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Research article
Depression, anxiety, and burnout among medical students and residents of a medical school in Nepal: a cross-sectional study
Nishan Babu Pokhrel
Tribhuvan University Institute of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4278-5753
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Psychiatry.
Background: Medical students and residents were found to have suffered from depression, anxiety, and burnout in various studies. However, these entities have not been adequately explored in the context of Nepal. We proposed to determine the prevalence of depression, anxiety, burnout, their associated factors, and identify their predictors in a sample of medical students and residents in a Nepalese medical school.
Methods: It was a cross-sectional study with 651 medical students and residents chosen at random between December 2018 and February 2019. The validated Nepali version of Hospital Anxiety and Depression Scale, the Copenhagen Burnout Inventory, and Medical Students' Stressor Questionnaire were used to assess depression, anxiety, burnout, and stressors respectively. We used univariate and multivariable logistic regression analyses to identify the correlation of predictor variables with depression, anxiety, and burnout.
Results: The overall prevalence of burnout (48.8%; 95% CI 44.9-52.7) and anxiety (45.3%; 95% CI 41.4-49.2) was more than that of depression (31%; 95% CI 27.5-34.7). Burnout and depression were more prevalent in residents than in medical students (burnout: 64.5% vs 37.6%, P-value < 0.0001; depression: 33.7% vs 29.1%, P-value 0.21). Whereas, medical students were found more anxious than residents (46.3% versus 43.96%, P-value 0.55). Academic related stressors caused high-grade stress to participants. Multivariable model for depression significantly showed anxiety, personal burnout, and work-related burnout as risk enhancing correlates; satisfaction with academic performance as a protective correlate. Similarly, the multivariate model for anxiety significantly identified female gender, depression, personal burnout, teaching and learning related stressors, and past history of mental illness as risk enhancing correlates; being satisfied with academic performance, getting adequate sleep, and being a second-year resident as protective correlates. The logistic model for burnout significantly showed being a first-year resident, depression, anxiety, and drive and desire related stressors as positive predictors. None of the variables were identified as significant negative predictors of burnout.
Conclusions: A high prevalence of depression, anxiety, and burnout was seen among medical students and residents. Most of them were stressed with academic-related factors. A strong correlation between teaching and learning-related stressors with depression and anxiety may be a call for an efficient and more student-friendly curriculum.
Keywords
Anxiety, Burnout, Depression, Developing countries, Medical students, Residents, Stressors, South Asia
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CURRENT STATUS: Published
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On 15 Jun, 2020
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Editorial decision: Accept
On 29 Apr, 2020
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Received 09 Apr, 2020
Reviewer #2 agreed
On 08 Apr, 2020
Editor assigned
On 07 Apr, 2020
Reviewers invited
Invitations sent on 07 Apr, 2020
Reviewer #1 agreed
On 07 Apr, 2020
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On 06 Apr, 2020
Editor invited
On 06 Apr, 2020
No comments provided
Editorial decision: Major revision
On 23 Mar, 2020
Review #2 received
Received 03 Nov, 2019
Review #1 received
Received 03 Nov, 2019
Reviewer #3 agreed
On 17 Oct, 2019
Reviewer #2 agreed
On 16 Oct, 2019
Reviewer #1 agreed
On 14 Oct, 2019
Reviewers invited
Invitations sent on 11 Oct, 2019
Submission checks complete
On 26 Sep, 2019
Editor assigned
On 23 Sep, 2019
Editor invited
On 22 Sep, 2019
First submitted
On 21 Sep, 2019
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Subject Areas
Psychiatry
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This preprint is under consideration at BMC Psychiatry. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Depression, anxiety, and burnout among medical students and residents of a medical school in Nepal: a cross-sectional study
Nishan Babu Pokhrel
Tribhuvan University Institute of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4278-5753
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 13 Apr, 2020
Published
On 15 Jun, 2020
No community comments so far
Review #2 received
Received 29 Apr, 2020
Editorial decision: Accept
On 29 Apr, 2020
Review #1 received
Received 09 Apr, 2020
Reviewer #2 agreed
On 08 Apr, 2020
Editor assigned
On 07 Apr, 2020
Reviewers invited
Invitations sent on 07 Apr, 2020
Reviewer #1 agreed
On 07 Apr, 2020
Submission checks complete
On 06 Apr, 2020
Editor invited
On 06 Apr, 2020
No comments provided
Editorial decision: Major revision
On 23 Mar, 2020
Review #2 received
Received 03 Nov, 2019
Review #1 received
Received 03 Nov, 2019
Reviewer #3 agreed
On 17 Oct, 2019
Reviewer #2 agreed
On 16 Oct, 2019
Reviewer #1 agreed
On 14 Oct, 2019
Reviewers invited
Invitations sent on 11 Oct, 2019
Submission checks complete
On 26 Sep, 2019
Editor assigned
On 23 Sep, 2019
Editor invited
On 22 Sep, 2019
First submitted
On 21 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Psychiatry
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Psychiatry.
Background: Medical students and residents were found to have suffered from depression, anxiety, and burnout in various studies. However, these entities have not been adequately explored in the context of Nepal. We proposed to determine the prevalence of depression, anxiety, burnout, their associated factors, and identify their predictors in a sample of medical students and residents in a Nepalese medical school.
Methods: It was a cross-sectional study with 651 medical students and residents chosen at random between December 2018 and February 2019. The validated Nepali version of Hospital Anxiety and Depression Scale, the Copenhagen Burnout Inventory, and Medical Students' Stressor Questionnaire were used to assess depression, anxiety, burnout, and stressors respectively. We used univariate and multivariable logistic regression analyses to identify the correlation of predictor variables with depression, anxiety, and burnout.
Results: The overall prevalence of burnout (48.8%; 95% CI 44.9-52.7) and anxiety (45.3%; 95% CI 41.4-49.2) was more than that of depression (31%; 95% CI 27.5-34.7). Burnout and depression were more prevalent in residents than in medical students (burnout: 64.5% vs 37.6%, P-value < 0.0001; depression: 33.7% vs 29.1%, P-value 0.21). Whereas, medical students were found more anxious than residents (46.3% versus 43.96%, P-value 0.55). Academic related stressors caused high-grade stress to participants. Multivariable model for depression significantly showed anxiety, personal burnout, and work-related burnout as risk enhancing correlates; satisfaction with academic performance as a protective correlate. Similarly, the multivariate model for anxiety significantly identified female gender, depression, personal burnout, teaching and learning related stressors, and past history of mental illness as risk enhancing correlates; being satisfied with academic performance, getting adequate sleep, and being a second-year resident as protective correlates. The logistic model for burnout significantly showed being a first-year resident, depression, anxiety, and drive and desire related stressors as positive predictors. None of the variables were identified as significant negative predictors of burnout.
Conclusions: A high prevalence of depression, anxiety, and burnout was seen among medical students and residents. Most of them were stressed with academic-related factors. A strong correlation between teaching and learning-related stressors with depression and anxiety may be a call for an efficient and more student-friendly curriculum.
Figure 1