Covariates Associated with Mental Health Problems Faced by Undergraduate Medical Students Undergoing Competency-Based Medical Education at a Rural Institution in North India: A Cross-Sectional Exploratory Survey

Abstract

Introduction: Mental health-related problems among medical students were well-researched before the era of competency-based curricula. These problems were revealed to be widespread among college students who experienced greater effort-reward imbalance and over-commitment. Such research is insufficient in the Indian context. Aims: The present study aims to assess the prevalence of mental health problems (stress, anxiety, and depression), and their covariates among female medical undergraduate students. Methodology: A cross-sectional exploratory study was conducted from March 2022 to May 2022 on 364 female medical undergraduate students in a rural institution located in Northern India. A stratified random sampling technique was used. The study included a semi-structured sociodemographic with personal and psychological domains proforma along with a Perceived Stress Scale-10, Generalized Anxiety Disorder-7 questionnaire, Becks Depression Inventory-II, Medical Students Stressor Questionnaire, and brief-coping orientation to problems experienced to assess perceived stress, anxiety, depression, stressors, and coping mechanisms, respectively. The Chi-square test and backward multivariable logistic regression analyses were used to investigate the correlates of dependent variables. Results: Of 364, around 40.7%, 36.5%, and 17.9% of students were highly stressed, anxious, and moderate to severely depressed, respectively, with a mean age of 20.44 ± 1.88 years. The results indicate that poor sleep and irregular exercise patterns were significant covariates of mental health problems. Respondents with interpersonal- and intrapersonal-related stressors were found to have two times (adjusted odds ratio [AOR] = 2.632; confidence interval [CI] = 1.216–5.698; P < 0.05) and four times (AOR = 4.230; CI = 1.832–9.763; P < 0.001) higher odds of perceived stress and anxiety symptoms, respectively. A personal history and family history of psychiatric illness among participants influenced perceived stress by 211%–226% while drive- and desire-related stressors influenced depressive symptoms by more than three times (AOR = 3.719; 95% CI = 1.702–8.124; P < 0.001). Conclusions: Findings from the present study suggest that a large number of students are suffering from mental health issues. Modifiable factors such as poor sleep and irregular exercise patterns can be addressed through various wellness programs and group sessions. Various supportive and preventive measures along with scheduled psychological interventions can be adopted by the institution to address various stressors faced by the students.

Keywords

• anxiety
• covariates
• depression
• medical students
• perceived stress