Prevalence and associated risk factors of depression and anxiety disorder among residents and medical students in College of Medicine and Health Sciences, Rwanda

Abstract

Background: Globally, mental health is a concern, especially among health care providers. Various studies conducted in medical schools have demonstrated that medical students suffer from depression, anxiety, and stress. However, there were no such studies in Rwanda addressing and exploring those entities. Our study intended to evaluate the prevalence of depression, anxiety, and their related risk factors in a sample of undergraduate and postgraduate students at the University of Rwanda, School of Medicine and Pharmacy. Method: This was a cross-sectional online survey with 544 participants (postgraduate and undergraduate) conducted between March and April 2022. We used the validated Patient Health Questionnaire (PHQ-9) scale and The General Anxiety disorder scale (GAD-7) to assess the prevalence of depression and anxiety. Additionally, to assess risk factors for these disorders, we asked a series of closed-ended questions. The collected data were entered into Epidata version 3.1 for database creation and then exported to SPSS version 25 for analysis. Results: The overall prevalence of depression was higher in postgraduate medical students at 37.3%, while the undergraduate in clinical and preclinical years was 24.5% and 17.6%, respectively. Anxiety was higher in postgraduate medical students at 20.3%, in clinical years at 12.7%, and in preclinical years at 9.9%. We found that 11.2% of all participants had both depression and anxiety. The predictors of depression were: being a female (OR=1.66, p=0.021), being above 30 years old (OR=1.88, p=0.008), being married (OR=2.19P, p=0.003), being a postgraduate student (OR=2.79, p=0.002), renting accommodation outside the school hostel (OR=1.97, p=0.011), nocturnal shift work (OR:2.65, p=0.008), absence of mentorship (OR:3.31, p=0.003), being worried about academic school performance (OR:2.44, p=0.001) regret of attending medical school (OR:2.57, p=0.002) and stress from next of kin and patients (OR=2.17, p=0.001). On the other hand, the predictors associated with anxiety were: being a female (OR=2.02, p=0.01), being a postgraduate student (OR=2.33, p=0.044), nocturnal shift work (OR:2.65, p=0.008), absence of mentorship (OR:2.65, p=0.001), being worried about academic school performance (OR:2.33, p=0.001), regret of attending medical school ( OR:2.31, p=0.002), and stress from next of kin and patients ( OR:3.36, p=0.001). Conclusion: This study showed that depression and anxiety were very prevalent in medical students, similar to study findings from other medical schools. These results show that initiatives should be created to address mental health disorders for medical students. Depression, anxiety, and their consequences could be tackled by continuous screening throughout the program.