Depression among medical students in Tunisia: Prevalence and associated factors

Table 1 Characteristics of study participants (n = 1138) (university year 2017/2018), n (%)

Characteristic		mean ± SD
Age, yr		22 (2.347) (min 18, max 37)
Gender	Female	888 (78)
	Male	250 (22)
Faculty	Monastir	304 (26.7)
	Sousse	248 (21.8)
	Sfax	163 (14.3)
	Tunis	423 (37.2)
Grade	Year 1	252 (22.1)
	Year 2	196 (17.2)
	Year 3	198 (17.4)
	Year 4	171 (15)
	Year 5	321 (28.2)
Marital status	Single	837 (73.6)
	Engaged	269 (23.6)
	Married	29 (2.5)
	Divorced	3 (0.3)
	Alone	193 (17)
	With friends/roommates	220 (19.3)
	Academic residency	127 (11.2)
	Family home	598 (52.5)
Socio-economic level	Low	71 (6.2)
	Moderate	921 (80.9)
	High	146 (12.8)
Children	Yes	23 (2)
	No	1115 (98)
History of medical illness	Yes	173 (15.2)
	No	965 (84.8)
History of mental illness	Yes	79 (6.9)
	No	1059 (93.1)
Leisure activities	Yes	349 (30.7)
	No	789 (69.3)
Physical activities	Yes	322 (28.3)
	No	816 (71.7)
Smoking habits	Yes	160 (14.1)
	No	978 (85.9)
Drinking habits	Yes	183 (16.1)
	No	955 (83.9)
Are you satisfied with your career choice?	Yes	619 (54.4)
	No	519 (45.6)
Have you ever thought of dropping out of medical studies?	Yes	664 (58.3)
	No	474 (41.7)
Stress management training	Yes	158 (13.9)
	No	980 (86.1)
Have you ever visited a psychiatrist?	Yes	228 (20)
	No	910 (80)
Why not?	No answer	261 (22.9)
	I feel fine. I don’t need it	392 (34.4)
	I need it, but I am always busy	366 (23.2)
	I need it, but my circle of friends/family discouraged me	119 (10.5)
Are you happy?	Yes	439 (38.6)
	No	699 (61.4)

Table 2 Prevalence of depression among study participants (n = 1138)

BDI-II total score, mean ± SD		Min 0, max 63, 18.730 (10.654)
Depression level	Absence of depression	410 (36%)
	Low	266 (23.4%)
	Moderate	271 (23.8%)
	Severe	191 (16.8%)

Table 3 Association between characteristics of participants and symptoms of depression, n (%)

Characteristic		D-	D+	P value
Age, yr, mean ± SD		21.820 (2.059)	22.100 (2.492)	0.048
Gender	Female	306 (34.5)	582 (65.5)	0.038
	Male	104 (41.6)	146 (58.4)
Faculty	Monastir	124 (40.8)	180 (59.2)	0.042
	Sousse	73 (29.4)	175 (70.6)
	Sfax	63 (38.7)	100 (61.3)
	Tunis	150 (35.5)	273 (64.5)
Grade	Year 1	91 (36.1)	161 (63.9)	0.57
	Year 2	72 (36.7)	124 (63.3)
	Year 3	74 (37.4)	124 (62.6)
	Year 4	52 (30.4)	119 (69.6)
	Year 5	121 (37.7)	200 (62.3)
Accomodation	Alone	63 (32.6)	130 (67.4)	0.597
	With friends/roommates	79 (35.9)	141 (64.1)
	Academic residency	43 (33.9)	84 (66.1)
	Family home	225 (37.6)	373 (62.4)
Marital status	Single	301 (36)	536 (64.0)	0.786
	Engaged	100 (37.2)	169 (62.8)
	Married	8 (27.6)	21 (72.4)
	Divorced	1 (33.3)	2 (66.7)	0.149
Children	Yes	5 (21.7)	18 (78.3)
	No	405 (36.3)	710 (63.7)
Socio-economic level	Low	9 (12.7)	62 (87.3)	< 10-3
	Moderate	330 (35.8)	591 (64.2)
	High	71 (48.6)	75 (51.4)
History of medical illness	Yes	50 (28.9)	123 (71.1)	0.034
	No	360 (37.3)	605 (62.7)
History of mental illness	Yes	14 (17.7)	65 (82.3)	< 10-3
	No	396 (37.4)	663 (62.6)
Leisure activities	Yes	172 (49.3)	177 (50.7)	< 10-3
	No	238 (30.2)	551 (69.8)
Physical activities	Yes	145 (45)	177 (55)	< 10-3
	No	265 (32.5)	551 (67.5)
Smoking habits	Yes	45 (28.1)	115 (71.9)	0.025
	No	365 (37.3)	613 (62.7)
Drinking habits	Yes	63 (34.4)	120 (65.6)	0.622
	No	347 (36.3)	608 (63.7)
Are you satisfied with your career choice?	Yes	305 (49.3)	314 (50.7)	< 10-3
	No	105 (20.2)	414 (79.8)
Have you ever thought of dropping out of medical studies?	Yes	167 (25.2)	497 (74.8)	< 10-3
	No	243 (51.3)	231 (48.7)
Stress management training	Yes	49 (31.0)	109 (69.0)	0.157
	No	361 (36.8)	619 (63.2)
Have you ever visited a psychiatrist?	Yes	51 (22.4)	177 (77.6)	< 10-3
	No	359 (39.5)	551 (60.5)
	No
Are you happy?	Yes	289 (65.8)	150 (34.2)	< 10-3
	No	121 (17.3)	578 (82.7)

Table 4 Binary logistic regression analysis of association between the sample and depression symptoms

Characteristic		Exp (B)	95%CI	P value
Gender		1.544	1.135-2.099	0.006
Socio-economic level	High	1
	Moderate	1.83	1.276-2.633	0.001
	Low	6.589	3.000-14.469	< 10-3
History of mental illness		2.693	1.470-4.932	0.001
Smoking habits		1.669	1.123-2.481	0.011
Grade	Year 1	1
	Year 2	0.991	0.653-1.504	0.966
	Year 3	0.796	0.523-1.213	0.288
	Year 4	0.918	0.584-1.444	0.711
	Year 5	0.667	0.456-0.974	0.036
Leisure activities		0.459	0.344-0.613	< 10-3
Physical activities		0.679	0.505-0.914	0.011
Satisfaction toward career choice		0.238	0.179-0.316	< 10-3
Stress management training		1.609	1.085-2.385	0.018
Happiness perception		0.143	0.107-0.193	< 10-3