Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Oct 19, 2023; 13(10): 772-783
Published online Oct 19, 2023. doi: 10.5498/wjp.v13.i10.772
Depression among medical students in Tunisia: Prevalence and associated factors
Badii Amamou, Sondess Alouani, Amjed Ben Haouala, Saoussen Alouani, Mohamed Ayoub Tlili, Ahmed Mhalla, Ferid Zaafrane, Lotfi Gaha
Badii Amamou, Sondess Alouani, Amjed Ben Haouala, Saoussen Alouani, Ahmed Mhalla, Ferid Zaafrane, Lotfi Gaha, Department of Psychiatry, Fattouma Bourguiba University Hospital of Monastir, Monastir 5000, Tunisia
Mohamed Ayoub Tlili, Department of Family and Community Medicine, Faculty of Medicine of Sousse, Sousse 4002, Tunisia
Author contributions: Amamou B, Alouani S, Ben Haouala A, Alouani S, Tlili MA, Mhalla A, Zaafrane F, and Gaha L contributed substantially to study conception and design, and data acquisition, analysis, and interpretation, and participated in drafting the manuscript or revising it critically for intellectual content; all authors approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Faculty of Medicine of Monastir (approval No. 3067).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: The data presented in this study are available on request from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Badii Amamou, MD, Associate Professor, Department of Psychiatry, Fattouma Bourguiba University Hospital of Monastir, Avenue Farhat Hached, Monastir 5000, Tunisia. amamoubadii@hotmail.fr
Received: December 5, 2022
Peer-review started: December 5, 2022
First decision: January 5, 2023
Revised: January 17, 2023
Accepted: March 22, 2023
Article in press: March 22, 2023
Published online: October 19, 2023
Abstract
BACKGROUND

Medical school is known for its lengthy process, which is both physically and emotionally draining. Students’ mental balance would shrink as they progress in their medical training. A systematic review and meta-analysis reported that the prevalence of depressive symptoms among medical students remained relatively constant at 27.2%.

AIM

To assess the prevalence of depressive symptoms among Tunisian medical students and evaluate its associated factors.

METHODS

This is a descriptive cross-sectional study that was carried out in the second semester of the academic year 2017/2018, between April 2018 and July 2018 among 1138 medical students. Data were collected using a socio-demographic questionnaire and the Beck Depression Inventory-II (BDI-II).

RESULTS

Sixty-four percent (n = 728) of the participants had depressive symptoms, of which 266 (23.4%) met the criteria for mild, 271 (23.8%) for moderate, and 191 (16.8%) for severe depressive symptoms. Female gender, low socio-economic level, smoking habits and history of mental disorder, performing leisure and physical activities, satisfaction toward a career choice, and happiness perception were the main prognostic factors for depression among medical students. Although academic grades may not be considered a prognostic factor, final-year students appeared to be less depressive than their colleagues.

CONCLUSION

These findings give insight into mental health issues and comorbidities among Tunisian medical students. It is a hopeful request for decision-makers and academic authorities to set serious measures and draw effective interventions to minimize the currency of psychological distress among this subpopulation.

Keywords: Depression, Psychiatry, Medical students, Mental health, Beck Depression Inventory, Tunisia

Core Tip: This study aimed to assess the prevalence of depressive symptoms among Tunisian medical students and evaluate its associated factors. This is a descriptive cross-sectional study that was carried out in the second semester of the academic year 2017/2018, between April 2018 and July 2018 among 1138 medical students. Sixty four percent (n = 728) of the participants had depressive symptoms, of which 266 (23.4%) met the criteria for mild, 271 (23.8%) for moderate, and 191 (16.8%) for severe depressive symptoms. Female gender, low socio-economic level, smoking habits and history of mental disorder, performing leisure and physical activities, satisfaction toward career choice, and happiness perception were the main prognostic factors for depression among medical students. Although academic grade may not be considered as a prognostic factor, final year students appeared to be less depressive than their colleagues.