Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2023

Open Access 01-12-2023 | Mood Disorders | Research

Pooled prevalence of depressive symptoms among medical students: an individual participant data meta-analysis

Authors: Wilson Baldin Zatt, Kenneth Lo, Wilson Tam, Depression in Medical Students Research Group

Published in: BMC Psychiatry | Issue 1/2023

Login to get access

Abstract

Background

The methodological choice of aggregated estimates for meta-analysis may be notable for some common drawbacks, including variations in the cut-off values of depression, and lower statistical power for analyzing the associated factors. The study aimed to refine the precision of previous findings on the prevalence of depressive symptoms among medical students, through gathering individual participant data (IPD) as identified from our previous reviews.

Material and methods

In the present study, we searched MEDLINE, EMBASE, PsycINFO, WanFang, Scielo and LILACS to identify published systematic reviews and meta-analyses up to March 2018, then individual data was requested for further analysis (PROSPERO registration: CRD42018091917). The participants’ age, sex, year of study, scores for depressive symptoms, and other predictor variables were requested. To pool the prevalence from the included studies, random-effects model (two-step method) was used. Multiple linear regression was used to examine the associated factors on the depression z-scores (one-step method).

Results

Of the 249 studies, the datasets of 34 studies were included. The crude prevalence was 19.4% (95% CI: 18.8%, 19.9%) by one-step method and the pooled prevalence was 18.1% (95% CI: 14.1%, 22.1%) by two-step method. Multiple linear regression revealed that being a female, older age, and senior year of study were significantly associated with the z-score.

