Prevalence of stress, anxiety and depression in undergraduate medical students: a cross sectional study

Gaurav Kamboj, Nilika ., Sweta Bhartiya


Background: It is important to identify the prevalence and risk factors of psychological distress among medical students which not only affect their health but also the academic achievements at different points of time in their study period. In addition, the patient care is affected by psychological distress among physicians such as poor communication, diminished quality of care and medical errors have been found associated with physical stress.

Methods: The present study was a descriptive type of cross-sectional study, which was conducted in a government medical college located in rural Haryana, India from June to July 2018 among 200 MBBS students after adopting inclusion and exclusion criteria. A pre-validated, pre-designed structured depression, anxiety and stress scale-21 items (DASS-21) (annexure 2) was used for obtaining information from the study subjects. The total score of the study subjects was computed and thereafter graded for levels of stress, anxiety and depression.

Results: The response rate was 94.5%. The mean score for DASS 21 scale was found to be 16.13 (±11.27). Out of the total, 61.4% students are suffering from different levels of depression. About two-third of the study participants (69.8%) were suffering from different levels of anxiety. The prevalence of stress was about 46.6% in the study subjects.

Conclusions: The study confirmed the general impression that there is considerable amount of stress, anxiety and depression in medical students.


Stress, Anxiety, Depression, DASS-21, Medical students

Full Text:



Adams J. Straining to describe and tackle stress in medical students. Med Educ, 2004;38(5):463-4.

Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proceedings. 2005;80(12):1613-22.

Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006;81(4):354.

Yusoff MSB, Rahim AFA, Yaacob MJ. Prevalence and sources of stress among University Sains Malaysia Medical Students. Malays J Med Sci. 2010;17(1):30-7.

Yusoff MSB, Liew YY, Ling HW, Tan CS, Loke HM, Lim XB et al. A study on stress, stressors and coping strategies among Malaysian medical students. Int J Stud Res. 2011;1(2):45-50.

Yusoff MSB, Rahim AFA, Baba AA, Esa AR. Medical student selection process and its pre-admission scores associated with the new students’ academic performance in University Sains Malaysia. Int Med J. 2011;18(4):327-31.

Shapiro SL, Shapiro DE, Schwartz GER. Stress management in medical education: a review of the literature. Acad Med. 2000;75(7):748.

Marcus M, Yasamy MT, van Ommeren M, Chisholm D, Saxena S. Depression, A Global Public Health Concern. Geneva: World Health Organization. Available from: Accessed on 13 July 2018.

Anxiety American Psychological Association. Available from: Accessed on 13 Jan 2018.

Stress American Psychological Association. Available from: Accessed Jan 13, 2018.

Kaplan HI, Saddock BJ. Learning theory Synopsis of Psychiatry. In: Behavioural Sciences/Clinical Psychiatry. 8th ed. Philadelphia: Lippincott Williams & Wilkins. 2000;148-54.

Silver HK, Glicken AD. Medical student abuse. JAMA. 1990;263(4):527.

Clark EJ, Rieker PP. Gender differences in relationships and stress of medical and law students. J Med Edu. 1986;61(1):32-40.

Niemi P, Vainiomaki P. Medical students’ distress-quality, continuity and gender differences during a six-year medical programme. Med Teach. 2006;28(2):136-41.

Flaherty JA, Richman JA. Substance use and addiction among medical students, residents, and physicians. Psychiatr Clin North Am. 1993;16(1):189-97.

Newbury-Birch D, White M, Kamali F. Factors influencing alcohol and illicit drug use amongst medical students. Drug Alcohol Depend. 2000;59(2):125-30.

Pickard M, Bates L, Dorian M, Greig H, Saint D. Alcohol and drug use in second year medical students at the University of Leeds. Med Edu. 2000;34(2):148-50.

Wolf TM. Stress, coping and health: enhancing well-being during medical school. Med Edu. 1994;28(1):8-17.

Abdulghani H, Al-Kanhal A, Mahmoud E, Ponnamperuma G, Alfaris E. 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.

Hysenbegasi A, Hass SL, Rowland CR. The impact of depression on the academic productivity of university students. J Ment Health Policy Econ. 2005;8(3):145-51.

Firth-Cozens J, Greenhalgh J. Doctors’ perceptions of the links between stress and lowered clinical care. Soc Sci Med. 1997;44:1017-22.

Marie D, Joneboey N, Runeson B. Stress and depression mong medical students: a cross sectional study. Med educ. 2005;39:594-604.

Khan MS, Mahmood S, Badshah A, Ali SU, Jamal Y. Prevalence of depression, anxiety and their associated factors among medical students in Karachi, Pakistan. J Pak Med Asso. 2006;56:583-6.

Kumar GS, Jain A, Hegde S. Prevalence of depression and its associated factors using Beck Depression Inventory among students of a medical college in Karnataka. Ind J Pys. 2012;54(3):223.

Yusoff MSB, Faud A, Rahim A, Baba AA, Ismail SB, Pa MNM et al. Prevalence and associated factors of stress, anxiety and depression among prospective medical students Asian J Psy. 2013;6:128-33.

Inam SN, Saqib A, Alam E. Prevalence of anxiety and stress among medical students of private university. J Pak Med Assoc. 2003;53:44-7.

Mohamed F, Hamed SA. Prevalence of psychological stress, depression and anxiety among medical students in Egypt. Psychiatry Res. 2017;255:186-94.

Wahed, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria J Med. 2017;53(1):77-84.

Motaz IB, Abdelreheem BH. Prevalence of anxiety and depression among medical and pharmaceutical students in Alexandria University. Alexandria J Med. 2015;51(2):167-73.

Shawaz I, Gupta S, Venkatrao E. Ind J Med Res 2015;141(3):354.

Vaidya, Pratibha M, Mulgaonkar KP. Prevalence of depression anxiety and stress in undergraduate medical students and its co relation with their academic performance. Ind J Occup Ther. 2007;39(1):7-10.