Depression, anxiety, and stress among graduate adults preparing for competitive exams at libraries in a city of Central India: a cross-sectional study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20252864Keywords:
Anxiety, Competitive exams, Depression, DASS-42, Graduate adults, Mental health, Public libraries, StressAbstract
Background: Graduate adults preparing for competitive examinations often face significant psychological stress due to prolonged self-study, performance pressures, and uncertainty about outcomes. These factors contribute to rising levels of depression, anxiety, and stress, which can adversely affect academic focus and quality of life.
Methods: A descriptive cross-sectional study was conducted over four months (October 2024 to January 2025) in Nagpur among graduate adults preparing for competitive exams at public libraries. Using convenience sampling, five libraries were chosen from 196, recruiting 310 participants. Data were collected using the Depression, Anxiety, and Stress Scale (DASS-42), a validated self-administered questionnaire comprising 42 items. Descriptive statistics were used to calculate prevalence, and the significance level was set at p = 0.05.
Results: Among the 310 participants, the prevalence of depression was 36.46%, anxiety 39.04%, and stress 33.23%. Female participants reported higher mean scores in all three domains compared to males. Medical graduates including MBBS, BAMS, BDS, nursing, and paramedical graduates experienced higher levels of psychological distress across depression, anxiety, and stress, whereas non-medical graduates from arts, commerce, and other science streams reported comparatively lower distress, with engineering students showing the least overall.
Conclusions: The findings indicate a considerable prevalence of depression, anxiety, and stress among graduate students preparing for competitive exams. These results underscore the urgent need for regular mental health screening, early psychological intervention, and the establishment of counseling services in public study environments such as libraries.
Metrics
References
Reddy KJ, Menon KR, Thattil A. Academic stress and its sources among university students using DASS‑42: A cross-sectional study. Ind J Psychol Med. 2018;40(5):498-502.
Sharma N, Gupta S, Yadav K. Assessment of depression, anxiety, and stress among medical entrance exam aspirants using DASS‑42. Natl J Physiol Pharm Pharmacol. 2021;11(1):45-9.
Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney: Psychology Foundation; 1995. DOI: https://doi.org/10.1037/t01004-000
Singh R, Kaur M, Sandhu R. Gender differences in depression, anxiety, and stress among nursing students using DASS‑42. Ind J Health Sci Biomed Res. 2021;14(2):128-32.
Mishra A, Shukla P. Factors affecting academic stress in competitive exam aspirants: A DASS‑42-based study. Int J Med Sci Publ Health. 2019;8(7):558-62.
Kerr M, Legg TJ. Depression and College Students. CRNP. 2017.
Gururaj G. Prevalence, patterns and outcomes. NIMHANS J. 2016;129:32-9.
Mental health action plan 2013-2020. Available at: http://apps.who.int/iris/bitstream/10665/89966/1/9789241506021_eng.pdf. Accessed 20 November 2022.
Pachole N, Thakur A, Koshta H, Menon M, Peepre K. A study to explore patterns and factors of depression, anxiety and stress among students preparing for competitive exams in central India. Int J Commu Med Publ Heal. 2023;10:1419-25. DOI: https://doi.org/10.18203/2394-6040.ijcmph20230918
Teh CK, Ngo CW, Aniyah R, Vellasamy R, Suresh K. Depression, anxiety and stress among undergraduate students: a cross sectional study. Open Epidemiol. 2015;5(4):260-8. DOI: https://doi.org/10.4236/ojepi.2015.54030
Civil Service India. Health issues. Available at: https://www.civilserviceindia.com/current-affairs/articles/health-issues-of-aspirants-of-competitive-examination-and-remedies.html. Accessed on 20 November 2022.
