Prevalence of Depression, Anxiety, and Stress Among Medical Students before their Final Examinations at a Private Medical College of Tamil Nadu, India: A Cross-sectional Study

Background: Medical education is competitive across the globe. The long duration of the medical and paramedical courses and exposure to clinical settings potentially causes mental health issues. The aim of this study was to estimate the prevalence of depression, anxiety and stress among undergraduate students in a private medical college in South India.Materials and methods: This cross-sectional study was conducted among paramedical and medical students at a private medical college hospital and research center in South India in the year 2021. The required sample size was calculated as 783 with an expected prevalence of 53%, 95% confidence interval (CI), design effect 2.0, and non-response of 10%. The study participants were selected based on simple random sampling. After obtaining informed consent, the data was collected using an email questionnaire. Standard data collection tools such as the Perceived Stress Scale (PSS); and the Depression, Anxiety and Stress Scale - 21 (DASS-21) questionnaire were used. The investigator computed the odds ratio (OR) and adjusted odds ratio (aOR) with a 95% CI.Results: Out of 1200 students, 1015 (85%) responded to the email questionnaire. Among them, 639 were females (63%), and 925 were paramedics (91%). Prevalence of depression, anxiety and stress were 59%, 43% and 11%, respectively. Almost 95% of students experienced moderate-to-severe stress in the last one month. Prevalence was higher among females and students of medical courses. Students of final year of college (aOR = 2.0; 95% CI = 1.2-3.5) and students of medical course (aOR = 1.5; 95% CI = 1.1-2.4) were independently associated with stress among the study participants.Conclusion: There is high prevalence of depression, anxiety and stress among medical college students in south India. The final year of study and medical course were independently associated with higher stress than others. We recommend periodic assessment of mental health status and additional mental health care for final year students and medical students.