Authors
Abstract
Objective: To examine the presence of depression, perceived stress, and associated factors in a sample of medical students at the Universidad de Caldas (Colombia). Materials and Methods: A cross-sectional, quantitative, and descriptive study was conducted in 2018 with 211 medical students from the Universidad de Caldas, in Manizales (Colombia). Participants completed three self-report instruments: a questionnaire on demographic and clinical variables, the Beck Depression Inventory, and the Perceived Stress Scale. Statistical analyses were performed using the chi-square test and a binary logistic regression model. Results: Sixty-three percent of the participants presented some degree of depression; 17% showed severe depression. Statistically significant risk factors included high perceived stress (OR = 18.7; 95% CI: 4.4–80), perceived poor health status (OR = 6.7; 95% CI: 2.7–16.7), spending time alone (OR = 4.2; 95% CI: 1.4–12.8), female sex (OR = 4.2; 95% CI: 2.2–7.9), and family history of suicide or suicide attempts (OR = 3.5; 95% CI: 1.6–7.7). Conclusions: A high prevalence of depression was found among medical students, mainly associated with elevated levels of perceived stress. It is necessary to implement support measures aimed at managing depression and stress. Future research should explore the coping strategies used by students to deal with str ess and mood variations.
References
2. GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry [Internet]. 2022 Feb [cited 2023 Mar 4]; 9(2):137‑50. Available from: https://doi.org/10.1016/s2215-0366(21)00395-3
3. Institute for Health Metrics and Evaluation. Global Health Data Exchange (GHDx) [Internet]. Seattle, WA: IHME; [cited 2023 Mar 4]. Available from: https://vizhub.healthdata.org/gbd-results/
4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5-TR. 5th ed, text rev. Arlington (VA): American Psychiatric Publishing; 2022.
5. Ministerio de Salud y Protección Social. Encuesta nacional de salud mental. Tomo I. Bogotá (Colombia): Ministerio de Salud y Protección Social; 2015.
6. Fernández CJ, GH. Prevalencia del trastorno depresivo y factores asociados a esta patología en los estudiantes de pregrado del programa de Medicina de la Universidad de Caldas, en el segundo semestre del año 2000. Manizales (Colombia): Universidad de Caldas, Facultad de Ciencias para la Salud, Departamento de Salud Mental y Comportamiento Humano; 2001.
7. Bonilla-Pabón J, Salazar-Espinosa JF, Molina-Correa Y, Vélez-Ríos DA, Ropero-Gutiérrez U. Prevalence of depression symptoms in medical students of the medical program from the University of Caldas, Manizales-Colombia Rev Méd Risaralda [Internet]. 2018 [cited 2020 Jun 28];24(1):20–23. Available from: https://doi.org/10.22517/25395203.9401
8. Alonso-Polo JD, Castaño-Castrillón JJ, Cerón-Rosero YE, Dávila-Menjura LM, De la Rosa AJ, De la Rosa-Marrugo PE, et al. Frequency of depression, according to Beck questionnaire, on medical students from Manizales city (Colombia), 2014: cross sectional study. Arch Med (Manizales) [Internet]. 2015 [cited 2020 Jun 28];15(1):9-24. Available from: https://revistasum.umanizales.edu.co/ojs/index.php/archivosmedicina/article/view/717/912
9. Iorga M, Dondas C, Zugun-Eloae C. Depressed as freshmen, stressed as seniors: the relationship between depression, perceived stress and academic results among medical students. Behav Sci (Basel) [Internet]. 2018 Aug 3[cited 2020 Jun 28];8(8):70.Available from: https://doi.org/10.3390/bs8080070
10. Guavita-Falla PM, Sanabria-Ferrand PA. Depressive symptoms prevalence, in one medical student population. Universidad Militar Nueva Granada School of Medicine, Bogotá-Colombia. Rev Fac Med (Bogotá) [Internet]. 2006 [cited 2020 Jun 29];54(2):76-87 Available from: https://www.redalyc.org/pdf/5763/576363925003.pdf
11. Bohórquez Peñaranda AP. Prevalencia de depresión y de ansiedad según las escalas de Zung, y evaluación de la asociación con el desempeño académico en los estudiantes de medicina de la Pontificia Universidad Javeriana [Master thesis]. Pontificia Universidad Javeriana; 2007.