Kumar KS, Akoijam BS. Depression, anxiety and stress among higher secondary school students of Imphal, Manipur. Ind J Commu Med. 2017;42(2):94-6. DOI: https://doi.org/10.4103/ijcm.IJCM_266_15
Maideen K, Sidik KS, Rampal S, Mukhtar LF. Prevalence, associated-factors and predictors of depression among adults in the community of Selangor, Malaysia. PLoS ONE, 2014;9(4):e95395. DOI: https://doi.org/10.1371/journal.pone.0095395
Poongothai S, Pradeepa R, Ganesan A, Mohan V. Prevalence of depression in a large urban South Indian Population, The Chennai urban rural epidemiology study. PLoS ONE. 2009;4(9):e7185. DOI: https://doi.org/10.1371/journal.pone.0007185
Strine TW, Mokdad AH, Balluz LS, Gonzalez O, Crider R, Berry JT, et al. Depression and anxiety in the United States: findings from the 2006 behavioral risk factor surveillance system. Psychiatr Serv. 2008;59(12):1383-90. DOI: https://doi.org/10.1176/appi.ps.59.12.1383
Shi M, Liu L, Wang ZY, Wang L. Prevalence of depressive symptoms and its correlations with positive psychological variables among Chinese medical students: an exploratory cross-sectional study. BMC Psychiatry. 2016;16(1):3. DOI: https://doi.org/10.1186/s12888-016-0710-3
Waghachavare VB, Dhumale GB, Kadam YR, Gore AD. A Study of Stress among Students of Professional Colleges from an Urban area in India. Sultan Qaboos Univ Med J. 2013;13(3):429-36. DOI: https://doi.org/10.18295/2075-0528.1499
Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA. Stress and its effects on medical students: A cross-sectional study at a college of medicine in Saudi Arabia. J Health Popul Nutr. 2011;29(5):516-22. DOI: https://doi.org/10.3329/jhpn.v29i5.8906
Hoe D, Wah C, Rian C, Eliza Au E, Goud B, Kamath U. Stress manifestations of medical students and its relation with gender and lifestyle changes. Int Med J Stud Res. 2012;2(1):37‑45.
Kumar R, Nancy. Stress and coping strategies among nursing students. Nurs Midwifery Res J. 2011;7(4):141‑51. DOI: https://doi.org/10.1177/0974150X20110401
Kumar R. Resilience, psychological well‑being, and coping strategies in medical students. Ind J Psy Nsg 2019;16(2):92‑7. DOI: https://doi.org/10.4103/IOPN.IOPN_22_19
Kumar R, Kaur G, Dhillon A. Organizational role stress and job satisfaction among nurses. J Ment Health Hum Behav. 2015;20(2):71‑5. DOI: https://doi.org/10.4103/0971-8990.174597
Wolf TM. Stress, coping and health: Enhancing well‑being during medical school. Med Educ. 1994;28(1):8‑17. DOI: https://doi.org/10.1111/j.1365-2923.1994.tb02679.x
Pulido‑Martos M, Augusto‑Landa JM, Lopez‑Zafra E. Sources of stress in nursing students: A systematic review of quantitative studies. Int Nurs Rev. 2012;59(1):15‑25.
Otao G, Maruta T, Yonaha T, Igarashi K, Nagata S, Kitamura K, et al. The usefulness of plasma levels of mature and total adrenomedullin as biomarkers indicating the magnitude of surgical stress responses: A single‑center, prospective, observational study. J Clin Transl Res. 2021;7(3):302‑10.
Martos M, Landa JM, Zafra E. Sources of stress in nursing students: A systematic review of quantitative studies. Int Nurs Rev. 2012;59(1):15‑25. DOI: https://doi.org/10.1111/j.1466-7657.2011.00939.x
Moran TP. Anxiety and working memory capacity: A meta‑analysis and narrative review. Psychol Bull. 2016;142(8):831‑64. DOI: https://doi.org/10.1037/bul0000051
Zarit SH, Reever KE, Bach‑Peterson J. Relatives of the impaired elderly: Correlates of feelings of burden. Gerontolog. 1980;20(6):649‑55. DOI: https://doi.org/10.1093/geront/20.6.649
Rani R, Kumar R, Mishra R, Sharma SK. Digital health: A panacea in COVID‑19 crisis. J Family Med Prim Care. 2021;10(1):62‑5. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1494_20
Warne T, Johansson UB, Papastavrou E, Tichelaar E, Tomietto M, Van den Bossche K, et al. An exploration of the clinical learning experience of nursing students in nine European countries. Nurse Educ Today. 2010;30(8):809‑15. DOI: https://doi.org/10.1016/j.nedt.2010.03.003