Investigating the link between vitamin d deficiency and depression and anxiety in medical students at Jazan university: a cross-sectional study

Authors

  • Omar Oraibi Faculty of Medicine, Jazan University, Jazan, Saudi Arabia https://orcid.org/0000-0003-4621-1113
  • Mohammed Somaili Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Essa Jaawna Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Sarah Alfaraj Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Jalal Majhali Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Alhanouf Zuqayl Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Abdulrahman Hadadi Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Ruba Ageeli Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Khawla Modawi Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Alaa Najmi Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Abdullah Majrashi Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Luai Alhazmi Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
  • Bassem Oraibi Medical Research Center, Jazan, Jazan University, Jazan, Saudi Arabia
  • Eman Bahkali Ministry of Health, Jazan, Saudi Arabia

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20233825

Keywords:

Depression, Anxiety, Medical students, Academic performance, Vitamin D deficiency

Abstract

Background: Numerous studies have assessed the prevalence of vitamin D insufficiency among Saudi individuals and correlated depression and anxiety with vitamin D deficiency. However, studies have not looked at these factors in Saudi Arabia's Jazan medical students. The current study aimed to clarify the relationship between low vitamin D levels, depression, anxiety, and academic performance.

Methods: A cross-sectional study was conducted among medical students at Jazan university. The dependent variables were depression and anxiety, and their association with covariates, including sex, marital status, GPA, BMI, vitamin D level, and physical exercise, was evaluated. The 21-item depression, anxiety, and stress scale, which has been validated, was utilized.

Results: Of 252 students, the prevalence of vitamin D deficiency was 54.4%; anxiety, 62.3%; and depression 68.7%. Comparatively, more female students than male students were vitamin D deficient. Stress was found to be substantially related to vitamin D deficiency (p<0.001). Anxiety was also significantly related to vitamin D deficiency (p<0.001), wherein the students with anxiety had a considerably higher prevalence of vitamin D deficiency than those without anxiety (84% vs. 32.5%). Similarly, depression was significantly associated with vitamin D deficiency (p<0.001), wherein students with depression were much more likely to get vitamin D deficiency than students without depression (86.7% vs. 27.5%)-no significant association otherwise with other variables.

Conclusions: Stress, depression, and anxiety are associated with vitamin D deficiency. This finding highlights the importance of mental health promotion among medical students owing to its link to quality of life and academic performance.

References

Anas NL, Taleb R, Wajdi R, Alanazi K, Alshehri N et al. Vitamin D Deficiency and its Impact on Depression among Al-Maarefa University Students, Riyadh, Saudi Arabia. Asian J Pharmac. 2018;12

Schneider B, Weber B, Frensch A, Stein J, Fritze J. Vitamin D in schizophrenia, major depression and alcoholism Short Communication. J Neural Transm. 2000;107(7):839-42.

Faiz S, Panunti B, Andrews S. The Epidemic of Vitamin D Deficiency. J La State Med Soc. 2007;159(1):17-20.

Bosomworth NJ, Fcfp C. Commentary Mitigating epidemic vitamin D deficiency the agony of evidence Prevalence of vitamin D deficiency. Canadian Family Physician. 2011;57(1):16-20, e1-6.

Goldstein D. The epidemic of vitamin D deficiency. J Pediatr Nurs. 2009;24(4):345-6.

Ahmed AH. Vitamin D Deficiency/Insufficiency and Anxiety Among Saudis: Degree and Differences. Eur Scient J. 2016;12(27):93.

Sadat-Ali M, Alelq A, Al-Turki H, Al-Mulhim F, Al-Ali A. Vitamin D levels in healthy men in eastern Saudi Arabia. Ann Saudi Med. 2009;29(5):378-82.

Hussain AN, Alkhenizan AH, El Shaker M, Raef H, Gabr A. Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia. Arch Osteoporos. 2014;9(1).

Elsammak MY, Al-Wossaibi AA, Al-Howeish A, Alsaeed J. ‫ High prevalence of vitamin D deficiency in the sunny Eastern region of Saudi Arabia: a hospital-based study. East Mediterr Health J. 2011;17(4):317-22.‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬

Al-Alyani H, Al-Turki HA, Al-Essa ON, Alani FM, Sadat-Ali M. Vitamin D deficiency in Saudi Arabians: A reality or simply hype: A meta-analysis (2008-2015). J Family Community Med. 2018;25:1-4.

Elshafie DE, Al-Khashan HI, Mishriky AM. Comparison of vitamin D deficiency in Saudi married couples. Eur J Clin Nutr. 2012;66(6):742-5.

Hasanato R, Al-Mahboob A, Al-Mutairi A, Al-Faraydi J, Al-Amari K, Al-Jurayyad R et al. High prevalence of vitamin d deficiency in healthy female medical students in central Saudi Arabia: Impact of nutritional and environmental factors. Acta Endocrinologica. Acta Endocrinologica Foundation. 2015;11:257-61.

Psychiatry.org-What Is Depression? Available at: https://www.psychiatry.org/patients-families/ depression/what-is-depression. Accessed on 1 August, 2023.

Overview - Generalised anxiety disorder in adults-NHS. Available at: https://www.nhs.uk/mental-health/conditions/generalised-anxiety-disorder/overview/. Accessed on 1 August, 2023.

Alanazi S. Impact of vitamin D deficiency on anxiety in the Saudi population. Int J Med Developing Countries. 2019;1.

Al-Gelban KS. Depression, anxiety and stress among Saudi adolescent school boys. J R Soc Promot Heal. 2016;127(1):33-7.