12. Gaviria Méndez AE. La Universidad de Antioquia como institución promotora de la salud (Medellín, Colombia, 2010‑2013). Investigación En Enfermería: Imagen Y Desarrollo [internet] 2016 [cited 2020 Jun 29];18(1):13‑30. Available from: https://revistas.javeriana.edu.co/index.php/imagenydesarrollo/article/view/10687
13. Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis [Internet]. JAMA. 2016 Dec 6 [cited 2020 Jun 29];316(21):2214-36. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2016.17324
14. Cuttilan AN., Sayampanathan AA., Ho RC. Mental health issues amongst medical students in Asia: a systematic review (2000-2015). Ann Transl Med [Internet]. 2016 [cited 2020 Jun 29];4(4):72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27004219
15. Abdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. Alexandria J Med [Internet]. 2017;53(1):77–84. [cited 2020 Jun 29] Available from: http://linkinghub.elsevier.com/retrieve/pii/S2090506816000063
16. Singh A, Lal A. Prevalence of depression among medical students of a private medical college in India. J Health Allied Sci.[internet] 2010 [cited 2020 Jun 29];9(4):1393-8. Available from: http://www.ojhas.org/issue36/2010-4-8.htm
17. Añasco Loor SY, Morán Espinel LK. Prevalencia y factores de riesgo de depresión en estudiantes de medicina de primero a octavo semestre de la Pontificia Universidad Católica del Ecuador en los meses de agosto y septiembre del 2017. Pontificia Univ Católica del Ecuador [undergraduate thesis] 2017 [cited 2020 Jun 29] Available from: https://repositorio.puce.edu.ec/handle/123456789/30490
18. Zeng W, Chen R, Wang X, Zhang Q, Deng W. Prevalence of mental health problems among medical students in China: a metaanalysis.
Medicine (Baltimore). [Internet] 2019 [cited 2020 Jun 29];98(18):e15337. Available from: https://doi.org/10.1097/
MD.0000000000015337
19. Seo C, Di Carlo C, Dong SX, Fournier K, Haykal KA. Risk factors for suicidal ideation and suicide attempt among medical students: a meta-analysis. PLoS One [Internet]. 2021 Dec 22 [cited 2022 Aug 29];16(12):e0261785. Available from: https://doi.org/10.1371/journal.pone.0261785
20. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet [Internet]. 2009 [cited 2022 Jun 29];374:1714-21. Available from: https://pubmed.ncbi.nlm.nih.gov/19914516/
21. Hodkinson A, Zhou A, Johnson J, Geraghty K, Riley R, Panagopoulou E, et al. Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ [Internet]. 2022 Sep 14 [cited 2025 Aug 29];378:e070442. Available from: https://doi.org/10.1136/bmj-2022-070442
22. Bassols AM, Okabayashi LS, Abd S, Carneiro BB, Feijó F, Guimarães GC, et al. First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms? Rev Bras Psiquiatr [Internet]. 2014 [cited 2020 Jun 29];36(3):233-40. Available from: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462014000300233
23. Thun-Hohenstein L, Höbinger-Ablasser C, Geyerhofer S, Lampert K, Schreuer M, Fritz C. Burnout in medical students. Neuropsychiatr [Internet]. 2021 Mar [cited 2025 Aug 29];35(1):17-27. Available from: https://doi.org/10.1007/s40211-020-00359-5
24. Wan DWJ, Goh LSH, Teo MYK, Loh CJL, Yak GHK, Lee JJH, et al. Enhancing self-care education amongst medical students:a systematic scoping review. BMC Med Educ [Internet]. 2024 Jan 8 [cited 2025 Aug 29];24(1):37. Available from: https://doi.org/10.1186/s12909-023-04965-z
25. Fink-Miller EL. Provocative work experiences predict the acquired capability for suicide in physicians. Psychiatry Res [Internet]. 2015 [cited 2020 Jun 29];229:143-7. Available from: https://aquila.usm.edu/cgi/viewcontent.cgi?article=2759&context=dissertations
