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      Prevalence and factors associated with depressive and anxiety symptoms among Palestinian medical students

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          Abstract

          Background

          Co-existence of depression and anxiety can be associated with severe detrimental consequences to the physical, mental and social wellbeing of the affected populations. This study was conducted to determine prevalence of depressive and anxiety symptoms among Palestinian medical students and to investigate associations between sociodemographic factors of the students with depressive and anxiety symptoms.

          Methods

          This study was conducted in a cross-sectional observational design using a questionnaire in the period between September 2018 and April 2019 in a major university in the West Bank of Palestine. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II) and anxiety symptoms were assessed using the Beck Anxiety Inventory (BAI). The questionnaire also collected the sociodemographic characteristics of the students. Reliability of the questionnaire was tested using the test re-test method. A total of 425 medical students were invited to participate in the study.

          Results

          Of those invited, 286 students completed the questionnaire, giving a response rate of 67.3%. More than half (56.6%) of the students had minimal depression, 20.3% had mild depression, 14.0% had moderate depression, 9.1% had severe depression, 23.4% had no anxiety, 29.7% had mild to moderate anxiety, 25.5% had moderate to severe anxiety, and 21.3% had severe anxiety. Multiple linear regression analysis showed that academic stage ( p-value < 0.01), Grade Point Average ( p-value < 0.01), mental health status ( p-value < 0.001), ever attempted suicide ( p-value < 0.05), and religious commitment ( p-value < 0.01) were predictors of BDI-II scores. Multiple linear regression analysis showed that academic stage ( p-value < 0.05) and mental health status ( p-value < 0.001) were predictors of BAI scores.

          Conclusions

          Depressive and anxiety symptoms were prevalent among Palestinian medical students in a major university in the West Bank of Palestine. Interventions might be designed to improve self-rated mental health of medical students in their academic years, ameliorate study conditions, and provision of counseling services to improve spirituality might be effective in reducing symptoms of depression and anxiety among medical students in Palestine. Future studies are still needed to investigate if these interventions could be useful in reducing depressive and anxiety symptoms among Palestinian medical students.

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          Most cited references54

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          A systematic review of studies of depression prevalence in university students.

          Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. There is evidence to suggest that university students are at higher risk of depression, despite being a socially advantaged population, but the reported rates have shown wide variability across settings. To explore the prevalence of depression in university students. PubMed, PsycINFO, BioMed Central and Medline were searched to identify studies published between 1990 and 2010 reporting on depression prevalence among university students. Searches used a combination of the terms depression, depressive symptoms, depressive disorders, prevalence, university students, college students, undergraduate students, adolescents and/or young adults. Studies were evaluated with a quality rating. Twenty-four articles were identified that met the inclusion and exclusion criteria. Reported prevalence rates ranged from 10% to 85% with a weighted mean prevalence of 30.6%. The results suggest that university students experience rates of depression that are substantially higher than those found in the general population. Study quality has not improved since 1990. Copyright © 2012 Elsevier Ltd. All rights reserved.
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            Prevalence of depression amongst medical students: a meta-analysis.

            Medical schools are known to be stressful environments for students and hence medical students have been believed to experience greater incidences of depression than others. We evaluated the global prevalence of depression amongst medical students, as well as epidemiological, psychological, educational and social factors in order to identify high-risk groups that may require targeted interventions.
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              Interventions to reduce stress in university students: a review and meta-analysis.

              Recent research has revealed concerning rates of anxiety and depression among university students. Nevertheless, only a small percentage of these students receive treatment from university health services. Universities are thus challenged with instituting preventative programs that address student stress and reduce resultant anxiety and depression. A systematic review of the literature and meta-analysis was conducted to examine the effectiveness of interventions aimed at reducing stress in university students. Studies were eligible for inclusion if the assignment of study participants to experimental or control groups was by random allocation or parallel cohort design. Retrieved studies represented a variety of intervention approaches with students in a broad range of programs and disciplines. Twenty-four studies, involving 1431 students were included in the meta-analysis. Cognitive, behavioral and mindfulness interventions were associated with decreased symptoms of anxiety. Secondary outcomes included lower levels of depression and cortisol. Included studies were limited to those published in peer reviewed journals. These studies over-represent interventions with female students in Western countries. Studies on some types of interventions such as psycho-educational and arts based interventions did not have sufficient data for inclusion in the meta-analysis. This review provides evidence that cognitive, behavioral, and mindfulness interventions are effective in reducing stress in university students. Universities are encouraged to make such programs widely available to students. In addition however, future work should focus on developing stress reduction programs that attract male students and address their needs. Copyright © 2012 Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                suhaib.hattab@najah.edu
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                19 May 2020
                19 May 2020
                2020
                : 20
                : 244
                Affiliations
                [1 ]GRID grid.11942.3f, ISNI 0000 0004 0631 5695, Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, , An-Najah National University, ; New Campus, Building 19, P.O. Box 7, Nablus, Palestine
                [2 ]GRID grid.11942.3f, ISNI 0000 0004 0631 5695, An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, , An-Najah National University, ; Nablus, Palestine
                [3 ]GRID grid.11942.3f, ISNI 0000 0004 0631 5695, Department of Medicine, Faculty of Medicine and Health Sciences, , An-Najah National University, ; Nablus, Palestine
                Article
                2658
                10.1186/s12888-020-02658-1
                7236464
                32429889
                9199c49f-46b1-4573-bfd9-07d34b09a54d
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 19 September 2019
                : 11 May 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Clinical Psychology & Psychiatry
                anxiety,depression,medical students,palestine,middle east
                Clinical Psychology & Psychiatry
                anxiety, depression, medical students, palestine, middle east

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