Conclusion

The pooled prevalence of depressive symptoms from the Individual Participant Data (IPD) meta-analysis was lower than the previous meta-analyses using aggregated data. Age, sex, and year of study were significantly associated with the depression z-score. IPD meta-analysis may provide a more accurate estimation of disease burden, and allow verification of associated factors.
Appendix
Available only for authorised users
Literature
1.
World-Health-Organization. Depression. Fact Sheet. In. Geneva: World Health Organization. 2020.
2.
American-Psychiatric-Association. What Is Depression? In. Washington DC, USA: American Psychiatric Association. 2017.
3.
Angst F, Stassen HH, Clayton PJ, Angst J. Mortality of patients with mood disorders: follow-up over 34–38 years. J Affect Disord. 2002;68(2–3):167–81.CrossRefPubMed
4.
Steptoe A, Tsuda A, Tanaka Y, Wardle J. Depressive symptoms, socio-economic background, sense of control, and cultural factors in university students from 23 countries. Int J Behav Med. 2007;14(2):97–107.CrossRefPubMed
5.
Tam W, Lo K, Pacheco J. Prevalence of depressive symptoms among medical students: overview of systematic reviews. Med Educ. 2019;53(4):345–54.CrossRefPubMed
6.
Dyrbye LN, Thomas MR, Massie FS, Power DV, Eacker A, Harper W, Durning S, Moutier C, Szydlo DW, Novotny PJ, et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med. 2008;149(5):334–41.CrossRefPubMed
7.
Aktekin M, Karaman T, Senol YY, Erdem S, Erengin H, Akaydin M. Anxiety, depression and stressful life events among medical students: a prospective study in Antalya. Turkey Med Educ. 2001;35(1):12–7.CrossRefPubMed
8.
Akdemir M, Aktekin MR, Senol YY, Sonmez Y, DoganavsargilBaysal O, Mamakli S, Kose F, Bozbay DS, Erdogan K, Gurpinar E. Depression and Psychological Distress in Medical Students A Prospective Study. Noro Psikiyatr Ars. 2022;59(2):116–22.PubMedPubMedCentral
9.
Prinz P, Hertrich K, Hirschfelder U, de Zwaan M. Burnout, depression and depersonalisation–psychological factors and coping strategies in dental and medical students. GMS Z Med Ausbild. 2012;29(1):Doc10.PubMedPubMedCentral
10.
Zhang Z, Wu C, Liu G, Fan C, Wang H. Depression and the influencing factors of medical college students in Guangzhou. Chin J Sch Health. 2006;27:51–2.
11.
Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016;316(21):2214–36.CrossRefPubMedPubMedCentral
12.
Puthran R, Zhang MW, Tam WW, Ho RC. Prevalence of depression amongst medical students: a meta-analysis. Med Educ. 2016;50(4):456–68.CrossRefPubMed
13.
Costantini L, Pasquarella C, Odone A, Colucci ME, Costanza A, Serafini G, Aguglia A, BelvederiMurri M, Brakoulias V, Amore M, et al. Screening for depression in primary care with Patient Health Questionnaire-9 (PHQ-9): A systematic review. J Affect Disord. 2021;279:473–83.CrossRefPubMed
14.
Pacheco JPG, Silveira JB, Ferreira RPC, Lo K, Schineider JR, Giacomin HTA, Tam WWS. Gender inequality and depression among medical students: A global meta-regression analysis. J Psychiatr Res. 2019;111:36–43.CrossRefPubMed
15.
Stewart LA, Clarke M, Rovers M, Riley RD, Simmonds M, Stewart G, Tierney JF, Group P-ID. Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data: the PRISMA-IPD Statement. JAMA. 2015;313(16):1657–65.CrossRefPubMed
16.
Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, Baker P, Smith E, Buchbinder R. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65(9):934–9.CrossRefPubMed
17.
Mathew T, Nordstrom K. Comparison of one-step and two-step meta-analysis models using individual patient data. Biom J. 2010;52(2):271–87.PubMed
18.
Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation; 1996.
19.
20.
Osman A, Wong JL, Bagge CL, Freedenthal S, Gutierrez PM, Lozano G. The Depression Anxiety Stress Scales-21 (DASS-21): further examination of dimensions, scale reliability, and correlates. J Clin Psychol. 2012;68(12):1322–38.CrossRefPubMed
21.
Bayram N, Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol. 2008;43(8):667–72.CrossRefPubMed
22.
Ozdemir H, Rezaki M. General Health Questionnaire-12 for the detection of depression. Turk J Psychiatry. 2007;18(1):13–21.
23.
Stern AF. The hospital anxiety and depression scale. Occup Med (Oxford, England). 2014;64(5):393–4.CrossRef
24.
LeBlanc JC, Almudevar A, Brooks SJ, Kutcher S. Screening for adolescent depression: comparison of the Kutcher Adolescent Depression Scale with the Beck depression inventory. J Child Adolesc Psychopharmacol. 2002;12(2):113–26.CrossRefPubMed
25.
Scoppetta O, Cassiani-Miranda CA, Arocha-Díaz KN, Cabanzo-Arenas DF, Campo-Arias A. Validity of the patient health questionnaire-2 (PHQ-2) for the detection of depression in primary care in Colombia. J Affect Disord. 2021;278:576–82.CrossRefPubMed
26.
Burke DL, Ensor J, Riley RD. Meta-analysis using individual participant data: one-stage and two-stage approaches, and why they may differ. Stat Med. 2017;36(5):855–75.CrossRefPubMed
27.
Legha A, Riley RD, Ensor J, Snell KIE, Morris TP, Burke DL. Individual participant data meta-analysis of continuous outcomes: A comparison of approaches for specifying and estimating one-stage models. Stat Med. 2018;37(29):4404–20.CrossRefPubMedPubMedCentral
28.
Pacheco JP, Giacomin HT, Tam WW, Ribeiro TB, Arab C, Bezerra IM, Pinasco GC. Mental health problems among medical students in Brazil: A systematic review and meta-analysis. Rev Bras Psiquiatr. 2017;39(4):369–78.CrossRefPubMedPubMedCentral
29.
Wong YL. Gender issues in medical and public health education. Asia Pac J Public Health. 2000;12(Suppl):S74–7.PubMed
30.
Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005;39(6):594–604.CrossRefPubMed
31.
Wallin U, Runeson B. Attitudes towards suicide and suicidal patients among medical students. Eur Psychiatry. 2003;18(7):329–33.CrossRefPubMed
32.
McClain T, Kammer-Kerwick M, Wood L, Temple JR, Busch-Armendariz N. Sexual Harassment Among Medical Students: Prevalence, Prediction, and Correlated Outcomes. Workplace Health Saf. 2021;69(6):257–67.CrossRefPubMed
33.
Bentivegna F, Patalay P. The impact of sexual violence in mid-adolescence on mental health: a UK population-based longitudinal study. Lancet Psychiatry. 2022;9(11):874–83.CrossRefPubMedPubMedCentral
34.
Babaria P, Bernheim S, Nunez-Smith M. Gender and the pre-clinical experiences of female medical students: a taxonomy. Med Educ. 2011;45(3):249–60.CrossRefPubMed
35.
Eid RS, Gobinath AR, Galea LAM. Sex differences in depression: Insights from clinical and preclinical studies. Prog Neurobiol. 2019;176:86–102.CrossRefPubMed
36.
Dyrbye LN, Wittlin NM, Hardeman RR, Yeazel M, Herrin J, Dovidio JF, Burke SE, Cunningham B, Phelan SM, Shanafelt TD, et al. A Prognostic Index to Identify the Risk of Developing Depression Symptoms Among U.S. Medical Students Derived From a National Four-Year Longitudinal Study. Acad Med. 2019;94(2):217–26.CrossRefPubMed
37.
Chen L, Wang L, Qiu XH, Yang XX, Qiao ZX, Yang YJ, Liang Y. Depression among Chinese university students: prevalence and socio-demographic correlates. PLoS ONE. 2013;8(3):e58379.CrossRefPubMedPubMedCentral
38.
Quince TA, Wood DF, Parker RA, Benson J. Prevalence and persistence of depression among undergraduate medical students: a longitudinal study at one UK medical school. BMJ open. 2012;2(4):e001519.
39.
Saravanan C, Wilks R. Medical students’ experience of and reaction to stress: the role of depression and anxiety. TheScientificWorldJOURNAL. 2014;2014:737382.CrossRefPubMedPubMedCentral
40.
Dyson R, Renk K. Freshmen adaptation to university life: depressive symptoms, stress, and coping. J Clin Psychol. 2006;62(10):1231–44.CrossRefPubMed
41.
Tan JB, Yates S. Academic expectations as sources of stress in Asian students. Soc Psychol Educ. 2011;14:389–407.CrossRef
Metadata
Title
Pooled prevalence of depressive symptoms among medical students: an individual participant data meta-analysis
Authors
Wilson Baldin Zatt
Kenneth Lo
Wilson Tam
Depression in Medical Students Research Group
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2023
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-023-04745-5

Other articles of this Issue 1/2023

BMC Psychiatry 1/2023 Go to the issue

Research

Cognitive impairment and factors influencing depression in adolescents with suicidal and self-injury behaviors: a cross-sectional study

Research

Schizophrenia: jinn, magic or disease? Experiences of family caregivers of patients with schizophrenia in Baloch ethnicity

Research

Inpatients in substance use treatment with co-occurring psychiatric disorders: a prospective cohort study of characteristics and relapse predictors

Research

Cognitive behavior therapy for diabetes distress, depression, health anxiety, quality of life and treatment adherence among patients with type-II diabetes mellitus: a randomized control trial

Research

Consultations for refractory cases in mental health services: a descriptive study

Research

Clinical characteristics and potential association to Parkinson’s disease and dementia with Lewy bodies in patients with major depressive disorder who received maintenance electroconvulsive therapy: a retrospective chart review study