26. Ortega RFF, Barros AC, Cantero OH. Depresión y factores sociodemográficos asociados en estudiantes universitarios de ciencias de la salud de una universidad pública (Colombia). Psicol Caribe [Internet]. 2011 [cited 2020 Jun 29];27:40-60. Available from: http://www.scielo.org.co/pdf/psdc/n27/n27a03.pdf
27. Di Vincenzo M, Arsenio E, Della Rocca B, Rosa A, Tretola L, Toricco R, et al. Is there a burnout epidemic among medical students? Results from a systematic review. Medicina (Kaunas) [Internet]. 2024 Mar 30 [cited 2025 Aug 29];60(4):575.Available from: https://doi.org/10.3390/medicina60040575
28. Bergmann C, Muth T, Loerbroks A. Medical students’ perceptions of stress due to academic studies and its interrelationships with other domains of life: a qualitative study. Med Educ Online [Internet]. 2019 Apr 22 [cited 2025 Aug 30];24(1):1603526.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493308/
29. Fitzgibbon K, Murphy KD. Coping strategies of healthcare professional students for stress incurred during their studies: a literature review. J Ment Health [Internet]. 2023 Apr [cited 2025 Aug 30];32(2):492-503. Available from: https://doi.org/10.1080/09638237.2021.2022616
30. Hope V, Henderson M. Medical student depression, anxiety and distress outside North America: a systematic review. Med Educ [Internet]. 2014 [cited 2020 Jun 29];48(10):963-79. Available from: https://doi.org/10.1111/medu.12512
31. Kötter T, Fuchs S, Heise M, et al. What keeps medical students healthy and well? A systematic review of observational studies on protective factors for health and well-being during medical education. BMC Med Educ [Internet]. 2019 [cited 2020 Jun 29];19(1):94. Available from: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-019-1532-z
32. Universidad de Caldas. Caracterización población estudiantes de la Universidad de Caldas [Internet]. 2024 [cited 2025 Apr 21];[aprox. 49 p.]. Available from: https://www.ucaldas.edu.co/portal/wp-content/uploads/2025/03/CARACTERIZACIONPOBLACION-ESTUDIANTES-de-Caldas-2024.pdf
33. Sanz J, Perdigón AL, Vázquez C. The spanish adaptation of Beck’s Depression Inventory-II (BDI-II): Psychometric properties in the general population. Clínica y Salud [Internet]. 2003 [cited 2021 Mar 9];14(3):249-280. Available from: http://www.redalyc.org/articulo.oa?id=180617972001
34. Sanz J. 50 años de los inventarios de depresión de Beck: consejos para la utilización de la adaptación española del BDI-II en la práctica. Papeles del Psicólogo [Internet]. 2013 [cited 2020 Jun 29];34(3):161-8. Available from: http://www.redalyc.org/pdf/778/77828443001.pdf
35. Remor E. Psychometric properties of a European Spanish version of the Perceived Stress Scale. Span J Psychol [Internet]. 2006 [cited 2020 Jun 29];9(1):86-93. Available from: https://doi.org/10.1017/S1138741600006004
36. Pedrero‑Pérez EJ, Ruiz‑Sánchez de León JM, Lozoya‑Delgado P, Rojo‑Mota G, Llanero‑Luque M, Puerta‑García C. La “Escala de Estrés Percibido”: estudio psicométrico sin restricciones en población no clínica y adictos a sustancias en tratamiento. Behav Psychol/Psicología Conductual [Internet]. 2015 [cited 2025 Aug 30];23(2):305‑24. Available from: https://www.imrpress.com/journal/BP/23/2/pii/20152302305
37. Díaz Corchuelo A, Cordón Pozo E, Rubio Herrera R. Percepción de estrés en personal universitario. Diversitas Perspect Psicol [Internet]. 2015 [cited 2020 Jun 29];11(2):207-15. Available from: http://dx.doi.org/10.15332/s1794-9998.2015.0002.03
