Evaluation of Risk Factors Associated with Depression Among Indian and Armenian Medical Students at Yerevan State Medical University: A Cross-Sectional Study

Abstract

Background: Medical education can be quite stressful. Studies have shown a high prevalence of depression among medical students. Psychological disorders on a personal level can contribute to substance abuse, broken relationships, suicide and attrition from the profession subsequently affecting students' care of patients, relationship with faculty and ultimately the culture of the medical profession. The mental health of foreign students in Armenia whose number increased since late 90s has never been evaluated. Objective: This study evaluated the association of migrational, social and cultural factors with the presence of depressive symptoms among medical students. Methods: A cross-sectional anonymous questionnaire was administered to Indian and Armenian students enrolled in the general medicine faculty at Yerevan State Medical University (YSMU) in Armenia. Elements from the Center for Epidemiologic Studies Depression (CES-D) scale were used to assess depressive symptoms. Components from daily hassle, perceived medical stress and social readjustment scale are included in addition to questions regarding social/demographic variables. Results: The final sample included 388 students; 191 Indian and 197 Armenian medical students. The prevalence rate of probable depression was higher among Indian students compared to their Armenian peers (50.8% vs. 27.9%). After adjusting for confounders, the study identified potential risk factors associated with the development of probable depression that included female gender (OR = 1.71; p = 0.04), high perceived medical school stress scale(OR=1.16, p = 0.00) and high daily hassles scale scores(OR =1.25, p =0.00). Conclusion: The study findings identified the key risk factors involved in the development of depression in medical students and can guide the design of targeted interventions that reduce the likelihood of depression via mentoring, wellness and mental health programs.