Dalia El-SD, Reda AI, Mohamed SO. Prevalence and Comorbidity of Depression, Anxiety and Obsessive Compulsive Disorders among Saudi Secondary School Girls, Taif Area, KSA. Arch Iran Med. 2015;18(4):234-8.

Nair R, Maseeh A. Vitamin D: The “sunshine” vitamin. J Pharmacol Pharmacother. 2012;3(2):118-26.

Khoshhal KI, Khairy GA, Guraya SY, Guraya SS. Exam anxiety in the undergraduate medical students of Taibah University. Med Teach. 2017;39(1):S22-S26.

Penckofer S, Byrn M, Adams W, Emanuele MA, Mumby P, Kouba J et al. Vitamin D Supplementation Improves Mood in Women with Type 2 Diabetes. J Diabetes Res. 2017;2017:8232863.

Burrows TL, Whatnall MC, Patterson AJ, Hutchesson MJ. Associations between Dietary Intake and Academic Achievement in College Students: A Systematic Review. Healthcare. 2017;5(4).

Llewellyn DJ, Langa KM, Lang IA. Serum 25-hydroxyvitamin D concentration and cognitive impairment. J Geriatr Psychiatry Neurol. 2009;22(3):188-95.

Slinin Y, Paudel ML, Taylor BC, Fink HA, Ishani A, Canales MT et al. 25-Hydroxyvitamin D levels and cognitive performance and decline in elderly men. Neurology. 2010;74(1):33-41.

AlZahrani WI, Oommen A. Role of vitamin D in the academic performance of health sciences students in Saudi Arabia. Arab Gulf J Scient Res. 2022.

Sample Size Calculator by Raosoft, Inc. Available at: http://www.raosoft.com/samplesize.htm. Accessed on 8 March, 2023.

Depression Anxiety Stress Scales-DASS. Available at: https://www2.psy.unsw.edu.au/groups/dass/. Accessed on 23 June, 2023.

Sedrani SH, Elidrissy AW, El Arabi KM. Sunlight and vitamin D status in normal Saudi subjects. Am J Clin Nutr. 1983;38(1):129-32.

Vitamin D status in health care professionals in Qatar. Available at: https://www.researchgate.net/ publication/40900586_Vitamin_D_status_in_health_care_professionals_in_Qatar. Accessed on 08 March, 2023.

Laleye LC, Kerkadi AH, Wasesa AA, Rao M V, Aboubacar A. Assessment of vitamin D and vitamin A intake by female students at the United Arab Emirates University based on self-reported dietary and selected fortified food consumption. Int J Food Sci Nutr. 2011;62(4):370-6.

Hollis BW. Use of topical sunscreen for the evaluation of regional synthesis of vitamin D3. J Am Acad Dermatol. 1990;22(5):772-5.

Matsuoka LY, Ide L, Wortsman J, Maclaughlin JA, Holick MF. Sunscreens suppress cutaneous vitamin D3 synthesis. J Clin Endocrinol Metab. 1987;64(6):1165-8.

Libon F, Courtois J, Le Goff C, Lukas P, Fabregat-Cabello N, Seidel L et al. Sunscreens block cutaneous vitamin D production with only a minimal effect on circulating 25-hydroxyvitamin D. Arch Osteoporos. 2017;12(1):1-7.

Tangpricha V, Turner A, Spina C, Decastro S, Chen TC, Holick MF. Tanning is associated with optimal vitamin D status (serum 25-hydroxyvitamin D concentration) and higher bone mineral density. Am J Clin Nutr. 2004;80(6):1645-9.

Berk M, Jacka FN, Williams LJ, Ng F, Dodd S, Pasco JA. Is this D vitamin to worry about? Vitamin D insufficiency in an inpatient sample. Aust N Zeal J Psychiatr. 2008;42.

Hoogendijk WJG, Lips P, Dik MG, Dorly, Deeg JH, Aartjan et al. Depression Is Associated with Decreased 25-Hydroxyvitamin D and Increased Parathyroid Hormone Levels in Older Adults. Gen Psychiatr. 2008;65(5):508-12.

Al-Atram AA, Ragunath G, Kannan SK. Relationship between Vitamin D and Mental Health among Dental Students in Saudi Arabia: A Descriptive Cross-Sectional Study. J Clin Diagnostic Res. 2020;14(4):VC07-10.

Aboalshamat K, Hou XY, Strodl E. Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: A cross-sectional study. Med Teach. 2015;37(S1):S75-81.

Bičíková M, Dušková M, Vítků J, Kalvachová B, Řípová D, Mohr P et al. Vitamin D in anxiety and affective disorders. Physiol Res. 2015;64(2):S101-3.

Hoang MT, DeFina LF, Willis BL, Leonard DS, Weiner MF, Brown ES. Association between low serum 25-hydroxyvitamin D and depression in a large sample of healthy adults: The Cooper Center longitudinal study. Mayo Clin Proc. 2011;86(11):1050-5.

Armstrong DJ, Meenagh GK, Bickle I, Lee ASH, Curran ES, Finch MB. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin Rheumatol. 2007;26(4):551-4.

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Published

2023-12-06

How to Cite

Oraibi, O., Somaili, M., Jaawna, E., Alfaraj, S., Majhali, J., Zuqayl, A., Hadadi, A., Ageeli, R., Modawi, K., Najmi, A., Majrashi, A., Alhazmi, L., Oraibi, B., & Bahkali, E. (2023). Investigating the link between vitamin d deficiency and depression and anxiety in medical students at Jazan university: a cross-sectional study. International Journal Of Community Medicine And Public Health, 11(1), 11–19. https://doi.org/10.18203/2394-6040.ijcmph20233825

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Original Research Articles