38. IBM Corp. IBM SPSS Statistics for Windows, Version 20.0. Chicago (IL): SPSS Inc.; 2010.
39. Bardeen JR, Fergus TA, Orcutt HK. Examining the specific dimensions of distress tolerance that prospectively predict perceived stress. Cogn Behav Ther [Internet]. 2017 [cited 2020 Jun 29];46(3):211-23. Available from: https://doi.org/10.1080/16506073.2016.1233454
40. Miranda Bastidas CA, Gutiérrez Segura JC, Bernal Buitrago F, Escobar CA. Prevalencia de depresión en estudiantes de medicina de la Universidad del Valle. Rev Colomb Psiquiatr [Internet]. 2000 [cited 2020 Jun 29];29(3):251-60. Available from: https://www.redalyc.org/pdf/806/80629305.pdf
41. Bernales A, Camaño E, Leonis M, Mendez O, Diaz M, Ureña N. Prevalencia y factores de riesgo asociados a síntomas depresivos en estudiantes de medicina. Rev Méd Cient [Internet]. 2010 Aug 11 [cited 2020 Aug 30];21(2). Available from: https://www.revistamedicocientifica.org/index.php/rmc/article/view/217
42. Pereyra ER, Ocampo Mascaró J, Silva Salazar V, Vélez Segovia E, da Costa-Bullón AD, Toro Polo LM, et al. Prevalence and associated factors WITH depressive symptoms in Health Sciences students from a private university in Lima, Peru 2010. Rev Peru Med Exp Salud Publica [Internet]. 2010 [cited 2020 Jun 29];27(4):520-6. Available from: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1726-46342010000400005&lng=es
43. Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ [Internet].2005 [cited 2020 Jun 29];39(6):594-604. Available from: https://doi.org/10.1111/j.1365-2929.2005.02176.x
44. Iqbal S, Gupta S, Venkatarao E. Stress, anxiety and depression among medical undergraduate students and their sociodemographic correlates. Indian J Med Res [Internet]. 2015 [cited 2020 Jun 29];141(3):354-7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442334/
45. Ferrel Ortega R, Celis Barros A, Hernández Cantero O. Depresión y factores sociodemográficos asociados en estudiantes universitarios de ciencias de la salud de una universidad pública (Colombia). Psicol Caribe [Internet]. 2011 [cited 2020 Jun 29];27:40-60. Available from: http://www.scielo.org.co/pdf/psdc/n27/n27a03.pdf
46. Coentre R, Faravelli C, Figueira ML. Evaluación de la depresión y el comportamiento suicida entre estudiantes de medicina en Portugal. Int J Med Educ [Internet]. 2016 [cited 2020 Jun 29];7:354-63. Available from: https://doi.org/10.5116/ijme.57f8.c468
47. Peplau LA, Perlman D. Loneliness: a sourcebook of current theory, research, and therapy [Internet]. New York: Wiley Interscience; 1982.
48. Mann F, Wang J, Pearce E, Ma R, Schlief M, Lloyd-Evans B, et al. Loneliness and the onset of new mental health problems
in the general population. Soc Psychiatry Psychiatr Epidemiol [Internet]. 2022 Nov [cited 2025 Aug 30];57(11):2161-78.
Available from: https://doi.org/10.1007/s00127-022-02261-7
49. Park C, Majeed A, Gill H, Tamura J, Ho RC, Mansur RB, et al. The effect of loneliness on distinct health outcomes: a comprehensive review and meta-analysis. Psychiatry Res [Internet]. 2020 Dec [cited 2025 Aug 30];294:113514. Available from: https://doi.org/10.1016/j.psychres.2020.113514
50. Petitte T, Mallow J, Barnes E, Petrone A, Barr T, Theeke L. A systematic review of loneliness and common chronic physical conditions in adults. Open Psychol J [Internet]. 2015 [cited 2020 Jun 29];8(Suppl 2):113-32. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636039/
51. Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry [Internet]. 2018 [cited 2020 Jun 29];18(1):156. Available from: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1736-5
52. González Olaya HL, Delgado Rico HD, Escobar Sánchez M, Cárdenas Angelone ME. Association among stress, depression risk and academic performance in students from the first semesters in a Colombian medical school. FEM Revista de la Fundación Educación Médica [Internet]. 2014 [cited 2020 Jun 29];17(1):47-54. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2014-98322014000100008&lng=es
53. Dirección Territorial de Salud de Caldas. Informe anual comportamiento de los intentos de suicidio en el departamento de Caldas. Dirección Territorial de Salud de Caldas. 2023. Disponible en: https://saluddecaldas.gov.co/loader.php?lServicio=Tools2&lTipo=descargas&lFuncion=descargar&idFile=5648

PDF
FLIP










