levels among the non-medical students.

There is a high prevalence of depression, anxiety and stress disorders (DASD) across the world. A previous report stated that around 4.4% (over 300 million) and 3.6% (264 million) of the global population suffers from depression and anxiety, respectively. Between 2005 and 2015 alone, there was a 14.9% increase in the incidence of anxiety. This report also considered depression as one of the major determinants of years lived with disability (YLD) and anxiety as a primary contributor of non-fatal health loss.^1,2 Another national-level survey reported 34.8% population to be suffering from stress, of which only 2% attained medical assistance.^3,4The amount of pressure faced by the university students might lead to a considerable psychological stress, which, in turn, leads to serious mental disorders, including anxiety, stress, and depression. Over time, the academic pressure may lead to worsening of the mental health and physical wellbeing of the students, which can only be detected at advanced stages. Certain studies on medical school graduates reported an association between the psychological stress among these students and suboptimal patient care.^5,6Several studies have evaluated and compared the anxiety, stress, and depression levels of non-medical and medical students.^7-11 A previous study in Saudi Arabia reported significantly lower depression rates among the medical students (37%) compared to non-medical students (60%).⁷ Contrarily, a meta-analysis reported no significant differences in the prevalence of depression between non-medical and medical students.⁸ A systemic review demonstrated significantly higher anxiety among medical students compared to general population.¹² Previous studies in Saudi Arabia also reported significantly high anxiety levels and low wellbeing of medical students.^13,14 Similar to anxiety and depression, the level of stress among medical students, in the same region, was as high as 59%, and was more prevalent among female and junior students.^15,16Several English scales have previously been used to assess the DASD prevalence in local population of Saudi Arabia,^7,13,17,18 and a number of local studies conducted on medical students exhibited certain methodological weaknesses, such as inadequate sampling.^19-21 Therefore, our aim was comparison of the DASD levels between medical and non-medical students with an adequate sampling method and by utilizing an Arabic validated tool that is more understandable in our culture, and to investigate risk factors for DASD among this population.