Prevalence and factors associated to depression and anxiety among medical students in an inland university in Brazil

Medical schools are known to be stressful environments for students and hence medical students have been believed to experience greater incidences of depression and anxiety than the general population or students from other specialties. The present study investigates the prevalence of anxiety and depressive symptoms together with factors associated with them among medical students in a public federal university in the south of Brazil. A descriptive study was performed using self-administered questionnaires to access socio-demographic, institutional and health variables in association with two scales - Beck’s Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) - designed to assess depressive and anxiety symptoms, respectively. The research sample consisted of 152 subjects. The depressive symptoms prevalence was 65.1% (BDI > 9), state-anxiety was 98.6% and trait-anxiety 97.4% (STAI > 33). Among women, 37.8% demonstrated moderate/severe depressive symptoms. High levels of state-anxiety symptoms and trait-anxiety symptoms were found in 44.7% of students under age 20. In the group with the lowest monthly income, it was observed the highest distributions for moderate/severe depressive symptoms, high state and high trait-anxiety symptoms, corresponding to 47.4%, 57.9% and 47.4%, respectively. Students attending the 3rd term of medical school had the highest percentage of moderate/severe depressive symptoms (62.5%) and high state-anxiety symptoms (50%). In addition, students who had both financial aid programs presented the highest percentages at moderate/severe depressive symptoms (46.2%), high state-anxiety symptoms (61.5%) and high trait-anxiety symptoms (46.2%). We also observed a correlation between depression and trait-anxiety symptoms (P = 0.037).  In conclusion, it was identified as risk factors for depressive symptoms the previous depression diagnosis, previous search for health service due to psychological symptoms, being in financial aid programs, dissatisfaction with the medical school and inadequate psychological help offered by it. For state-anxiety symptoms and trait-anxiety outcome, there is an increased risk among low-income or students who have financial help from financial aid programs and younger age students.